Letting Your Pessaries Fall Where They May

Sydney with the OB nurse (who got hit with the flying pessary)

You know the phrase, “let your chips fall where they may?” Getting into a rhythm here in Togo has taken a few weeks, but we are beginning to see some of the dust settle. Especially the first week, though, felt like an interesting dance to try to figure out new systems and expectations and workload and balancing kids and new househelp and new jobs. After several particularly busy days wherein I felt like I was expected to be doing surgery, running labor and delivery, rounding, and seeing patients in GYN clinic and supervising OB clinic, all at the same time, I was very tired. The day before, I had left 9 patients waiting to see me and simply put them off until today. And today, as I was trying to get wrapped up, several OB patients were complicated and I needed to stop and see them. It was already beginning to get dark, and I knew that my husband wasn’t likely home yet because he was playing soccer that afternoon, and I knew we were having company over for dinner, in 30 minutes…. So I was stressed. An OB patient with history of incompetent cervix now with twins had a shortened cervix. She probably needed a cerclage or pessary to reduce her risk of preterm delivery (OB's reading this, I know there is no evidence in twins.)

I barely had time to discuss it with her, and quickly found a pessary that would probably fit. This particular kind folded, and to put it in place supporting the cervix, one usually uses gel. So I did. And then I folded it. And in my hurry to place it, the thing slipped right out of my grasp, flipped up in the air and flew across the room and hit the poor GYN clinic nurse on the shoulder. She didn’t bat an eye, but bent over and picked it up to go out and clean it. I just stood there with my glove on, pondering how incredibly funny it was to have flying pessaries, and how thinking of that was going to help keep my stress level down as I finished out the final patients and headed home for a busy evening. Things will get better, we’ll settle into a routine, but until then, a few more flying pessaries to lighten the mood may be in order. And we’ll just let them fall where they may.

Let’s back up a couple of days. When we arrived in Togo, there were a couple of visiting retired OB/GYNs who were taking care of essential clinical care and being on call, so I was able to concentrate on unpacking and organizing life. I took over on Thursday, rounded with the departing OBs and reviewed their patient lists and treatment plans. I was on call, which means I admit patients, am first call for labor and delivery, and can go home for night but need to be available for 24 hrs. It wasn’t super busy, but there always seems to be a question about something around 5:30am that inevitably wakes me and little Zack for the day. Friday I was somewhat tired, but went in for a C section I had put off for the morning, as it wasn’t urgent. It was routine. Second baby. Second C section.

But… I struggled getting through tough fascia. I struggled getting the baby out through an unforgiving scar. And then her uterus wouldn’t contract. Refused. As in, it NEVER felt firm. I did what I’ve been taught to do- gave IV Pitocin, gave IV methergine, gave rectal misoprostol, gave more IV Pitocin, gave IM methergine, slapped and massaged and hit and pleaded with that uterus to contract and get firm. She was a young patient, unlike the momma we had done a C-hyst on for her 9^th pregnancy having just given birth to triplets almost at their due date. THAT made sense. If I was a uterus and had carried 9 pregnancies, two of which were triplet pregnancies, I would probably refuse to contract too. I’d be done too. And a hysterectomy after C section in a momma like that is only done when necessary, but it is an easy decision when they bleed. For young patients without many children, this is a VERY hard decision to make.

