a birth!!!!!!!!!!!!!

The last 48 hours I have been itching to see a Haitin birth before I leave and see Beth McHoul (midwife) in action. After taking Jenny to see baby Kenley we went back to the hospital to have dinner and I was going to stay and watch Enchanted with the kiddos. Beth and I were walking back to the hospital and a little boy came and told us there was a mom who was getting ready to habe a baby!!!! I almost couldn't speak! We went in.... I took vitals and beth checked mom... 6cm with buldging bag of waters. We headed to the clinic and Beth's Birth Center. Carol and Mary (nurses who are sisters), Barbie PA, Dr. Jen on standby, Tara Livesay administrator and record keeper and me (along with husband and mama's sister) were all their. We changed to scrubs, made mom comfy, had her use the bathroom to empty her bladder, and I checked fetal heart rate with every contraction.... it was 8:20 or so. This was her third baby, other two births were in a hospital that doesn't exist anymore and they live right in the neighborhood but Beth had never met them. She normally wouldn't deliver someone she doesn't even know or done a prenatal on but with us all there she did! Mom was so graceful.... taking deep breaths and only making this clicking sound in the back of her throat with the strong contraction (a very Haitian thing to do). She labored squating, sidelying, on her back, the yoga ball for a little and the on all fours on the bed. I played Doula with Mary supporting her and I rubbed her back with olive oil, assited her to bathroom and helped monitor fetal heart rate. By midnight I checked her and she was fully dilated (yes I did a few internal exams with some coaching and then people following up in between!). We all decided we better make coffee in case this was a long night since co0ntractions were winding down. Beth and I went looking for coffee and her water broke. She ended up pushing on her back through two contractions and baby was born at 0100. Carol (a L&D nurse who hasn't worked for 8 years and had never delivered a baby) caught. I grabbed lower half of baby on the way out... came out to fast!!!! I felt that baby was a girl!!!!! She had a lot of secretions since she was born so fast Apgar at 1 and 5 was 8 but then she started nasal flaring and needing suctioning.... in seconds her color was poor so Melissa and Barbie (the baby team) started bagging and even did some compressions. We woke up Dr. Jen who also helped till baby's color was back and she was crying. It did scare Mama and she didn't want to nurses b/c she thought baby was sick. We encouraged her that baby was fine and needed to nurse to help deliver the placenta.... that took almost and hour. Baby weighed in at 8lbs 1oz. That is a large size in Haiti and Mama was all belly! The baby's name is Natale (I think). I helped sister shower mom and we took mom and baby to Heartline Hospital for the night. Then us girl crashed in bed at 0330. The whole Birth Team!

I now feel I have come full circle... I feel my trip is complete. I also KNOW that being a midwife is exactly what I want to do!!!!! And I know I need to get home to see my baby girl do this: www.facebook.com/video/video.php?v=516066023881

The whole deliver i kept thinking how this birth was like Cora's.... lots of people, all women except dad, third basby, quiet mom, bulging bag of waters, a few pushes, secretions after birth and needing some assistance (this baby more that Cora)... and a happy Mama at the end! This is why I feel so at home here. Man I am going to miss this place! Every day has brought a new chanllenge, a new joy and so much love and hope! It is all bittersweet! Now I am off to say good-bye to all my new friends and colleuges down here. I fly out at 5:30 with sisters Mary and Carol, meet their other sister in Ft. Lauderdale... go for dinner and get a hotel room, then fly to Boston at 12:30 noontime and see my family for dinner! Pray for a smooth transition and much rest! I am feeling good but want to catch up tonight before I see the kiddos! Thanks everyone for following my trip, praying and encouraging me!Carol "the baby catcher" and me the Doula!

circle of life in Haiti...

Last night we took care of lots of new pt's off the Truck from Cite Soleil. One woman was a 59 year old women who's son had seeked out the truck b/c he had gotten out of jail after being in for 6 months and then he came home and found his mom wasting away. She had a big belly (? Hepatitis), lower extremity edema, rhoncorus lungs, upper arm the size of my wrist and a productive cough. Her HIV test was positive and she looked like she was about to die. Her son was really sweet taking care of her. We had her on Tuberculosis precautions with her own tent and mask (we wore N95 mask too!). We I was over accessing her, giving Tylenol for a temp and pain her son asked me for some sandals for his mother because she had nothing for her feet.... I was all teary and said to myself what your mom needs is a Morphine drip and palliative care.... so sad but beautiful to see him care and love his mom even in her delicate state.

