Mom

My mother has been diagnosed with Cancer.


 She had been having abdominal pain for about 6 weeks when she finally went to the doctor. A CT was obtained with that fateful call on Friday afternoon with the news that it looks like widespread cancer in her abdomen. The following Friday was her appointment with the Gynecology Oncologist - the most experienced of only 6 in the state of Nebraska with this specialized title. He said "it's not an emergency, but we are going to get you scheduled for surgery next week." She was scheduled for Wednesday, just 1.5 weeks after that CT scan was performed. That was 2 days ago.

 It's Friday night now. I've been with my mother in the hospital since her surgery with Dr. Morris Wednesday afternoon. He is a good doctor. She has had a rough go of it, with extreme pain in post-op recovery, requiring large doses of narcotics. She was in recovery for almost 3 hours before getting to the floor, and it was only there that she was able to get some rest. Her hospital course has been complicated with severe gas pain, nausea, vomiting, near fainting, and low O2 levels. She was initially doing better, but has declined throughout today, vomiting 3-4 x today with little to no intake of food and water. She is back on IV fluids and meds and as an ileus.

 Her cancer is described in the CT as omental caking, and widespread peritoneal carcinomatosis. It was thought that she likely had ovarian cancer, but during surgery when the ovaries were visualized, they were essentially unaffected. This is most likely a primary peritoneal carcinoma, biopsies pending. He took out the fallopian tubes, ovaries, the omentum, and as much of the remaining tumor as possible. He removed 90-95% of the tumor burden. She is without mets to other organs such as spleen, liver, etc. It seems to all be contained in the abdominal cavity. Even so, this nasty disease sneaks up on a person and by the time they have any symptoms, it is advanced.

 The doctor says this is not ovarian cancer, but an "ovarian type of cancer," usually more amenable to chemotherapy. This is good news, but I have yet to know what the outcome/survival rates are. I have been too chicken to ask. Work has been very kind to me, rescheduling all my patients and letting me be gone during this challenging time. My focus and ability to concentrate is definitely affected, so I am glad I am not seeing patients at the moment. I'm sitting on a chair, next to mom's hospital bed, using her heating pad to warm my legs that are next to hers in bed. She woke up vomiting about 30 min ago, desperate to sit up immediately. She generally feels miserable with a distended abdomen, incisional pain, gas pain, shoulder pain, back pain, and this relentless nausea. She grabs her vomit sack (as I call it) and moans. I've never seen her so sick. She tells me she has never been so sick. Its so hard to see someone you love so miserable. This has been so stressful, not only for me, but for her as well.

 It's Sunday morning now. They had to put an NG tube to decompress the stomach last night. They got 1400cc out immediately! (Imagine that much fluid just sitting in your abdomen for days) Her abdominal distention is going down, and she hasn't had to vomit all night, and has been able to get some rest. Initially, we thought we would probably be going home yesterday or today, but it will more likely be Monday if all goes well with this ileus. She has had some good bowel sounds today, so we are hopeful.

