I’ve still been rounding on that 44 day old kiddo who came in with respiratory distress and probably has pneumonia. I have him on Rocephin and nebs, but I think it’s viral based on his labs. I consulted with the pediatrician and she said she wouldn’t change anything. He’s slowly getting better, so hopefully we’ll be able to get him out of here by tomorrow if we can wean him off the O2. Right now he’s able to breathe pretty well on 1 liter without desaturating.
Clinic was pretty nice yesterday. A bunch of people didn’t show up so I only had to see a few, which were as follows:
-52 yo M with GERD, HTN
-42 yo F with chronic cholecystitis, sent her to surgeon to remove gall bladder
-3 yo F with viral URI
-2 yo with subjective fever and CVA tenderness; basically nothing going on there if I remember correctly
-42 yo F with lumbar strain and migraine h/a
-14 month old with viral URI
-57 yo F with lumbosacral back strain
-3 yo M with urticarial rash x 18 days
I had mentioned at some point to Peter that Maria is a dentist, so he showed me the dental set up yesterday:
Here’s a pic of one of the dental operatories, in case Dr. Wittman or any of her dental friends are interested.
lots of supplies, most of which are words I don’t understand in Spanish let alone English
Más cosas
Drill thingies, immediately adjacent to the fluoridation station basin
My original post said “they even have a pano hiding back there”. Somebody* pointed out that this is actually just an xray head. Thanks wife.
After work, I was on call for the night. I had a fifty-something lady come in with pyelonephritis that I thought could be treated as an outpatient…so I gave her a shot of Toradol and some antibiotics and sent her on her way. The other one that came in was a 17 yo G1P0 at 41.2 weeks. I delivered the baby just a little before midnight. She had a second degree perineal lac but otherwise did well. Baby is doing well but has a right sided hip clunk, so he’s going to need some close follow up.
Clinic today wasn’t too bad either. Here’s a pic of the “plato” I enjoyed afterward, which is basically the dish of the day.
My clinic patients today were as follows:
-13 yo F with newly diagnosed sickle cell anemia
-7 yo F with tinea capitis
10 month old male with subjective fever and oliguria
-7 month old male with viral syndrome and also maybe oliguria (but mom’s history was sort of subject)
-28 d old with viral URI
-38 yo G4P2012 approximately 8-13 weeks with either a threatened abortion or missed abortion
39 yo G5P4 at 21-25 weeks (depending on the documentation) here for a routine prenatal visit
This is where the baby makin’ happens…makin’ them come out, that is. Notice that handsome brand new wood door in the background, escorted to the hospital by myself and a few other gents.
This afternoon I was trying to think of something to do…so I decided to take a mototaxi to Lis-Lis, another small town just west of Balfate. I cost me $1 and would have taken over an hour to walk there if that gives you any idea how poverty stricken the area is…and that’s probably even a bit steeper than most people are charged given the fact that I’m a gringo.
Just a regular afternoon stroll carrying a large bundle of sticks
Puente just east of Lis-Lis…can’t remember the name of the river though.
Pulperia en Lis-Lis
Farming and grazing land just west of Lis-Lis
I don’t know what these are, but I’m guessing they’re either delicious or deadly.
Calle de Lis-Lis
Just about 6.3 km from the hospital
As I was walking through town, I came across the local school where these kids were playing béisbol. Pretty sure this poor kid struck out. While I was there, I noticed a normal looking older guy just hanging out on the street. I went over and introduced myself and he said his name was Alfonso. He was waiting for the bus to swing by to take him to the neighboring town of Limeras, so he could get to church. By this point, I had decided I’d seen most of what Lis-Lis had to offer, so I thought I would wait for the bus as well…except I’d be going east and he’d be going west. We talked for quite a while as we waited. The bus isn’t really on a schedule. It just sort of gets there when it gets there. Alfonso said there were about 1000 people who lived in Lis-Lis. He also mentioned that everybody is really friendly, but they definitely takes note when there’s a random gringo walking around. That pretty much goes along with what I experienced. Everybody I ran into was really friendly once I said “buenos tardes” or “como estan” or something like that, but I definitely got the sense that they were also kind of like “what are you doing here?”. This part of the country is definitely pretty well cut off from the rest of the world…but I find these areas most interesting because I think the isolation has helped to preserve their unique culture, unlike a lot of other areas where people have immediate access to the internet and have sort of meshed their heritage with modernization.
Casa en Lis-Lis
I ended up taking the bus from Lis-Lis to Balfate and was dropped off right next to this barberia/pulperia…sort of like the Honduran version of a Taco Bell/KFC I suppose.
One of many roads that go directly to the beach
Playa de Balfate…sin que nadie presente
In the evening after clinic with the sun growing low on the horizon
Yet another selfie contraption
Another road to the beach
Maria doesn’t know it yet, but we’re thinking about buying this house. Note the proximity of the beach.