One of our other patients from the truck team was a 10 hours old baby and his mama. She was having sever abdominal pain and had not yet nursed him and her neighbor found our team to help her. She had a boggy uterus and needed some postpartum care. Me and the three nurses I was woking with put our brains together to check her fundus, flow and perineum. It was fun! At 3am mom was tired from having baby at her breast all night!!!!!! (boys!) I told her it was okay to let us hold him and she could sleep, she was reluctant but then agreed. I sat in a wheel chair and rocked him... letting him suck on my little finger for almost 20minutes. He then fell asleep and looked so cute sinking into his blanket (wish I could load my pics!) It can't help to think the Circle of Life in Haiti never ends.... and with Heartline having Beth running her prenatal clinic and also the hospital I am sure they will continue to see this forever.... such a gift from above!

Gangrene...

Today I worked in the hospital but became more of the clinic nurse. Putting in IVs, taking vitals, doing drsg changes, removing sutures and staples, and helping place cast. It was a very busy but very fulfilling day!

I have that stink stuck in my nose from a pt that was found on our truck run today.... one of my new friend's Barbie PA went out on the truck with Mike, a paramedic today. They brought back to the clinic a woman who had a cast placed maybe a month ago(?) but she didn't get it followed up two weeks ago like she was told. She must be left by herself to care for her children b/c she didn't want to stay the night and this must be why she didn't get follow up care. Maybe she is widowed... it breaks my heart to even go there! She said there was a wound under the cast and she needed it looked at. I helped Barbie and Mike cut the cast and get the drsg off. As soon as we cut into the cast we could smell the gangrene. YUCK!!! It was so gross! We ended up giving her Morphine and Ketamine to sedate her. She then allowed us to change the drsg. She has a very unstable tib/fib FX (lower arm fracture) that is so loose you could make her wave with out using her elbow. Kind of freaky. We gave her IV antibiotics, redressed the wound, put her in a half cast and will try to get her to Merlin tomorrow for evaluation for surgery. Her wound actually didn't look that bad but the smell was horrible. The reason I tell this story is to show you the people in Haiti need follow up care. You can't just cast someone in the field with a huge wound and leave them.... this woman almost (and may even still) loose her arm.

Heartline is one of the few clinics/hospitals that has a follow up program and in patient ward. We even give our patients cards with follow-up instructions and if they are from the slums we give them a date to return when the truck/ambulance is going to be in that area.

Another beautiful thing we have here at Heartline is excellent networking where we can take someone like "gangrene arm" women and send her to Merlin (a British hospital that does Ortho and Plastics cases. We send them pt's for surgery and then take a couple patients from them that just need inpatient things like meds, vitals and dressing changes and discharge plans. The USS Comfort will take our more general surgery patients and ICU pt's. We also have Miami of University that will take our emergent pt's like the boy yesterday.

We also have nannies from the orphanges that had most of their kids fly State Side. They cook, clean, bath, do laundry and care for the pt's. It is so cool to see the nannies still having jobs after the quake! And some interpret for us too!

But the most exciting thing is just to see that God has a provision for Heartline. We are all volunteers over-lapping and it is excited to see who God brings her next. We have a new team flying in and it should be neat to see how they fit in. I am off to bed soon after I shower!

Just one fun story... Alex was a little guy (6 but looks like Daisy size) who came to Heartline awhile ago. He had to have his middle and ring finger amputated from and injury in the quake. So now he looks like a "rockstar" when he holds up his hand..... so cool! Well once it is healed and he learns how to adapt like with it like that it is cool! The sad part of Alex's story is he lost his Mom and sister in the quake but he has his dad and his dad has him. In the past Dad has tried to braid his hair and he looked like Buckwheat. But today Dad took it out and a mom who was recently reunited with her daughter braided "Rockstar's" hair b/c he was going home today. It looked awesome! I had a little photo shoot with Alex today and can't wait to share those pics. Dad seemed happy to leave but it is bitterweest b/c they have a community here at the hospital. I am sure life will look different for them but they do have each other!

