spoiled weekend

As in, we are spoiled by you.  We have had a relaxing, fun, delicious weekend made possible by the generous gifts and packages we have received. It started when I got home from work and found a new package on the table!!!  Our friend C came over, saw it, and got super-excited as well....so excited she stayed to "help" us open it. :)

A package opening party- smiling and laughing and dancing about.

We had some friends over to play a game of Settlers while drinking tea and eating candy and chocolate.

We've been blessed with enough Skittles to share. Our Australian friend who had never heard of Skittles is now a big fan.

It poured rain for several hours on Friday night and it was blessedly cool Saturday morning.  

Martin coping with the cold weather by rolling up into a ball.

By "cool" I mean less than 90F...which means we can sit in our living room in relative comfort. After 120F, 82F feels downright amazing.

I enjoyed some coffee with flavored creamer and had some quiet reading time.

My weekend home improvement project: our toilet paper holder before.

After: Painted black using some paint my mom brought over for us.

Luke woke up and asked what was for breakfast. I reminded him about this tasty goodness in the refrigerator.

Pop Tarts = Happy

 Then, C came over and we had a cooking/baking party. 

chocolate chips...like gold around here :)

Chocolate chip pecan cookies!!!  (Vanilla, chips, pecans, baking soda all imported)

Salmon croquettes with Siracha mayo. They were amazing!!!

Chillin' reading some magazines.

After baking and eating salmon croquettes we enjoyed a few games of Dutch Blitz. And that was just our Saturday...made possible by people like you. :)

To all the peeps!

We are approaching the quarter pole of our African journey. Our break in Europe for a couple weeks gave us the chance to step back and think about all that we have accomplished over the past year and a half. Tab did so many surgical procedures she practically completed a second residency. I learned so much about computer networks and bio-medical equipment that I feel like I could actually be of value to a medical center somewhere.

We also started to realize that our time here is winding down. I decided to make a list of goals that I want to complete before I leave. I know this sounds like a procrastinator panicking but, this was something that I couldn't do before.  It took over a year to begin to understand where we are and where we would like to see this place go. With a lot of work and little luck we might get an electronic medical records system up and running here before I leave. It will be huge task but also a huge step forward for this hospital. Tab is just hoping to make it through the next several months of every other night call. We'll see how it goes and keep you informed.

And finally, I would like to give a HUGE shout out to all the people that have sent us care packages over the past year and a half. The little tastes and sights of America have been an incredible encouragement and fun respite from the realities of being so far from home. But now, since our time in Africa is coming to an end (for now) we must ask that you cease and desist. Or, if you are going to send them, send them now! :) Well, you don't have to, we just might not be here to enjoy it. But there will probably be people here that would enjoy it for us...

This picture pretty much says it all. I couldn't eat all of these. But wait...I almost have!  I still have some. Fourth of July peeps woot woot.

Hearts

In honor of Valentine's Day, I played heart surgeon.  When I was on call last night a young man came in with abdominal pain. My intern evaluated him in the ER, noted his abdominal tenderness and some difficulty breathing. Then he did an ultrasound and reported to me, "His abdomen is tender and. I think he has a pericardial effusion ["fluid around the heart"]...but I can't be sure."  I'm proud of him for doing the ultrasound and looking at the heart- its not something a surgeon always looks at when consulted for abdominal pain!

I took the ultrasound to the ER to evaluate the patient. He couldn't breathe well while lying down, his liver was enlarged and tender...then on ultrasound I saw a HUGE pericardial effusion. Biggest I've ever seen  It was like the heart was a tiny, quivering ball surrounded with fluid.

A picture of a small pericardial effusion from the internet. Probably measuring about a centimeter.  Now imagine the fluid space to be wider than the heart...that's what I saw

I measured the distance from the heart muscle to the sac: over 9 cm! Usually pericardial effusions are graded as small (less than 1cm), moderate (1-2 cm), and large (>2cm). This effusion was off the charts. We also got a chest x-ray:

a normal chest x-ray (thanks Wikipedia)

His chest x-ray...his heart shadow took up half of his chest!

Amazingly, his heart rate was only a little bit fast and his blood pressure was normal. Obviously he had had the fluid for a very long time. Months probably (likely from tuberculosis). His liver had been hurting for three weeks because of the pressure build-up. After seeing an effusion that big, I wanted to rush him straight to the operating room to get the fluid off.   But it was the middle of the night, he was stable, and the effusion had been there a long time. So, we took him this morning. I opened the heart sac, put a drain in it, and got over 1 1/2 liters of fluid out! It was a pretty satisfying operation and I got to literally touch someone's heart on Valentine's Day. :)

Yesterday, we got a package from my mom with some amazing Valentine's treats (just in time!). She included some heart-shaped sprinkles. I happened to have a box of cake mix and some frosting and was inspired to make a last-minute Valentine's cake to bring for the OR staff.

