Update

Dear Brother and Sister Hansen,

This is Elder Arner, the Area Medical Adviser.  I want to provide you with an update on your daughter, Sister Hansen and to assure you that she is safe, comfortable and improving health wise.  She is currently in the MRC (Missionary Recovery Center) in Manila where she is recuperating after a particularly nasty bout of gastroenteritis that necessitated her being hospitalized at Baypointe Hospital in Olongapo.  All of the sister missionaries in her apartment got ill simultaneously and there was some concern that it was amebiasis, although Sister Hansen's tests were negative for that diagnosis.  I suspect that it was more likely shigellosis though no cultures were done so this remains a supposition only.  She was treated and was rehydrated and subsequently discharged when her symptoms resolved and she was showing improvement.  We moved her to Manila when it appeared that the recovery might take longer than 48-72 hours. 

The MRC is a comfortable, safe residential unit on the grounds of the Church's Philippines Area Offices complex and it abuts the MTC, but is functionally separate from it.  It is across the street from the Manila Temple.  It is also directly above the Area Medical Offices.  It is overseen by two experienced nurses, Elder and Sister Kasteler, both of whom are full time missionaries.  It is not a hospital or even a clinic, but it is a pleasant place to recover for missionaries who may also need access to additional medical services that can be found only in Manila.  Incidentally, this is the only MRC in the Church.  While in the MRC, she has the opportunity to participate in several service projects and to attend the temple regularly.

You are undoubtedly aware that Sister Hansen has had a variety of medical problems since arriving in the Philippines, including skin infections as well as the GI problems.  Through all of this she has been very upbeat and has demonstrated the commitment and endurance we so admire in our missionaries.  There is no question this has taken a toll on her but she presses forward and does not complain.  She has a bright and happy countenance even though at times there has been substantial discomfort.  She has improved since arriving in the MRC but is not completely recovered at this point.  I visited with her at length again today to assess where we are and to formulate a longer term plan.  When she arrived she was still having intermittent problems with abdominal pain and with loss of appetite.  She also had a recurrence of a very itchy skin rash which may in part have been due to the medications she received previously and she had a urinary tract infection.  The rash and the UTI are largely corrected but the abdominal discomfort persists intermittently.  Her appetite has improved and she is eating and drinking normally.  You would not know there was any problem to see her or to visit with her, but it appears she has a residual gastritis with a component of mild reflux.  She has been started on a proton pump inhibitor (the generic form of Prilosec) in addition to her medication for the UTI and her rash.  I am hoping that she will respond well and will ready to return to her mission in a couple of days.  All of her lab work at this point is normal.

I am a bit reserved in this assessment due to the slow nature of Sister Hansen's recovery.  There does appear to be a small subgroup of North American missionaries who, for lack of a better term, develop an allergically mediated response to certain foods and/or other environmental factors as yet unidentified and have great difficulty getting past the abdominal pains associated with this reactive gastroenteritis.  This is not the same thing she had when she was admitted to Baypointe.  That was true bacterial gastroenteritis.  What she has at the moment however looks very much like what we have seen in so many others.  It is a condition that frequently requires a medical release and reassignment after an appropriate time of healing at home.  We are not at that point yet, but I mention it because it is a possibility given all of the medical problems she has had to endure.  If we cannot get excellent control of her abdominal pain with medication and diet, we may have to revisit that choice.  Sister Hansen is fully aware of this and I have informed President and Sister Dahle, though all of us hope that she will return to the field fully functional in a few days.  By the way, I should mention that President and Sister Dahle are extraordinarily watchful shepherds over their missionary flock.  There is no Mission President and wife combination who does a better job of that here (and I suspect anywhere).  She is fortunate and blessed to be a part of the Olongapo Mission. 

I will update you as things progress.  We should know much more in a few days and as soon as things appear to be moving in either direction I will contact you.  Please be reassured that she is comfortable and in very nice surroundings.  She is not suffering.  Having had a son who had similar gi problems on his mission in Russia, I am not only empathetic, I am sympathetic.  I know how anxiety producing these situations are for parents when our children are a great distance away.  We tend to imagine the worst.  However, she looks great and sounds great and is actually blessing the lives of others who are concurrently residents in the MRC through her cheerful attitude.  You have every reason to be very proud of her.  She truly has embraced this great cause of hastening the work of salvation among these wonderful people in the Philippines. 

If you have questions, I will certainly try to answer them. 

Gratefully,

Elder Mark C. Arner, MD
Philippines Area Medical Adviser
The Church of Jesus Christ of Latter-day Saints