Five Days to Go

I have 5 days to raise the initial payment for my Mission to Mongolia. My goal is raise $10,000 to cover specific fees for staying in Mongolia, travel costs, rabies titer, passport fees, and incidental costs that arise. In 2014, I actually ended up needing medical care while in Mongolia.

In 5 days, the initial $2,000 need to be in my CVM fundraising account. If you are interested in helping me reach my initial and final goal, I would greatly appreciate it! Please also keep myself, CVM, and the Mongolian people in your thoughts and prayers.

How to Donate to a Short Term Missions Account Online:

  • Go to http://www.cvmusa.org/ and then to Support > Short Term Missions.  Fill in the Designation box with a drop-down menu to “other” (at the bottom of the list). A white box will appear, and please enter in my account number (UCVSTM1655) and write in my name, Melanie Goble – ST Missions in that box. CVM will make sure it gets designated to my trip. Please let me know if you have questions.
  • Checks can be made out to Christian Veterinary Missions with “UCVSTM1655/Melanie Goble” on the memo line and mailed to Christian Veterinary Missions 19303 Fremont Ave N, Seattle, WA 98133 or given to me to mail in.

I can’t wait to see you again, my Mongolian friends!

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Return Mission to Mongolia

I am happy to announce that I will be returning to Mongolia with Christian Veterinary Missions to train and mentor veterinarians in their small animal clinic in Ulaanbaatar, the capital city. I purchased my airline tickets this morning and will now start the journey of preparing my mind and soul, and raising the funds to travel.

Golden Eagle in Flight

Golden Eagle in Flight

My last mission to Mongolia in 2014 was a life changing experience. I left a portion of my heart in Mongolia with the loving people and the vast, amazing landscape of the countryside.

When I returned from Mongolia in 2014, I unexpectantly was removed from my job, but that provided me with the amazing push to start my own business, Renewed Strength Veterinary Services.  A lot has changed for me in the last 2 years, but thankfully, I am a stronger, and hopefully better person than I was before.

Please keep me in your thoughts and prayers as I move forward on this journey.

If you are interested in supporting this mission or would like more information, please let me know. You may also go to the “Mission to…” page on this blog to learn how to donate. Please, take a moment to leave a message of missions you have been on or how someone has been a blessing in your life.

Thank you and God bless you!

Mongolia Update (August 18-23)

August 18, 2014

Today dawned with a little sadness as I recognized this was my last week in Mongolia and there was still so much to do before leaving. I have been writing teaching handouts and clarification pieces for the veterinarians so that when someone isn’t there, they have documents to refer to. I love the looks in their eyes when a new piece of information locks in and they are able to use it with their patients. It took me awhile, but I finally am comfortable enough to hold impromptu teaching sessions, well, that and there is finally a couple minutes of “free time.” The clinic has been so busy, that a time when there was a free veterinarian was difficult. Today, things finally slowed down enough that we could gather 1-5 people and have a session. As these young veterinarians move forward, I pray that they have many people to come in and mentor them. Although their knowledge is good, the implementation of the knowledge and the overall application of techniques need to be honed. It is easy to treat the immediate problem for which a person brings their pet into the clinic, but to address the entire animal by obtaining a complete history and performing a comprehensive exam is so important to the welfare of the animal and it is easy to overlook. It was a good reminder for me as well with my return to the USA.

Today was also interesting as the power was a little less trusty. It went out in the morning, but thankfully did come back on. The fallout from this is that when we went to lunch, my food (meat of course) was not completely cooked. I ended up grabbing something else at the mini market, because I didn’t want to risk getting sick again! Dinner was a lot better with my food being cooked, and then I was given the adventure of going to a hair salon in the basement of a building where my hair was greatly shortened. A bit shorter than I am used to and what was requested, but the woman did a lovely job. Another first, getting my hair cut outside of the USA.

