OB Miracles

It was 4pm on a Monday.  For reasons I'll describe later, I was hanging out on the OB ward with Dr. Rebekah (the OB equivalent of me here at Tenwek) when a stretcher rolled into the labor/triage area carrying a pale, sick looking woman.  The trail of blood tracing back to the entrance of the hospital told us immediately what was wrong, that this woman was bleeding to death.  We got the full history from Dr. Terer, a Kenyan OB doctor at Tenwek who happened to be working that day at the small rural clinic this lady stumbled into.  "Her name is Janeth, and she began bleeding after her home birth this morning," said Dr. Terer.  "When I saw how much she was bleeding and that her pulse was 160, I did for her all I could at the clinic, then got here as quick as I could."  By saying he had done all he could, Dr. Terer had started an IV, given her IV fluids, and gotten her blood type.  We estimated that she had bled out over half of her blood volume and we needed to get her to theatre quickly.

General surgeons on the mission field truly are general surgeons.  Instead of focusing only on the areas I was trained in, I am also expected to know some basics of neurosurgery, ENT, pediatric surgery, Urology, orthopedics and yes...OB/GYN.  Since I did zero C-sections in residency and could count the number of hysterectomies on two fingers, I decided to hang out with the OB/GYN team for the month of March and get comfortable taking care of the patients general surgeons always try to avoid.  "Getting my feet wet" in the world of OB/GYN meant that on this day they were going to get wet with blood.  

We began resuscitating Janeth in the OB theatre with IVF and all the A positive blood the blood bank could offer.  From my experience with trauma, I felt comfortable taking care of a hemorrhaging patient and knew what treatments were needed.  I knew by her vitals and altered level of consciousness that she was in severe hemorrhagic shock.  I knew she needed blood, and that we needed to stop the bleeding.  However, I had absolutely no experience with a bleeding postpartum uterus and was glad that Drs. Rebekah and Terer were with me that day.  After what seemed like an eternity of trying different maneuvers and medicines, we had slowed the bleeding but not stopped it.  There was talk of a hysterectomy, but we knew that she had bled so much that she was in DIC and surgery would not have a good outcome.  (DIC is a bad problem where your blood can't clot anymore because all the clotting proteins are used up.)  With the alarm of the monitor informing us that her blood pressure was still low, 70/30, and that her heart rate was still in the 160's, we needed a miracle. Dr. Terer suggested that we pray and all the staff in the room stopped and laid hands on Janeth.  As we lifted our heads, Dr. Rebekah immediately said, "Why don't we try a Bakri balloon." In the quiet of our prayer, God put into Dr. Rebekah's mind one option we hadn't tried yet.  The bleeding was tamponaded and slowed to a stop.  Another couple units of fresh blood still warm from the missionaries who donated them gave our patient the clotting factors that she needed.  Janeth stabilized overnight in the ICU, and once she was fully conscious she became aware of how close to death she was.  During her hospital stay, Janeth understood God's plan for salvation and accepted Christ as her savior.  By God's grace she is alive today in more ways than one, and is on her way home to follow Christ and take care of her four children.  

After Janeth stopped bleeding and began to improve, we all knew we had been part of something special.  Dr. Terer said it best when he told us, "We get the joy, but God gets the glory."  I loved that saying, and plan on using it for years to come. 

Taking care of Janeth brought back memories of a different OB patient I took care of about this time two years ago.  On March 15th, Tucker turns two years old, and it marks the anniversary of when Erin got sick and nearly died.  I learned a lot through that experience, about how faith can be strengthened through difficult circumstances, about how faithful God is in times of trial, and about the power of prayer.  For months after Erin’s hospitalization I couldn’t stop thinking about all that we had been through and how God forced us to depend on Him.  However, as time passed, memories faded and the clarity of God’s lessons became less sharp then when they were first learned. Two years later, God reminded me of those lessons through taking care of Janeth.   God is present in times of trial.  He puts us though tough situations to strengthen our faith and dependence on Him.  Prayer is powerful as we verbally acknowledge the frailty of our humanness and openly state our dependence on God.  And, when miracles happen, we get the joy, but He gets the glory.