Thursday, April 26, 2012

Wound Update

I can't believe how many of you are following this boil adventure!  I knew there were a few crazies out there who'd be interested in hearing about the boil and my health issues and even fewer that would want to actually SEE it in pictures... well, I THOUGHT I knew, anyway.  I've gotten more hits on my past couple blog posts than I have ever gotten on any other post!  No kidding!

Ok, well, if you all are still interested, here's a bit of an update.  My neck/back are still a bit out of whack, but I keep doing my stretches and at least I'm sleeping a few more hours consecutively each night.  I still wake up plenty, but the pain doesn't keep me up for hours at a time like it had been doing.  My boil is definitely on the mend.  The crater continues to ooze pus, but this morning I noticed that it's a bit smaller.  I think it's starting to heal around the edges, which is encouraging news.  The skin around the boil is still pretty raw from all the tape and trauma of the whole fiasco, but I'm pretty sure it will improve in the coming days.  I can also see the shape of my knee again, which is nice!  There is still some swelling and general soreness, and I have a feeling it will be a few weeks before I'm fully back to normal.

The real challenge has been that Micaiah three small spots that could be boils.  They're small, and could actually just be spider bites.  So far it's been super-mild compared to mine.  We're not even positive that they are boils, but given all that I've been through, we don't want to take any chances!  So for the past three days now I've been on a cleaning rampage.  EVERYTHING is getting washed.  Floors, door knobs, door frames, bathrooms, sheets, towels, buckets.... from what I've been reading, boiling water is one of the best cleaners, so we'll be washing all our linens in boiling water for a while.  And dettol is my new best friend. :)

Any tips on how to eradicate any lingering bacteria in our house?  Any key spots that I need to be sure to check?  Light switches, door knobs.. that sort of thing?  I know that boils just sometimes happen, especially out here in the tropics.  They're super common and so many of our friends and neighbors have shown me their scars (which I could have done without in some cases...) and assured me that these are normal for this area. Even the doctor and nurse at the clinic were quick to reassure me that my massive boils were "normal."  I don't think I'd go that far, but still, it was comforting that they've seen these before and weren't phased by it.  I could have given the infection to Micaiah (especially early on before we knew what it was!), but it's also possible we just got it from a common source.  No way to tell, really.  But we're doing our best to rebuild our immune systems, get enough sleep, eat healthy food, and keep stress to a minimum (!!).

Anyway, that's the update.  Here's a picture for all you crazies out there who like to see the progress visually.

-JLR

Monday, April 23, 2012

Wounds, part 2

**DISCLAIMER** 
This post may make you violently ill!  Please do not view these pictures if you are eating or plan to be eating in the next couple hours or you might not keep your food down.  You've been warned... proceed with caution.

I'm calling this Day 1.  It is not the first day of the boil, but it's the first day I went to the clinic-- once I realized that this thing was out of control!  This is the boil.  It doesn't look like much more than a big zit in this picture, but you can see in the second that my leg is quite swollen. 

This is one of the best pictures I have of the swelling (also Day 1).  My thigh, calf, and ankle all swelled up to about twice their normal size at their largest. 

Day 2.  This is the first day it was "squeezed" at the clinic.  It hurt so bad and I could not walk on my leg-- the pain was too intense!

Day 3.  This was after it was squeezed the second day.  You can see here that there are at least three centers within the boil.

Tim dressing my wound (also Day 3).  His facial expression is completely justified-- I myself gagged everytime I looked at it!  Glad we brought those gloves and even more glad we took that First Aid/CPR class! 
Day 4.  The "tissue plug."  It was nasty.  I don't want to keep talking about it because I don't want to keep thinking about it.  Oh, and you can see my blackened toenail in this picture, too!
 
Day 6 (sorry, I apparently didn't take any pictures on Day 5).  The tissue plug came out, leaving a big crater in its wake.
 This picture shows the crater really well (also Day 6).
 
Day 7.  This is today.  I'm regaining some mobility, the swelling is starting to go down, and the crater continues to ooze greenish-yellowish goo.

Enjoy your lunch!

-JLR

Sunday, April 22, 2012

Wounds, part 1


It has been much too long since my last post.  I'm not going to attempt to make up for that gap in time and space other than to acknowledge it and ask that you be patient with me.  I have been in a season of intense hurts ranging from the physical to the emotional, and God has been walking through these things with me. I often wish I was the type of person who could blog in the midst of those things, but I am generally not.  This post is a portion of my musings from the past month or so.  May it encourage and challenge you.