Reflections

Late Posting written in Jan 2017 As I sit here on a Friday evening by my heater after all this week of business, I'm feeling reflective and reminiscent. Drew and I have been back to the states now for almost 9 months after living overseas in Mozambique. Drew and I are both working, and the time has flown past. Somehow I have gotten sucked into this busy lifestyle. We are always doing something, always going somewhere, meeting someone, running this or that errand, working on something. Americans are so independent. we have touted this to be a good thing - to be self reliant. In some ways it is. Also, in some ways it is not. Today I am missing Africa. I miss walking down the road and seeing little groups of people talking to each other, genuinely enjoying simply spending time with each other. Cheerful, laughing, and always welcoming a new person to chat. The simplicity of life, the lack of distractions, the beauty of such a social culture and the happiness that it brings - this is what I am missing today. When I stand back and watch the social interactions of plenty of Americans, they almost never seem so free. It seems every conversation has to have a specific purpose, and once that purpose is fulfilled, it's over. Everyone has a plan, an agenda that they must stick to because they are busy. If it so happens they are not busy, they either want to appear busy, or not interrupt someone else who might be busy. Busy people are perceived as important. People who are not busy are viewed as lazy. I know this does not apply to everyone, it's just my general observation. As a result, people are not as happy. It is evident on the faces of so many I see. People are more socially isolated, claiming they "don't have time" to spend with family or friends, and often feel they would be an intrusion on other people's time. Time is precious here, and Americans want to be more and more time efficient. I find myself thinking this way as well! How many things can I pack into this time that I have? How productive can I be during this free moment. I still had a drive to be productive and efficient while in Mozambique, but Africa has this way of rubbing off on you, and I feel myself missing the times I threw efficiency and productivity to the wind (mostly because it was impossible to obtain) to visit with friends, go to the beach, play some games, or just relax on the roof of our house. Today when I left the house to go to work it was 1 degree F outside. It had snowed for the last day and a half, bringing us a couple of inches and some slick roads. It's the kind of cold that gets into your core and makes you chilly all day. Wind chill was -11, and things become frozen solid very quickly outside. Today just happened to be the day that one of my friends in Mozambique posted a short clip of the Mozambican beach on a perfect day - the sun, the beautiful blue water gently lapping on the shore, a boat gently rocking, a thatch roof on the shore across the way. Ahhh.... This may have inspired some of the missing of Mozambique as well. I especially yearn for the beach in weather like we are having now. It seems like this weekend would be the perfect time to slip away for a little sun, white sand, and clear blue water. This past year has been a year of change for Drew and I. We had to close up a project in Mozambique that was dear to our hearts and it was painful. We moved from sea level with extreme humidity, to >5000ft elevation with little to no humidity. We went from living in the bush to living in suburbia, from a place with limited resources, to one of limitless shopping and every convenience. This time last year was when we were starting to see the real effects of the drought on our vegetable farm with extreme heat, scorched crops, and our irrigation supply of water becoming very low and brackish. It was a time of turmoil, prayer, and searching. After our course of action was made clear (Thank You God!), we then set forth on the exit strategy. This proved quite difficult. We sold all our things, packed up all the farm equipment and sold/donated to a farm up north that was in need and the drought was not as bad. We left our 1st home as a married couple and our friends who had become so dear. We came to Denver as it seemed that God closed one door and opened another, in perfect timing. Drew stepped immediately into work the day he arrived in Denver, as the company had been anxiously awaiting his arrival. This left little time for re-adjustment to American culture, barely enough time to recover from jet lag. It seems we have just gotten swept up in everything and haven't had time to reflect. To most people here, it is as Mozambique never happened. If it ever comes up in conversation, the other party often does not know what to do with this information. No questions asked, no interest, the subject is dropped. I think it is because it is such a foreign concept - living in Africa - that people just cannot relate at all. They can ask you all kinds of questions if you saw the last football game, or ate at the same restaurant, but starting a company in a third world, Portuguese speaking country... it's too strange. This phenomenon makes me sad. I think I would adjust better to living in America again if I could talk about Africa. Like therapy! Praise the Lord for my husband. We talk about Mozambique all the time, and it's been good for us. We are both missing Mozambique right about now, not just the beaches, but the people/culture/experience/purpose. On a more upbeat note, I am really enjoying working as a PA again. This work is very fulfilling to me. I love explaining complex medical diagnosis/treatment in an easy way for patient's to understand. And it is incredibly refreshing to be back in a hospital setting. I am always looking forward to seeing the next patient and find myself smiling as I walk through the halls of the hospital.

Paintballs and H2O2

We had some excitement last night. After midnight I awoke to Drew loading the paintball gun, our defense. The dog was barking outside and Drew had seen the lights of the truck on. We were sure that our truck was being stolen! The only other person at our house is our trustworthy guard Xico, and we could not see him. Drew told me to get dressed and put my shoes on, which I dutifully did. I also grabbed the spray gun of concentrated hydrogen peroxide, another good defense we have easily available when you are in agriculture. We were careful not to turn on any lights, and kept quiet. Our plan was to go outside, immediately to the roof to check things out. As Drew opened the door, however, we were greeted by Xico. He said he has checked multiple times, and he is the only one here. No intruders, nothing. He was concerned about the car lights as well and suspected someone had slipped by him, but he had found no evidence of anyone around. Mind you, we have a fairly secure house. We have a 10 foot concrete wall around the perimeter with razor wire, electric fence, and security lights. Our guard has a high powered flashlight that allows him to see well at night and use the light as a weapon as it will temporarily blind a person. And we also have our dog Xai-Xai. Though she seems useless all day, sleeping spread out on the floor, she stays alert and active all night long. She's a great guard dog. This is her now, after an exhausting night:

As Xico and Drew looked at the car, they found that the switch for the lights had not been turned on and it appeared to be a short in the wiring. Drew thumped his fist on the hood and the lights went out. As to why they decided to turn on in the middle of the night, we have no idea. It did get our blood pumping and remind us to be on our toes as theft and robbery are a real threat.

