July19, What Did You Take?

We seem to be having a surge of hypo and hyperglycemia this week.

One woman has 3rd CN palsy that is beginning to resolve with her sugars once over 600, now under control. We have Metformin here and a drug called Glibencamide, as well as short-acting, long-acting, and mixed insulin solutions.  A young gentleman presented with ataxia, slow mentation, confusion, delayed verbal response, and uncoordinated movements. We were thinking some kind of tumor or encephalopathy, but many of his tests were coming back clear, except the history of recent traditional medicines. With no history of diabetes, his blood sugars were high and he was progressing to renal failure with weak respiratory effort. After almost 2 weeks, he is sitting up, eating and conversing with family. Another 2 patients, an 18 y/o and a 60 y/o came in comatose, with sugars in the 45 range after taking traditional medicines for stomach upset. It is frustrating because we often do not know what the traditional medicine is, only what it is doing.  I am sure that there may be some traditional medicines that do help symptoms, these are just not the ones that we are seeing. Both are doing fine now, sugars back to normal, up and about.

By the way, our gentleman with tetanus who was having full body spasms and inability to open his mouth… he is now recovering
well, off the diazepam drip and on po diazepam bid.

We lost a little 3 y/o girl last night… she was wearing a shiny pink satin dress. She came in with respiratory distress, grunting respirations, and pox of 69%, and only localizing pain. My stomach turned over as soon as I saw her. She had been sick for the week and they had tried traditional medicines as well. We don’t know if this was progression of the original illness, or aggravation by some traditional substance. My heart goes out to her and her family. May she be surrounded by all God’s angels.

In the clinic we had a 14 mo/o with breast tissue and galactorrhea; a fractured femur and ankle; cough for 6 months progressed to hoarseness; malaria; hyperglycemia; generalized body weakness; “scrofula” TB adenitis; chest trauma on a motorcycle. By the way, the motorcycles here are used as taxis. We do not ride them as it is very dangerous, but this is how some people get around. Taxi cars are also used here and they can be filled beyond capacity.