Boy was I happy to see some formed stool today...as gross as this may seem to all of you...this may have been one of my happiest days, knowing that I fought this acute gastro enteritis without having to take my medication! I only have enough to cover me once....so I must use this wisely! Feeling much better today...no vomiting, fever, or diarrhea!! I ate well :) It's amazing what 24 hrs can do to you!!
Another regular day at the clinic...so busy! What's interesting about these clinics is that the people who are coming here are all presenting with such different problems! Graves disease, prolactinomas, abscesses, pregnancies endocarditis, liver cancer and much more. The only problem is that we don't have that many labs to get to a proper diagnosis. Really the labs that we commonly do are: blood smears for malaria, WBC, HCT, urinalysis, clotting (for snake bites), stool culture, sputum. If we need anything else, we will probably refer patients to go to Tamale where there is a teaching hospital, about 2 hours away. Also, we have X-rays and U/S (ultrasound). It's amazing how useful the ultrasound is over here....they only got this portable one about 4-5 years ago. Basically ultrasound everything...I have gotten pretty good at the basics. We mostly use this to screen for pregnancies, free fluid in abdomen, suspicious masses. So most of the diagnosing will stem from the limited investigation tools, following your gut and infectious disease textbooks!
Tonight I am on call...there was a boy who we brought to the OR for a suspicion of a volvulus ( large bowel obstruction)...he had fever, abdo pain and xray showed lots of stool stuck! His abdomen was huge! Felt like it was going to pop any second now. Only issue was that the local anesthetist for some reason was not able to be reached. We sent someone to his house and it seemed like he went off to some village. So we used one of the ER docs from LA (Dr. Sam) to fill in as the anesthetist and I was the first assist with Dr. Ravi the other ER doc from LA. Operation was a success...the boy didn't have a volvulus but ended up with a bowel perforation likely due to Typhoid fever! We sewed this up and brought him back to the ward. It's amazing to see how little monitoring we do here, just simply sedate him with some ketamine and valium....then wake him up and back to ward...no recovery room. Hopefully he will recover well from this operation with no further complications.
I was talking to a friend here today and told him I was blogging...I realized that most of my stories seem depressing and may paint a scary picture...I do however want to say that we do a lot of good for a lot of people here. Everyone is always so appreciative when they see us, they smile, will bring me stool to sit while I chart, will breastfeed their children while I am examining them so they don't cry from the scary white man! The communication may be difficult but seeing the sick walk out better, happy and lively is a great accomplishment here! We all do with what we got and try to make the best out of every situation!
On another note...I got some other news for my family and Evie and her family :) I got accepted to do a surgery elective in downtown Vancouver at St-Paul's Hospital from July 2nd to 27th!! I am so happy fort this :) Will get to spend a month with Evie and her family during summer while doing a surgery elective! AMAZING! This time Evie will be coming with me :) Yayayayayaya :) Helene...if you are reading...we need to book the flights soon ;)
Bed time! Unless they call me to go back to the hospital!!
P.S.
Dear Lexi - your mom tells me that she reads you my blogs at night for bedtime :) So happy to hear that you enjoy them. To answer your questions - I have made lots of friends here! Most of the little kids are scared at first but then they open up and smile :) Africa looks really beautiful, the weather is always hot! and the ground is dry with this red dirt road everywhere. There is lots of grass too and you need to be careful for the snakes at night! So far I havent seen any yet! I am not sick anymore and I feel much better :) I am sad for a little bit, but I know that they got the best care possible over here and we tried our best to help them! But I know that I am really happy for the kids that leave the hospital with their moms - all the mothers carry their kids on their backs here...seems like so much fun to be a kid! Thank you Lexi for all your questions! Hope you have a good night tonight! Take care Phil
P.P.S. Evie - booojoobodowowow :) xox
Another regular day at the clinic...so busy! What's interesting about these clinics is that the people who are coming here are all presenting with such different problems! Graves disease, prolactinomas, abscesses, pregnancies endocarditis, liver cancer and much more. The only problem is that we don't have that many labs to get to a proper diagnosis. Really the labs that we commonly do are: blood smears for malaria, WBC, HCT, urinalysis, clotting (for snake bites), stool culture, sputum. If we need anything else, we will probably refer patients to go to Tamale where there is a teaching hospital, about 2 hours away. Also, we have X-rays and U/S (ultrasound). It's amazing how useful the ultrasound is over here....they only got this portable one about 4-5 years ago. Basically ultrasound everything...I have gotten pretty good at the basics. We mostly use this to screen for pregnancies, free fluid in abdomen, suspicious masses. So most of the diagnosing will stem from the limited investigation tools, following your gut and infectious disease textbooks!
Tonight I am on call...there was a boy who we brought to the OR for a suspicion of a volvulus ( large bowel obstruction)...he had fever, abdo pain and xray showed lots of stool stuck! His abdomen was huge! Felt like it was going to pop any second now. Only issue was that the local anesthetist for some reason was not able to be reached. We sent someone to his house and it seemed like he went off to some village. So we used one of the ER docs from LA (Dr. Sam) to fill in as the anesthetist and I was the first assist with Dr. Ravi the other ER doc from LA. Operation was a success...the boy didn't have a volvulus but ended up with a bowel perforation likely due to Typhoid fever! We sewed this up and brought him back to the ward. It's amazing to see how little monitoring we do here, just simply sedate him with some ketamine and valium....then wake him up and back to ward...no recovery room. Hopefully he will recover well from this operation with no further complications.
I was talking to a friend here today and told him I was blogging...I realized that most of my stories seem depressing and may paint a scary picture...I do however want to say that we do a lot of good for a lot of people here. Everyone is always so appreciative when they see us, they smile, will bring me stool to sit while I chart, will breastfeed their children while I am examining them so they don't cry from the scary white man! The communication may be difficult but seeing the sick walk out better, happy and lively is a great accomplishment here! We all do with what we got and try to make the best out of every situation!
On another note...I got some other news for my family and Evie and her family :) I got accepted to do a surgery elective in downtown Vancouver at St-Paul's Hospital from July 2nd to 27th!! I am so happy fort this :) Will get to spend a month with Evie and her family during summer while doing a surgery elective! AMAZING! This time Evie will be coming with me :) Yayayayayaya :) Helene...if you are reading...we need to book the flights soon ;)
Bed time! Unless they call me to go back to the hospital!!
P.S.
Dear Lexi - your mom tells me that she reads you my blogs at night for bedtime :) So happy to hear that you enjoy them. To answer your questions - I have made lots of friends here! Most of the little kids are scared at first but then they open up and smile :) Africa looks really beautiful, the weather is always hot! and the ground is dry with this red dirt road everywhere. There is lots of grass too and you need to be careful for the snakes at night! So far I havent seen any yet! I am not sick anymore and I feel much better :) I am sad for a little bit, but I know that they got the best care possible over here and we tried our best to help them! But I know that I am really happy for the kids that leave the hospital with their moms - all the mothers carry their kids on their backs here...seems like so much fun to be a kid! Thank you Lexi for all your questions! Hope you have a good night tonight! Take care Phil
P.P.S. Evie - booojoobodowowow :) xox
No comments:
Post a Comment