Munguluni Mission

A few weeks ago Drew and I were presented with an opportunity that we could not pass up. Two friends of ours needed to go to Mungaluni Mission in the North of the country. They had acquired a vehicle and paid fuel for the trip through their work (ADRA), and asked us if we would like to drive them and come on the trip. This was an amazing opportunity as we both (Drew in particular) have wanted to go to the north of Mozambique for quite a while now. It is a place of intrigue - the REAL wild Africa. When you look at a map of Mozambique, it doesn't seem very big in comparison to the rest of Africa, but let me assure you, it's a long country. I just did a google search and found that California coastline is about 840 miles. Mozambique, on the other hand has 1534 miles of coastline. And most of this coastline is completely unspoiled! Pristine white sand beaches, etc... I could go on and on about the beautiful beaches here... But let me get back to the story. Fuel is expensive here, so having the fuel paid on this trip was a big deal. We could not say no. So we packed the back of the Toyota Hilux 4x4 and took off to see the north. For four people, it was a very full truck! But with good reason. You see, one cannot just stop at a restaurant and get food whenever you want when you are in the bush. Especially 4 vegetarians! So, I had cooked a heap of food and froze it in our deep freeze. This was our food supply, but it was bulky. Here is a picture of Drew deep in the back of the truck.

We were supposed to leave Thursday afternoon, but Drew got tied up at the farm finishing a project that had to be completed before we left. By the time we got into town to pick up the girls, it was about 8pm. Not only were they tired, but Drew was tired as well. Our friend Elizabeth had been moving out of her apartment, cleaning and packing, and had just handed the keys over that day. This is what they looked like when we got in

All but me voted to sleep and leave the house at 2 am. Unfortunately I was very awake at this point, but tried to sleep anyway with limited success. I was up again shortly, and we left at 2:30am on the beginning of our trip north! Drew and I tag-team drove, and I happened to be the only one awake when the sun came up. It was beautiful! Especially for a night person who doesn't like mornings. But, as this was an exciting morning with new adventure ahead, it was beautiful. We ate snacks and drove all day, noticing that the further we went north, the smaller the road got. Notably, this is the ONLY road that goes North-South in Mozambique.

You'll notice that one truck had to hit the ditch for them to pass. How do they determine who hits the ditch when it's oncoming traffic?!? It's like playing chicken every time you drive... Also, the further we got north, the further south the quality of the facilities went. In Maputo, at least you can find a toilet with a seat on it. North of Maputo, none of them had running water, never a toilet seat, and the smell became increasingly bad. In the end it was much better to go in a bush. These are two of the better toilets

Then we crossed the Save River. This is essentially the mid-way point in Mozambique.

After this we started seeing many vehicles/busses/tractor trailers that were on the side of the road abandoned after accidents, mostly of which included fire. Here is one of the busses.

The road was narrow and bad with a lot of pothole dodging and fairly intense driving. There were always people. There is no way you could check a text message while driving - you might hit a goat, dog, giant pothole, or crazy driving car who is also trying to dodge potholes causing severe and sharp turning sometimes into your path. Even if you were looking for a snack! As the sun set and we welcomed the Sabbath we were greeted by this beautiful bridge

I have never experienced a road that would surpass the road we then encountered. This road was the worst of all roads. In comparison, the road to that point was nothing - like a beautiful road. By this point it was late at night and we just wanted to BE THERE!! The potholes were so bad that it bounced our battery out of it's place and the truck shut off. We coasted to the edge of the road and got out under the starlight to try to fix. Amazingly enough, even at 10:30 at night, when you think you are way out in the middle of nowhere, there are still people. We were surrounded by a small group of curious villagers in minutes. It was at this point that Drew found the battery connector didn't have a nut to tighten it to the battery post. Not only that, but the battery was the wrong size for the battery holder, of which was also broken. Oh dear. It was held on with a flimsy sort of wire, which had wiggled loose and broke with the bad road. This is how things are fixed, even on a new car here in Mozambique.... no wonder you don't see many old cars on the road. They don't last that long!! Thankfully we got the connection back but did no have the equipment to fix it correctly. We would drive a little further and another giant pothole would dislodge it again. This proceeded to happen at least 10 more times on this road. You see, the problem is that the road construction crew would sneakily repair a section of road, making you think that the potholes are over. As you slowly gain in speed and confidence that you may be out of pothole territory, you are greeted around a corner with the worst of the potholes that you are completely unable to slow down for. Needless to say, no one could sleep during this section of the road. Poor truck. I wish I could have gotten a picture of this road... Alas it was dark. During the night we also came across a terrible accident. With no markings, no warning, and had we not been paying attention, we would have crashed right into it as well. There were no people there. Hopefully they had gone to seek medical attention. As we passed we learned that the first truck had pulled over, putting a small branch of a tree in the road as a warning (as they do), but the second semi didn't see the warning and plowed into the first. Yikes!!!

We finally arrived to Gary's house just after 2 am. It took us 24 hours to get there! We were exhausted, and shortly fell into bed. The reason that we had pushed through those 24 hours was so that we could make it to Munguluni for church. We had made it to Mocuba, which normally is only 1.5 or 2 hours from Munguluni, but due to large floods earlier this year, the bridge was washed out. The only way to get to Munguluni was by a boat crossing. We had coordinated to cross in the morning, and dutifully got up early and left Mocuba at 5 am. (note how much sleep we had... :/ Gary drove us to the river and we were able to see the devastation that the floods had. Very impressive destruction! It was here we saw that we were going to cross this river in boats that were made out of bark.

