Two Special Patients

Today is Monday here and i can't think of a better way to start the week in clinic. yesterday in church, i was stricken by how short of time we have here (only a month) and how much i'd still like to be used to share God's love with the Thai patients in the clinic. i decided, i'd try to be more open in discussing the Lord with patients today and was hoping for "divine appointments." well, they came...
A special lady was sitting in the room when Noi and I went in to start the exam. She was an elderly lady with her dark grey hair pulled back wearing a colorful woven skirt that was floor length and a blouse with flowers on it made out of silky material. you could tell she worked in the fields by her dry hands and sun beaten dark skinned body. her eyes gleamed above those high ridged cheek bones that the thais were specially created to have. i, of course, said "swadeekeah." i found out her reason for being there was that she fainted two weeks ago and ever since has had multiple problems, like constipation and her chest burning. she was supposedly worked up for this syncopal episode at a hospital two weeks ago, but i didn't have any records nor could i trust if they worked up her heart. after all, she had some pills they had given her for reflux (ranitidine). i knew that's what the chest burning most likely was as well, but i thought she deserved proper treatment, so i got her an ekg for starters. she had normal sinus rhythm and was fine for now. she may have an arrythmia, but we can't check that unless she has the episode in front of us, and thailand doesn't have cardiac holter monitors so there is no point in sending her to a cardiologist here. see, it's very different here.
my conclusion was that after that syncopal (fainting) episode, she was probably very worried or concerned. i felt like it was creating anxiety or maybe she already had anxiety. her other complaints of heart burn and constipation that she attributed to the fainting just don't match the story and don't go with syncope. my gut was that we should talk to her about anxiety and that was my open door to telling her about this amazing Physician who gives peace like no other. Yes, you got it, my Lord. we asked her if she wanted to pray and she said, "kapoonkah." I was so nervous to hear what she'd say, b/c i've already seen some patients refuse it. i was so relieved when i heard a thai word that i actually knew that means "thank you." she nodded her head, and Noi led us all in prayer. I'm so thankful for that divine appointment. there was a purpose in seeing that woman and certainly for being at clinic today. by the way, we did treat her GERD with doubling her ranitidine dose and also gave her some meds for anxiety. i would have been satisfied with just this patient for today, but God surprised me with another HUGE blessing!

we had 30 patients sitting out in the waiting room just for this morning. it was a rather busy Monday for us. i also felt like i wasn't moving at my usual pace. i was just taking more time with people, which i realized was a good thing. also, not to mention, dr. tom turned me loose and didn't let me use him as a crutch today for dosing children's medicines. they are not easy to dose, you have to calculate a dose according to their weight. he wanted to help me before i was turned loose literally this coming june. he did say "you'll be doing pediatrics." hello, that was an eye opener for me. i forget sometimes, since I know i ultimately want to be a pediatric neuro-oncologist. i have to get board certified in peds first, though.

as i was in the hallway about to go see another patient, julie stopped me and said she needed me to come see her patient. she wanted me to talk to this 13 year old Thai girl who was losing all of her hair. I was taken aback. Of course, i jumped right in to see this precious child, whom my heart was already breaking for that she would have to undergo such a change in life at such a young age. Pi Poo Pan translated every word for me. I went right in there and checked her out. she had diffuse alopecia as well as round patches of hair that were gone. this was all too familiar to me. it was like i was staring at my own self in the mirror only two years ago. all the emotion she must have been feeling, all the questions of why? yes, i knew and was right there with her and couldn't get words out fast enough to try to explain how i had been there. but look, i had such a gift of hope to bring to her! i have beautiful new curly hair that is down to my shoulders now. i had to take the pony tail down to prove it to her. i swished the hair back and forth and showed her that she too can have this in just two years worth of time. God is so good. I also wanted to tell her about how much it gave me a new persepective on life and my faith. I shared with her that i believe in a God who is the true doctor and who heals and brings true peace. julie added that He even knows the number of hairs on our head and cares for each one. wow, did i hang on to that verse two years ago. i told her that she was a remarkably strong girl with a remarkable beauty she was going to discover. Her inner beauty. i said, maybe God gives this to girls who have pretty faces so He can just reveal them more. (hey, i wanted her to feel good about her self-esteem, plus it was very true for her). i told her this was only temporary and that she was in a valley in life and soon she would be out on the mountain top. i told her how God had changed my life with it and i am now getting to share with other girls just like her and like she will do with other girls one day too. i'm so excited about having girls who go through chemo therapy so i can share this joy and love with them one day. i marveled at her strength. she wasn't even in tears when she was in the room. that was quite different from me, b/c i could barely stay composed enough to tell the doctor what was going on with me two years ago. her situation seriously paralleled mine and i wondered if she too had alopecia areata secondary to hashimoto's thyroiditis (an autoimmune disease), like me. julie wanted to test her thyroid right away b/c of my diagnosis. i knew checking her TSH, T3 and T4 wasn't enough. after all, mine were normal for a good while. i wanted us to check her antibodies in her thyroid. we don't have the ability to do that here though. dr. tom was surprised that julie and i were just sailing right on through this case and julie had to explain that i had been through this too. i did look at a strand of her hair just in case, to rule out telogen effluvium. i really think it is alopecia areata. so, dr. tom said "what do we treat her with?" i immediately said, "we need steroid injections." we only had dexamethasone, so we put it in a syringe and i gave julie those honors. she injected each of the girl's bald patches and we told her to come back in two weeks for more injections. we asked her if she wanted us to pray for her. she and her mom both said "kapoonkah." Yes! Pi Poo Pan led us all in a prayer while julie and i rested our hands on her frail body. julie wanted to touch her head during the prayer, but it is a thai rule not to touch the head b/c they consider the head to be the most important part of the body so that would be like an insult. julie caught herself and just held the girl's hand.

i rejoice in my weaknesses and will boast about my weaknesses all the more for when i am weak He is strong.


tomorrow, tuesday will be special too. tuesday is my day to share during the evangelism time. i'm thinking it will work out really well with the whole analogy of the head being the most important part of the body. i'm thinking i'll relate that to Christ being the head of the church and work in the wonderful miracle that the Lord did for my little head 10 years ago! i'll be sharing around 10 am our time, so it might be 10 pm your time.

i'm just so excited to be here!!!!!!!!!!!!!!!!