Breathing A Sigh Of Relief

Posted on January 20, 2012

In fairy tales, the hero in the quest always conquers the monster under the bridge.  She never entertains thoughts of said bridge collapsing like a big pile of matchsticks and tossing the hero at the feet of an indifferent water buffalo looking for a little trampling action.

I am certainly entertaining these thoughts as Roza rattles us across another pile of broken boards that can only been called a bridge in the most generous of spirits.  Frankly, I am not feeling particularly generous.  If there is a state out there not interested in using infrastructure stimulus package money, I know a bridge they can buy in Trang Village.

It’s been a busy couple of days.  Roza and I have been doing home visits on Safe Haven kids so I can see the progress they are making first hand.  While I was looking forward to seeing the kids,  the sorry looking bridge on the way to Kosol’s house was one I was hoping to NOT get reacquainted with.  Fifteen minutes later, we are faced with an even shabbier offering.  This one is half the width….and half the sticks.  Roza idles in front of it for a few minutes before deciding to go down and up the small ravine it is traversing in favor of trying our luck.  I breathe a sigh of relief.   Roza can be a bit of a nervous mother hen when I am on back of the motto.  Having suffered a brain injury and gone through brain surgery after a particularly nasty motto accident, he tends to be overly cautious when the situation calls for it.  I’m a big fan of this trait.

We get to Kosol’s house without further threat to life and limb and find our journey all for naught.  Kosol isn’t home but the reason he is not home is one to celebrate.  When Roza and I first came across Kosol a year and a half ago, his stiff and spastic muscles from his Cerebral Palsy prevented him from being able to grasp and hold objects and he often fell down when trying to walk.  His mother was unable to work because Kosol needed help to eat and drink and he could not take care of his basic needs on his own.  He wanted to go to school but could neither walk there or hold a pen.  He was one of the first children in the Safe Haven Outreach Program.

In August, we hired a full time physio therapist named Pheakdey and she began intensive PT with Kosol.  We were seeing the results in his absence from home.  His aunt came over to tell us Kosol was in school.  Pheakdey and Kosol’s hard work had miraculous results.  He was now able to hold a pen and write the alphabet.  He was able to eat and drink on his own and able to walk without falling.  With Kosol in school, his mother was able to go to the rice fields to help support her family.  And the aunt had one more piece of news to share.  Kosol had finished top of his class in his test scores two months running.  The family was very proud of him.  Now THAT was worth a little sketchy bridge crossing.

Home visits are not the only thing on our agenda.  We have a couple of children with appointments at Ankor Children’s Hospital.  Most of our kids prior to joining Safe Haven have never seen a doctor.  Because we focus on children with complex disabilities and/or medical issues, many of our kids have multiple health issues to be addressed.  Reaksa and Rouet Channy are no exception.  They are sitting in outdoor waiting area at AHC when Roza, Jess and I arrive to accompany them to see various specialists.  Reaksa, who has Down Syndrome, is munching away on a long loaf of bread that is spotted with mold.  He gives me a big smile and offers up some of the bread.  I decline his generous offer and pretend the moldy bread is penicillin in the rough.

Rouety Channy doesn’t have the ability for meaningful conversation.  We are not completely sure what is wrong with her.  Jess’s initial diagnosis was “Beats the hell out of me.”  which is an apt description for many of the unusual and complex issues we run into on a daily basis.  Some things are a little clear, she is spastic on her left side and we suspect she may have CP.  Autism is also likely.  She stims for hours flapping pieces of paper in her right hand.  She also has unusual features that suggest some type of genetic disorder, but frankly, sophisticated testing is really not possible here.  Today, our main focus is her seizures and getting her started on medication.

Reaksa needs to see a surgeon for a consult.  He has bladder issues that require surgical intervention.  We take him in first to see the pediatrician for a basic check up.  Reaksa is having none of this poking and prodding and makes a dash for freedom out the door.  The big bad white woman brings him wailing back into the room and he promptly lets me know what he thinks of the whole situation by peeing on my foot.  I resist the urge to sigh.  Really, it wouldn’t be a trip to Cambodia unless some child peed on me.  We finish with his exam and see the Cambodian head of surgery for a consult.  He lets us know there is an American urologist arriving in April and we schedule Reaksa surgery for then.