August 19

Apparently, yesterdays teaching sessions went over well, because now the veterinarians are asking for more impromptu sessions. Of course, the first one they asked me to do, I didn’t have anything planned, but that is quite alright. “The Coughing Dog” was a great topic and not one that I would have thought to make a handout for previously. Most non-medical people do not realize how “coughing” can mean so many things – bacterial or viral infection, parasites, heart disease, asthma, bronchitis, cancer, and the list goes on. This also took us into evaluating various lung patterns on radiographs (x-rays). Hopefully, they will start using the books more frequently – especially those with pictures – to be able to recognize different patterns in the future. I know there are times, I still need a refresher and reminder of the various pattern and what they mean for the patient. We also worked on parvovirus. A disease that is preventable with vaccination, but unfortunately many people don’t realize it. I can’t tell you how many puppies would be lined up in cages, set up to their IV fluids, receiving medications, and being cared for, but just don’t make it. They are so tiny and usually at the beginning of their lives, but they aren’t able to pull through. It breaks my heart here as it does at home that lack of education of the people causes so much suffering in the animals.

I went out to Ultziit again to visit with the Spence family and two other Americans that are over for the Fast Horse Training. Tom and Johnny have been coming to Mongolia for the last 15 years or so to teach veterinarians – specifically to care for horses. I am so impressed by the work and dedication that they provide to the Mongolian people. I cannot say how many lives (both animal and human) their training has saved over the years. They spoke of veterinarians that are using a stethoscope for the first time and hearing hearts beating after 20 years in practice. It is amazing! Johnny also shared about a wonderful program that he has been involved with recently called Victory Junction, a camp for children with chronic illness and disease that allows them to have a week where their disease does not stop them, does not control them. This camp is amazing and such  a blessing to have available to children.

Despite having another wonderful time, I just wasn’t feeling good overnight, but finally got some rest. I think I had a fever and it finally broke overnight. Not sure if it was the undercooked food from the day before, but am I glad that it didn’t progress to have me end up in the hospital again!

August 20

I had a day off today to get some more shopping done, to start packing, and to go to the Ensemble – a Mongolian cultural show. It was an amazing event! The throat singing and music were interesting and I have no idea how the throat singing works (you should not only hear it, but watch it!) The craziest part of the show was the contortionist. My joints still feel sore just from watching her. Absolutely amazing!

It is really hitting me that I will be leaving soon. I miss my husband, cat, family, and church, but I really want to stay here!

August 21

I have been reminded again about the difficulties in practice here. Here, I am “the specialist.” The one with experience. The one that is supposed to have the answers. Today, I was faced with a pup that I knew what needed to be done, but I didn’t have the equipment, medications, or specialists needed to treat the pup. At home, it normally comes down to money – people can afford to treat or not, they want to treat or not. There is a specialist somewhere that can take care of the situation in many cases.

This is the story of Coco. Coco is a tiny Chihuahua (1.6 kg, about 3.5 pounds) that was given large amounts of vodka and had fallen off of a bed two days previous. Now, she has torticollis (her head and neck are tilted around making the head almost look like it is upside down), nausea, and anisocoria (her pupils were of different sizes). She also has bulging of her skull between the eyes. Normally, one would place her on oxygen, monitor her blood pressure, and a wide variety of other things (MRI, CT scan, etc), but I can’t do any of those things here. Thankfully, I have access to the Veterinary Information Network (VIN), which includes veterinarians, including specialists, from around the world that I could request help from. We were able to find some Mannitol – a medication that helps decrease brain swelling – at the corner pharmacy, so we could start that treatment. Sadly, there is no overnight care or monitoring here, so she was sent home with her owners with instructions to come back first thing in the morning. We all prayed that she would survive the night.

We also had a young kitten (maybe 3 months old) come in that had fallen off of a balcony. The family had never had a cat before and were watching her for a couple days. The family knew nothing about cats, so they left her on the balcony while they went away for a short time. They couldn’t find her upon their return on the balcony and finally found her on the ground 4 floors below. She had a broken leg (fractured femoral neck) and a pneumothorax. Thoracocentesis was performed to remove the air, and we will have to see about the leg. It is a type of fracture that can be repaired, but could also potentially be left to have the femoral head dissolve on its own. We will wait and see what happens over time.