The power went out, so I ended up baking the cake mostly in the dark ...but it still turned out.

When I gave it to the OR supervisor, he was a confused when I said "Happy Valentine's Day." It took a few minutes to explain why I brought a cake because I didn't know the French word for Valentine's Day and its not really celebrated holiday around here. Most of the OR staff didn't even know it was Valentine's Day, but now they do and they were very happy to eat some cake! :)

I also made some Valentine cookies last weekend...

The cookie press was left here by a missionary several decades ago. Still works fine!

Usually I would make Spritz  wreaths for Christmas....but the Christmas red hots came in January this year. So I made the Valentine version of Spritz...What do you think? Perhaps a new Valentine's tradition has been started.

Happy Valentine's Day!!!

Merry Christmas!

For to us a child is born, 

to us a son in given, 

and the government shall be upon

his shoulder

and his name shall be called,
Wonderful Counselor, Mighty God,
Everlasting Father, Prince of Peace.
Isaiah 9:6

Christmas season feels different here. Instead of snowstorms we have dust-storms and "cold season" doesn't mean below freezing- it means lows in the 70's, highs in the 80's or 90's but there are plenty of people dressed in heavy jackets, gloves, and knit hats!

we miss this...

But, the lack of snow and family hasn't kept us from finding ways to celebrate.

We've made more cookies (mostly to give away as Christmas greetings)!

And, just when I thought we weren't going to get any Christmas packages...one came on Monday!!!  We talked about waiting until Christmas day to open it, since we have only one present under the tree. But, we just couldn't wait. Then, we stumbled upon a compromise...

after Luke opened the top flap of the box

we noticed the second flaps were still taped together- still concealing the box contents (way to go, Mom) :)

so, on the day before the day before Christmas,  we began removing items from the box one-by-one

so far we've retrieved some pretty awesome stuff

Luke loves Peeps!

Its Christmas morning as I'm posting this...and we have somehow managed to save about 1/3 of the box contents for today. :) But first, its time to enjoy some cinnamon rolls, coffee (which will hopefully help me stay awake for a the 3 hour church service today) and bacon!  Thank you to those who have sent us the cinnamon, coffee, bacon, and pecans that have made this Christmas breakfast possible. I hope you all have a wonderful day with friends and family!

Yippee!

I was missing America quite a bit today. I knew we had a couple of packages on the way and was hoping one would come soon. After a long week of operating, call, and Hausa class, I walked into the house and saw this on the table:

America in a box!!!

So many wonderful things including American candy and various amazing goodies from Target and Trader Joe's!!! 

Feeling blessed. :)

a little goes a long way

In surgical residency, I didn't spend much time in the kitchen for various reasons: I ate at least 2/3 of my meals at the hospital, where I was given free food from the cafeteria. We lived in downtown Seattle surrounded by restaurants (although we didn't eat out much) and grocery stores. I was too tired when I got home from work to cook...and I had too much hospital-related work to do at home. Bottom line: cooking just wasn't worth the time and energy when already-made, affordable food was so easily accessible. Here in Africa there is no free hospital food. No restaurants. No real grocery stores (although we do have a small store that is open 2 hours a week and sells some handy things like flour, canned vegetables, ketchup, ramen, and nutella). If I want yogurt, I have to make it. Ground beef? Grind it. Cinnamon rolls? the only option is to bake them. You get the idea.

When I can summon the energy, cooking and baking has become one of my most frequent forms of "entertainment" around here. Its challenging. Its interesting.  The end results are highly appreciated by my husband (and me).  :)

Thankfully,  wonderful people find ways to send us hard-to-find supplies to supplement our cooking...like liquid smoke, canned salmon, vanilla flavoring, spices, marinades, mustard powder... having just a teaspoon of vanilla flavoring or some cream of tartar can make all the difference! :)

Cheese is expensive and has to come from the capital city... either by plane or a 6 hour drive. I knew I loved cheese...I just didn't know how much until it became a luxury food item!

Crock-pot enchiladas (with taco seasoning from the USA)

Abdou's spicy chicken and mac&cheese (made with mustard powder, cheese powder, and a bit of real cheese)

We do have a few convenient food options. We order samosas delivered to our door every Thursday and cooked chickens on Saturdays.  Also, a sweet lady, M, spends a few hours cooking for us on Thursdays. She usually makes tortillas and sometimes bread or beans & rice.  The rest is up to us. We are figuring it out. We are learning to enjoy more of the food we can get around here...like roasted peanuts, coconut bread, and spicy chicken. I am learning to use homemade yogurt  "cheese." And we are trying new recipes.

MMMmm...smoked salmon/cream cheese omelet...kind of like he used to order at our favorite Saturday morning breakfast place in Seattle.