18. “Do you know where this word comes from?” (Steve putting on his professorial role.)
All posts in category Cindy Gauger
Posted by Mongolia Bound Team on July 27, 2014
It has been two years, Jonathan. First time I went in 2012, I was inspired by your dream and wanted to be part of the team to live it out. I went without knowing much about this country Mongolia that fascinated you, except that the people are traditionally nomads and their country neighbours my motherland.
With Candace’s and the boys’ great emotional support, I packed my bag and went! I was blown away!! I went home deeply inspired and touched. I then understood why you were so fascinated about Mongolia! The people there are so pure, content, positive, and happy. Living their simple lives in the endless plains of the Mongolian Steppes, enjoying happy times with their family closely bound by their deep traditions in the warm gers, going through harsh winters with perseverance and strength, without fears… They have so much in common with you! I was touched by their courage and strength to live… as nomads, as warriors against cancer. I learnt the love that drives them to go on: the love of lives and nature; the love for their families. I was moved by the innocent smiles that the Mongols patients had, even when battling life threatening diseases… just like you did. I was touched by the love that the parents showed by being with them and holding them tightly… just like your parents did. I learnt fatherhood at a deeper level when Steve was running around collecting Mongolian stones for you, and when he was praying in silence in Karakorum, and him turning your love into helping others. I was inspired by the love of the doctors and nurses in Mongolia taking care of their little patients, even putting them before their own families… just like your doctors and nurses did. I got to know two missionary families who went way way way before us to the Land of Blue Sky answering the Lord’s calling, taking care of Mongol children and being living testimonies of Christ’s love. Two years later, these inspirations didn’t fade a bit; they only grew stronger!
Thank you so much, Jonathan. I would not have the opportunity to learn and experience all these without you. Thank you for having such wonderful dream and letting us be part of it. Jonathan, I thank our Father for giving you such a loving heart and being such strong living testimony of His love and sacrifice. I can tell you that we made many friends in the Mother & Children’s Hospital and we are honoured to partner in battling childhood diseases in the U.S. and in Mongolia. There are many things that we have learnt from each other. We are making many changes to take better care of the patients entrusted to us because of you! Although I may not be able to go back to Mongolia in the near future, I am forever bound with them via the friendship that is beyond time and space, just like ours.
Please continue to watch over us and inspire us. We are honoured to partner with you to do all these and I will continue to tell these amazing stories… all started by one child’s dream. The time will come when we meet again and chat and laugh over our little travel stories in person (milk curds in coffee, fly camp, Russian van…), until then, take good care of yourself and your family.
Posted by Mongolia Bound Team on July 26, 2014
It’s time to say goodbye to the smiling faces of the hematology/oncology team who have so graciously welcomed us during this week. As I look back and reflect on my week at the Mother and Child Hospital, I have to say that I am taking home many heartwarming and fond memories from our time spent here.
Degi, a pediatric hematology/oncology attending physician, met us at our hotel on Monday and escorted us through the maze of bustling traffic and buildings to begin our first day. When we arrived that morning, there was a lot going on. Patients, parents and siblings filled most of the beds and outpatient children were arriving to be seen. We rounded as a team that day, which allowed me to gain a baseline understanding of the flow of the unit and what types of patients that they generally see.
In the afternoon I was able to follow one of the nurses as she went about her day. It was amazing to see that they mix the patients’ chemotherapy right at bedside. It was good to see that the nurses have implemented the recommendation from two years ago that they wear gloves during this process. They do not have central lines, so they must maintain peripheral IVs which can be challenging at times. For the few patients that required new IVs during our rounds, family members often offered assistance and applied pressure above the desired site so that no tourniquet was needed. We made several trips to the lab to drop off specimens so that tests could be run and so that blood products could be ordered. These nurses work quickly and efficiently to deliver care to these adorable children.
On Tuesday, we started our day with the news that two new patients had come in overnight and both would need bone marrow aspirations that day. It was touching to see doctors and nurses utilizing the art of distraction, using stuffed animals and singing, to try to console the children as they were prepped for their (painful) tests. Prior to their procedures, we gave both children Mickey Mouse necklaces, and it was touching to see the smiles our gifts brought to their faces.
During the course of the week I was able to spend a good portion of each day with the children. One little girl refused to crack a smile while John and I made our “child life” rounds. However, after we used stickers as an ice breaker, she smiled and then like a chain reaction her mom smiled. We spent the rest of the day playing balloon volleyball and puppets with other patients as laughter filled the hallway. Interacting with these children truly was one of my favorite aspects of this trip. It is amazing that while we could not understand each other’s words, smiles and laughter needed no translation.
