Clinic today started out again with some more OB shenanigans. One lady came in overnight at 42 weeks, so we got her induced and started up Pit this morning. Another lady came in at 36.3 weeks and I delivered her a few hours later. Vance was in surgery all morning, so he basically just had me run the show and let him know when all the babies were out and moms sewn up. The second lady had a bit of a post partum hemorrhage, but it quickly stopped with a bimanual uterine massage. I’ve always been slightly amused that it’s referred to as a massage, because it looks like it would be anything but relaxing.
The rest of clinic was just kind of a mess. We were down a doc because she was sick, so we were pretty busy. I can’t really remember any interesting cases except for a 3 year old boy with what I think was probably a hydrocele. I’ll have him follow up with one of our surgeon’s to get it fixed. I saw a few people again as follow ups from last week, and they’re all doing better now. I saw several people for their regular OB appointments, one of whom was coming in for the first time. She thought maybe she was about 8 weeks pregnant, but had been bleeding for a few days. I obtained a urine test, which confirmed a pregnancy, but when I did a sterile spec exam on her there was a bunch of blood coming from the cervical os. So, I took her back to Vance’s office and we did an ultrasound that basically showed an empty uterus. It didn’t look like she had an ectopic, so she must have had a missed abortion.
That lady in respiratory distress ended up going home with her family today. I can’t imagine she’ll last much longer now that she’s off the oxygen.
After clinic I walked to the town of Balfate, which is about 6 kilometers to the west. I walked the whole way in the glaring heat, which turned out to be a bad choice. I did, however, make a friend on the way:
As I was arriving into town, a guy carrying a machete approached me. I can’t remember what his name was because I could barely understand him, but he apparently worked up in the mountains cutting down limbs. He also showed me a sack that was full of some kind of herbs. I have no idea what they were used for, but from talking to him I wouldn’t be surprised if they were hallucinogenic. There really wasn’t much going on in town. I think maybe about 500 people live there. He walked with me for a while and led us to a roadside pulperia, which he on more than one occasion told me sold cerveza. When we got there, I asked for guy for a couple of beers and he pulled two cans out from under the counter. They must have been about 95 degrees, but I went along with it and we stood in the shade and chatted a while. By this time, I figured I should get heading back, so my machete wielding friend directed me back to the road where he hailed a moto taxi for me. He said it would cost me 15 lempiras for a ride back to the hospital, which amounts to 75 cents. I gladly paid this to avoid walking several miles in the scorching sun. On the way back, we zipped back and forth over all parts of the road to avoid potholes and other vehicles. These moto taxis are kind of squirrely vehicles, and they drive them pretty fast. Here’s a picture of one that I found on google images just to give you an idea:
Once I got back, it was time to do some laundry. The washer here doesn’t work, so I had been doing everything by hand in a utility sink at my apartment…which pretty much resulted in me wearing clothes that were still dirty. So, I asked Peter if I could come over to his place to use his washer. He lives up the hill a ways in a good sized house that overlooks the sea. It’s a pretty awesome spot. They have a nice sitting porch, several mango trees, and a huge garden where they’re growing all kinds of stuff. He ended up asking me to eat with him and his family while I waited on my things to wash, so it was a pretty good ending to the day.