Saturday, November 6, 2021

WEEK 2 KIJABE HOSPITAL



Operating Theater Staff

My second week I definitely felt more comfortable with how the system worked at Kijabe and in the operating theater.  The anesthesia team and surgical techs were a huge help.  They knew their equipment well and were amazing at improvising when needed.  Although the instruments were not what I am used to I honestly don't think it affected the surgical results at all.

I spent my time in the operating room each day.  We performed a bilateral cleft lip, several sinus surgeries, cleft palate repairs, tracheostomy and even a fat graft to the left cheek.  Several of the cases I will always remember.  

Alex was a 17 year old boy who presented with a large sphenoid sinus mass. the sphenoid sinus is in the back near the skull base. The mass had eroded all the walls of the sinus and he had become blind in 2019.  He had debilitating headaches in addition.  The plan was to biopsy the mass.  His brother of 23 was caring for him and was informed that the surgery would not restore his sight and would likely not improve his headaches.  We would try to get a diagnosis for him.

Ct scan of large sphenoid mass

I was concerned about bleeding and cerebral spinal fluid leak.  The lighting was poor and the bleeding was enough to make it difficult to see well.  Another danger factor!  But I perservered and entered into the region of what I thought was going to be slow growing tumor.  But praise God he had a massive mucocele.  These can form in the sinuses and cause slow expansion and pressure on surrounding structures.  The cyst was widely opened and drained.  This would cure his headaches and prevent any further damage to his brain.  The day after surgery Alex was headache free and going home with his brother.  What I learned- "Trust in the Lord with all your heart and lean not in your own understanding.  In all your ways submit to him and he will make your paths straight." The Lord drew him to Kijabe not for a biopsy complicated by bleeding or CSF leak but for a healing.  I had the opportunity to share with Alex and his brother how the Lord was providing for him.  Although he is still blind I know that God is watching over him.

Below is one of the precious cleft lip children we operated on.  He has a bilateral cleft which involves both sides of his lip.  These are much more challenging to reconstruct. This family traveled 5 hours for surgery.  He had a long surgery but is recovering well


On my last day, we rounded on a 34 year old female who had arrived hours earlier.  She had a large thyroid mass compressing her trachea and making it difficult for her to breath.  She has been seen at another hospital several weeks before where a CT scan showed a highly malignant thyroid cancer.  She would die without a tracheostomy (breathing tube in the neck).  This would not be easy with this large mass obstructing her trachea.  We prayed that God would have mercy on her.  We were able to get the tube in place and do biopsies to help us determine if she would be a candidate for further surgery.  God proved faithful again despite our fears of the difficult situation.

I am ending my week in awe of God's faithfulness.  He will never leave us nor forsake us.  He makes a way for us. 

"So do not fear, for I am with you;  do not be dismayed, for I am your God.  I will strengthen you and help you;  I will uphold you with my righteous right hand."

Thank you for your faithful prayers- They worked!!
Chase

Sunday, October 31, 2021

First Week at Kijabe Hospital



  


I arrived safely to Kijabe, Kenya last Saturday at 7pm.  I left Rochester at 7 am Friday morning so it was 36 hours of travel!  My luggage arrived and there was no inspection for which I am so grateful.  My least favorite aspect of the journey is shopping in Nairobi for supplies.  This was especially difficult as I have not worked at Kijabe previously so I did not know what would be available.

 

Monday started a busy week.  I operated 5 days and can say I am now comfortable with the way the operating room flows.  The staff have been wonderful and are quite knowledgeable in the typical ENT procedures.  The cases I have been performing are back logged surgeries from the missionary ENT who has been overwhelmed with work.  I have performed a number of surgeries from cleft lip, cleft palate, reconstruction of ear tympanic membranes, mastoid surgery, tonsillectomy and ear tubes.  

 

 

The cleft lip repairs are always such a blessing to perform.  Although technically challenging the surgeries are transformative for these children.  The deformity is considered a curse in this culture but God’s redemption is so evident through this surgery.  Below are several of the kids we operated on this week.  Smile Train is providing the funding for these surgeries.


 

 


    This weekend after rounds I was able to walk to town to purchase some supplies needed.  The locals sell their goods in a market and at Duka’s.  I was able to purchase my vegetables and eggs for the week for $3.00!  I continue to learn the art of cooking in Africa.  Some tips I have learned are don’t put your vegetables in the refrigerator- they will freeze.  Hang them in baskets in the kitchen where the cockroaches can't get them.  Gather long sticks in the woods to light the propane stove so you don’t burn your hands! 




 This week is another busy week full of surgeries each day.  Continue to pray that God will select patients for the surgeries.  That He will be the surgeon directing my hands.  That the patients will find healing in this place.  I am counting on you holding up my arms in this battle against sickness and disease.  Fortunately, we know the battle is already won!!

