Isaac Hotz, one of our great LdL missionaries shares the following “Short stories from the team at Loma de Luz.” It summarizes the recent work at Hospital Loma de Luz so well that we are just passing it along in its entirety. ~Bendiciones, jcm
‘GOOD NEWS’ WHEN WE ARE ALL TIRED OF BAD NEWS: SHORT STORIES FROM THE TEAM AT LOMA DE LUZ
Many people are probably aware that the word “gospel” literally means good news. It’s somewhat easy to take that for granted especially until one starts living in a world that seems saturated with ‘bad news’. Then one starts to yearn for good news and the words seem to suddenly have new meaning or context as I’m sure they had when they were first used.
I was nearly brought to tears of joy a couple days ago when Pastor Oscar came to us and told us that a patient of ours whom we had cared for here at LDL for months inpatient was sending us pictures of himself and audio messages, thanking us for saving his life. One of the other missionaries instantly replied to him, “We didn’t save you, the Lord did. And if He did, then follow Him from now on.” It was good news to us all.
The young man, shown below, was in our hospital for months with a high output fistula. Basically, he had a hole in his intestines that actually connected to his abdominal wall such that everything he ate bypassed the majority of his intestines (where nutrients and energy are absorbed) and leaked out the hole in his abdomen. He was slowly losing weight day by day for more than a year and was emaciated. He had seen other doctors and been hospitalized in other hospitals without success. Finally, he came to LDL and after months of doing battle, day by day with no certainty of success, the battle was finally won. The fistula finally closed. Thank you, Lord.
It’s almost hard to believe that there are actually other diseases in the world besides COVID-19 but we thought we should take this opportunity to share that thus far, we are 100% successful in treating the disease (we’ve had one known case so far). That is good news as well. Seen below is an 88 year old female whom we found to be hypoxic but in no respiratory distress and actually quite angry that we were treating her with respiratory precautions. She was both Ab IgG/IgM and PCR positive, seen in the wheel chair below.
Some more good news is. that our construction project to build a new building to house our electrical and maintenance (see photo below) is NOT a new hospital crematory. Evidently, a small rumor in the community started that we were preparing for so many people to die from COVID that we were building a new crematory. We are delighted to report, this is not true. We are NOT building a window-filled building where we will do cremations. This building houses our backup generator and oxygen generating machines, among other machines that keep our mission hospital operational.
A couple of weeks ago a little 8 year old boy jumped and landed on an old fence post and impaled himself. The stick entered in a dangerous location, close enough to be concerned about injury to the spleen and the kidney, and certainly intestines. After taking him to the OR, we determined it did indeed pierce into his abdominal cavity and therefore needed to be explored. Thankfully after exploration, we found that the piece of wood did not injure anything important. The little boy did well and is now home!
Here is a renal ultrasound of a 6 year old little girl that I saw in clinic this past week:
She had seen another doctor somewhere else and told she had a “mass” in her abdomen. The above video was made to send off to a urologist for consultation and to get a second opinion on how best to help this little girl. Upon performing an ultrasound of her abdomen, we found that her bladder was massively distended and both her kidneys were “full of water” indicating they were being obstructed. More than a liter of urine came out when we put a foley catheter in to drain her bladder.
The above x-ray was done on the same 6 year old girl, finding significant constipation. We did the x-ray to see if there was concomitant constipation to see if ‘dysfunctional elimination syndrome’ was the cause of her symptoms or certainly an odd neurological disorder (she did not have any other neuro findings on exam). We are still working on caring for this little girl and appreciate prayers for her. We are thankful that her mother finally is pursuing treatment for her condition which had been going on for at least the past 3 years.
The above presumed liposarcoma (tumor) of the leg was removed by Dr Dave recently. The significance of this photo is that there had been threats to shut down access to our hospital to the rest of Honduras by closing the only road access, using a military blockade. (An effort to keep COVID from coming to our area of the country). We went before a large community of leaders and I had to gently inform them of the negative side effects of such a decision, including someone like this patient (an example I used in the meeting). Leaving tumors to grow during this time would also have a morbidity and mortality associated with it. This patient came to us from another area of the country.
