Caren

Outcomes. In the States, this is how we measure success. Here in Africa, it seems a little more complicated. Patients present late in the course of their disease. Often survival is not an option. And sometimes, when everything looks bleak - life triumphs.

Recently, we took care of Caren, who had severe preeclampsia. She was brought to the hospital at 28 weeks gestation; she was seizing at home off and on for 8 hours. She was still having seizures on presentation. Her blood pressures were markedly elevated and she was unaware of her surroundings. Initial lab tests of her liver and kidney functions and platelet count were very abnormal. Sadly, she was also diagnosed with an intrauterine fetal demise (stillborn). She was given IV medications to stop her seizures and lower her blood pressure. Upon placing a foley catheter into her bladder, frank blood was noted.

Since she was not in labor and needed to be delivered, she underwent a C-section and was then transferred to the ICU. Fortunately, she had minimal bleeding during her C-section. All of her organ systems slowly began to recover, except for her kidneys. She developed renal failure. Her creatinine was 10X the normal value. A family conference was held with her husband and her brother to recommend transfer to Moi University Hospital (3 hours away) where she could get dialysis. The family agreed and went back to their home village to try and gather funds for dialysis. Each dialysis treatment would cost $100 and Caren would need 3-4 treatments per week. This was a large amount for her family to raise.

Caren became more stable and was transferred out of the ICU while we waited for the family to return. One of the many frustrations and difficulties of practicing medicine here is that there are sometimes available treatments, but they are unaffordable. During our wait, Caren became more alert each day. We were pleasantly surprised when her kidney function started to normalize even without dialysis. As we rounded on her this week, we helped her out of bed and she was able to stand (the first time we saw her upright since admission). She was recently discharged home after spending 3 weeks in the hospital. It is very likely she will have an element of chronic renal failure, but she has three children that are blessed to have their mother home.


Caren prior to discharge

Sweet Sixteen!!

There are many ways to follow your alma mater basketball team during the NCAA tournament:
1. Go to the game and watch
2. Watch the game on television as it occurs
3. Wake up the next morning in Africa, and get the results on-line

So it goes, this year I was in the last group. Looking up the results on the internet, we discovered Butler had upset #1 ranked Pittsburgh (71-70) last night to advance to the Sweet Sixteen. It is awesome to know that the Bulldogs are having another great year in the NCAA tournament. Maybe last year was just a warm up, and this year will be when the Dawgs go all the way. I will be standing by my computer and following with all my other Butler fans.

Milk and Cookies

Today was a relaxing Sunday for the Popps. We went to church then played outside for awhile. After lunch, the boys took a nap, so Anna and I decided to bake some chocolate chip cookies to surprise the boys.

As we were measuring and mixing the ingredients, I found it amusing where all the ingredients came from. The eggs come from Joseph, a local man who spends most of his earnings running a nearby orphanage. He sells us a dozen eggs every Tuesday for 120 shillings ($1.50). The flour and sugar we buy at the local dukas here at Tenwek. We buy the butter in Nairobi, which we go into Nairobi about every eight weeks. The most treasured ingredient in the cookie batter is the chocolate chips. Here in Kenya, it is even more treasured because the semisweet chocolate chips only come from the United States. We can't buy any chocolate chips here. Those delicious Nestle Tollhouse chocolate chips have to be hand carried or shipped here by loving family or friends.

So needless to say, chocolate chip cookies are quite the treat! Bryan and Leo woke up from their naps to the sweet smell of freshly baked cookies. We had a nice cold glass of whole milk to go with the warm cookies. Did I mention that the milk comes straight from the cow? We buy our milk twice a week from Charles. It comes unpasteurized and unfortified. Once we get the milk, we boil it for 10 minutes then refrigerate it. Although the milk tastes "fattier", it sure goes well with chocolate chip cookies!

An Honor

This line of work we have chosen is largely unpredictable. It would be more convenient for all parties if babies could be delivered on a schedule of our making. Some would argue - "Where's the fun in that?" We might argue - "We could get a lot more sleep!"
But in the end, it is all about timing and location.

Delivering a baby in Africa comes with many uncertainties, but God was shining on the McLaughlin gang as they added another member to their family. There are many ways things could have gone wrong. The power outages, the lack of continuous fetal monitoring, the uphill walk to the hospital, the lack of privacy at the hospital, the limited resources for neonatal resuscitation . . . shall we go on?

But this was to be a blessed delivery - a successful labor at home (and indeed there was a power outage), a safe walk in the dark to the hospital, a private OR to deliver in, perfect fetal heart tones and an inspiring mother and supportive father. It was truly a special moment, that may well be, the highlight of our time in Africa.

Thank you Rachel, Eric and baby Benjamin Kenneth Kipruto McLaughlin. It was an honor to be part of your special day.

