Sunday, April 22, 2012

Chantal

There were so many ways to introduce this story and I re-wrote the beginning several times... But in fact, nothing is good enough! When you save so many lives it's hard to accept the fact, that sometimes everything you do is still not enough...

Here is a beautiful post from Deb Louden, a nurse who cared for Chantal...

Chantal came to us at the very beginning of our Togo outreach.  She presented with a huge, gaping wound in her right arm pit and down her arm.  The wound was very raw, very infected and discharged very smelly fluid.  Chantal was small and skinny, for her 25 years, but had a bright smile on her face despite her circumstances.
She was admitted right away into our isolation room and we swabbed her wound wondering what sort of bacteria it was growing.  We completed all sorts of tests, during which we found multiple bacteria growing in her wound and that her body was HIV+.  Immediately I thought, Oh man, this is going to be an up-hill battle, but we will fight with all we have!
For the first couple of weeks Chantal endured very painful, 2 hour long, daily dressing changes.  She complained of pain constantly, leading to morphine infusions, scheduled pain medications and a myriad of other treatments.  She had a poor appetite and we had to encourage her to take every bite of nutrition.  Her nurses and those caring for her were amazing with the care they poured upon her, often going the extra mile and gently propping her pillows and massaging her hands when she was uncomfortable or distressed.
After some of the infection was cleared up, she was able to have a muscle flap and skin graft to her wound by our plastic surgeon.  Some of the graft took, other parts of it sloughed off.  Again the daily dressing changes continued, some happening in the OR under general anaesthesia for her comfort and pain relief.  And then again we regrafted the area where the previous graft had come off.  More dressing changes, more pain relief, more hand massages, more encouragement to eat enough food for her body to cope and heal her body and fight disease.
We moved her from the isolation room into the ward community.  She began to brighten!  A smile lit her face.  She would sing during devotions.  She was able to get herself to the toilet and she wanted to walk the hallways to stretch her legs.  She could go, with some help, to deck 7 to see the sunshine.
But again, she was knocked back by something.  Her heart rate skyrocketed, her appetite disappeared.  We put in a feeding tube and fought with her to keep it because without it her body just wasn’t coping.  We pumped more and more antibiotics into her body to fight the infection in her wound.
And finally after months of this, getting better, moving back into the ward and then having a set back and going back into ICU, we weren’t winning.  The bacteria in her wound was resistant to all our available antibiotics, her heart rate was still in the 160’s while she slept, her breathing was fast and not saturating her body with enough oxygen on room air.  We had done everything we could possibly do and we just weren’t winning.  Chantal knew we weren’t winning too and she didn’t want to fight anymore.
So a couple of weeks ago now, the decision was made to stop fighting and just provide comfort measures.  We stopped all antibiotics, we stopped her oral supplements and she didn’t want her feeding tube, so we removed that.  Her dressing changes became just for soaking up the drainage every 2-3 days.  And we continued to prop her pillows, massage her hands and give her whatever pain relief we had available.
We had a plan for her to go home to be with her uncle and aunt, but we had to have everything ready and organized. Tuesday and Wednesday nights I looked after her on my night shift.  I knew it wouldn’t be long now until she gave up completely.
Then yesterday before I went for dinner I went down to the hospital.  There was Chantal in her big ICU bed, at the pilots entrance of the ship, (two big steel doors of deck 3 that the pilot enters and exits during the sail in and out of the port) with a beautiful view of the ocean water rippling in the wind.  We could see the green of trees, feel the gentle summer breeze and as the light slowly faded Chantal rested with one of her dear nurses and her mentor friend.  She called out Jesus’ name.
After about an hour resting there, we wheeled her back into the ICU and over the next couple of hours she slid away to be with Jesus.  Her last words being, “Jesus is here.”
We fought so hard in the physical, but we lost.
But during her time on the ship Chantal asked Jesus to be in her heart.  You could see the change in her spirit, but her body didn’t have enough energy to fight.  So even though we lost her, she is not lost forever.  She is being held in the arms of Jesus, her Saviour and she has no more pain, and there will be no more suffering.  She has been saved. 
(Deb is the one on the left)

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