So I refused to give up on this uterus. I had already sewn the uterine incision in two layers, but there was blood oozing from the suture lines, from the inside of the uterus which wasn’t contracting (normally this clamps off blood vessels), and I knew that there was likely a huge amount of blood underneath the surgical drape because the cervix is open. I tried a B-lynch suture around the top of the uterus to force it to be smaller. I scrubbed out of the sterile field and packed the inside of her uterus with three foley balloons to make a “uterine sandwich” with the B-lynch suture holding it clamped down from the outside and pressure from inflated balloons on the inside.
I noted that there wasn’t as much blood in-between her legs as I had feared. Weird. I scrubbed back in. I oversewed a bleeding area to try to stop oozing. I was tired. So I decided to put the uterus back in the abdomen (I know this is creepy to non-medical folks, but we can easily pull the top of the uterus and the tubes and ovaries out of the abdomen during a C section). I tried really hard. Remember that tough fascia. Yeah. Still tough. I actually ended up cutting the skin and fascial incision open wider to put the uterus back in! It had already been big enough for the baby to come out, and then the uterus right after, but now I couldn’t get the uterus to go back in without cutting my incision wider!?! And she continued to ooze. It was odd. With how boggy her uterus felt, she didn’t have a ton of blood between her legs nor was blood pouring out of the incision site. But a non-contracting uterus almost always requires action, so I needed to make a decision of whether to do a hysterectomy to save her life. Surely she would just continue to bleed until there was no blood left. After all, 500mL of blood is going to the uterus at the end of pregnancy every minute.

You know those visiting OB’s? I knew they were still around for another hour before their vehicle left to take them back to the capital for their flight back to the US. I called one of them in. I just felt that as long as they were there as a resource, I should get their second opinion. One graciously came and scrubbed in. We took a long look, evaluating the amount of blood lost, evaluating the still soft and very large uterus. She finally said, “well, let’s use Surgicel and close her.” You might have to take her back to the OR later, but her vitals are fine, she isn’t bleeding that much even though her uterus is not contracting down, and she might do well!” So I used the gray mesh called Surgicel that helps small oozing vessels to coagulate, and I closed the fascia and skin.

Even though I was post-call, I couldn’t get her off of my mind. I told the on call family doctor (Dan) to keep a close eye on her. I worked until evening, then headed home to the family after working a full day and being on call at night and then working a full day. I hadn’t even finished eating the last bites of dinner when Dan walked by the house on his way in, saying that her blood pressure was very low now and he was going in to check on her. I knew what that meant. She had lost enough blood now that her uterus needed to be taken out. I kissed my husband and kids goodbye, swallowed a few more bites of dessert, and changed back into scrubs. I was sad, but I was convinced that she either would die or I’d take her uterus out.

But, I met Dan walking out of the hospital. He said that she didn’t clinically look bad, the ultrasound didn’t show free fluid, and her repeated blood pressures were not as low. He thought she was stable. I wanted to be sure, so I went in and repeated the ultrasound and pushed on her belly. Indeed, she didn’t look like she was bleeding to death. So I went back home in time to put the kids in bed, hoping I wasn’t just delaying the inevitable until the middle of the night. 

In the maternity ward with a happy ending

Sure enough, I got a call from Dan at 2:30am. Even though I wasn’t technically on call that night, I’m still the one they look to if there is a serious problem as I have the most OB experience of the doctors here. But it wasn’t about her. It was a new patient who had been emergently transferred here because she had a hand presentation- instead of the head coming out first, the hand had delivered and the baby had died in the labor process already. She was only 34 weeks. Dan asked my advice, and I recommended trying to avoid C section for a dead baby unless the mom is unstable or had had previous C sections and it seemed dangerous. It’s not difficult to deliver by C section- just deliver as you would a breech presentation, I told him. I went back to sleep. At 4:30am, I was awakened again.

**************************Notice- this next part is extra medical, so if you don't care to read it, just skip to the "One Quiet Night" picture.****************************************

This time, it was to do a hysterectomy, but NOT on the patient I had been so worried about. No, it was for this new patient. They had put a foley catheter in her bladder in preparation for delivery, and it had returned as straight up blood. Concerned about uterine rupture, Dan had called the general surgeon back up to do a C section for probable uterine rupture, as he did not want to wake me. But when they opened her abdomen and had taken down the adhesions, the whole bottom portion of the uterus was ballooned out and dark red, as if the placenta had invaded through the anterior uterine wall and was now in the bladder. Indeed, the foley catheter balloon could be felt at the top of this red mass.