That evening as a thank you, I purchased pizza for the entire clinic. Something that is so simple and easy that it is one of the most common things to do in America, but for them is often cost prohibitive. For about $45, I was able to blessed with their joy and fellowship.

August 22

I gave my farewell devotion this morning and was brought to tears multiple times. I, of course, stood out as emotions are not often shown in Mongolia. I on the other hand tear up at Hallmark commercials, so it wasn’t a far stretch for me to cry now. There were hugs all around and such amazing love, support, and acceptance. Thank you for allowing me to be here and to hopefully have made a difference!

The clinic itself had a slow day, but we continued to work with Coco. She even began to show her Chihuahua nature again and started to growl at me. She had some nystagmus (rotation of her eyes) today, but wasn’t rolling quite as much. She still has significant swelling of her head, but I think she may have a chance. Perhaps will never be 100%, but she has a chance to live. Enkbeyer is doing a great job. Although he is quiet and hasn’t needed a lot of help, I am happy to have become his friend.

Coco on her way to recovery

Coco on her way to recovery

I tried not to cry when the time came to say good-bye, but that didn’t happen. I was able to keep most of the tears in until I started to walk away. A part of me will remain here forever.

Dinner and then the trip to the airport went well, until I realized I had neglected to hand over my apartment keys!  Oops! The airport allowed me to call Mary, but due to the way security is set up, no one is able to come and get the keys. They will need to be mailed to the next shuttle (person traveling over to work at the clinic) when I get home. I did get to have a lovely conversation with a Pilipino woman that had just finished a trip around Mongolia. Despite living in California for the last 56 years, she still travels all over the world. I will keep her in my prayers as she was so sad that all of her traveling companions are passing away. She was very sad.

Final devotion, Final picture

Final devotion, Final picture

August 23

Despite a lot of turbulence, the flight home was good. I was able to get more sleep than on the way to Mongolia. The man next to me was a lovely gentleman from Thailand, that now lives in the USA. He travels frequently for work, and was excited to get home to his wife and high school aged twins. He recommends a trip to Thailand, I think that is a good idea!

I was then double blessed upon arrival to see my husband and Laura and Steve – friends from church that offered to pick me up. After a short chat, we walked out to the parking lot where we were also met by more church members – Gary, Ann, and Addi – I didn’t expect to see them 3 hours from home, but they were in Chicago and saw my plane landing, so they hopped into the van and found us in a parking lot at O’Hare without a telephone call or anything. If God wasn’t in that, I don’t know what else to say!

Thank you to everyone that has followed my journey. I hope that it will happen again. I will share more in the future as tidbits of my time in Mongolia come back, but the great story of this trip is over. Perhaps it is just the beginning of many more though!

May you be blessed and find a way to make life a little bit better for someone around you today.

Mongolia Update #3 (Aug 8-14)

Ϲайн байна уу! This is a regular greeting in Mongolia, essentially saying, “Hello. How are you?”

So much has happened since my last update that I have a lot to cover! After taking some time to heal after my hospital incident, I headed back into the clinic on Friday afternoon (August 8th). On the way to the clinic, I met one of my neighbors from across the alley. She was a lovely woman that had adopted a dog in Hong Kong and has since moved to Mongolia. We discussed behavior and the ways to improve the experience of clients and patients at the clinic. Once I arrived, I assisted Bayaraa and taught her some surgical techniques that I have found to be helpful in building my confidence and skill in the operating room. Dinner was with a great guy, Dorjoo, We had a great conversation about how we got to where we are in our lives and how he is excited to raise his children in a Christian home. He and his wife are expecting their first child in February! The greatest part about the day is that a very important prayer had been answered for many people.

That Saturday was very busy as I infused the Mongolian economy with fresh cash. I went shopping with Saikhnaa, one of the cleaners at the clinic, and her daughter Erikhaa. Despite the language barrier we had a wonderful time. Dinner was with Suugi (we had pizza) and then stimulated the economy some more. We went to Mary and Martha’s, but I realized I had forgotten my credit card and I didn’t have enough on me, so they held most of my items for me to pick up later. It was a busy day, but I lazed around in the evening finishing the presentation for my lecture that was supposed to be one when I got sick! I also finished the first of the Genghis Khan books “Birth of an Empire” by Conn Iggulden and started the second “Lords of the Bow.”

