Merry Christmas!

Here is our Christmas letter some of you got via snail mail :) Thought this could jump start my blogging with more to come later...I hope! 

For to us a child is born, to us a son is 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

                  Consistently through God’s Word, we are told to remember & recall what He has done & where He has taken us.  Well, in just over a year, God has taken us on quite a journey.  J Shortly after getting married, we found out that God not only planned to bless us with marriage, but also with parenthood.  Our friends jokingly wrote “Happy Negative Nine-Month Birthday, Baby Reimer!” on chalkboards at our wedding…we’re thinking God just had a smile on His face because He had already planned on this!  Nine months later, Ezekiel James made his grand appearance & captured our hearts…and the hearts of many—he’s quite the charmer already, just like his dad. J

                  Prior to Ezekiel being born, God had a few things in store for us.  Sean had just finished medical school the week before we got married, making it possible for him to be in Kansas with me as I continued my residency training.  For Sean, early winter held interviews for General Surgery residencies, studying, mastering his culinary skills, and just loving & taking care of me. 

Late winter, we had the opportunity to escape the cold & go with World Medical Mission to Angola & Zambia in Southern Africa.  We spent 6 weeks working with Dr. Steve Foster in Angola, & then just over 2 weeks in Zambia with Sean’s parents.  Both places have helped shape who Sean is today & play integral parts in where we are going as a family—so it was important for me to see & experience.  God taught us many things while there not only medically, but also spiritually & relationally. 

While in Zambia, we found out we were going to be moving to Ohio this past June for the start of Sean’s surgery residency training.  In June, I placed my letter of resignation without knowing if or when I would be able to complete my training, & we moved 1,000 miles East to our new home.  Sean then started residency July 1^st & Eze was born July 2^nd. 

                  For the past 5 months, I have thankfully been able to stay at home with Eze.  It’s been a huge blessing & joy.  Sean has been working hard, enjoying work, & doing well.  Things are soon to change as God has opened some huge doors for me to resume my residency training here starting in January—just 16 months to go.  Once done, I will hopefully just work part-time with my main focus being taking care of my boys. J  We know these 16 months will not be easy, but are trusting that God will provide as we have peace He is directing our steps.

                  As Christmas approaches, we are not only enjoying recalling what God has done & looking forward to what He has in store for our family, but are rejoicing as we remember God’s greatest gift—Jesus Christ, our Savior & King.  May His light & love warm your hearts with peace & joy this Christmas season.  Merry Christmas & Happy New Year!

In His Grace,

The Reimers

The White Rhino :)

Our Final Time in Africa...This Time :)

We were driving along a scenic African dirt road that happened to be through a game park while enjoying seeing the impala in multitudes with occasional warthogs and others.  It was a few hours into our trip when we came across a baby duicker (a small antelope) drinking in a puddle in the middle of the road.  It did not seem too afraid of the car, and we managed to drive right up to him.  I then had the idea that maybe I could jump out and catch him…  So I jumped out of the car and dove into the bush after the little guy.  After a bit of a fight, I managed to subdue the beast and bring him back to the car for a photo op.  Then I did something I have never done before…I released him.  Normally a nice young one like this makes for very nice meatJ   I’m not sure what the little pink doll thing is that I was holding:)

Our time in Angola finished well.  It all seemed to go by so quickly as these things often do.  It was a great time for us as we think about the future and see what it could be like to practice medicine off in the bush somewhere.  God has His ways of leading us and we are confident that He will guide us the rest of the way as we continue with our training in the States.   

After Angola we made our way to Zambia to visit my parents and give Ashley a chance to see where I grew up.  We had a great time and were able to spend several days out at Mukinge Hospital where I was born and spent 17 years growing up.  We worked for a few days in the hospital and had one good day in the Operative Theater.  We were able to visit with old friends and see many of the places that I’ve always talked about.  We were then able to go down to Livingstone and visit Victoria Falls.  We had a really nice few days down there enjoying the game park where we managed to walk right up to a big old white Rhino (a first for me).  During our time in Livingstone we also found out where we will be moving for the next 5 years.  The big residency match happened on March 17^th and we found out that we will be moving to Youngstown, Ohio where I will be starting my General Surgery Residency.  

We are amazed by God’s goodness to us and are excited to be starting out on this next path.  We will move to Youngstown in early June and begin my residency not long after…and some time in there we will become parents:)  It’s a lot of stuff but we know God has His hand on us and will continue to be with us as we move forward.