Most bizarre pregnant uterus 

I had never seen this before. Placenta percreta? That means the placenta would not come out easily; she would need a hysterectomy, and even then, the placenta was likely invading the bladder so how would we repair that? I decided to start with the known part. I split the uterus front to back. Sure enough, there was anterior placenta and baby feet. As soon as I ruptured the amniotic sac, the big purple mass which looked like the invading placenta simply collapsed. And we saw the baby’s head where I thought the bladder was. I tried pulling the baby out by its feet, but the muscular part of the uterus was contracting too much (opposite problem as previously).


So I continued to cut down anteriorly until I had completely transected the anterior part of the uterus and it was now filleted open in right and left halves. To my surprise, the placenta easily came out. And then the baby did. Now we just had two halves of a uterus to finish removing. It was easy enough to detach the remaining posterior cervix from the vagina. We left the ovaries, and clamped along each side of the broad ligaments until we got underneath the cervix. With that, the two halves of the uterus were removed. I tried to find some remnant of anterior vaginal wall to sew the posterior wall to in order to close the opening, but it wasn’t clear. The remaining large purple part still had a foley catheter which was palpable, so that was the bladder. Its surface felt extra thick, so I decided to take part of that tissue in my bites in order to close the vaginal opening to make a cuff. Nothing was bleeding, so we took one last look at her abdomen and then closed her fascia and skin.

I left around 7am, scratching my head and wondering what in the world I had just seen… uterine rupture which happened a while ago? A pregnancy that grew within the old cesarean section scar and slowly opened it?… bizarre. And I was incredibly thankful that Zack hadn’t woken up yet wanting to eat. Not 10 minutes after I walked through the door, he started whimpering to eat, and I took him and cuddled with him and he nursed. And I thought. Wow, I just did a hysterectomy, but it wasn’t on the patient I thought it would be on. Wow, God did a miracle and the first mom is doing well. Wow, I’m tired. Wow, I hope things slow down. I was on call the next day, Sunday, again, but it was as if I had played the “One Quiet Night” card in the game of Pandemic. After regular rounding and seeing that both post-op patients were doing well, there were no further surgeries or emergencies. Eerie.

The next week started out busy again with surgeries, and by Tuesday, there were flying pessaries. That’s why I was stressed. A short-termer pace is unsustainable long-term, especially with a family and young kids. We’ll let the pessaries fall where they may, but only after we make adjustments, decrease expectations to a reasonable level, and try to ensure that these kind of weeks are the exceptions and not the rule. May God give us wisdom, the needed “One Quiet Night”, and a few more comedic moments to help us laugh, even if it’s a pessary flipping end-over-end across the exam table.

The Longest Week- Stepping Out

It’s been the hardest week of my life. I have a gift of empathy, and it is extremely hard for me to disappoint someone. Try disappointing a whole village, a whole hospital, your “family”, and closest friends for the past year. It’s awful. It’s additionally awful not because the situation was out of our control, but because we were actively taking a step of courage to be obedient to what we feel God has called us to. And that allows all sorts of doubts to creep in. The same, “Did God really say to ….?” that Eve dealt with in the Garden of Eden is whispering in my ear as we say the hardest goodbyes.

Sydney, oblivious to danger, stands atop the dirt and waves to people as they go to get water from the Source

Stepping back for a minute, here is the context. At the recommendation of our sending organization, we took a vision trip to Togo from mid-August to mid-Sept. This year has been extremely difficult for Ryan especially, trying to find a place and purpose in a location that has used tribalism, witchcraft, intimidation, and passive aggression to thwart his intentions to help the hospital run more efficiently. His talents and gifts have gone largely un- or under-utilized. For me, I have been able to work in my field of specialty in OB/GYN, have been able to teach, to make friends, to have colleagues that work well with me. It hasn’t been all roses; I’ve had my share of frustrations. But it has been nothing like what Ryan has endured at the hand of a few influential people.