Sunday, August 10th brought me to Hope Church in Ulaanbaatar (UB). It was helpful that they have little headsets that you can use to have the message and prayers translated into English. Even though I couldn’t understand the praise songs, the power and energy of the music was inspiring. The message was very inspiring as well. I couldn’t believe the amount of scripture that was covered during the service. What stood out to me though were two stories shared by the pastor. The first was about a young man in Mongolia that heard the Gospel and became a Christian, he was rejected by his family and friends, and he had to leave home. He found a church that welcomed him and his life had a new beginning. The message was about how the Lord provided for him and it was amazing. The part that really got me was that this was when Christianity was first reintroduced to Mongolia, 20 years ago. I have been struck time and time again how young this nation of believers is, yet their faith and reliance on God is greater than I have seen by most in the USA. I believe we have become too complacent in our faith in America. I am not saying that this is true of everyone, but there is a large portion of believers that think believing is enough. That believing doesn’t change who you are inside and out. That we can do whatever we want and all is good. Yes, accepting Christ is enough, but it is a daily accepting that changes the way we behave. What kind of example do we give if we say we believe, but then ignore our neighbor in need? Luckily the truth of Christ is not changed by the behavior of Christians. The second story was about a young boy with Down Syndrome. He was the oldest in his Sunday school class and was often not included by the other children. One day, the teacher gave each of the children a plastic egg and told them to fill it with something that was a sign of life. Most of the children filled their eggs with flowers, butterflies, and rocks, but this little boy had nothing in his egg. The other children laughed at him, but he explained that the empty egg was like the empty tomb that gave us all new life. He died not long after. At his funeral, the teacher and children lined up and placed empty eggs in his casket to remind all that we have new life in that empty tomb. After a lunch of bacon cheeseburgers in a friend’s home. I went bicycle riding with Kristal (another American), Suugi, and Selenge. Chinese food and great conversation topped off the evening.

August 11th was busy working on handouts and lessons for the Mongolian veterinarians. There was little animal work for me to do, other than a consult for 2 feather picking lovebirds, until 5 minutes after work was supposed to be over for me, but such is the life of veterinary medicine – it doesn’t matter what country you are in! I also learned that one of the surgery patients from the week before had passed away over the weekend. I am still struggling with not having access to all of the things that I am used to having on hand. I don’t know if those things would have made a difference, but it is still very depressing. Dinner was with a large animal vet and we spent most of the time going over English and Mongolian phrases. She is much better at English than I am!

August 12th, I was busy with cases, one was an ex-pat from Canada with a dog that has skin issues. Pheobe, the dog, did great. Yvonne was a joy to work with and we talked about a lot of things. One great part of the conversation actually helped me come to terms with some of my struggles with the basic nature of medicine here. The result is that I get back to the basics of medicine. By doing this and focusing on my physical exam, histories, and understanding of health and disease, I know I will be a better vet in the long run. That being said, I do really appreciate the supplies at home! I went to dinner with Pagma, one of the teachers that goes into the countryside, and her niece, who is a champion archer here in Mongolia. They are amazing people. Pagma also shared her story with me. She was raised Buddhist and married a Buddhist, but while at university, she learned about Christ and converted after a time. A year later, her husband also accepted Christ as his savior. Pagma was going through a very difficult time in her life and her parents died within a year of each other. Her mother, while being consumed by cancer, asked Pagma for some Scripture verses. Pagma had never seen her so at peace.

August 13th Not a lot went on in our clinic today, but we did have a visiting veterinarian from another clinic in town that asked me to look over a pup for her. I had diagnosed the puppy with hip dysplasia the week before, but the symptoms were progressing. I think this may be my first case of distemper, but with only caudal neurologic symptoms. If this is the case, the pup will likely die within 3-5 weeks. Given the supplies and limitations for testing, all we can do is offer pain relief and keep symptoms in check. I was also able to help one of the youngest veterinarians find some masses in a large dog via ultrasound today. Not very good for the dog, but pretty exciting for the vet to see what can be done with ultrasound. Meals were wonderful and we said goodbye to Kristal from Oregon, USA today. I did have my first taste of airag today (fermented mare’s milk) – not ideal for my palate.

