In less than 24 hours we fly out to the US for Luke's graduation. We leave about 30 minutes shy of Thursday and leave the US again on Thursday. It's a short turn-around. And like many of our trips, we're working full speed up to the last moment. So today was a somewhat typical day, and impending absence may be inspiring nostalgia, but I'm really proud of Kijabe Hospital today. The morning started with a call during rounds that the OB team was taking a mother for an emergency C Section due to cord prolapse. That means the baby's umbilical cord was coming out ahead of the baby, which would result in the baby dying. A midwife had her fingers up the mother's vagina to keep the baby's head from smashing his own blood supply and cutting it off, and they were wheeled together (midwife and mother) into the theatre for a rapid extraction. The baby (who also happened to be premature and HIV-exposed . . ) was a star. She is lovely and perfect, crying and active. A truly dramatic save, happy ending to what could have been a disaster. (The photo is from a later CS this evening with Scott. That baby was also one that would have probably died many places, with a cord-around-the-neck very distressed infant).
Mid-day, we got a call that another hospital wanted to send us a baby with gastroschisis, a defect in the abdominal wall so that all the intestines are spilling out and exposed to air. Bad news. However it was a nearby hospital, and this was the baby's first day of life, and they were coming with an ambulance transport, so it all sounded good. Even though we had 31 babies (WAY over capacity) at the time I said yes, because we have the only gastroschisis survivors in Kenya (4 so far I think). This baby rolled in with a temperature of 34 (that's COLD), unmeasurably low blood sugar, in shock, blue. And again I was so proud of our team. Within fifteen minutes we had that baby warm, sugars up, fluids pushed, bowel decompressed and covered, pink, on oxygen, and 100% improved. We were able to send him up to ICU for the night, and the Paeds surgeons will be managing his extruded bowel, slowly pushing it into his abdomen. He went from almost-dead to possibly-surviving . . . a complicated baby that got fast and effective care.
This is baby K on the day he was born with a severe skin condition called ichthyosis (we think), and today. He's been with us for just about two weeks. We really thought his condition was probably fatal but decided to give it our best try to keep him alive and see if we could help him. The change is remarkable. Just as we were settling the little one above, baby K's mom called that he had stopped breathing after a trip to the OR for a biopsy .. but he was quickly stimulated and OK. It's amazing to see that good nursing care, fluids, antibiotics, moisture, feeding have allowed such a dramatic transformation.
The preemie with the Rh-negative mom is alive and kicking, after three exchange transfusions he is doing very well, with relieved and thankful parents. Again, there are very few places in Africa where a 1.3 kg premature baby with dangerous and severe jaundice could emerge alive and well.
This little guy was brought to us starving from South Sudan after his mother died, and he's finally putting on a little weight and settling from his fevers. So sweet. And a little connection with our Mundri team (who is, at the moment, only Scott Will plugging away in the danger zone) and a way to connect and contribute to a place that has been dragged down by war again.
Perhaps not as cute, but something to be proud of, this growth chart on a 27 week preemie who has been with us for about two months. This is what is supposed to happen. Yeah.