Visiting the triplets born in my absence, but all named after me because I diagnosed and gave prenatal care. Jean. Jeanine. Jeanette. Here I go by my middle name, Janeen, because it is French (Jeanine) and easier to remember.

As a result of this disparity of experience, we as a couple have not been on the same page regarding our future. Thankfully, our marriage has stayed strong as we have so many outside forces opposing us. But still, our vision for what the future of our family looked like was not the same. I saw opportunities for improvement in the situation at Vanga; he saw obstacles left and right as he tried to move forward. I saw our kids being so well taken care of by Mama Lutti and Tata Mbuta; he saw the need for school options and more interaction with friends for our kids. I saw the pain of leaving; he saw the pain of staying. So we committed to praying together every day, out loud, for unity and clarity regarding our future. And so we continued throughout the months of July, then August as we saw family and friends in the US, and then Aug-Sept as we experienced a new hospital situation in Togo.

There is a time to plant and a time to uproot what is planted. A time to tear down and a time to build. A time to weep and a time to laugh. -Ecclesiastes 3

In brief, Togo was a very good experience. We both easily integrated into their hospital system, enjoyed the numerous relationships renewed from language school days, and our kids had quite a few friends to play with. Two moments in particular felt to me like they gave some direction for our future.

After a women’s bible study, one of the older women was telling someone just ahead of me in life stage (Melissa) that God WILL make things clear. We just need to be still and quiet for long enough to hear Him. In my head, I was shaking my fist. Isn’t that what we’ve been yearning for, praying for since April? And so far, it has felt anything but clear. Melissa then turned to me and we began talking about life. She said, I believe led by the Holy Spirit, that “there have been several times in my life that I have let loyalty hinder me from doing what God wants me to do.” She told me a couple of examples, one being a contract that they had to shorten because they felt strongly that God was telling them to go to Togo. It felt eerily similar to our situation. “Our loyalty needs to be to the Lord.”  I left feeling like that was a message straight from heaven, but I didn’t like it.

The next night, I was recounting this conversation to Mindy, a labor and delivery nurse who is volunteering there for 3 months. I teared up, saying, “I’m sad because I feel like that was from God. I feel like all roads are leading us away from Vanga, whether that is us going back to the US so Ryan can feel fulfilled or us coming [to Togo] to finish out our term and potentially stay long-term. What are we supposed to say to those we pushed for change? I’m not sure what to say, because things are changing, but now we might still not stay. Why were we…?” And then an overwhelming sense of peace came over me. That change needed to happen regardless of us. And God is working His Will out in Vanga. If we were only there for a year to help make that transition happen, to be a catalyst, that was still HUGE. And God cares about that goat more than I do. (This is a reference to a previous blog.) God cares about Vanga more than I do.

But the decision to move from Vanga to Togo was complicated. From the moment we left for the US, change was happening so rapidly in Vanga it was hard to keep up. The corrupt district pastor finally moved on.  The interim seems unafraid of witchcraft and proves that as he walks out in the village after a curse has been placed, proclaiming that Jesus is more powerful than the evil spirits. The hospital medical director resigned and was replaced by our partner, Dr. Tim Rice, who has a huge job in front of him to get the house in order. An internal audit was called immediately to determine the financial condition of the hospital. The staff seemed to understand the situation and were actually quite ecstatic to get their salaries only 2 weeks late instead of up to a month late. The village has stopped listening to the old village chief who was calling on them to riot to stop the changeover in administration at the hospital. The village was completely quiet, despite 2 attempts over a megaphone to call people to action. Ryan saw rebuilding from zero as a challenge which might be fulfilling to him. The needs are huge. But making a decision based on need is problematic. The reality is that most mission hospitals around the world need help. The majority don’t have the luxury of turning down scores of surgeons and medical personnel trying to come work in a resource limited setting. It was too difficult to give a final answer and we, oddly enough, needed a sort of vision trip back to Vanga to complete the loop.

