october 11th 2010

finally, i am able to blog again!
i have been wanting to write a blog to tell about things here for the past month of so, but unfortunately i have NO INTERNET where i stay and so when i do get on the internet it's every couple of weeks or so.
i have lots of stories to share!
things at the hospital never cease to be interesting. there have been some crazy stories, like always. some of which i was there for, some of which i heard about secondhand.
a few of them:
there was this female OB who came with this MW to do this kind of community teaching course, and the OB helped with some surgeries in the OR. one of these was this woman who came in with a placental abruption. when they did the c-section, this woman had already bled out so much that where she cut into her skin, it didn't bleed at all. and her uterus was totally white, not pink. also, as they were preparing to do the surgery, they discovered that there was no electricity in the OR, and they had to call the guy who maintains the generator to come turn it on for them. as this lady was crashing. her blood pressure was 80/40. they did the surgery, almost lost her, then when they tried to order blood to transfuse her, there was no blood that matched hers: she needed blood that was A-. so, it turns out that this visiting OB, who did the surgery to save her life, she has the same blood type. she herself went and donated blood, which was then given to this woman, again saving her life. this story was incredible to me.
the same night they did the c-section for this lady, at the same time as this was happening, there was also this lady in the delivery room with active TB hacking her lungs out, and then at the same time, there was a lady with severe pre-eclampsia, with blood pressure of like 200/130. all 3 of these super high-risk ladies, one of our students, our star student actually, who is amazing, she was actually managing all 3 of them simultaneously. crazy.
the volunteer midwives for the past few weeks have been donating blood at the local red cross. such a good idea. there's often not blood when someone needs it.
the other day, someone brought a baby in, a week old, whose cord had just fallen off and had WORMS in it. i saw 2 of them. we told her to bring the bb to the pediatric unit (which is a joke)--and she said that they had sent her to US. so, we just cleaned the cord stub, and luckily we had some silver nitrate and i cauterized it, and we explained danger sings and sent her home.
a few days ago a lady was brought in after giving birth at home in the morning. her 3rd birth. came in for retained placenta. they said she had already bled alot at home. we started an IV on her and antibiotics and gave her an injection of ketorolac--thank god we had it--a painkiller--then about 15 minutes later we started doing the manual removal (of the placenta). i wanted marthonie to do it, she wanted me to do it, so i did it. i knew it would be a hard one. the placenta was implanted way high up in the fundus, on one side. it was really hard to get my hand around the placenta and reach up to where it was implanted. finally, when i separated the placenta all the way and came out with it, i looked at it and it was definetly not complete. it was one of those long placentas. one side of it looked like it had been ripped off from the other part. i went back inside for the other part, and it was really hard to tell if what i was feeling was a huge piece of placenta, or the inside of her uterus and it was rough feeling. it felt like the whole anterior part of her uterus was covered with a big chunk of placenta. i started to try to separate it, but then i stopped, because it felt weird and i wasn't totally sure of what i was feeling, so i stopped, because i didn't want to to poke a hole in her uterus. so, we called the Dr, the OB, and explained everything to him, and asked him to come in and see her. also, this lady had a 4th degree laceration from a previous birth that had healed over like that--she had a fistula--the anterior part of her anal sphinctor was gone--retracted behind the skin.
her hemoglobin this day was 8; 2 days later it was 4. she got transfused--another high risk situation that one of our students managed basically on her own.
she is doing pretty well now. once she is stable enough, they will decide about her reconstructive surgery. and, the OB did a sonogram (abdominal) on her and said there was no placental pieces inside of her. her uterus is involuting well and she hasn't had any signs of infection...but, i know from her placenta that there still is a piece inside of her. maybe it will just come out on its own or maybe it is reabsorbing.
the other night the american volunteers and a couple of students worked the night and had a twin birth. well, at 11pm the electricity went off and the birth of the first twin was AT 11:40PM. the second twin came about 20 minutes later, with like a 1 apgar, and they resusitated this baby for 30-40 minutes. in the dark, with a headlamp. this baby seems fine now.
lots of crazy things all the time. the hospital is crazy...i don't even try to go into detail about the personalities that work there and the politics. crazy.
and my personal life...things are going well. blada, my partner who i met here, he is wonderful. we are doing so well, letting things unfold naturally, getting to know eachother, having a good time, etc. he is a beautiful beautiful person.
being with him is the main reason i decided to come back here and do the next class here for midwives for haiti.
last night we participated in a little dance program at the place we always go dancing. we danced a salsa and he also danced a haitian folkloric dance. it's like african dancing. so beautiful. it felt really significant to me that we were invited to perform at this event, like, it felt significant to me with him as my dance partner and partner, and also for myself as a part of this community.
i got a video of both dances--sometime when i am able to, i will put them on facebook. the lighting isn't good and our dance, i felt that i didn't dance so well but whatever.
the group i work for is going to rent a house in order to centralize everything. once i come back here in january, hopefully it will be ready. i will stay there, as well as the volunteer midwives who come each week. and we'll keep all our materials there. i hope we have internet!!!!!!!!!!!!!!!
i will be in NC for the month of december. really looking forward to seeing folks there!
and in el paso for just a few days, before that.
i feel relieved--i had alot of things to write about!
once i have good internet access again i will hopefully start blogging again regularly, like once a week.
take care
reina