I'm standing on the edge of the bridge. Can you see where the road picks up again on the other side?

They can carry all kinds of things over this river! Just not a truck :(

We unpacked our things into a boat and got in as well. As the "driver" pushed off with a large stick the water lapped at the side of the boat with only a few splashes coming in. The water pooled at our feet and we were quite happy to make it to the other side.

This is our scared friends Evani and Elizabeth following us across in a different boat. A staff member of Munguluni was there to greet us and take us the rest of the way to the mission.

Attracting all kinds of attention

We drove down a little trail that was called a road and encountered a few other bridges that had been swept away by the floods. These had been repaired by industrious local men who had charged a toll for anyone crossing directly after the floods. By this point, there was no one manning the bridges as there was a very limited number of cars on that side of the river anyway. Apparently it wasn't as lucrative as they thought. I could not keep my eyes open as we crossed over these bridges because they were that scary. I had accelerated heart rate and sweaty palms... and if you know me very well, I don't get scared easily. I actually got out and crossed one bridge on foot as I was sure the truck would fall through.

I made a short video of this potential destruction, but they made it across the bridge. If I can figure out how to insert that, I will... We made it to Munguluni and were greeted by Evani's house mates who hadn't seen her in many months! (She was unable to return to Munguluni for some months as she was down south when the floods happened and bridges destroyed). We had breakfast with them in their humble home (which was one of the nicest in Munguluni) and walked to church. We were stuck with how beautiful it is there. Munguluni is surrounded by these interesting and beautiful mountains.

Church was translated from Portuguese to the local dialect. Too bad for us. According to the nice people around me, I am learning Portuguese quite fast, but I still could only pick up on maybe 2 words per sentence if I'm lucky (and very focused). Regardless the church service was most interesting. All the children sat in the front. None of them with their parents. The older ones took care of the younger ones, no matter if they were family or not. They sat still and quiet through the entire service.

Then the most interesting thing happened. It was time for offering. The deacons got up and held plates at the front of the church. A few people came forward and put their offering in the plate, but then two men brought forward a large sack stuffed full of corn. Then a lady came forward carrying a large basin on her head. She knelt and put the basin down in front of the deacon filled with rice she had grown. This continued as the people of the church brought their first fruits of harvest. I was blown away! I had heard of giving of your first fruits in the Bible, but never thought of it happening in real life. It was such a simple, wonderful, pure gesture. Seeing this type of giving, giving of what you have, is very humbling. It makes your re-evaluate your giving habits. Are you really giving what you can to the Lord? Isn't it all His anyway? I wish I had a good photo of this... I really do need to figure out how to upload videos here, because I have a video of this. Seems like I've done it before, but like... 10 years ago. Gettin' rusty We enjoyed the rest of the day with a larrrge nap. We got up for supper on Sabbath. Truly a day of rest! And we felt sooo much better after that sleep. We were truly sleep deprived and I don't think I have done a road trip like that since college! That evening we played games with our new housemates - Rummikub was the favorite, though Uno a second. The generator came on nicely just after dark for the few hours a day of electricity that they have at Munguluni. The lights went out during play, and so we finished playing by candlelight (and the light of a cell phone). Imagine only having electricity for about 2 hours a day.

Sunday we went for a walk out in the village and were greeted by many friendly villagers, with relatively tidy homes. This lady was pounding corn into a corn flour that they use for their staple "Xima" pronounced "sheema"

Monday was a holiday, and we were in the right place for it because it was Children's Day. This day is set aside to celebrate children. I think we should have this day in the states as well! Munguluni has about 400 children in their school and they all participated in a day of fun including songs, sone dancing, and presentations from the classes. We started at their normal gathering place for information and songs, but then moved under a large tree, enjoying the shade for class presentations and games. They loved the sack races in particular.

As I was taking some pictures, I noticed that there were so many american t-shirts! You know that the kids or their parents don't know what the t-shirt even says. So, if you donated children's t-shirts to Africa. Be assured these kids and all of Africa got one.

As we headed back we saw the washed out bridge from the other side. What a devastation. You can see that a lot of trees and such had washed up and gotten stuck on the right side of the bridge. This apparently was there from a previous flood and was not removed. The water therefore could not get through during the recent flood and instead choose a new path washing out around the bridge leaving a huge gap. Careful! There is only a small stick warning that you may drive off the cliff!!!

Overall, one of the best experiences that I've had in Mozambique was at Munguluni. It is filled with amazing people, warm and friendly, and I can really feel the Spirit of God at work there. There is not much information about Munguluni. If you are interested in learning more about this amazing place, follow this link:http://documents.adventistarchives.org/Periodicals/SEQR/SEQR19610301-V28-01.pdf