Sydney learning from Mama Lutti as Zack watches.
Mama Lutti has taught Sydney colors and numbers and
how to work and cook and color and we love her dearly.

We arrived back in Vanga last week on Thursday. Indeed, a sense of peace prevailed and people seemed optimistic and very welcoming. The hospital seemed to be functioning well enough, and Ryan was invited to a meeting for planning the interim period. I stayed at home to get things in order before starting work on Monday. We enjoyed reuniting with friends and colleagues, as well as our beloved Mama Lutti and Tata Mbuta playing with and enjoying our kids. Even though we were leaning towards finishing our two-year contract with Samaritan’s Purse in Togo, maybe we would stay through December and help out with the transition, or maybe and better yet, I thought, we would find that the situation had improved enough that Ryan would feel fulfilled. I was still leaning to stay; Ryan was leaning to go. We didn’t yet have unity.

Carrying down donated baby blankets to the maternity ward.

Then Saturday evening happened. We were sitting around the table after dinner celebrating our return with the other missionaries. The discussion turned more serious as we learned that some paperwork still hasn’t been finalized for my work to continue in Congo. It is a direct result of the local political conflict here and actions not taken by administration last year at this time, and other actions taken by administration in February this year, specifically aimed at intimidation. As we talked, I realized that this news, in turn, is a threat to my ability to finish my board certification in the US this year. And time is running out. Secondly, another letter written by the village chief in the adjacent village was delivered on Saturday which was disparaging of the missionaries in general.

Turmoil within. The rest of Saturday night and Sunday were spent mulling over the options. We talked, thought, prayed, and had no inner peace. In the end, we decided to wait until Wednesday of this week to try to see how things would play out in Kinshasa. I decided to go to work as planned on Monday. I hardly slept Sunday night. Monday morning, I was exhausted as I pulled on my scrubs and white coat and started towards the hospital- my family was still asleep. As I continued down the path, I found I couldn’t continue. I had zero peace. My mind was whirling. What if something happened in the operating room while I’m in this emotional state, exhausted, in turmoil? I turned to the left on the path away from the hospital and cried as I trudged to the Rice’s house.    

Nighttime routine- reading books with Aunt Kathy after dinner

Nighttime routine- discussing really important goings-on at the hospital with Tim

I sat on their porch swing overlooking the beautiful Kwilu as the sun rose and cried. I knew I had to say yes to God that I’d follow Ryan’s lead and we would leave Vanga. Tim cried. And Kathy made a list. (If you know them, this might make you chuckle). I called Ryan and we knew what we had to do. But doing it was another thing. It took a boatload of courage that I didn’t think I had to start the process- to get past the point of no return was extremely hard. As the schedule for flights out of Vanga was limited, it was a choice to leave quickly or leave after a couple of weeks potentially. Knowing we would leave for sure, we chose to leave sooner in order to not prolong the pain.

“Be willing to act and expect God to be responsible for all the consequences that flow from obedience to His guidance.”

We made the decision to leave Monday morning, and started the painful process of telling people we were leaving. Heartbroken does not begin to describe the emotions. Congolese frequently wail when family or friends die, but many times this is to demonstrate to others that they did not put a curse on them or cause their death. But this was a different kind of sorrow. Some left the room sobbing loudly. Some had tears streaming down their face silently. Some were more stoic but then broke after a few minutes. Most, like me, were in disbelief. Why? Why now when things seem to be getting better? I cried most of the day and fitfully slept most nights from Monday-Wednesday. As I walked and went through the motions of packing on Monday, it took all my strength to keep going. Big deep breaths. Tears. Packing our life. Denial about what was happening. Hoping I could wake up and it would all be a bad dream. Seeing the looks of shock and disappointment from those I love dearly here over and over in my mind. We had only told a few by Monday night, but we finished packing late and went to bed, knowing the next days would be more emotional than physical.