Anyone who has talked with missionaries knows that health concerns are one of the greatest fears/concerns that we have.  Here in Mpanda we are 2 days (or one 12-14 hour day!) drive away from Mbeya, the nearest town where we could get decent medical care.  Perhaps I should define my terms, since you don't live here and don't know what I mean.  In Mpanda, we have clinics and we have a hospital.  I would never plan to go to the hospital here.  There are tons of sick (and very contagious) people everywhere, and I would never subject myself voluntarily to that type of situation if I could at all avoid it.  I've been in a Tanzanian hospital before (in Mwanza) to see a particular doctor, and the experience gave me nightmares and panic attacks.  The doctor (from the US) was great, but seeing horribly wounded people wheeled through the waiting room on stretchers uncovered or barely covered... it was too much for my overprotected western eyes.  So that's how I feel about hospitals.  Clinics are generally better, but depending on the setup can be a similar situation.  Also, there is no guarantee you won't wait for hours and still not see the doctor.  We are thankful here in Mpanda to have a couple clinics, one of which (TMC Dispensary) is rarely busy.  But for anything requiring quality testing, ultrasound, extensive blood work, or other more complex treatment, we need to go to Mbeya.  And they can't treat everything in Mbeya, so from there we'd go to one of the bigger cities-- either Dar es Salaam or Nairobi.  Obviously if there is an emergency, we are able to get a medical evacuation by plane, but the situation and outlook need to be very severe before that is a viable option. 

I've had a number of health issues in the past few years, most of which have been treated or I am still undergoing treatment from a distance.  Nothing that I have is life-threatening in the sense that I can't be living out here doing the work we've been called to do. 

On April 2, I had an accident.  We had gotten home from the office and it had just started raining, and I was headed to open the gate so Tim could pull the car into the compound when I slipped on some wet tiles.  I fell.  Hard.  My right leg went forward and scraped and bruised the back of my calf.  The other leg went backward and my big toe struck a rock with great force, causing a deep gash in the skin and pain in my toenail.  I must have put my hands out to catch myself, twisting in the process.  I thought I was broken.  When I realized that I was hurt but nothing seemed broken, I picked myself up and continued on (with my sore leg and gashed toe) to open the gate.  I would need Tim's help getting cleaned up. 

I did get cleaned up.  I was able to get my cut (a deep cut on the end of my toe) cleaned and dressed.  I also noticed bruising under my toenail and bruising on my calf.  It wasn't going to be easy, but all in all I felt ok.  Sore, sure, but ok.  I didn't need to be flown out. 

Then the next morning came.  I woke up with the most AWFUL pain in my neck, back, and down my left arm.  It was nerve pain-- a type of searing, stabbing pain that I am all too familiar with!  I had nerve pain for about 6 weeks in late 2009.  I wanted to die then, and I wanted to die now.  There is no end to it, no matter how much ibuprofen or aleve you take!  Granted those things can help sort out muscle spasms and tension, but not the nerve pain.  Nothing cuts the nerve pain.  I had two straight weeks of intense pain.  I couldn't sleep more than an hour at a time, and it hurt to lay down or lay still.  I spent a lot of time talking to God and wrestling with Him over a few things I had been thinking about. 

The nerve pain is not gone, but it has been reduced.  I was able to talk with a physiotherapist friend from Canada who walked me through some stretches over the phone.  I also talked by email with a D.O. friend from the US who helped me sort through some of the medications and muscle stretches (in addition to the ones from the physiotherapist).  Between past experience, internet research, and my expert-friends' opinions, we figured that I had at least two vertebrae in my lower neck or upper back that were twisted, which was pinching those nerves.  So I stretched.  And waited.  And ate healthy food/snacks.  And waited.  Eventually (now) I'm able to sleep a bit more and the pain is more of a dull throbbing instead of a stabbing.  By God's grace I will beat this thing. 

And if that weren't enough.... about 12 days into all this neck/back pain mess I started having pain in my knee.  Who knows where it came from or why, but I got my very first boil.  And like any sickness/illness/injury, I went all out and got a big collection of them.  I think technically it's a carbuncle, though it's still treated the same as if it were a singular boil.  I started out treating it at home with warm compresses (experimenting with salt water, garlic, and baking soda at various times), but I knew right away that I was out of my league.  It was growing.  It was becoming massive.  And I needed help.  So we went to the local TMC Dispensary (clinic).  They started me on antibiotics and said to come back the next day so they could squeeze it.  Uh oh.  That doesn't sound good.  It hurt to walk or accidentally bump it, I couldn't imagine having it squeezed ON PURPOSE!  Plus, everything I had read warned that squeezing the boil could cause the infection to spread.  Yet, I knew that in putting myself under this doctor's care that I might not 100% agree with the treatment plan either because of the meds or the approach.  But I prayed for wisdom and felt that God had led me here, so I would follow the dr's instructions.  I went back that next day and he saw me right away.  He confirmed that it was indeed a boil (at least 3, actually), and he used both hands to squeeze that thing from the base until a thick, nasty brownish-yellowish-reddish pus drained out of it.  It hurt like nothing I've ever felt before.  Nothing.  And I've been through childbirth and a painful, 28 hour labor when I had Micaiah.  And I think this might have been worse.  Maybe it was because it was unexpected, maybe because I was feeling overwhelmed from all the pain in both my neck/back and now my knee... whatever the case, it hurt like crazy! 