I love you and hope to update on the prenatal clinic I am doing with Beth before I work tomorrow! Love you all!

Tuesday... ah the day shift!

I had a busy day to say the least.... Helped save a 3 yo having seizures and transported to the U of Miami hospital, I helped change over half the patient;s drsg for Merlin the British hospital that has plastic surgery and ortho services, I tried 5 angio caths (different IV than I am used to) and I had a 4 out 5 success rate!, I played with a few kids, taught one little girl how to use my camera (she loves it! She is 7 and is taking care of her paralyzed brother from questionable Guillian Barre Syndrome. She speaks great English since her dad is Haitian American and i told her about photojournalist and that when she grows up she should take pics and sell them to the newspaper) She loved the idea!, I changed a little girls drsg just b/c everyone else got to hav3e her drsg changed, I showed off my pictures of our family to the kids since they love my hair and I knew they would love Doodles. All teh boys were surpirsed by Kevin and acted surprised that I had a husband anbd they could tell he was tall! So funny! Anyway I am ex-hausted after little sleep last night. Under the mosquito net I go.... BTW hun you picked a great net! Love you all!

aftershock....

I have been up since 0130 when I woke up with a cough and somewhat disoriented and then about 30seconds later felt an after shock. I am sleeping on the top of a bunk in the Livesay's home now. The Physical therapist that is here is woke up and asked if I feel off the bed and I said I was fine but we both ran down stairs to see if everyone else was okay. Everyone was fine and sleeping. I was so happy to be safe but now I am all worked up and nervous. And cannot sleep! I am not sure how big it was but it really was much scarier than I thought! The power went out after that so i went to bed but never slept. Bummer! It will be a hard day that is for sure... but it should be slow since our doctor is flying home this am and we just have a PA here. I can't believe that one little after shock affected me so much... I cannot even imagine what the Haitians experience when it happens... I am sure it is horrific for them. I am off to shower than off for dayshift at the hospital. The sun is rising so fast, the roosters are crowing.... it's a beautiful day in the neighborhood!

Tour of PAP....

Yesterday I was awoken in the middle of the day to find out the tour was going out to Port au Prince to see the area that was largest hit. I guess the epicenter is outside of the city but most the buildings that fell are in the city. The tour was pretty amazing.... building fallen in between two standing builds. The palace has fallen in the middle and I guess it sinks more everyday. across from the palace is amarket and then tent cities with port-a-potties. Nobody is to sure why but most of the government buildings are levelled. I don't want to get into the politics but it isn't very pretty here when you look at leaders that are in high places and only seek to serve themselves. But don't you think God is speaking when almost every building in a corrupt government has fallen and beuildings around them are standing. I was told by Ryan a nursing student here (working as a nurse and lived here last summer) that rumor has it every church he has heard of still has the cross in front of it standing.... isn't that crazy! The whole church building fell but the cross is still up? Amazing!



The president of Haiti called for 3 days of fast, confessing and praying for the one month anniversary of the quake. On Saturday we had a little boy come in that had a high fever, malria and hadn't eaten/drinken in 4 days due to the fast.... I mean honestly these people have nothing and now even if they do have food they can't eat it b/c their leader wants them to fast and confess? Very upsetting!



The other thing that hit me during the tour was when we got through the downtown area we drove along the coast and saw an area that smelled horribly. I had said to one of my friends "I guess no port-a-potties here!" and then it struck me that the houses here weren't tents they were sheets of metal and more permanent....this is a community that was like this pre-quake. The smell was so alarming and to think it is always like that! And I guess there are poorer communities we didn't see. It really broke my heart! The problems in Haiti arenot beginning they have been here forever!