Thursday, August 14th. I finally taught my behavior lesson today! We started the lesson with a devotion based on Genesis 1:27-28 – God instructed man and woman to rule over creation. We discussed how ruling does not mean abusing, that it means loving and caring for those that you are held responsible for their health and safety. I believe this is when God actually gave the first jobs out – veterinarians, farmers, ecologists, etc. Some say prostitution is the oldest profession, I beg to differ. From this scripture, we then discussed how it is our responsibility to not cause any additional stress to our patients than is already inherent in the job. Understanding body language was the start, and then we finished with low stress handling techniques. It was a lot of fun seeing the veterinarians and technicians practicing on each other! We then went back to the clinic where I ate lung and blood filled intestines – also not for my palate! To clean said palate, I then went to lunch and had a hot dog 🙂 An afternoon full of recheck appointments kept me busy. Dinner was with Saikhnaa (the accountant, not the cleaner) and I had a Korean meal that was actually pretty tasty and not too spicy for me. I must say the day was great, but I was exhausted. My hat is off to teachers everywhere. Three hours did me in!

What is left on the plate of lung and intestines filled with blood (I did not eat the majority of this)

What is left on the plate of lung and intestines filled with blood (I did not eat the majority of this)

I have a lot more to share to get you caught up, but I think today’s post has gone on long enough! Until next time, stay blessed, and try something new. You might like it, you might not, but either way, you can say you tried!

Mongolia Update #2

This trip has continued to amaze me. Earlier this week, I had the joy of doing two ultrasounds on dogs to verify that their puppies were still alive. One of them came back the next day and had her puppies in the clinic without assistance. They were so cute! I have not heard about the other one, they were trying to raise some money for a C-section, but hopefully she had her pups at home as well. I am becoming more confident in helping the veterinarians with their cases. Trying to remember not to tell them what to do, but rather help them come to a conclusion on the best course of action. We have been going over better methods of restraint and blood collection methods as well.

I had a chance to so some sight seeing – museums and Genghis Square, not to mention some shopping. I have begun finding some amazing gifts for those that mean so much to me. Flat Jesus and Genghis Khan (pronounced Chinghes Han) even got to hang out for a bit!

Flat Jesus with Genghis Khan

Flat Jesus with Genghis Khan

 

On Tuesday night, we had the joy of traveling to Ulzit to spend the night at the home of the Spence family. We had an amazing dinner, sang songs for hours, and had the most enjoyable fellowship. The time with the Spence family will always be marked in my mind and soul. They have traveled to Mongolia to serve with the same group I am in. How many people do you know would uproot their family (they have 9 kids!) to move from New Zealand to a foreign land without knowing the language to serve others. They are an inspiration to me.

Perhaps my favorite thing this week, occurred when we arrived at the main office on Wednesday. The security guards had found a bird that couldn’t fly in the parking lot, so they put it into a box and presented it to us when we arrived. Everyone looked at it, but I was the one that began to work with it. (It appeared to be a swift of swallow of some type) I picked it up and examined its wings and legs – no fractures found – but he was slightly neurologic. We suspected that he had flown into a window or some such thing. At this point, he couldn’t even perch on my finger or a tree branch. I placed it back into the box and into a quiet corner for about an hour. After devotions and prayer time (with a special prayer for the little bird’s healing), I went to check on it. It was still not 100%, but an insect that was not in the box before was hanging out in the box and the bird appeared to have eaten part of it. I took the little bird outside and had it perch on my finger, it still wasn’t where I wanted it to be, but it was able to then perch on a branch. I placed him back on my finger and he flew onto my shirt and then clung to my braid. I gentle removed him and held him up with a slight lift and lower of my hand to help him get his wings back in order. After a couple test flaps, he took flight. There was a great clatter and other birds of the same species flew up from the bushes and trees, they circled him and they flew off together. An amazing sight!