Below is a chest x-ray of a patient that Dr Nathan diagnosed tuberculosis in this past week and a photo I shot with my iPhone down the lens of the microscope looking for the pink staining rods on an AFB stain. (Its a bit difficult to appreciate, being more obvious looking through the microscope.) The third photo is demonstrating free air under the diaphragm. The x ray significance of that finding is that it indicates there is an abdominal perforation somewhere and a life-threatening surgical emergency exists. The patient ended up being HIV positive and had a spontaneous perforation without any history of abdominal surgery. He had not been undergoing any treatment for his HIV. After successful surgery, we referred him on to the HIV treatment center in La Ceiba.
The photo below demonstrates a rare moment with both Dr Dave and Dr Jeff operating simultaneously on the same patient, but performing essentially separate operations (when it’s late at night, efficiency is appreciated). The patient was a young victim of a car accident who presented with an abdomen full of blood (internal bleeding) which Dr Dave was operating on. Meanwhile, Dr Jeff started putting in an external fixation device for his fractured and mangled leg in order to stabilize it. After transfusing 4 units of blood and resecting some sections of bowel that had perforated from the deceleration injury, the patient did well and was able to go home. Evidently, they were driving their car at night and ran into the back of a truck that was not moving, going over a speed bump, and must not have had taillights.
We started to feel like we are a level 1 trauma center when less than 24 hours later we had the next patient show up to LDL (see photo below). He was a young male that had multiple bullet shots to the neck, chest and abdomen in an assassination attempt. Notice the slugs in the photo. Amazingly, after an emergent surgery to repair multiple holes in his intestines, he too lived. One shot that glanced off the base of his skull and traveled down through his neck, ended up superficial to his chest cavity near the clavicle seen below. The other slug shown below also never entered the chest cavity, so he ended up not even needing a chest tube. Rumors spread that when he was known to be alive, his assassins might come try to “finish him off,” so we called some military armed support to guard our hospital so we wouldn’t get caught in the cross-fire. We never felt unsafe, but felt like we should take the rumor seriously.
Below is a little infant born at LDL about 3 weeks ago. She was born prematurely at 29 weeks and 3 days weighing 3 pounds 1 ounce. Her mother had an IUD in place when she got pregnant, and we think this may have played a role in her premature labor. Fortunately, our team had seen the warning signs of premature labor at a previous visit and she had been given steroids to mature her baby’s lungs prior to when she came in and delivered. We actually attempted to transfer the infant to a larger hospital, but upon contacting a neonatologist there, he told us there were already 6 other infants sitting in the ER waiting for beds in their NICU and it didn’t look promising that the baby would be able to get one anytime soon. Given the level of respiratory support she needed and the fact that she was having apneas and bradycardia’s of prematurity (spontaneously stopping breathing and then having her heart rate drop, needing stimulation), we decided that her chances of living were better if she stayed with us. We put in a central line and fed her TPN (IV nutrition) and then have been able to transition to tube feeds. She still is unable to eat any food on her own, but she continues to slowly grow with tube feeds. Her respiratory needs also have significantly decreased. Please keep her in your prayers. She would have been 32 1/7 weeks old today if she were still inside her mom.
Below is the most recent critically ill patient at LDL. We would really appreciate your prayers for him. He has Guillan Barre Syndrome. This is a very odd syndrome that occurs often after an infection where your own body’s immune system, in fighting off an infection, creates an antibody that accidentally attacks the myelin sheath (covering) of your own nerves. It paralyzes you. It almost always starts in the legs and then rapidly paralyzes you, in the worst of cases (as was demonstrated here) paralyzing you until you can’t even breathe for yourself. He was on a ventilator for 2 months in the capital city. He still is paralyzed but actually just moved one finger for the first time since the illness. He is able to barely speak and has a tracheostomy (hole in his neck made to breathe for him rather than keeping a tube down his mouth/throat).
He is emaciated from the illness (look at his legs). Given the hospital he was at is overwhelmed with COVID they asked us to take him on a transfer. So we accepted him here at LDL and are going to work with him to rehab, continue treating his illness, and probably most importantly, improve his nutrition. We started feeding him through a tube into his stomach. The expectation is that he will slowly regain use of his arms and legs over time if we can keep him alive and avoid complications. Yesterday was his first day at LDL, which also happened to be his birthday. Please do keep him in your prayers.