Thanks for reading, and for your thoughts and prayers.

Sean and Ashley

Frustrating Moments

Before coming to Angola, I had never thought just how frustrating medicine could be here.  Being in my 2^nd year of residency, I’ve learned a great deal on how to practically diagnose patients, treat them, and fix what’s going wrong with the resources available in the States.  I’m beginning to realize just how much I’ve taken it all for granted.  I knew things would be limited here, but just not how limited…  Last week, within 2 days, 3 patients died—2 older adults and 1 baby.  The older man died because of severe kidney failure.  He presented with acute urinary obstruction due to a big prostate.  A Foley catheter was easily placed to empty his bladder, but he was dehydrated and his kidneys had already taken a hit.  He had labored breathing due to all the acid build-up in his blood.  He needed fluids and lots of it.  He wasn’t with it enough to actually drink it.  An IV was placed but one could never placed that gave him fluids at a rate even close to maintenance—nothing that could actually help him out.  He likely had electrolytes out of balance, but we can’t test for them and don’t have the medicine to replace them anyways.  Within a couple days, he passed away.  Really he just needed something as simple as IV fluids, which couldn’t be provided.  It was very frustrating to watch.

The other older patient was an elderly lady with advanced inflammatory breast cancer.  I’ve never seen anything like it.  We had done a bilateral mastectomy down to nearly her ribs just for palliative care.  The wound was left open with dressing changes every day.  The thought was eventually to do skin grafts to cover the muscles and bones, and then let her live her last days at home—with her type of cancer, how advanced it was, and our limited resources, she had maybe a month or 2 to live.  Well, in her recovery, she contracted malaria from the blood transfusions required (50% of blood given has malaria), she then developed a septic-like picture, and just did not do well.  We have no means to increase calorie and protein intake besides encouraging eating.  We had no means to make her anywhere well enough to promote healing.  And then her wound started to smell—it was just a heart-breaking picture.  We were hoping her family would take her home for further care and dressing changes, but that never happened—they assumed we could somehow make her better…

And the baby that died…  We aren’t quite sure what happened.  His parents brought him in with sudden respiratory distress.  He had been diagnosed with malaria 2 days earlier.  He had been given the proper treatment…along with some other antibiotics for an unknown reason—there were no records available to see what the doctor had been thinking.  Anyways…he came in slightly blue, but his chest sounded clear.  We tried to get an x-ray but the developer wasn’t working (eventually it did 2 hours later) and the ultrasound machine was broken.  We had no way to do any type of imaging.  We couldn’t get an oxygen saturation or vitals really because he was 3 months old and they just have older kid and adult-sized instruments to take them.  We were able to give oxygen and he did seem to improve.  We did get blood.  His malaria was still positive and he had 44% bands on his white blood cell count—meaning he was infected with something else, but with what we couldn’t figure out.  He seemed stable when we left that evening, but suddenly died later that night probably due to malaria, but only God know what else.  Malaria does seem to take the lives of the young, old, and pregnant.

Although frustrating at times, good things and amazing things are happening here.  Many do get better.  People who would otherwise get no help are getting healed and helped for the better.  What can be done on limited resources is done.  (Just wanted to add some light at the end of the gloom J)

Right now, Sean and I are in Cavango.  It was nearly a 12 hour drive on some rough roads at times—500 km from Lubango.  Cavango is quite out in the “bush” and is a beautiful sight off a major river.  Since it’s the rainy season, things are very green and lush.  Cavango has a long history with the Foster family.  Currently, Steve’s youngest sister, Shelley, and her husband are living and working here.  There’s a medical clinic—which Sean helped build nearly 5 years ago with Samaritan’s Purse.  They’re working on making a hospital here.  Over 60 years ago, foreign help started here with a leprosy colony.  Steve’s dad, Dr. Bob Foster came in the 1970 and developed a hospital with more of a mission station, and stayed here for a number of years…  Then the war started and all was destroyed.  There were many brick homes and such that are now just foundations with piles of bricks amongst the bush.  Now, the Fosters, Samaritan’s Purse, and Advancing the Gospel in Angola are working to develop this mission station once again.  We’ll be doing a medical clinic here for at least one full day (nurses do all the consults now) and fly back on the MAF plane.  It’s so refreshing being out of the city with fresh air amongst God’s glorious creation.