Using Their Imagination

This afternoon, Anna came into the kitchen and said, "Look Mom and Dad!" She had stripped her Graco booster seat of its covering. She used the seat cover as a backpack. The arm rest covers she was using as boots. My first inclination, since I am Type A, was to be upset that she had taken apart the booster seat. Thankfully, I quickly got over it before I said anything and realized she was being rather creative. Leo then walked into the room with his booster seat on his back. He was Buzz Lightyear. In this day and age where all too many kids are absorbed with their I pods, DS video games, and DVD players, I was happy that Anna and Leo were using their imagination--even if it meant that I had to put the car seats back together later.

Only in Kenya

We apologize for not blogging in the last two weeks. No need to worry – we are okay. As a matter of fact, we are better than okay. Our dear friends, Steve and Beth Rolfsen, are visiting us from Michigan. They left their three wonderful kids with trusted family and are spending two weeks with us. We are thrilled that they are able to share in our Kenya experience. Steve and Beth arrived February 13th and hit the ground running.

After just 24 hours to recover from jetlag, Steve and Beth went with Tenwek Community Health to a clinic in Tembu, a village about 45 minutes from Tenwek. They worked all day seeing pregnant women (weighing and taking blood pressures) and immunizing babies. They saw over 100 patients and skipped eating lunch. They returned to Tenwek exhausted but filled with the desire to see more.

Just as we were about to eat dinner, we received a call that one of our postpartum patients (s/p cesarean section complicated by a wound infection) was actively bleeding from her abdominal drains that were placed to drain her infection. She needed O positive blood stat. Beth volunteered to donate. So we quickly fed her a PBJ sandwich and took her to donate blood. Bryan and I took the patient back to the OR and packed her abdomen to slow the bleeding while she received the blood transfusion. Our patient survived the night and is still in critical condition in the ICU. Steve and Beth were quickly introduced to missionary life.

We did give Steve and Beth some R&R this past weekend. We left Anna and Leo with friends and took the Rolfsens on safari. We had some much needed time to talk and catch up and see some amazing animals.


Today, Beth and I went out with Tenwek Community Health to educate local school children about HIV prevention. It was a typical day in Kenya - filled with many frustrations and many joys. As we have mentioned in previous blogs, nothing happens at a fast pace here. We are on “Kenyan time”.

Beth and I promptly arrived at 9:30am. No one at Community Health seemed to be in a hurry to leave. 10am – time for chai tea - which delays our departure even more. By 10:50 am, we were finally ready to leave. What should have been a 45-minute drive, turned into a two-hour trip. We had to pull over at a gas station to get the spare tire patched (30 minutes). We then go to get gas – why didn’t we get gas while we were waiting for the spare tire?? Beth and I were asking the same question. Weren’t the kids at the school waiting for us? We get back on the road only to stop 30 minutes later to fix the back two tires - which felt “loose” to Cosmos, our driver. This was a 45-minute detour. 3 ½ hours after showing up at Community Health, we arrive at Lelaitich Primary School by 1pm.

But wait, our frustrations do not end there. 1 pm is when the kids walk home for lunch. So once again, Beth and I wait. Thank goodness we were together and could spend the time talking. The kids started to return from lunch and one by one they run to see us. Pretty soon, Beth and I were surrounded by smiling, curious kids (approximately 100 kids). Of course, the Community Health workers by this time were nowhere in sight. So Beth and I started teaching the kids some English and they, in turn, taught us some Swahili. We realized that this is why we came – to be with the children.


Lelaitich School has over 500 students with only 10 teachers. The school has no electricity so our team had brought a generator to power the video on HIV. The children learned today about HIV and HIV prevention. We also discussed how important education is and encouraged them to continue to study hard. What a joy it was to see how happy the kids were to have us at their school.


Lelaitich School

After a rewarding afternoon with the school children, we were ready to head home. Although Beth and I were eager to get home, we were not excited that Cosmos was driving like a maniac on the horrible roads. When asked why he was driving so fast, he answered, “I am not driving. God is driving”. I know I should have found comfort that God was driving and in control, but all I could think of was that my children are too young to lose their mom. But praise God, we made it home safely.

I should mention that on our way home, we made several detours and stops to pick up various Community Health workers that were heading to Tenwek. Just when Beth and I thought we were so close to getting home, we would make a random stop and someone would climb in with his/her belongings. After all was said and done, we had 10 people piled into a 5 passenger SUV. Also in our car was a generator (leaking gasoline), two VCRs, a large speaker circa 1980s, a stereo amplifier, and a projector. I am so happy that Beth was able to share in all the frustrations and joys from today. As we bounced around on the bumpy roads, I had to smile and think…only in Kenya.

Super Bowl 2011: Packers vs. Steelers

Even in Kenya, we were able to watch the Super Bowl. We even organized a Super Bowl party - complete with loyal fans and too much junk food. It was recorded via satellite and we watched it a day later. We all agreed not to look at the score before the party. We had a great night of fun and good football.