The next day I had to go back so he could drain it again.  I was having anxiety attacks that morning out of sheer fear of the pain I knew was coming.  But what other choice did I have?  So I went back, wore my bravest face, and let the doctor squeeze my boil.  And squeeze he did!  He got a ridiculous amount of pus and fluid that second day of squeezing!  I couldn't believe it!  And that was the point where my leg started to feel better.  The core of the boil was about 6cm by 3cm at its largest, and the redness area wrapped all the way around to the sides of my leg.  I'm guessing the redness area was something like 24cm from left to right and 16cm from top to bottom, all centered around the boil, which was a few cm below my kneecap.  Yes, I definitely think that was the midway point, and I'm praying that from here on out it is falling action. :)

I went one more day when they squeezed it again, and that brings us to today.  When we went in today the doctor was able to dislodge what he called the "tissue plug".... gross.  It's this big yellowish blob that looks like an overgrown booger.  It came out of the boil, leaving a big crater in its wake.  Well, I should clarify that about 75% of the tissue plug came out.  The rest is still in there just hanging out.  But from what I understand, that will dissipate and drain out as the skin heals and the wound starts to close.  But for now I have a big crater on my knee that continues to ooze!  Reminds me of when we went to Ngorongoro Crater here in Tanzania... well, except the oozing.  I will have a scar.  And it will be large.

I've been thinking a lot about wounds.  The ones we carry in our bodies and the ones we carry in our hearts.  Dealing with all these health issues has led me to ask God some very difficult questions.  I've read through Job.  I've read through Habakkuk.  I've considered Jeremiah and many of the other prophets... why doesn't God protect His people?  Why are sickness, illness, disease, and injury allowed to happen and to affect His people?  Is it the enemy's work?  Is it spiritual warfare?  Is it my sin?  Is it something I've done to offend Him?  I've wrestled with these questions and more.  I got a few answers (or pseudo-answers), and a lot more questions.  I was comforted by the words in the "Streams in the Desert" devotional (by LB Cowman).  I was challenged and comforted and sometimes angered by what I read in the Scriptures.... who is this God I say I love and how will my understanding of Him change through all of this? 

Wounds.  They go deep.  They ooze crazy pus.  And there is only one Healer.  I don't know why He does what He does, but I know that He is good.  And I trust that even on the days I don't understand, that I will someday see and understand.  I just pray that my faith is strong enough to get through the now and to not lose hope. 

Oh, and a heads up -- I plan to post pictures of my boil in my next post, so if you are not one with a strong stomach, I'd recommend you avoid that one like the plague.... hehe. 

-JLR

Friday, December 9, 2011

Birthday Festivities

30 isn't so bad... but turning 30 in rural Tanzania where there are only a handful of westerners and little to no access to shopping?  Now that takes a little getting used to!  Tim and Micaiah did a good job, though, and I am happy to say that I felt properly celebrated and sufficiently embarrassed, and that's the point of a birthday, right? :)

An overview of my day...

Sleeping in!  Yay for an extra hour of sleep!  Tim had already asked what I'd want for breakfast, so we planned ahead for a pineapple-banana-kefir shake topped with my homemade peanut butter granola.  Yum! 

Leisurely morning.  The power went off shortly after Tim made the aforementioned shake, so that slows things down a bit.  Normally our day consists of a full morning of school with some activities carrying over into the afternoon.  Instead, I did about an hour of school with Micaiah and let the non-essentials go for the day.  I also enjoyed a leisurely, hot bath (once the power returned and we were able to use the hot water kettle!).  It sounds mundane, but since we normally take cold showers in the mornings, I assure you that this was quite a treat!

Messages, Messages, Messages.  I'm almost entirely certain that Tim did a bit of work to remind people that it was my birthday and urge friends to post thoughtful, encouraging messages to me.  I got more than a hundred emails and messages on facebook!  Not only that, but many of them were exceptionally meaningful and heartfelt-- I appreciated all who took the time to give me the gift of encouragement on my big day!