Seeing hope in our patients is the thing that gets me through... one of our pt's "Collette" Sincere was the first woman to have a baby on the USS Navy Comfort. She lied in the rubble for 7 days with a broken pelvis, femur FX and 7 months pregnant. She came to Heartline Hospital where they just watched her not knowing what to do. They got her to the ship as one of the first patients and they recieved her weeks later along with her baby for rehab, continued pain control, antibiotics, help with breastfeeding and lots of support and encouragement. She is healing from three surgeries and is breastfeeding. As well as getting out of bed to the bathroom and wants to do it all by herself. I love that she has such strength, power and hope for herself and her baby. She is the most aware of germs and protecting herself. She wipes the toilet before she sits and uses hand sanitizer when she gets back in bed. It is so cute. The only thing she has problems with is the breastfeeding. The last couple nights she wanted a bottle for the baby and we had decided that was fine at night so she can sleep but she was wanting it more and more. As I was informed by midwife Beth we were to encourage her nursing baby Esther before a bottle so this morning I noticed she had leaked milk on her shirt and she asked me for a bottle. I told her she should nurse, it was "beyn for baby" (good for baby, my creole is horrible but I made flashcards and I am working on it... you should be proud mom!) I told her using mostly sign language that I fed my baby till she was 1 year and it is best for baby! See when Collette goes home she will have no formula and she will need her milk supply for her baby especially since Esther was a premie. Not to mention the antibodies to boost the babies immune system and protect the baby. Her reaction was still hesitant and then I told her MamaJohn (Beth) wanted this and she realized I wasn't going to cave. It was hard for me b/c she is trying so hard but I know she has such hope for her baby. She then put baby to breast and I was overwhelmed with joy that she made a choice to do the right thing. The daily bread verse today was "Hope does not disapoint." Romans 5:5. Totally feeling that today!

*I plan to post pics but need a cable... have to find one to borrow.

"We are the world... We are the children..."

Saturday night we were coming into the clinic and we got report on the pts... I was orienting one of the nurses that flew in with me to the night routine and the pt's were all getting ready for bed. We passed 8pm medications to opur hospital pts. Those pt's have injuries so severe they cannot just be sent home, they need IV antibiotics, fluids, pain medication around the clock, aggressive physical therapy, food and water, drsg changes and learning how to live w/o arms, legs, and with casts, external fixators in place. They are all pretty complecated cases when you read their history... Not to mention the PTSD from being in rubble for up to 13days! Lossing parents, siblings, babies, and other loved ones.

Anyway after we did the first round on pt's the interpreters (which are two young men in med school in PAP that no longer exsists) were setting up their laptop and screens for a the evening movie... all the sudden I heard the "We are the world: 25 for Haiti" playing. All the 28 pt's raised their hands and started swaying them... I am left to wonder "Do they know that they are the world to many of us?" "They are the children that are loved by so many." "Are we willing to embrass them and help them know that?" "They are the children of a Father that loved them enough to give them the most perfect and never ending grace and love?" Somehow I think they do by knowing they have survived.... they quake brought horrible devastion to them but they are here in the world and we are also here in Haiti making them "our world".

I am so impressed with this clinic, all we are doing, the passion of so many I am working with even before the quake... it really is humbling to see. A nurse that had the day off yesterday came in and did pedicures on all the woman... trust me that makes you feel like you are "world"

Off to sleep... peace...

Update from Haiti

When I walked to the hospital yesterday they were seeing pts that came off the truck from Cite Soliol. There was a baby that came that was 3lbs 3oz and was born 17days ago. Beth the midwife was trying to feed the baby some breastmilk and get some help from mom who was suffering from mastitis. The baby was lethargic but arousable. Beth handed him off to me since I wasn't on shift yet and said to try to work with him to drink from the bottle. Baby had periods of waking up and sucking and swallowing but then had periods of lethargy and apnea (not breathing!). I am not a PICU/Nicu nurse but I know that is not normal. I asked one of the nurses to talk to Dr. Brad and see about an IV and some D5 (fluids and sugar) to wake him up. He said no but wanted some vitals.... the nurse came back to get vitals and noticed the apnea and asked me what I really was thinking... "I told her I think he is going to die."... Next thing I know we were getting him resuscitated over on the treatment table... we gave him an IV, fluids, some chest compressions (heart rate was 60-80s), dextrose(sugar was 34), OGT, caffeine, Oxygen and lots of TLC. He was crying and starting to move after 15minutes of work... Thank God! The Dr and a nurse and PA took him to the U of Miami field hosp. at the airport. They got him in an isolet and on a ventilator for a short time. Baby is still alive this morning but we all wonder if he does survive what will happen to him. Many of us wonder what will happen to these kids with amputated arms and legs... will they be able to work when they are older? Will they live meaningful happy lives in now ruined country? We can't even go there and just hope for the best. If anything it helped us all feel more confident as a medical team and built some strong team spirit there.