Yesterday had its first major wrench in the works of this trip though. My roommate, Allie, and I both came down with vomiting and diarrhea to the point that we required assistance to rehydrate, so we went to the SOS clinic – an international hospital here in Ulaanbaatar (UB). We both had IV catheters placed and received 2 liters of fluids each, along with various medications. As per usual, when the doctor heard I had diabetes insipidus, he immediately wanted to check my blood sugar levels and I had to explain that it has nothing to do with blood sugar or my pancreas, it is my pituitary gland and a lack of vasopressin resulting in significant dehydration. I then explained what tests he needed to run and that I required IV fluid supplementation. Thankfully, he agreed with my assessment. My electrolytes were all low, but thankfully, not in a dangerous range. Between the medications and prayers from around the world, Allie and I both improved dramatically. Thankfully, for Allie, she was well enough to catch her plane home late last night. For awhile, we didn’t know if that would be able to happen.

So, despite a crazy day in the hospital and missing out on all I was supposed to do yesterday, I know that God is good. He is the Great Physician that cares for each of us – from the smallest bird to the largest whale, the fish in the seas, the beasts of the land, and each person. His love is greater than we could ever comprehend.

Until next update, I pray that you will have a wonderful and blessed week, month, and year to come. Stay hydrated my friends!

Mongolia Update #1

I have been in Mongolia for almost a week now and it has been amazing. After a 21 hour trip, I arrived in Ulaanbaatar around 10:30 pm. Thankfully, I was through customs with my luggage in about 10 minutes and didn’t have a long wait. I was picked up and delivered to my apartment where I met my roommate. She is a recently graduated veterinary technician from Nebraska and is finishing up a 3 month-long internship in the next week. I am going to miss her when she leaves!

The following morning (Tuesday), I was up bright and early – mainly because I only got 2 hours of sleep – after devotions, we went to the small animal clinic and we began our day. The most memorable case of the day was a little cat named Fluffy. Her owners noticed her having difficulty breathing for the last few days so they brought her in for an exam. She was found to have fluid around her lungs. I assisted the Mongolian veterinarian in thoracocentesis (removing fluid from the chest cavity with a needle). Later in the day, I learned that the clinic has an ultrasound machine, so we decided to take a closer look at the chest and see if we could see any heart problems since the fluid obscured the heart on radiographs (x-rays). What we saw changed everything. There was  lot of fluid in the chest, but there was also fluid in the sac around the heart. I recommended a pericardiocentesis (removing the blood from around the heart with a needle) and it was agreed that this would be a good idea. I then learned that they did not know how to do this and would like me to show them. I am happy to say that my first pericardiocentesis was a success! I was able to drain fluid from both around the heart and from the lungs. Additional recommendations were made to the owner for care, but they decided to take her home and monitor her, even though there was a good chance that she would die. I have not heard how Fluffy is or if she is still alive, but I hope that she is.

On Wednesday, I met a wonderful woman, Ogi (pronounced Auggie), with two dogs, Sabu and Helga. Sabu is older and in wonderful shape, Helga is a 6 month old French Mastiff that has a premature physeal closer of the distal radius (the growth plate fused too early). I had one of the other doctors, Andrew, take a look at the radiographs and he is coming up with a plan to treat Helga over the next 6-12 months – most likely with external fixation to gradually lengthen Helga’s leg as she grows. We will see what can be done with the limited resources available. I have completely fallen in love with Helga. Ogi is also amazing and has offered to help me out with anything here in Mongolia. We exchanged information so we can stay in contact after we are done treating Helga.