Gifts.  Somewhere between the homeschooling and bathing and breakfasting (that's a word, right?), I got gifts.  Micaiah and Tim gave me a metal stand to hang some of my mugs on (yay!), some pringles, some chocolate, and-- the best surprise-- an episode of CHOPPED!!  It's my favorite tv show, and a completely surprise gift.  I'd never have imagined that the internet would have been good enough to download something like this through i-tunes.  Oh, and I may be forgetting two of my favorite gifts-- Micaiah picked out a beautiful bouquet of silk flowers (!) and the shop-owner of our favorite shop in town gave me a musical, light-up birthday card!  It was so sweet!  Nothing like a bit of Tanzanian flare to spice up a birthday. :)  Don't worry, pictures are below...

Food.  Can't be a birthday without more good food!  I already mentioned the shake and granola for breakfast.  For lunch we had beans and rice with our workers and talked about birthday traditions here in Tanzania (which are minimal).  I had made my cake the day before-- a strawberry (read: pink! yuck!) box cake that my friend Jamie gave me, topped with a delicious almond buttercream icing (with REAL butter!) and garnished with chopped dried cherries that I brought all the way from the US.  It was delicious!  Since I'm still not eating a lot of sugar or flour, I've had to limit myself to one piece a day, but it was a nice splurge.  Yesterday I had had enough and cut the remainder into slices and stuck it in the freezer.  That way I can spread out the treat and not go into a sugar coma. :) 

Food (continued).  For dinner I made pizza.  Before you go feeling sorry for me that I had to cook my own birthday meal, remember that I actually like to cook.  And I had saved a few very special things for my birthday meal, including our last package of pepperoni and some mozzarella cheese I managed to find in town!  So I made pizza (pepperoni, onion, ground beef) and garlic breadsticks. 

And now for some pictures:
Can you believe this mosquito?  This is MY pink cake thank you very much!  :)
 The finished product.  I thought after the fact that I should have added some dark chocolate chunks in with the chopped dried cherries... that would have been yummy!
 Cooking up a big birthday dinner. 

The dinner-- two pizzas (I'm not going to waste precious mozzarella on Tim, who doesn't even like it!)
 This card was amazing!  It had an instrumental rendition of the "happy birthday" song and lit up every time I opened it..... Micaiah may have enjoyed it more than I did!  The roses on the front (not pictured) were like this but 3D. :)
This is the lovely (!) bouquet of silk flowers that Micaiah spotted in town and decided I MUST have as part of my birthday present. :) 
Me with my birthday cake.


Quote of the day: "Thank you, Jeana, for making your birthday so special for me!" --Tim. :)

Thanks to all who helped make my 30th birthday special for me, too! 

-JLR

Saturday, November 19, 2011

The Quest for Clean Water

We are thankful that our water situation in Mpanda is as good as it is. We have a 1000L (264 gallon) tank that (ideally) gets filled up at least once a week. That tank feeds into our house and helps us wash our hands, wash dishes, flush the toilets, i.e. all the normal things that you just sort of take for granted in the States. We have a friend who works for the water department in the St. Louis area who says there's a daily usage of around 200 million gallons. If I've done the math right that works out to around 71 gallons a person per day. That would about wipe out our tank in one day. That's not to make anybody feel guilty or anything, I'm just trying to give a comparison.

And it's not just enough to get water, because we do have to bathe in it and drink some of it and that's a bit different than just flushing the toilet with it. This is sort of what it's like when it comes in. It looks (and smells) a lot like river or lake water.



We have a Katdyn water filter (micro) that filters out microbes but leaves behind a large residue of dirt, bugs, leaves, etc. This ends up clogging up the 3 ceramic filters and really slows down the process.


Hence, my quest to build a working bio filter that works on the macro level (and theoretically would work to filter out bad bacteria, amoeba, etc. as well). One step at a time though. I got the idea from some missionaries in the Mara region working on water filtration. It basically uses layers of sand and rocks (which naturally filter all sorts of water around the world in underground springs, etc.) I've gotten as far as a prototype (pictured below in white) which seems to be working well at the macro level.



Each run through seems to show the water getting clearer and clearer. I've already thought of a few improvements I could make, so we'll see how it goes. Check out: http://villagehealthproject.org/biosandFilters.html for more information. There are loads of NGOs/missions doing this sort of thing in Africa. This site happens to have PDFs for plans and photos of each step in the process for building concrete bio filters.


-TMR