Kwaheri Tenwek!

Dear friends,

Our time here at Tenwek is coming to a close for another year.  It is always a bittersweet time as we say goodbye to new friends and old, and reflect back on the patients that we have helped care for while here.  It is with much joy that I can report back on a patient that I wrote about earlier this month (see posting 9/16/19, “Why am I here?”).  Her initials are E.O., and she is a 29-year-old mother of 4 young children.  She initially came in with severe mitral valve stenosis, tachycardia, severe right heart failure, hypotension, and respiratory failure.  I fully expected her to die within the first 24 hrs. of her presentation, but she miraculously survived with aggressive efforts at supportive care.  I wrote to you about how I felt that God had His hand upon her during that critical period, and how I was awed to be able to participate in His plan for her survival and care.  She remained very tenuous during the subsequent days while in the intensive care unit, and gradually was able to be weaned off of ventilatory support.  We were very pessimistic that once extubated, she would be able to support her own respiratory needs, but again she miraculously surpassed expectations, and was able to breathe on her own.  Despite this, she remained dependent on IV medication to support her blood pressure, due to the severity of her rheumatic valvular disease.  We were never able to stabilize her BP adequately, so that she could be moved out of the ICU.  In desperation, we reached out to the Cardiovascular team and informed them that we thought E.O. was as stable as we could get her with medication, and that she would likely die in the hospital, or shortly thereafter without surgical intervention for her valvular heart disease.  The long-term missionary in charge of the cardiovascular team here (Dr. Russ White), evaluated her with his team, and agreed that she had essentially no detectable blood flow past her severely narrowed mitral valve, and his statement to me was: “I don’t know how she is still alive”!  He was planning to operate on another patient the next day, but would then have a period of one week during which no surgeries were planned due to shortages of personnel, and vacation time for some of his critical staff.  He was willing to try to replace her diseased valve the following day, but reported that the patient was declining surgery because she was convinced that she had been placed under a curse, and would die if she sought medical help or hospitalization.  It was her belief that she would survive only if she left the hospital and abandoned efforts at medical care.  Many members of our team spent time with E.O. and her family explaining her disease and what was needed to help her.  They also prayed with her, and over her and informed her that our God was bigger and more powerful than any curse that might have been placed on her.  The hospital chaplain also came by and counseled her, and prayed with her and her family.  E.O. remained very ambivalent and indecisive.  She gave consent to proceed with surgery, then again revoked consent.  This pattern repeated itself several times, before her family finally intervened and gave consent on her behalf, claiming that she was not able to rationally make a decision for herself.  Finally, as she was being prepped for surgery on the afternoon of 9/25, with the consent of family, and ultimately of the patient herself, she was taken to the operating room for mitral valve replacement.  Dr. White had confided in me that he was uncertain what to expect.  He did not know if her right ventricle would recover from being chronically overstretched and dilated, or whether it would recover once the mitral valve obstruction was relieved.  He thought that there was a relatively high risk of death intraoperatively, or shortly thereafter.  E.O. was covered in prayer by our team and myself as she went through surgery.  On the last day of our time here at Tenwek (9/26/19), I awoke with some trepidation and anxiety.  I had not been called about E.O. overnight and presumed that this meant that she had survived the night, but was uncertain about her status.  Marilyn and I walked up to see her in the recovery room this morning, and I was greatly relieved to see E.O. sitting up in bed, extubated, and alert!  She looked as stable as I have seen her over the course of her hospital stay!!  I silently thanked God for bringing her through her ordeal safely, and expressed to E.O. my joy at seeing her on the road to recovery and wished her and her family a happy and blessed life.  I told her that I would be returning home later today, and asked permission to have my picture taken with her.  Once again, she refused,…then consented…  I am confident that one day she will be able to smile again, and will come to believe that the curse that she has believed to be her destiny has been lifted by the grace of our great God!!  Glory be to God on high…. and thank you for the life of E.O.  May she have a long and joy- filled life, and may she be a living testimony to the love and grace of God…both to her family, and to her community.

To our Tenwek family ….Kwaheri!  To our U.S. family and friends…see you soon!  To Peter and Petra…see you in Lisbon!!

E.O. in recovery following mitral valve replacement!