Meanwhile, Rouety Channy’s mother is telling the intake nurse that she is at the hospital because Channy has a cold.  Jess shakes her head and patiently explains to the nurse why we are really there.  This is a huge obstacle we face with the parents and working with them with the goal of having them be able to take over the responsibility of their child’s care.  For some reason, whenever they are asked what is wrong, they always say the child either has a cold or a fever.   There could be a gaping wound on their child and they would tell the intake nurse they were there for a little Tylenol.  It is an interesting phenomenon but certainly a hindrance when trying to build a case history.

In short order, we have all the needed medications and follow up appointments in hand and we send Channy and Reaksa on their way.  Our last stop of the day will be 4 year old Kompheak’s house.  Kompheak has such low muscle tone in his torso, he cannot clear his lungs normally of secretions and as a result, he has chronic lung infections and sounds like a diesel truck in low gear.  Last month we bought him a nebulizer to use at home but discovered his family has no power.  Roza and I went into the market to buy a generator.  The only one they had was fairly large and weighed a good 120 pounds.

The Tuk Tuk driver we rustled up for the journey out to Kompheak’s house in the country was probably super sorry he took our $5 fare.  Between the big old generator,  the two big old Americans (me and jess); Roza, the worlds biggest Cambodian, Pheakdey,  2 medical bags, the nebulizer and four backpacks our Tuk Tuk was so weighed down we were barely moving through the streets of Siem Reap on our way out of the city.  Roza’s long legs were hanging off the side.  Annoyed drivers beeped at us as they zipped around us.  Little old ladies walking cattle were moving faster than we were.  A bus roared past with enough wind sheer to knock you over, but luckily we had enough ballast to keep us putting merrily along.

A 20 minute trip wound up taking over an hour but we finally arrived at Kompheak’s house.  The Tuk Tuk driver hurried to give Roza a hand offloading the generator.  I’m betting he was relieved to discover it was getting left behind.  Kompheak was wheezing away in the yard, propped up with his elbows bending outward due to extreme hypertension in his arms.  His big brown eyes, so dark they are nearly black followed us as we sat on the ground around him.  Pheakdey and Jess double teamed him checking his lungs and oxygen saturation levels, which were predictably horrible.  His breathing is so labored it is a wonder this kid gets anything down those congested air passages of his.   Jess walked his mother through how to put the medicine into the nebulizer and put the mask on Kompheak.  We fired up the generator and settled back for 30 minutes while Kompheak, lulled by the mists of the nebulizer lays back in his mothers arms and dozes, his rough breathing gradually smoothing out.

My lungs were NOT feeling the love sitting next to the diesel fuel fume spilling generator and I heartily wished for my own asthma inhalers located in the blissfully cold air conditioned oasis of my hotel room.  Kompheak may have been getting some quality medication, but we were not improving the overall air quality around us with the power source.  Kompheak’s father is very pleased with this new piece of equipment we’ve brought and hunkers down to exam the generator with a cigarette dangling out of his mouth.  We take it as a good opportunity for a teaching moment about not smoking near his lung challenged son OR flammable objects.

Treatment finished, Pheaksey does a little chest PT on Kompheak to help clear out his lungs and we pack it up for the drive back to the city.  Our  Tuk Tuk driver, either anxious to be rid of us or overcompensating for the missing weight of the generator takes off like a bat out of hell down the bumpy red clay road.  The Tuk Tuk nearly flips over at least a half dozen times but we make it back to the city in record time.  I collapse happily into my hotel room and whisper sweet nothings at my inhaler.

It’s been a long week with a lot of successes with our kids.  Two successful surgeries, two successful post op recoveries, all of our kids with seizures now on medication, our physical therapy kids having amazing progress that is changing their lives.

Inhaler or not, at the end of the day, I’m certainly breathing a little easier.