INSANE 24 Hours

WOW! The last 24 hours have been absolutely insane! If I hadn't put up two posts yesterday I wouldn't even know where to start. We've had a few major events since the last post. Here are the highlights and then I'll go into details below:

1. My sister Danielle Buckland gave birth to her firstborn a little before 6PM on Feb 4th. Baby boy Lex had some complications and may have to spend some time in the Neonatal Intensive Care Unit (NICU)
2. Right around closing time at the clinic here in Kenya, we had a twin delivery. The second baby had complications and we provided support resuscitation for over an hour before she perked up.

Now for the details! If you read my posts from yesterday you will know that it was a rough morning and our staff were already wiped out by mid-afternoon. It's been over a year since we had a patient die at our clinic. So our staff took it pretty hard. Especially because we all thought that this little girl was going to make a full recovery. We were able to get her body transported to her home where she would be buried.

Late in the afternoon we had a mother in labor arrive. She was already dilated to 7-8 cm so she was too far into labor to refer out. On assessment Kiptoo found she was carrying twins. Baby girl #1 delivered just fine. The problem was that part of baby girl #2's umbilical cord came out with baby #1. The danger of a prolapsed cord is that it will be compressed as the baby delivers. Basically the cord gets squeezed during the delivery process. That squeezing cuts off circulation to the baby thus depriving her of oxygen.

As soon as we saw the cord, the power went out and the room went completely dark. Thank God we had some awesome donations of head-flashlights by some teams last year. We now keep one in each department. So I fumbled around finding the maternity headlamp as someone else ran to get a second one. In less than a minute I was gowned and gloved and reaching in with my fingers to decompress the cord. I could go into a lot of graphic details here but I've probably already gone a bit to far....

So finally the baby was delivered in the dark and was pretty much non-responsive. No breathing, but she had a strong heartbeat. So we initiated support breathing with a resuscitation bag. After a few minutes the heartbeat dropped below 100 so we began support compressions. We were now doing CPR for the second time in one day. A pretty big deal for our little clinic!

We continued with supportive resuscitation and suctioning for well over an hour. I kept doing spot checks and kept finding a decent heartbeat. Our team decided that as long as we had a heartbeat we would keep going. And we were thrilled with the fact that the baby never turned blue. About thirty minutes in she started trying to gasp every few minutes. As her gasps got closer and closer together our faith grew. Her sister start crying and we told baby #2 "Can you hear your sis cheering for you? Come on breathe little one!". Then as I would suction her she would make an effort to suck on the tube I was placing in her mouth. Soon enough she started breathing steadily on her own. Within a few hours she had a hearty cry and was breast-feeding. Mom and both babies were doing great when they discharged this morning.

It was late by the time I got home. After assisting with a delivery I always want a hot shower. Our shower uses electricity to heat the water and since the power was out I heated water on the stove to get washed up. We had scrambled eggs for dinner. Sometimes I wish we had take-out or could call for a pizza!

About 20 minutes after I went to bed I got a call from my sister Danielle that her water and broken and she was in labor. She delivered a baby boy a little before 6PM CA time. Baby Lex had a double nuchal cord which means that the cord was wrapped around his neck twice. He was born almost three weeks early and was 6lbs 5oz I believe. My sister had gestational diabetes and when Lex was born his blood sugars were extremely low. There was talk about sending him to the NICU but they are trying to bring his blood sugars up while he is with Danielle and Brett.

They are closely monitoring the situation and will take him to the NICU if it becomes necessary. Danielle went totally natural for the childbirth and has already advised me that when it is my turn I should come to the USA and get hooked up with an epidural! I've asked them to text me if he gets admitted to the NICU. Otherwise I'll just call them in the morning (my evening) to check on things.

As you can probably imagine, I'm hoping for a calm, slow day today!