One last C section with my best friend, fellow
doctor, fellow new mom, Laurene.

We told most people during a regular morning hospital meeting on Tuesday, inviting them to a going-away party of sorts that evening. I then engaged in tying up some loose ends at the hospital. I did some ultrasounds for the last time, I did a C-section with my best two friends for a final time, I saw a few patients that had been waiting for weeks for my return for follow up. It wasn’t much, but did help with closure. We swam in the Kwilu a few more times with the kids, played games with the missionaries, and focused on relationships. I cried a lot. We got on the plane on Thursday (after getting the ok from SP due to the unrest in Kinshasa it was literally “up in the air” until then). We have closure. We felt very loved on our exit. It will take time to make sense of this, the timing, the why’s, and to see how God will take care of Vanga and the loved ones and patients we left behind. Regarding our partnership with the Rices and the Congo Health Connection, it feels like when Barnabas and Paul went separate ways for the sake of the gospel, although we’ve had no conflict. For now, we and the Rices are clinging to these promises.

Playing a new card game with the missionaries- we hail from Oregon/Missouri,
Texas/Missouri, Switzerland, and Germany

“I know what I’m doing. I have it all planned out—plans to take care of you, not abandon you, plans to give you the future you hope for.” -Jeremiah 29:10-11 MSG

New Congolese outfits, made by Angele (left) that same day. Sydney has one too!

“You parents—if your children ask for a loaf of bread, do you give them a stone instead?” -Matthew 7:9 NLT

We gathered with all of our employees and their (large!) families,
as well as employees from the hospital for a small going away party.

“Brothers and sisters, we want you to know about those Christians who have died [in our case, left] so you will not be sad [in the same way] as others who have no hope [to see each other again.] 

-1 Thessalonians 4:13 NCV

Junior and Ryan, coworkers and friends

“Being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus.” 

-Philippians 1:6 NIV

Ladies from the maternity came and sang with me our last day in Vanga. And I cried.

“So do not throw away your confidence; it will be richly rewarded. You need to persevere so that when you have done the will of God, you will receive what he has promised.” -Hebrews 10:35-36 NIV

“Now then, stand still and see this great thing the Lord is about to do before your eyes!” -1 Samuel 12:16 NIV

There is no one quite like Mama Lutti

“’Not by might nor by power, but by my Spirit,’ says the Lord Almighty.”- Zechariah 4:6b NIV

“Jesus looked at them and said, ‘With man this is impossible, but with God all things are possible.’” -Matthew 19:26 NIV

The operating room team

“Do you not know? Have you not heard? Has it not been told you from the beginning? … He sits enthroned above the circle of the earth, and its people are like grasshoppers. He stretches out the heavens like a canopy, and spreads them out like a tent to live in. He brings princes to naught and reduces the rulers of this world to nothing. No sooner are they planted, no sooner are they sown, no sooner do they take root in the ground, than he blows on them and they wither, and a whirlwind sweeps them away like chaff... Why do you say [Potters], “my way is hidden from the Lord; my cause is disregarded by my God?” 

Trying to hold it together. One last "family" picture before we took off.

Do you not know? Have you not heard? The Lord is the everlasting God, the Creator of the ends of the earth. He will not grow tired or weary, and his understanding no one can fathom. He gives strength to the weary, and increases the power of the weak. Even youths grow tired and weary, and young men stumble and fall; but those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.” -Isaiah 40:21-31 NIV

Saying goodbye to some doctors I taught in Kinshasa who just got their results that they passed. 

Hanging out with the Spanns in Kinshasa (A MAF family we love and will miss)

He Giveth More Grace- Annie J Flint

1.       He giveth more grace when the burdens grow greater,
He sendeth more strength when the labors increase;
To added afflictions He addeth His mercy,
To multiplied trials, His multiplied peace.