– Alex Boddie
Posted by Mongolia Bound Team on July 26, 2014
Although we had been prepared for what was to come, I will have to admit that the experience at National Center for Maternal and Child Health was both eye opening and rewarding.
To start our morning we make our way through the traffic, honking horns, broken sidewalks and dusty construction. Once we arrive, we meet the oncology team to discuss new patients and events that occurred overnight prior to making rounds. Dr. Sandler, I think they missed you; I tried my best to fill your shoes. Although some physicians were on vacation, we were fortunate enough to have Degi, a fairly new oncologist, and Oyunaa, a pediatric resident, as part of our medical team who were able to translate. Rita was also there ready and able to help as well, for which we are truly grateful.
On our first day we rounded on every patient on the oncology floor. A very full floor we must say. There must have been 15 patients in house. There were plenty of teaching opportunities and discussion. Diagnoses included predominately ALL, but also AML, Histicysosis, Aplastic Anemia and a few Lymphomas. The available chemotherapy drugs sound much better than years past, thanks in part to our previous teams’ recommendations. However, there is more work to be done as it was quite heartbreaking seeing so many Leukemic relapses.
With three to four patients in a room at times, it made no difference that there was no air conditioning – these children are so adorable and loving and quickly warmed up to Alex and John. It was truly a heartwarming experience.
Thanks to Dr. Sandler’s initiatives, I do believe that Hepatitis C PCR testing is under development. On a bright note we were able to tour a new oncology building to be completed this fall. The 2015 team should be quite impressed: Oncology alone will occupy 3 floors. The cardiac cath lab will be located on the first floor.
Our laboratory tour was quite impressive and afforded me the opportunity to view slides of a newly diagnosed patient. I was excited to learn that flow cytometry is now available, at least on peripheral blood. Acute Leukemia is now accurately diagnosed as pre-B ALL, T-cell ALL and AML. A future goal might include the ability to perform Methotrexate levels so that high dose Methotrexate can be delivered.
Lots of oncology, but hematology was not to be denied. On day two I met an adorable little girl with 1% factor VIII, on weekly Advate prophylaxis! However, we did learn that recombinant factor is in short supply and what a dream it would be for our Hemophilia Treatment Center (HTC) would be to “Twin” with Mongolia. Missy, are you ready?
The medical team remained eager to learn, always asking appropriate questions and very receptive to our input. It has been an amazing week, such wonderful people to work with. I hope we can continue our Mongolian working relationship.
Posted by Mongolia Bound Team on July 25, 2014
After two years, I am back to the National Mother’s and Children’s Hospital! The rooms and corridors may have changed, but the friendliness and hospitality of Mongols remain. I was completely overwhelmed and touched by my Mongol friends’ warm welcome, even the people that I had met only once or twice during my last visit!!
After a brief Meet’n’Greet with the Hematology/Oncology group with endless coffee, tea, crackers, and the famous dried milk curds (Cindy’s/Alex’s first), we started going through some treatment protocols. It certainly was very exciting to see that many of our recommendations from our first trip were put into clinical practice, including drugs we recommend to put on formulary, bone marrow needles, and diagnostic machineries. We were so excited, we wasted no time and started seeing patients.
There are MANY major differences between Americans and Mongolians: geographic locations, cultures, faiths, languages, traffic patterns, diets, etc., etc. However, in the Hematology/Oncology wards, we are drawn together by the same calling to heal, to comfort, and to love.
Entrusting the very lives of their most beloved children into the doctors’ hands, the parents’ eyes have the same mixed feelings of fear, uncertainty, and threads of hope… The same eyes that I saw two years ago. The same eyes that I see back home in the US.
We see little brave warriors fighting for their lives receiving chemotherapy drugs that even adults fear. We see a teenager girl broken into tears knowing that she needs to endure more vincristine infusions that cause her lots of pain with every dose. We see families fight on with courage despite relapses, side effects, and failures. We see worried fathers sitting at the end of the bed, wandering outside of the rooms sharing his deep love and concern in silence. We see mothers comforting suffering children with their loving arms and big hugs. We see the same heroic stories beyond skin colours, cultures, and medical backgrounds back home and here in Mongolia.
However, in the dark and partially ventilated Oncology ward, we also see angels in white coats who bring hope to every dark corner. They may not be able to cure every patient, but I see the same hands of Mongolian and American doctors delivering not only the best skills in healing, but also care, comfort, and hope to the families they serve. In their eyes, I see the same passion and determination to cure as possible. It is our honour to fight along side our Mongolian counterparts again to battle childhood cancers together. May our busy week start!
Posted by Mongolia Bound Team on July 23, 2014