We only have 1 week left here in Angola—we leave on Thursday.  Time has definitely flown!  We’ve sure enjoyed our time here.  God has been teaching us many things about Himself, ourselves, and what He’s been doing and is doing.  And, of course, we’ve been learning plenty of medicine. J  Thanks for all your support and prayers.  We pray you’re all experiencing God’s goodness, kindness, mercy, love, and grace.  Until next time…cheers.

And our next week :)

I had blood all over my gloved hands and was wading through some small intestines looking for any signs of damaged or twisted gut.  This isn’t so great for the patient, but I was quite comfortable;)  Sorry if I’ve already spoiled your lunchJ.  The patient was six years old and had a fairly large umbilical hernia and some bad abdominal cramping.  We were worried about a strangulated hernia in her and consequently explored things a little bit before we fixed the hernia.  I ran the whole gut and found everything looking quite normal, but then I noticed something was sitting inside her intestines and it was quite alive too.  She had a very large hook worm about 14 or 15 inches long and about the diameter of a drinking straw!  We fixed her hernia and treated her for the worm with medicine, which will die and leave her feeling much, much better. 

Ashley and I are continually challenged by the meager medical resources here in Angola.  We often wonder what we have to offer as we have gotten so used to the fancy things we have in the States.  It has been great to learn from Dr. Foster as he shares his wealth of clinical practice with us when we sit and discuss how to treat our patients.  Ashley has found that she has been able to help teach a young Angolan intern who has been learning from Dr. Foster and another Brazilian clinician who also works at the hospital.  Ashley’s strong emphasis in internal medicine has been a great asset on the wards.  We are both learning a great deal and it’s been quite helpful as we talk about our future and what and where we may end up. 

We cherish your prayers as we work and interact with patients.  We pray this finds you well and learning more of our Savior and what it means to truly pursue Him. 

   

Angola After One Week :)

So this is my first attempt at blogging...and my first trip to Angola :)  This is Sean's 4th time here...  We've now been here for just over a week.  Settling into things and still trying to find our feet/roles at the hospital.

For those of you who might have forgotten or just didn't know, Sean and I are now in Angola--SW Africa.  We're here with World Medical Mission working at hospital in Lubango for the a total of 6 weeks.  We're working with Dr. Steve Foster who is a surgeon here and has been for nearly 30 years (you can read the book Sword and Scalpel if you want to know more :)).  Porteguese is the official language--English is not at all spoken.  Spanish is kinda similar..so I can pick-up on a number of words, but am missing quite a bit.  Sean has been here enough that he knows a fair amount and is getting along well enough--which will only get better as we're here.  Anyways, I'm feeling quite at a loss with the language--hoping my ears will start picking more as I get settled in here...and that I'll learn some Porteguese along the way.

Right now, there's enough medical people here with doctors, residents, and med students that we've been able to divide up in teams.  Sean is on the surgery team and I'm on the medicine side.  We all kinda end up working together regardless.  I've been seeing a whole lot of malaria and Sean all kinds of things.  The first week was a short one.  Friday was an official country holiday and we all had the day off.  AND then of those first 4 days, I was at the hospital for 1.5 days, and home sick and then recovering for the other 2.5 days.  We're thinking the combination of some virus, the pregnancy, all the traveling, being in a new place/culture, and going virtually nonstop since the beginning of November all equated to me getting sick.  But no worries, I'm all better now and even feeling better than I have since arriving :)

We're currently spending the holiday on a "farm" about 4-5 hours drive from Lubango (but only 200km).  It's really just African bush, but is a farm by definition here in Angola--nothing like what I'd think of back in Nebraska/Kansas :)  Mainly raising cattle, starting a game park, and it'd be hard to explain what all is going on here---there's a clinic, church, the wife's a vet (Donna), many different families living on the farm and raising the cattle, and it's just beautiful.  The farm belongs to Steve's brother, Stirling, and his family.  Uncle Bob Foster and his wife are here living their last days at this home...  Sean has been here many times in past...so nothing new here for him except additions made since his previous visit and the 2 kids are growing up...

Well, that's probably enough writing and reading for now :)  We'll be trying to keep the updates coming, especially as some more interesting/exciting things come along...  And we're definitely coveting any and all prayers coming this way. :)

Ashley (for the both of us)