2.       When we have exhausted our store of endurance,
When our strength has failed ere the day is half done,
When we reach the end of our hoarded resources
Our Father’s full giving is only begun.

3.       Fear not that thy need shall exceed His provision,
Our God ever yearns His resources to share;
Lean hard on the arm everlasting, availing;
The Father both thee and thy load will upbear.

4.       His love has no limits, His grace has no measure,
His power no boundary known unto men;
For out of His infinite riches in Jesus
He giveth, and giveth, and giveth again.

Eating cheesecake with Uncle Jonathan in Kinshasa

Enjoying kittens and Mama Katherine in Kinshasa

SBarring any new developments or flight cancellations due to unrest in Kinshasa, we will be leaving for Togo tomorrow, less than a week after we made the decision to leave. It's been the longest week, but we are stepping out in faith that God wants us to take this leap. We will trust that God will keep His promises to work out His Will in Vanga and for those we left behind, and also in our lives in our new adventure and life in Togo. 

Three Week Blitz in the US

Imagine a 2 year old, sitting atop her daddy's shoulders, waving her passport out of his reach. This was just one of the fun airport moments we had during our long travels with a 6 month old and toddler. Perhaps the airline crew member did not approve of us coming through the line with the other priority boarding members, but most airlines encouraged early boarding for families with young kids. The crew member stopped us the first time we tried to board, saying we each had to be holding our own passports. With Zack on my front, I usually lugged the carry-ons while Ryan had Sydney on his shoulders while handling the passports or boarding passes and the kid's bag. We stepped to the side, Ryan gave me my passport which took some reshuffling of hands, and we stepped up again. She again said, "everyone needs to have their passports in their hands," and shooed us to the side. Ryan asked incredulously, "You want me to give the passport to our two year old and the baby?" She nodded her head, motioning for him to give it to Sydney. Thus, we had the situation which followed. Sydney joyously took the passport, held it up like a trophy, and started swaying back and forth in tiredness and boredom, refusing to let Ryan take the passport back much less show it nicely to the crewmember before boarding to compare her face (still her 3 month baby pic anyway) with her ornery 2 yr old face. Ryan looked back at me and smiled. What was she thinking??

Our journey started as took the short 1.5hr flight from Vanga's grass runway to the regional airport in Kinshasa. We stayed overnight with our good friends, the Lind's, who graciously host us when we spend time in the capital, and provide entertainment for Sydney and Zack with their 4 kids. 

The Lind and Potter kids (minus Levi)

The newest missionary babies, already holding hands

The next night, we took a flight from Kinshasa to Paris to Atlanta to San Antonio. Our 8 checked items took the first flight, 3 joined the airline strike in Paris, and 1 took a vacay in Atlanta. We got our lost half of baggage back in 3 installments, and one had to be mailed to our final US destination because it enjoyed the Paris airport THAT much. In all seriousness, we had what we needed except for my breast pump.

We spent about a week each in San Antonio, St Louis, and Tulsa. Ryan, of course, spent several days in Dallas standing up in a wedding for a good friend. Turns out the bride was originally from Congo! I don't want to blog an endless itinerary, nor do I want to leave people out. Everyone we saw, even if it was for a short time, was a tremendous encouragement to us. I will highlight a few things. 

My grandparents and my aunt DROVE over 20 hrs roundtrip to see us for just a few hours on Sunday morning. It was a complete surprise, and they were waiting behind a door when we walked through. It was one of those familiar feeling, wrong place moments, and I wondered who else might be lurking around the corner. I confess that I spent more time watching Zack pick up and swing my grandma's cane during the service that I did paying attention, but it was a moment I will cherish. 

Snuggles with great-grandma

Coloring with great grandpa

My initial reaction when walking into Walmart was utter joy to be able to get haircuts, buy food, electronic items, misc, and clothes, and go to McDonald's, all without leaving the building. I ate ice cream 1-2 times a day. And it was awesome. Sydney enjoyed playing on many playgrounds with old and new friends. This is not original, but a quote from a missionary mom on Facebook, but it is very similar to our feelings.

