Saturday, June 23, 2012

Samuel's Wheelchair

Monday was busy in Outpatient.  Killer busy.  One of those days when the stack of charts of patients waiting to be seen seems to be growing taller as the day goes on, rather than smaller.  Each of the doctors here has ways of trying to cope with that kind of day, ways to make themselves go faster.  You think harder about whether you really need xrays, or tests.  You ask yourself if the results will really change anything about how you care for the patient.  Sometimes you postpone things until the next time the patients comes in.  It's all necessary.  The time you save increases the total number of people you can help.  I find that on those days I talk less with the patients, spend less time finding out who they really are, what they are about.

But when little Samuel came in, it really slowed me down.  His mom's immediate concern was his cough, but it was obvious that there was a lot more going on.  He obviously had less than normal muscle tone.  His arms were a little stiff.  He didn't make eye contact.  He didn't show the normal apprehension that a child his age (about 4) would usually show toward a big, ugly, white doctor.  He didn't speak.  As I asked questions and thumbed back through his record book, the story gradually emerged.

About a year and a half ago, Samuel had developed a fever and seizures.  Although the family lives near Nazarene Hospital, for reasons I don't understand, they took him to the government hospital in Mount Hagen.  He was admitted there for almost 4 months.  Although his mom concluded that he must not have been treated properly, I know that this isn't necessarily the case.  They had done a lumbar puncture and had documented that he had meningitis.  They had treated him with intravenous antibiotics.  I can tell you from frustrating experience that sometimes you do everything right, but meningitis takes a terrible toll on a child.  Whenever I make this diagnosis, I now routinely tell parents that sometimes children recover well, sometimes the die, and sometimes they are left with brain damage.

I asked Samuel's mom if she knew about the rehabilitation program at a nearby Catholic mission.  Although this program is not active at the moment because of lack of staff, it has provided valuable help to many people over the years.  "Yes," she replied.  "They taught me how to exercise his limbs, and how to take care of him!"  As I examined him, I noticed that he had pretty good flexibility, and that his skin was in good condition.  Apparently they had taught her how to secure him safely in a chair so that he could sit up and watch the world around him.

Just then we were interrupted by a knock on the exam room door.  I'm a believer in "divine appointments".  Sometimes God plans events that seem random to us, but accomplish His purposes.  This was one of those events!  It was Judy at the door.  I have completely forgotten what she came for--some relatively-trivial question, or to give me something.  But as soon as she saw Samuel, the original purpose of her visit was forgotten.  Judy loves kids, and has extensive experience working with cerebral palsy kids as a speech therapist.  She immediately focused on him.  She was delighted to know his name (you understand that Samuel is one of our favorite names).  After visiting for a few minutes, she said that she had a "CP chair" that she thought would be about the right size for Samuel.  We planned for Samuel and his mom to come back on Thursday, both to follow up on his cough, and to try the chair.

Later in the afternoon, she brought the chair to my exam room.  I put it in the corner for the time being, and a couple of days later had a chance to look at it more closely.  It looks to me that this wheel chair was a custom chair for a particular child, with attachments needed by him or her.  (Edit:  Judy just reminded me that the name "Ethan" is embroidered on the backrest!)  I'm guessing that he or she was a little bigger than Samuel.  It was obviously used, but well cared for, and in very good condition.  I noted the tools that I would need to adjust it.

We receive valuable equipment and supplies from many sources, but two organizations help us a lot.  Nazarene Hospital Foundation, in Medford, Oregon, under the leadership of Dr. Todd Winter has supported us for many years, shipping 2 to 4 containers per year.  I have blogged about the arrival of their containers several times.  You can see stories here, here, and here.  We also occasionally receive containers from Project S.A.V.E., out of Chick, California.  Both of these groups send us high-quality, useful equipment.  Judy isn't sure which group sent this chair.  It had been in the storeroom for some time.  A special item like this sometimes has to wait for a while to find just the right person to go to.

Yesterday, Samuel and his mom were back.  When she saw the chair, her eyes lit up!  I busied myself with my tools, moving the various fittings to accommodate Samuel.  There were a couple of items that I didn't think he needed that I removed.  I adjusted the straps and foot rests and headrest.  The chair is still a little bit too big for him, but close enough.  The addition of a thin cushion at his back made it fit pretty well.  I showed his mom how to use the different features, including adjusting it from fully upright to fully reclined.

Then it was time for another divine appointment.  Missionary Mike Chapman came to the door of my exam room.  Again, I can't remember why he came, but as he usually does, Mike had his Cannon D7 camera hanging around his neck  He took the pictures that help you all to enjoy the story.

Imagine the difference that this chair will make in the lives of Samuel and his mom.  Instead of tying him to a chair to allow him to sit up, she can just squeeze a lever, and move the chair to the upright position.  When he needs to rest, but it isn't time for bed, she can just tip him back into a recline.  When she wants to give him a different view, she can just wheel the chair.  And as he grows and gets heavier, she won't have to carry him, along with whatever else she needs to transport.

Please pray for Samuel and his mom as he grows and his needs change.  Pray that the whole family and village will be supportive and helpful.  Pray for Nazarene Hospital Foundation, and for Project S.A.V.E., and all the other groups that are blessing others in the name of Jesus.  Pray for us as we serve those around us day by day.

For more photos, see our Facebook page here.
AB

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