Friday, April 13, 2012

Ruptured Membranes


Hello from the Tropical Paradise of Papua New Guinea,

My pen has been quiet for the past few weeks and realize I only have a little more than one week before we leave the station. I am sad and relieved all at the same time, it is hard to describe.
Tyronza and I are doing well and remain healthy. We have had no further earthquake activity and the rains have been steady and are keeping my cisterns full.
Our power has been much better as of late. The maintenance guys have recently changed the filter on the big diesel generator and it has been working well. The PNG power company has also seemed to have much fewer outages. I have discovered the local power comes from a large hydro-generator about 40 miles away. This fall a team of engineers will arrive from South America to build a dam on the river here at the station. The Australian government is funding the 3 million dollar project, which should solve the power problems for our area for many years to come. The construction of the dam and hydro-generator will take a little more than a year to complete.
The medical practice is much to same and I have some good things to report and some bad. First the good, I may have told you about my premature rupture of membranes (PROM) patients. I have been managing three PROM mothers. One ruptured at 29 weeks and two ruptured at 24 weeks. The 29 weeker carried without infection to 35 weeks and was delivered last week by caesarian. The baby really had a smashed head, but that rounded up quickly and she looked very good within 24 hours. Both mother and baby are now home and doing fine. One of the 24 weekers delivered at 31 weeks. The baby weighed a little over 900 grams and died after 48 hours. The other 24 weeker is still pregnant and is now 33 weeks along. There has been no sign of infection and the baby seems to be growing. The baby is in the transverse position and my plan is to deliver her in another week. Please pray for this mother. I will keep you posted.
Now for the bad news. Last week I saw two very sad antenatal patients in the clinic. One was 24 weeks pregnant and newly diagnosed with leukemia. The mother went into labor this weekend and the baby died, but the mother has now been started on chemo for the leukemia. The other mother is also 24 weeks and has advanced cervical cancer. Both kidneys seem dilated and I am not sure the patient can survive long enough to get the baby to adequate lung maturity for delivery.
Gynecologic surgery has been interesting with several ectopics and PID abscesses. One of the abscesses was so bad, we had to remove several feet of small bowel. She was so ill I thought she might die, but she passed flatus on day 4 and looks like a rose.
Hope you are all well and doing fine. We pray for all the folks back home every day and I know many of you pray for us. We do appreciate that.
God Bless,
Scot & Tyronza
for photos:
http://www.facebook.com/media/set/?set=a.250305375044841.59195.100001961413037&type=1&aft=268196119922433&l=209e4ae86b