 

Thank you for joining me in this venture,

 

Chase

 

Thursday, October 21, 2021

Kijabe Hospital, Kenya

 


KIJABE, KENYA  10/22–11/8/21

 

I love this photo as it depicts how I am clinging to Jesus as I prepare for my next trip.  Kijabe is a Christian mission hospital and a large referral center for central Kenya.  They have had a team of three Otolaryngologists in the past but are now down to one with a long surgical queue.  Many of the surgeries are cleft lip and palate.  I am hoping to give a much-needed rest to the one remaining Otolaryngologist.  Kijabe means “wind,” and its name is fitting because the times I have served at the nearby AIC Cure hospital, the weather has been cool and windy.  The main tribe served is Kikuyu, but I understand that many from Nairobi travel to Kijabe because of its good reputation.  A nearby cemetery houses missionaries from the 1800s.  History tells us that part of the missionaries’ preparations were to have all their teeth extracted to avoid deadly dental infections prior to the antibiotic era and to travel with a casket knowing that they would never return! 

 

My greatest need for this trip is your prayer support!  I will be bringing only a short list of supplies I feel I can’t go without.  I will be relying solely on the surgical instruments at Kijabe.  I expect to be involved in a number of different surgical cases and as always, need prayer that Jesus will be the surgeon, and I am just a tool in his hand.  Below is a number of other prayer requests:

·      Safe travels and arrival of luggage without tariffs

·      Protection from COVID and other illnesses

·      Adequate sleep

·      That the surgical cases being lined up are chosen by him

·      That God would heal his people

·      That he would prepare hearts to know him as Lord and Savior

 

1 Peter 4:11: “If anyone serves, he should do it with the strength God provides, so that in all things God may be praised through Jesus Christ.  To him be the glory and the power for ever and ever.  Amen.”

 

My biggest prayer of all is that God will get the glory.  Thank you for your faithful prayers.

 

Chase Miller


Tuesday, August 10, 2021

2nd week

 It always seems to take a week for me to adapt to the pace and cultural differences at Tenwek.  I feel over my head in numbers of patients.  Each step I take is often interrupted by a medical question from a local or staff member.  My agenda needs to be to take care of the person in front of me.  I can not plan on a schedule or anticipate the next medical problem or surgical case.  And yet I can trust that the Lord is guiding my feet and bringing those to me that He desires me to care for.  I can trust that He will never leave me or forsake me.  That He has not called me without equipping me.  But when I look at the problems before me it is hard not to wonder "why me?".  There are so many others that are more capable.  " His power is made perfect through my weakness"!  Where I am weak, He is strong!


Joy

Joy is a 1.5 year old with 3 weeks of post auricular swelling and irritability.  Mother denies ear drainage or history of ear infections.  CT scan reveals findings of abscess and mastoiditis.  This infection began in the ear, spreading to the bone behind the ear, and into the tissues behind the ear.  She underwent urgent mastoidectomy.  This is not a procedure normally performed at Tenwek.  I was able to use the neurosurgical microscope and ear instruments that I have stored in our ENT cabinet.  God was faithful to lead me through the surgery.  Joy is still in the hospital getting IV antibiotics and awaiting culture results.  She is feeling much improved and we give all honor and glory to the Lord!

Meshack

Meshack is an 8 month old with a large swelling in the floor of his mouth left side plunging into his left neck.  He is growing and eating well but the mass is enlarging and encroaching on his airway.  His family has been unable to pay the monthly fee for national health insurance so his medical care needs to be paid by family members.  They could not afford any preoperative evaluations.  He underwent surgical removal of the cyst which was a ranula.  This is a cyst arising from a salivary gland in the mouth. The cyst was large and plunging into his neck.  All went well and Meshack was able to be discharged post op day 1.  His hospital bill was paid for by generous donations raised prior to our trip!


This young man was found on the side of the road struggling to breath.  He was taken urgently to the operating theater where he was found to have a partial tracheal transection.  The weapon was blunt, tearing through the tissues of the neck and airway.  He was fortunate in that the trauma had created a breathing passage and his voice box was spared.  We performed a tracheostomy and repaired the torn trachea.  He is recovering well on the wards.  We are praying for him and the chaplains have been seeing him to provide support.

ENT Clinic was especially busy this year.  we saw between 30-45 patients on each clinic day. We held an extra hearing aid clinic on our last Saturday in order to accommodate everyone.  Overall, we fit more that 25 hearing aids to grateful elderly and children that were hearing impaired.  This ministry has grown to the point where we need a separate hearing aid provider when we return in February.  

I am so grateful to the Kenyan general surgery residents who worked hard to help care for the onslaught of ENT patients in clinic and the operating theater.  It is a privilege to join in the great work that is being done at Tenwek Hospital.  God has built a mighty place of healing for his people here.

