Monday, March 7, 2022

Arrived home safely

 We arrived home safely and are COVID negative!  A few travel issues required us to come home 2 days earlier than planned but we are grateful there were no major issues.

As I reflect on the month, I see God's hand on so many details.  He orchestrated patients to be seen, all the help I needed in clinic, and miraculously healed his people. I am grateful for my neurosurgical colleagues who were so helpful on several cases.  Enock had a benign growth in his sinus that was impinging on his eye and brain.  He underwent excision of the mass.  It was quite difficult to remove but we were able to save his eye and there was no cerebral spinal fluid leak.



I enjoyed teaching the general surgery resident assigned to me.  His name is Yves, from Burundi.  He tells me his height is a trait found in his tribe.  He certainly learned how to handle trauma this month.


There are always the cases that break my heart.  Shown below is an 18 year old male and his older brother who came to clinic early in my trip.  They had traveled far to get help.  They had no money and no place to stay locally.  Fortunately his care was covered by student health insurance.  Ricky presented with left ear pain and decreased hearing.  On exam he had fluid behind his left ear drum.  He also had a large mass in the back of the nose suggestive of a malignancy.  His scan showed a large unresectable mass.  We did a biopsy and connected him with the oncology team who will likely treat him with chemotherapy and radiation therapy.  He is going to have a difficult course ahead of him.  We prayed for God's healing power.



The hearing aid business was a blessing as usual.  I was able to fit 10 patients with hearing aids this trip.  I had some powerful aids donated from a hearing aid company and these were perfect for my severe hearing loss patients.  I connected with a deaf interpreter and was able to fit 2 teenagers that had profound hearing loss.  This was the first hearing aids these kids owned.  We were also able to connect them with sign language school which will give them another tool to communicate with in school.




Thank you for your prayers and support.  I look forward to sharing God's faithfulness now in the states.  I am planning on returning again in August.  

Blessings,
Chase Miller

Tuesday, March 1, 2022

God Heals!

 What a blessing to be part of all God is doing for His people at Tenwek Hospital.  I continue to be amazed at how well patients recover despite lack of updated equipment, substandard sterility, and minimal instruments.

This is the young girl we operated on for the cerebellar abscess and chronic ear infection.  She is fully recovered with no permanent deficits.  God's miraculous healing power!

I have seen lots of trauma cases this trip.  Not only road traffic accidents but also tribal violence.  The panga is the weapon of choice in this area.  The deep belly adds weight for slicing even through bone.


This elderly women was assaulted with a panga weapon which sliced right through her mandible bone (lower jaw).  Her husband was killed.  She came to us for repair 6 weeks after the injury.  She was unable to eat because of the malunion of the mandible bone.



The next gentleman sustained a panga injury to the face.  He presented with facial paralysis and a large laceration that was closed at an outlying hospital about 48 hours prior to presentation.  With close examination there was slight movement of his lower lip so I know the main trunk of the nerve was not severed.  He underwent exploration of the wound.  We were able to find the distal branches of the upper face that were severed.  We then identified the main trunk of the nerve and followed this to the area of trauma.  The nerve branches were sutured together which would give him better chance of recovery.


He had a recovery I can not explain medically.  It usually takes 1 year to see recovery of the reanastamosed branches.  Post op day 1 he had almost complete recovery where he was paralyzed prior to surgery.  God is Good!

We are preparing to leave now. As always it is so sad to be leaving such a beautiful country and wonderful people.  I have promised to come back soon as there are some many others that need treatment.

Thank you again for your prayers!

Chase









Wednesday, February 16, 2022

 


Otolaryngology and Neurosurgery have been intersecting this trip!  Aaron and I were able to work together this week on a combined urgent case.  Young 18 year old with a brain abscess secondary to a chronic ear infection.  We worked long and hard but praise God she is doing well. This is only by the grace of God as I usually do my ear surgery under a microscope.  This week I have been using my operating loupes which are only 2.5 magnification.  


Road traffic accidents are a common occurrence here.  Motor bikes are the cause of most of the accidents. Although all drivers most have helmets, the law does not state that helmets must be warn.  This 25 year old man sustained a head injury and complex facial fractures.  I spent most of last Friday repairing his fractures.  In my 1.5 weeks here I have seen 3 other patients with facial fractures.  I will be repairing the next patient's fractures on Friday. 

Clinic has been a busy place.  This year I have had some added help with a nurse, clinical officer, and a surgical resident.  We have been fitting hearing aids which is a huge joy.  Patients are so thrilled to be able to hear again.  I received some really great aids as a donation from a reputable hearing aid dealer.  These aids have been extremely helpful for the profoundly deaf individuals.

Next week I will be training our new ENT Clinical officer.  He is completing 2 years of schooling to work in the ENT area.  I think this will really help us as a department get more organized with scheduling surgeries prior to our arrival.

