Sunday, July 02, 2006

And more...

Hi all,

Thursday and Friday were fairly busy days with a sufficient amount of crisis. Thursday lots of sick babies...Ais mostly dealt with them so she can tell you. I think there was 3 maybe 4 births that day. All fairly straight forward except for the last one. Was able to get some more suturing experience which was good. The last delivery of the day was one that we thought would be short and sweet before we went home (well of course it didn't work like that!). The baby needed some resus after delivery (completely flat)...after 30sec including stimulation and PPV the baby came around just fine. Meanwhile the woman who had delivered started to hemorrhage...very boggy uterous. She had already had active management and had an IV in already so we gave more oxy and Cathy did bimanual compression...this worked well and the fundus firmed up and bleeding stopped. She also had a very ragged tear that Cathy and Mickey ended up suturing...due the complexity, tiredness and time. We probably left the hospital 2 hours later than expected...oh well. Another big thing that happened on Thursday was this woman who had been in since Monday with Sepsis and a three week intrauterine death (who had been given multiple doses of misoprostol and prostaglandin)...and was extremely sick (high temp and pulse...looked on deaths door)...finally went into surgery to get a hysterotomy (a procedure that's kind of like a classical incision c-section to take out the dead baby...I know this is all very grim). Anyways we saw this woman on Friday post surgery and although she looked dreadful her friends thought she would live...I hope so!! The obstetrician said he had never seen anything quite like it..or anything so bad. It was very bad and sad. Ahhh ok. Friday we went in for a short day as we were leaving that afternoon for Lake Mburo. Friday morning there was basically nothing going we just went around to woman we had delivered, babies and moms we had been concerned about to check up on them. One of the women who Cathy delivered wanted her to name her baby...a Muslim name...after talking with some other fluent English speaking Muslims Cathy came up with a name and did a little ceremony. Then...a couple hours before we were about to leave on vacation this 16 year old primip came into the delivery room. The delivery went well with a 30 min pushing phase, but then...her placenta would not come. It took 15 minutes followed by a huge gush of blood and a boggy uterous. I did bimanual compression, after inspection of the placenta we gave ergot (this did not help), set up an IV an 20 IU oxy then the bleeding stopped and the uterous was firm, but high and off to the side. Catheterized and then 10 minutes later it all started again. I expelled multiple huge clots and we did more bi-manual compression, hung another bag of fluid and oxy...then finally it stopped!! Mickey and Cathy then inspected the cervix (good to see how to do this) and looked for tears. She needed a small amount of suturing. Needless to say this was the biggest hemorrhage that Ais and I have had to actively manage. After an hour after our interventions her pulse went down to normal and all was ok. Thank goodness her baby was totally fine from the minute it popped out. We've been trying to figure out why the hemorrhage happened, but still no real answer. Having done hard work we headed out to lake Mburo. This was a wonderful little get away. A national park with a tonne of wildlife and a beautiful big lake. We stayed in Banda's with no electricity or washroom...very rustic and a nice get away. The restaurant was on stilts over looking the lake with hippos hanging out right at the edge of the water. We went on a day game drive, boat game drive and night game drive. I enjoyed the most the Warthogs, Zebras and many beautiful birds. The boat outing was magnificent. I saw my first real close ups of crocodiles...yikes! Skipped the walking game drive on Sunday and slept in and read my book (Nana..I'm reading the book you gave me..I love it). Now back again for another week...of I'm not sure what (we never seem to know). We will probably be here in Masaka till Thursday noon, then to Kampala for a day and then out with Cathy and Mickey for Safari again on the weekend.



Blogger Elaine Barnes said...

Wowsers! I am having so much fun reading all about your wild and whacky African midwifery adventures! Thanks so much for doing this blog. I would _love_ to do this placement next year. Enjoy the safari and take care of yourselves. You gals are gonna be stellar babycatchers for sure with all this experience! Please say hi to Cathy and Mikki too!

2:41 PM  
Blogger Unknown said...

Hi Elaine,

I'm terrible sorry to contact you through this blog. We are Andrea and Ricardo Gamero, you were our midwife and helped us deliver Mikaylah on October 10 2009.
We need your advice and we are wondering if you could be so kind of email us. We are looking forward to hear from you and your baby girl.
our email address is ahoude[at]shaw[dot]ca


Ricardo and Andrea Gamero

12:35 AM  
Blogger Beverly Ketchum said...

Hello - I was wondering if this is the same Elaine Barnes that delivered my first child in October 1981 at home in the city of Lawndale CA. I am part of a Community Based Doula program and thought it would be incredible to have you as one of our mentors. We are a pioneer program through the Health care bill and we are funded through grants and fund rasing events. We assist low income families that are at high risk and get other women to become Community Based doulas to serve their community. I would greatly appreciate a response. Thank you! Beverly

10:05 AM  

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