Therapy Day 14: Come What May...

I want to take a break from the therapy stories and cute pictures to give you a feel of what a typical day on this trip is like, outside of the therapy. It's gonna seem like I am all over the place, but these days are up and down and up and down and up again…

I woke up real early (as in 7:15- that is early to this girl) with a sore elbow. Did I mention that I totally fell on the way to the burial yesterday (luckily it had not started)? We were crying and had to go under a barb wired fence to reach the burial. Tears and a base of poor coordination are a bad combo. Totally face planted, glasses flew off, and all the Zambians gathered around and said, “Oh sorry, so sorry, so sorry Miss!” I just kept walking, tried to secure my chatangi that was starting to reveal my legs above the knee (which is not acceptable in the Zambian society) and hissed to a team member, “I am fine just get my glasses. Let’s act like that didn’t happen!” It’s okay to giggle. I think humor can be found in all situations. Enter, my sore arm.

So since I woke up early, I just did some yoga to center myself before the day. And don’t let that make you think I am getting too earthy- I will still down a Dr. Pepper. If there was one to down. Oh I miss Dr. Pepper. So much. You know what I really wish I had? Dublin Dr. Pepper with real cane sugar. Anyone driving from Texas to Nashville soon (hint, hint cousins) who wants to load up on those for me, I will get you back. I just feel better drinking pure sugar. It makes me feel justified in my choices.  What was I talking about?

Oh, yes, so after yoga and breakfast, we hit Haven 3. I had the grad students lead the group today to see if my teaching has amounted to a hill of beans. Seems like they are learning very well. B. Weave asked me to look at Alfred when we went over to Haven 1. Here’s the back story: Alfred is a little guy who came a few weeks ago. He is 1 month old, and over the last few weeks he has been demonstrating some rather atypical behaviors, including eyes rolling in the back of his head, eyes twitching, signs and symptoms of aspiration while eating, very weak suck, and nasal regurgitation of his feedings (comes back up through the nose- indicating velopharyngeal incompetence, which is poor palatal/nasal sealing while eating). I spent time with him a few days ago, and tried everything I knew and nothing really worked (thickening his feedings, changing positioning, changing bottle nipples, etc). So we decided to include him in therapy and just do as much as we could to rebuild his muscles.

Back to today: Once we got to Haven 1, I checked on him. His breathing disturbed me, as we was puffing his lips while exhaling. His eyes were also rolling back more. I opened his little onsie, and Oh. My. Word. His breathing was so shallow that his clavicles were sinking in (clavicular retractions) and his ribcage was rocking back and forth. He was panting for air and had escalated to respiratory distress over the past few minutes.

I took him out to B. Weave, and with one look at each other, we rushed around to take him to the clinic. The Aunties were a little shy about it. They do not rush, they do not make quick decisions. We were not going to take him without their permission. We had several moments where they would talk in Tonga and then look at us. Several times. I finally gently took one of the Aunties hands, one with whom I have a good rapport, and said, “May we take him for help?” She agreed, and off went B. Weave and Sarah with Alfred to the clinic.

I went back to supervising. About an hour later, B. Weave came zooming back in, reporting that Alfred was at the clinic and that they needed bottles with milk, diapers, and an oxygen mask ASAP. B Weave yelled, “I’ll get the diapers!” I yelled, “I will get the milk!” And somebody ran off to find the oxygen mask. After I returned with the bottles, I found that no one knew where to find the oxygen mask. So I tried to communicate again with the Aunties. Remember, they do not have ANY urgency in their culture. So they were slowly walking around looking for the O2 mask, and I said calmly, “We need to hurry.” No change in pace. I decided that maybe they didn’t understand me, so out of nowhere I said, “Make haste!” Didn’t help them walk any faster, but it sure did make the quote book for this trip.

I ran over to Haven 3, and found nothing but a nebulizer and emergency bag masks. So we sent them on their way. And then we waited for news. In the meantime, I did a presentation on Pediatric Dysphagia (swallowing). A crash course if you will.

When we got to dinner, we found out that Alfred is hanging on, but he has aspiration pneumonia. It is HEART BREAKING to have a situation right under our noses that we KNOW how to fix, yet have no resources to do so. There is no such thing as alternative means of nutrition (feeding tube) or of video swallow studies here. They have identified the problem, and now we wait. We pray that Alfred, by some miracle, can be healed not only of the pneumonia, but of any swallowing difficulties that are going to cause future aspiration. We feel helpless, but we hope for the impossible.

Tonight, Mrs. Hamby set up the movie projector on the back porch. We all came in our pjs, and found popcorn awaiting us. And of course, what would an outdoor movie in Africa be without a few bats flying around the screen?

Sound like a crazy day? It’s what we have come to known as a typical day in Zambia... Come what may.