"I did the most amazing thing today. I was feeling cooped up and wanted to get out with my daughter. I slipped my shoes on and we walked out the door. Three and a half blocks later we were at a beautiful park. Playing. On a playground. all I could do was cry. Innocence. Beauty. Adventure. We don't realize the bondage we live in until we taste freedom. No one was staring at us, or touching us, or wanting to take pictures with us, or asking us for stuff."

First haircut :)

Reading with Granddad Potter

All smiles with Nana

Making breakfast together

Jump!! into the backyard pool with the cousins

We left open several time periods to fill with hanging out or meeting people, but no one had filled the day before we left San Antonio. On the same day, my brother-in-law had a job cancellation. So, on the spur of the moment, we all decided to spend the day at Schlitterbahn Waterpark. Nana, Kara's whole family including 3 girls, and our family headed out to a day of splashing around. My favorite moment was getting to the front of the line and finding out that Zack had to ride in his own tube (with a bottom)! The kids all had lifejackets on, and the tubes indeed proved to not tip as they went down the steeper parts of the slide. In fact, Zack slept through most of it as we floated along between chutes. At the top of a particularly steep chute called "a waterfall" the lifeguard pushing us over the edge looked at Zack sleeping peacefully and said, "Sorry buddy," as he pushed him over the edge. Although it woke him up for about 20 seconds, he went right back to sleep.

Schlitterbahn kids play area

Sooo much fun!

The Potter clan all together in San Antonio

On our trip from Dallas to St Louis, one of our supporters based in St Louis was the pilot. He made sure we had extra water on the flight and greeted us by name when giving the captain's greeting before the flight!

We were able to visit the hospital where I lived, err, did my residency, in St. Louis. It was wonderful to be reunited with faculty and nurses that were nearly my family for four years. 

Speaking at First Free church in St Louis

Spent the better part of a day at the St. Louis Zoo with my mom and the kids. It was so fun to see the joy and excitement on Sydney's face, see the new polar bear which put its face right up against the glass for Zack to stare wide-eyed at. The Orangutans were hilarious. The male kept spitting on the female, antagonizing her until she had had enough, started chasing him and wrapping him up in a rolling tackle. 

The carousel!

Up close and personal with the polar bear!

I had little hope that we'd get an appointment, but I decided to call one of the dentists who supports us to see if we could come in to get our teeth cleaned. At first we were told they were booking into the month of October, but after I explained that the dentist had invited us personally by email to call, they got back to us that we could come the next day in the afternoon. It just fit perfectly into the very hectic St Louis schedule. Even though it was less than 24 hrs notice, the dentist gave us a personalized frame of our family picture from the newsletter. It was one of those moments that we felt particularly cared for.

The hospitality shown to us was over the top. They specifically stocked their pantry with food items they knew we missed, the laundry fairy came by and our clothes were neatly folded, sometimes with extra items added. They told us to make ourselves at home and invite others over, and they truly meant it! That significantly freed us up to spend more adult time with old friends as our kids could rest in their beds as needed.

In Tulsa, we got to eat at a Brazilian Steakhouse to help celebrate my parent's 40th anniversary! If you haven't eaten there and you like meat, it was a place not to be missed! Tulsa was our most restful stop, with lots of time spent just hanging out with the family at home. My aunt and uncle drove to see us and we got to see a cousin’s wedding in realtime as it streamed live from California.

This was a perfect capturing of a relaxing afternoon playing yard games, Zack eating, and Sydney playing in the background with cousin Marcus

Yard games with a competitive family :) This is a spoof on a pic we took many years ago with aerobies

Toews siblings

Toews grandkids all on Grandpa's back

The Toews clan all together in Tulsa