Carrie and Anthony Petruso’s Guatemala Adventure

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written by Anthony

Clinics have been going smoothly.  I’ve been getting more comfortable with my role here and have to pester Dr. Pope less and less for the day to day routine things we see here.  I still stumble a couple times a day with my Spanish but my medical vocabulary has grown quite a bit.  It’s less stressful and more fun.

We were at one of our very established clinics today and saw difficult stuff.  The first patient set the tone for the day: slow.  He was a “60″ year old man (a lot of Mayan’s don’t neccesarily know their age) who looked like he was about to die any minute.  For 6 months, he had hardly been able to eat for nausea, stomach pain, and had fallen from 120 lbs to 90 lbs.  He was very much wasted away and extremely weak.  He was having a hard time breathing and was complaining of constant chest pain.  His heart was absolutely pounding away and skipping beats, he had no color to his skin.   He’s the kind of patient that’s just screaming at you that something terribly wrong is going on.  His family had taken him to the National Hospital Santa Elena (across the street from where we live), and they told him he had anemia and gave him vitamins and an antibiotic without any laboratory studies or imaging and sent him on his way.  He also went to a private doctor who didn’t do anything.  Apparently the poor Mayan’s sometimes are discriminated against by the hospitals and medical community here and don’t get adequate care even when they are obviously severly ill.

Anyways, while examining him, I flipped up his eyelid which can give you a relatively decent estimate of someone’s level of hemoglobin, or blood, in their body.  This was the whitest I’d ever seen. We only have a couple of lab tests available to us so we did what we could check; his blood sugar was normal, his hemoglobin was 3.6.  This is the lowest number Dr. Pope and I had ever seen, roughly one sixth of normal.   If we had any blood or the ability to give it we would’ve given it to him.  With that little blood in his body his ability to get oxygen to his heart, brain, and the rest of his body is severely limited and precarious.  Any minor imbalance could push him over the edge into a heart attack, intestinal infarction, or stroke.  We wrote an urgent letter to the National Hospital Santa Elena Emergency Room detailing our laboratory results and requesting that they transfuse him with blood and perform basic studies to try to help this man out.  The clinic we work at has a fund available for such things, so they paid for a ambulance service to come and retrieve this man.   Sometimes the gringo influence can help the hospital act.

From a medical perspective, as far as why he was so anemic and deathly ill, it is difficult to say for certain without any testing.  Most likely given his symptoms I believe would be a colon cancer, slowly bleeding away in his intestines.  I really doubt that anything that happens at the hospital will be curing him.  Probably in the best case he will receive some blood transfusions to just live a little easier and some palliative pain management to live out his last few months without so much suffering.   We’re keeping him in our thoughts and prayers here.