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Last week as part of our ministry at Bongolo to show Jesus' love to the people of Gabon, we removed the cataract in her right eye. She was very happy, and I think her daughter is relieved too!
We will likely remove the cataract in her other eye in the future. However, our surgical schedule is full for the next whole year! At least she will have one eye to see with while she waits.
I don't have a picture of Papa Isaac, but here is a picture of a similiar cataract I removed from another patient (this is a big one actually!). It was encouraging to see Isaac on Wednesday, as he was a routine followup....We've been here now long enough to see some long-term results!
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When Isaac came in to the eye clinic originally, he could see only hand motions with either eye. That means he couldn't count fingers from any distance, or of course see any letters on a vision chart. (Try squinting your eyes enough to have difficulty in seeing one finger right in front of you, or your hand moving.) We removed the problematic cataract from the first eye 10 months ago, and from the second eye 5 months ago. And this week, he is still seeing 20/20 with both eyes!
Dr. Elisee, our ophthalmology surgical resident from the Congo, is progressing excellently. He is now entering his 7th month of residency with me. So far, he has performed eviscerations (removing blind and painful eyes), done YAG laser procedures, and has even done one entire cataract surgery on his own! He regularly performs the first third of cataract surgeries for me, and we will continue to keep extending the number of steps he performs each time until he can do the entire surgery without too much stress or risk. He also sees clinic patients, gives presentations regularly, and takes exams. Way to go, Elisee!
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We are also very happy to report that construction on Elisee's family's apartment has begun! Praise God for all the donations that have come in, and thank you for being a part of this. Check out the beginning of construction....
We are also so thankful for the visit by our friends, Dr. Mike and Anita, and also our friend Henri! They took over the eye clinic while we were in the states for my boards exam, and it was a great comfort and joy to know that the clinic was in such good hands while we were gone.
Here's a picture of the eye clinic staff with Mike and Anita in front of our house....(Henri and our cleaning staff lady are missing.) Elisee is the one wearing the white coat.
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For those of you interested in a slightly graphic patient photo and story...please see the end of this blog entry. Otherwise, the following is a recent home-life event here in the jungle of Gabon.
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The expats here usually buy bread from the local town baker. However, for several weeks the baker stopped making and delivering our bread because he was "out of flour." (The store down the street sells flour, but never mind that.) The bigger problem, however, was when his oven broke shortly thereafter. So we have not been able to buy bread for the last couple of months, and we don't know if he will ever fix his oven. This has necessitated some baking at home.
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There weren't too many surprises involved in that first endeavor, except that after buying flour in town, we realized we did have to sift it. Can you see the many small bugs left in the sifter? We just found this sifter in our house here, and are thankful for whichever missionaries left it for us to find! It worked great, and to my knowledge, not one bug was found in the bread itself.
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Here is the story to accompany the final photos here. I first saw this lady my first week or two here in Gabon, last June. Her right eye was slightly protruding but not badly and it wasn't affecting her vision, so I sent her home without an intervention. We don't have a CT scanner here, and in general I am not an orbital surgeon, so we pursue "conservative measures" whenever possible and try to do more good than harm.
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However, she came back a few months ago, looking like the first picture below - significantly more severe. In talking with the eye nurses (pictured above), I found out that she actually comes to the eye clinic about twice a year for the past 10 years looking like this, and the eye nurses put a huge 22G needle right above her eye to drain out a thick brownish liquid and this resolves the problem.
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Never having seen this abnormality before, I was skeptical but allowed the nurse to proceed as usual, and this is what happened - see the before, during, and after photos below. Never doubt a good nurse when they're sure of themselves! He removed about 15-20cc of gel-like fluid and the patient was very happy.
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I think this diagnosis is a frontoethmoidal mucocele, for those who are interested. It would be possible to do an orbital surgery to remove this cyst, but without a CT scanner and not knowing how much bone is intact between the cyst and the brain, I would be quite reluctant to do this. So we'll likely see this patient back again in another few months to repeat the same procedure.
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