Thank you for your faithful prayers.  We could not do this work without you lifting are arms in the battle!

chase miller






Thursday, August 5, 2021

Visit to Kitoben Children's Home

 This past Saturday we ventured over to Kitoben Children's Home to visit Alice and Samwel, who run the home, and all of the children.  Every visit we make we see some new changes to the school.  They have completed a beautiful, multi-purpose dining hall that will serve both the home and the school.

                                                Here's a pic of the outside of the new building:



           This is Alice and Samwel Langat - they started and continue to run the home and the School.

Here's a short video right after Isaiah gave the children a couple of soccer balls.  Notice that a cow shares the space with the kids!

One of their greatest needs now is to build a new, larger latrine on the school compound which will cost about 350,000 KES or about $3,500.00.  The government now requires all schools to have a quarantine space for children that come down with COVID, which is another added expense for the schools.

The children are well here and are loved by Alice and Samwel.  They constantly teach the children about Christ and what it means to follow Him and to serve Him.

                                               Here's a pic of the inside of the new building


Please keep them in your prayers!

Peace,
Jimmy

Sunday, August 1, 2021

Hearing Aids

 Isaiah here! 

 At the end of this first week at Tenwek, I've had the chance to look back and reflect on the experience thus far. And it's been amazing. My time has been split between two main paths. First, I have been shadowing some doctors in the operating room and am truly experiencing first-hand the ins and outs of surgery. I have witnessed parotid tumor resections, tonsillectomies, pituitary gland tumors resected through the sinuses, cataract surgery, and more! A great part of watching these surgeries is the preparation I can do pre-operation. I have read about the surgeries beforehand and grasp, to some degree, what is going on and the anatomy involved. The doctors have been great resources and have helped me learn a large amount in just a span of one week.

 The second focal point of my time at Tenwek, which I would like to highlight, are clinic days. Here, I have been assisting my mom in her ENT clinic performing various tasks. Most importantly, I have had the opportunity to head up the hearing aid distribution, under the jurisdiction of Dr. Miller, of course. My responsibilities span from first administering a hearing test to a patient to actually fitting them with a hearing aid. This ministry has been a great blessing. The Kenyans are extremely grateful and nothing beats the smiles that come when a son or daughter speak softly to their parent and they hear clearly for the first time in many years. 



The man shown above is 60 years old with bilateral hearing loss. He was fitted with a hearing aid for moderate hearing loss in his left ear. While the language barrier does present some issues when explaining how the hearing aid works or how to take good care of it, nothing hindered the gratitude this man showed when the aid was turned on and he could hear someone talking from across the room. A large smile broke out on his face and his hands were clasped together as he repeatedly exclaimed, "Yes! Asante! Thank you!"

Everyone who comes through the ENT clinic receives prayer over them. We have such an opportunity to spread the Word here and give the glory to God for how He works in our lives and the Kenyans. While the hearing aids we supply grant physical hearing, we pray that each who receives will also proceed to hear the Lord. We pray that each individual will hear the calling of Jesus and become one after His heart and goodness. I am constantly amazed by the Kenyans' faith, perseverance, and gratitude. I hope to model this as I grow as a person and in my relationship with the Lord. Thank you to all who have made this ministry possible and I cannot wait to share more in the upcoming week!



All the best,

Isaiah 

Friday, July 30, 2021

Week 1

 Week one has been full of surgeries and clinic visits.  I am always amazed how the hospital staff have no idea I am coming yet within two hours of starting my work the word is out and a line is forming.  The need for ENT services is so great here it is hard to walk from one end of the compound to the other without getting stopped several times to diagnose a staff member's problem.  

On Monday, my the surgical team had prepared a patient with a large salivary gland neoplasm.  This had previously been partially removed but recurred soon after her last surgery 4 years ago.  It was steadily growing and there was concern for malignancy.



Surgery was much longer than expected and very difficult.  Praise God that she is doing well with all tumor removed and no nerve damage.  She was discharged today praising God!

The remainder of the week has involved 2 days of clinic and 2 additional days in the OR.  We have repaired a complicated mandible fracture from a boda boda (motorbike) accident.  Today we operated on a patient with a large facial cyst which went well.  Clinic has had a variety of patients with tonsillar issues, hearing loss, tumors of the jaw, voice box and neck.  We have been busy fitting the hearing loss patients with hearing aids. 


I have had 2 general surgery residents to teach this year which has been a real blessing.  They are so skilled and are hard workers.  This may be the only ENT experience they have before they graduate so it is important to equip them with as much experience and knowledge as possible.  God is training them up for many "acts of righteousness for His names sake"!

Thank you again for the prayers.  I need everyone of them.
Chase Miller