After the baby we all went and had dinner and debriefed. Then I started actually working my shift and worked all night. It was fairly easy nursing in the hospital but difficult due to emotional issues of pts and the language barrier. I am off to bed and going to rest I am back at work tonight.

Bonjou from Haiti!

I kinda get to sleep in today since I am working all night... not easy to sleep in here since there are helicoptors, radios, people singing and doing laundry. Someone is going to walk over and get me ar 10am so i can just hang out, meet the kids.... and get a feel for things before tonight. They asked if I wanted days or nights and I jumped for nights, I figure why not.... I think sleeping during the day will be harder that at home but I sis bring ear plugs. I was able to have dinner with midiwfe Beth and two other midwives... they are hoping for a birth soon but one mayb e a full-term mom that they think just miscarried. No baby heart sounds or placenta sounds and no movement for a day or so. So she should deliver soon or at least come back to the clinic on Monday. They asked if i wanted to come to a birth even if the baby was dead. I was like "I guess so.... somebody needs to be there." That will be difficult to say the least but even if I am not there for the mother I can be there for the midwives right? We will see what happens. That will be hard to say the least. Please pray for that mom and baby and prepare those that will be there when she delivers.

I just saw my fellow nurses off to their first day of orientation, I guess your first day is pretty overwhelming and then you just figure it out by day two or three. The hospital is now hold 40 patients and their families. Should be a busy day for them b/c they are send 7 pts home, going to Cite Soliel (a slum) to do drsg changes, find new people that need treatment and bring them back to the hospital.... I hope to go one day and check that out... don't worry they go with interpreters and a armored gaurd. BTW mom and all my worry worts... all buildings are gaurded by armed guards and the house I am living in has a 225lb Old English Mastiff named Larry! He is such a love to us though! I am off to take a shower and listen to Ray LaMontagne on my phone.... peace!

I am here!!!!!

Hey all I am in Haiti and had the most amazing day! God worked wonderfully and we made it safely! We arrived to see many US Air Force people which was very comforting! We met John McHoul from Heartline and road in the back of the truck with the 1000 lbs of supplies we brought! We even left some home... We went to what used to be the clinic to unload and then off to the hospital and met the nurses, docs, PT, EMTs, PAs we will be working with. We then went and had dinner: mango!!!! (my favorite!), chicken, rice and beans I ate with mudwife Beth Mchoul and a couple other midwives! So good!!!! Then we came to the house we are staying in... It is a home of missionaries that have gone state side for awhile, we have electricity via generator, cold water (which is fine since it is hot and sticky), I have a queen bed to myself.... needless to say this is all way more cushier than I had imagined and I feel a little guilty. We drove by a few fallen buildings but nothing like the dowtown area that was really horribly destoyed... so we have been told. I saw a woman crocheting in the hospital and told her the purse she was making was "Bel"- beautiful in Hatian Creole. We studied on the plane. I will be working nights with another nurse!!!! So happy about that. They even have a cot for us to sleep if can at night. I don't really start working till tomorrow night but I will go hang out and play with the kids, learn the patients names, and the staff for awhile, I will come back and take a nap and be ready to work at 7pm... sounds familiar huh? Well I am signing off.... love you all!!!!!

Mama's make-up!

Daisy has a habit of getting into my purse and finding "cream" hand cream and "lips" Burt's Bees... but a few weeks ago she found my lip stain.... that she then stained her hair with... what can I say she is my child after all!

Name Silhouette Pillow 101 class

You are invited to my first ever "craft class". This is something I have wanted to do forever! Let me explain... In my effort to raise money for Haiti I am trying to think outside of the box and here is one idea:


I am having a class On Wednesday February 10th 7p-9p at my house in Holden, where you will come and learn how and actually make a Name Silhouette Pillow. These make great gifts and are wonderful for teaching little fingers to work with buttons. I will have all the materials for you here and ready. You will cut out the letters to make the name of your choice in the colors you choose. You will learn to sew a button, cut fabrics and use a sewing machine. The price is $30 and you walk away with a great gift. If you are interested e-mail me @ keylimecutie(at)gmail(dot)com. Thanks for you support!