Thank you for your prayers and support.  I couldn't do the work without you.  Please continue to pray for healing for the patients.  Pray for my general surgery resident that he will learn the skills he needs to practice in the future.  

God Bless you,
Chase Miller

Saturday, February 12, 2022

Getting 'out and about' again!

 

Setting up some filters for the headmaster of Tirgaga Primary and Secondary schools!  He wanted to treat me with a gift so he went out back and cut some bananas from his banana tree!  It's pretty amazing how so many Kenyan families are self-sufficient with their land and what they can grow.


Had a wonderful visit with some of the teachers and students at Tirgaga Schools.  This is a photo of some of the teachers with their new filter and tap.  I drilled 5 extra buckets for them with taps.  They were very excited to have the filters, they had actually been struggling with Cholera recently with many children falling ill.


The secondary school has 60 children while the primary school has 300 children.  I was able to set-up more filters and taps at the larger primary school.  The photo below shows us having some fun with the younger children.  We were having a whistling contest!  The headmaster later told me that the children hadn't laughed like that in some time - he said it was good medicine from the mzungu (white person).


The children had fun touching my hairy arms!  Not many white people come through this area and when I arrived classes stopped - I was a major disruption!  Nehemiah, the head teacher was very encouraging to me telling me that this visit will have an impact on these children.  He told me that they now will go to the maps in their classrooms and locate Rochester, NY and Lake Ontario and have more conversations about where I came from.

I was asked to pray over the children and bless them - this is a public school!  My time at Tirgaga was such a blessing and it was wonderful to see and hear the name of Jesus being proclaimed!

Thank you to so many people that have given towards the water filter ministry - many, many people are now receiving clean water in the name of Jesus!

PS:  Chase and Aaron will be posting soon - they have been very busy in the hospital - please keep us in your prayers!  

Asante Sana,

Jimmy

Wednesday, February 9, 2022

We made it!!

 We made it safely to Tenwek Hospital but not without a few surprises along the way.  Our first flight from Rochester was delayed for ten hours which would've made us miss our flight to Nairobi, so we were able to hop on a Delta flight which actually left a half hour earlier than our original Jetblue flight!  Thank goodness we went to the airport early - thank you Lord!

Met up with Aaron at JFK and our flight took-off on-time and flew 14 hours to Nairobi.  Landed at 11:15am Kenya time, wiped off the dreaded 'X's' on three out of six bags that security would inspect and sped through security!  Thank you Lord!  Went outside to meet our driver, but no one showed!  Thankfully we've done this trip enough and have cell numbers of the Samaritans Purse drivers and eventually got our ride.  We did our shopping in Nairobi and then got on our way.  

Tuesday was our first full day and Chase and Aaron got right into the thick of it.  Chase saw 18-20 patients and Aaron observed about 10 hours of Neurosurgery!  We are beginning to feel a bit more normal adjusting to the 8 hour time difference.  Jimmy continues to make plans for trips and has already given away and set up 20 filters!  We keep leaning on the Lord for everything and trust Him in all things!  Thank you Lord.

Thank you for your prayers!  More to come.

Peace and blessings,

Jimmy, Chase, and Aaron

Saturday, February 5, 2022

Feb 6-March 4 Tenwek Hospital trip



 


TENWEK HOSPITAL February 6- March 4

 

We are preparing to leave for Tenwek Hospital in Bomet, Kenya.  Jimmy, Aaron and I will be traveling to Kenya together.  Jimmy will have a 10 day trip to focus on water filter distribution in schools and churches.  I will have the joy of working alongside my son Aaron as he serves with the Neurosurgery team for the month.  I anticipate a busy trip overall as COVID restrictions have prevented many short-term missionaries from traveling. God has been blessing the hearing aid ministry so I plan to fit 30 hearing aids.  I will be training a general surgery resident and family practice resident on this trip. 

 

2 Corinthians 9:8-11

“And God is able to make all grace abound to you, so that in all things at all times, having all that you need, you will abound in every good work…You will be made rich in every way so that you can be generous on every occasion, and through us your generosity will result in thanksgiving to God.”

 

We are so grateful for your partnership as we serve those in need of medical care.  Your prayers lift us up as we travel, care for patients, and preach the gospel.  We are the feet but you are fanning the flames with your intercession. May God abundantly bless you for remembering us.

 

Specific intercession needs include prayer for health; this seems to be an area the enemy loves to attack.  We are asking for wisdom and discernment in choosing patients for the operating theater. I cannot explain the intensity of the struggle I have in this area.  The patients have diseases far beyond what we see in the US.  I am often operating beyond my comfort level and relying on God’s guidance as I work.  We ask the Lord to bring those that do not know the Lord to us so we may reap a harvest. Jimmy will need divine appointments to distribute water filters. We also pray for the long-term missionaries that we can bring encouragement and relief.

 

In Him,

Chase, Jimmy, Aaron Miller

 

https://www.purewaterforafrica.org

www.samaritanspurse.org

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You can find me under ‘Chase’

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