I am snuggling with Helga

I am snuggling with Helga

Thursday brought a ferret into the clinic. Ferrets are not common pets in Mongolia and everyone looked at her with suspicion. It was exciting to meet her. She is about 2 years old and was never spayed. She has been in estrus (heat) for 2 months. Ferrets that are not spayed (had their ovaries removed) and are not used for breeding develop estrogen toxicity. The estrogen from their ovaries damages their bone marrow and they stop producing new red blood cells. Luckily, the treatment is to spay them. Usually, it is recommended to use hormone treatment or even blood transfusions to get them into a safer state for surgery, but we didn’t have those options, so we spayed her. She did very well in surgery – my first ferret spay – and looked good the next day as well, even though she was very pale (her hematocrit was only 22% before surgery). We were also able to discuss ferret behavior. The first time this little one came into the clinic, the veterinarian thought she was aggressive and attacking them, but it was only play behavior. Later that day,we had a veterinarian that used to work at the clinic, and has since started her own clinic, come in with a case – a husky puppy that had been hit by a car the day before. He had been diagnosed with a fracture femur (broken back leg), but had been doing well otherwise. When he came into us, he was having difficulty breathing. His heart and lung sounds were muffled on his left side and radiographs showed that he had a diaphragmatic hernia – his stomach was in his chest instead of his abdomen and it had displaced his heart and lungs. As the owners decided to have him euthanized, he died in our arms. I was allowed to do a necropsy, which although sad was amazing to see how a small hole in the diaphragm could cause so much destruction.

Friday, we performed surgery on a Pekingese that had been attacked by a dog the week before. She had multiple hernias, one contained the majority of her intestines that were outside of the body wall, but still under the skin. We had to remove the contents of the hernia pouches back into the abdomen, then clean the areas, repair the torn muscles, close the hernias, and remove the spleen that had also been damaged. It was a long surgery, but Bayaraa (pronounced ByRa) did wonderfully with me as her assistant. This was her first splenectomy (removal of the spleen) and a major trauma case. Choppa (not sure how it is really spelled) did great and went home that afternoon. We had another emergency case later in the day, a cat that was in dystocia (labor complications). The owner agreed to C-section and spay. None of the veterinarians I was working with had done a C-section before and one has not spayed anything either, so they had me do the surgery while they watched so they would know what to do in the future. The kittens were already dead and rotting, the mother cat was toxic. Surgery went as well as could be expected with rotten tissue that were falling apart. Sadly, The little cat did not make it. She died about 20 minutes after surgery was completed. I cried and mourned the loss of the cat.

This week has been filled with highs and lows medically, but I know that God has a plan in it all. I wasn’t sure if I was going to be able to do much here and really make a difference as I am just a regular doctor, not a specialist, not a genius. What I have found is that here, I am the specialist. There is no one else to go to with more experience. Although there is a veterinary school it is all book learning, there is no hands on teaching. There is not an emergency or specialty hospital near by…or anywhere in the country. We are the specialty hospital! I am thankful that Andrew is here to take care of the orthopedic (bone) problems as they make my stomach turn, but otherwise, I am currently the go to person for exotics, behavior, anesthesia, surgery, internal medicine, ophthalmology, dermatology, and the list goes on and on. I am thankful to have had such a well-rounded education and experience thus far. I am also thankful that I have not always worked in places that had every gadget and gizmo, the latest medications or diagnostic tests, because I have very few of them here. I have about 4 antibiotics, 3 anesthetics, 3 pain medications, and some deworming medications to work with. I have ultrasound and radiography, but I don’t have blood machines – we have to send them to the human hospital and wait a day or two for results which are not always accurate. There are cages full of dogs with diarrhea and vomiting, but the test to find out if it is parvovirus is too expensive for most Mongolians to afford. There is no true isolation to prevent spread of disease either. I am  learning to practice with the basics again – focusing on my physical exam and reviewing the differentials for any case with a keener eye as I can’t test for many of them.

Outside of the medicine, I have met so many people – it is hard to keep all of the names and faces straight! I have started to learn some Mongolian, very slow going, but hopefully, I will have enough down to have a basic conversation soon. The food is nothing like HuHot, but it is very good. I don’t know that I have ever eaten this much meat and rice in 1 week before!

The best news of all was that as I was checking in for my flight leaving Chicago, my sister had her baby!  Will was born at 3:07 pm in the UK. Congratulations, Kayla and Tom, and big brothers David and Trenton! Happy birthday, William!!

Kayla and William

Kayla and William

Please continue to keep in your thoughts and prayers:  Mongolia, Kayla and William, the Mongolian people and the veterinary community, and me – that I can do the work that I have been sent here to do with the love and peace of Christ leading me each step of the way.