My name is Jen Hathorn. I'm a family medicine physician. Since January 2015 I have been living in Egbe Nigeria, which is in Kogi State. I am serving at a bush hospital practicing full spectrum family medicine. I am working with an organization called World Medical Mission which is a part of Samaritan's Purse. This blog is my place to stay connected with you through stories, meditations and pictures. I hope that you enjoy reading the posts!
Tuesday, July 7, 2015
Her chest was heaving and a high whistled wheeze squeezed out with every breath she sucked in. With a voice miraculously intact she explained that for the past few days her breathing had become markedly worse. Two previous neck surgeries had left her with paralyzed vocal cords creating a constant fight against the residual effects. She insisted that she had only occasional issues with her breathing and it was never this bad. She knew this time it was different, she just couldn’t fight it anymore. Her eyes flashed signs of fear and anxiety as each breath was born out of great labor, the muscles in her neck straining to pull open her stubbornly unmoving vocal cords. In the emergency room we treated her with medicine and she improved a little. I told her that the best thing would be to transfer her an ENT (Ear, Nose and Throat) doctor and get her to a hospital that was better equipped to handle this case, but she didn’t have the resources to go…maybe tomorrow she said.
The night was dark and cool. I trudged down the lane to the hospital, glad for the cool breeze that woke me up. I had been called by the resident because her breathing was worse. Standing outside the women’s ward, a large cement building, I could actually hear her breathing. It sounded awful. I walked to the bed where she was sitting straight up leaning forward onto her bedside table desperately fighting to breath. She was visibly exhausted. I examined her and then started to discuss her case with the resident doctor never taking my eyes off her struggling form. Our choices gone, we had one option left - intubation! We urgently needed to bypass her vocal cords to provide an unobstructed opening for the air to get in and out, and we needed to do it fast. Once the decision was made the race was on. She was wheeled to the ICU by 2 student nurses, the nurse anesthetist was called and came down quickly, she was sedated and her muscles were relaxed with Propofol, and finally a tube was passed down her throat forcing open her treacherously stubborn vocal cords. For the next few hours we took turns squeezing the ambu bag 12-14 times a minute to fill her lungs with oxygen. As the sedation wore off she began to breath on her own and she struggled against the tube in her throat. Still experiencing that in-between state of awake and drowsy she was trying to understand what was going on. The more alert she became the more she settled down and then for the first time in days, she slept peacefully.
Morning dawned bright and warm. What a delight to see her sitting on her bed in the ICU with an endotracheal tube protruding out of her mouth trying to smile despite the tube! She went to the OR later that morning to have a small hole made in her throat so that a permanent tracheostomy cannula could be placed. She never stopped smiling. Even in the days that followed as we suctioned thick mucus out the tube over and over and taught her daughter how to clean and care for this new invasive contraption in her neck, she smiled! She was experiencing the happiness that only a person who had battled to the brink of death could know — freedom to breath.