It’s Monday! The start of another week! Rounds were finished in record time (which was great!) It gave me time to chat with my favorite patient…the older man with the stomach ulcer. He continues to improve daily. I told him that I prayed that the surgery would go well and that he would be better soon; I also asked him if he knew Jesus, and a great big smile came across his face as he answered that he knew Jesus. I hope that is true…I hope he has faith in Jesus; here, people often say yes to appease you…or say what they think you want to hear (sound familiar to some of you in the US?). I hope that his comments were true and that he has a relationship with Jesus. It would be great to be dancing together in heaven in the years to come.
Clinic was also good, but REALLY busy! In the room I was in, there was an attending physician, myself, and another medical student, plus 2-3 translators, plus 3 patients, plus 1-3 other family members…all talking at once. It was crazy!
I also saw some crazy things. One older man had Pott’s disease, which is TB of the spine, where the TB forms an abscess like area around the spine and the vertebra degenerate; in his case, his torso is at a right angle to his hips and legs; it was so sad to see him walking. Unfortunately, there is little we can do to help him except treat his TB so his spine does not get worse. I also saw several cases of HTN, constipation (because most of the foods here are carbs), or general body aches (almost everyone has this complaint). Other unique things include a man with severe osteomyelitis (infection) of his lower leg with multiple ulcers draining pus…that he has had for over 4 years…and is just now seeking care, a young woman with kidney disease, a baby with hydrocephalus (her 3 mo old head was the size of a large, round watermelon), kidney infection, eye infection, and an old lady with sepsis.
I became very protective of this old woman, ensuring that she got the labs and other tests we needed as well as treatments ASAP. She was super sick. After the test results came back, it was clear she had a severe UTI and pneumonia and that she was very dehydrated. We started antibiotics and other fluids and I wanted to start oxygen since her O2 sat was 79%. The problem was that the hospital has a limited number of O2 concentrators…so I went from ward to ward asking if anyone had an oxygen machine that we could use. I even reassessed some babies to see if I could safely take the oxygen away from them (if they did not need it anymore), but decided that they were too sick to be off the O2. After giving up on the search, I went back to the female ward, and an O2 machine was sitting by her bed! (so there are at least 3 working machines in the hospital). I was relieved! I hope that she will do well overnight.
After a long day of clinic, we returned to the guest house. We had pizza for dinner, which tasted great! It was a nice farewell treat to two residents who leave tomorrow. This leaves a surgery resident, a family medicine resident, and two med students here with the long term workers…I hope rounds go well tomorrow!