There was a young lady who came in about a month ago unable to walk. The history was that she had the herpes zoster virus on her back and she needed something for the pain. A street chemist gave her 3 injections in each of her upper, anterior thighs (1 near or on each femoral nerve?). She presented to us with zoster pain and inability to walk, urinary retention, and b/l leg pains. They had no idea what the solution is the syringe was. So over the course of these weeks, she is now walking, albeit with a walker. Her strength is improving, although her gait and leg movement is still a bit uncoordinated. The biggest problem we had was her urinary retention. We checked her urine and treated her for a UTI. She had the catheter removed twice with no luck, these were the days that I walked into the women’s ward and she had no smile for us. We tried to get a medication called Bethanacol to help the bladder, but no one could find it in the pharmacies. It was a struggle. As I was reading up on this issue, I found that constipation was also a factor. We added mineral oil to the regimen, ibuprofen for any swelling, and prayed. Two days ago, after teaching her to press on her bladder downward when trying to void, the foley came out. The next morning she was smiling! It was a relief… She had some dysuria and we treated her empirically with Cipro, but we are waiting on a possible urine culture. Yesterday morning I knelt at her bed and we both thanked God for His divine intervention. (Update: cx came back Ecoli, not susceptible to Cipro, so changed her to gatifloxacin. She has been discharged, but some patients remain for many days until they are able to settle their bill. They are not charged for the days after official discharge. Usually the family at home is trying to gather monies together to pay the bill).
Another younger lady came in with headache x 1week, diplopia, papilledema, and nausea. No fever. We started her on steroid and antibiotic treatment but we weren’t sure if there was a meningitis brewing or space occupying lesion. After a couple of days, she was better and we backed off on the treatment. Then she developed a fever, severe headache, and vomiting. She also had a swollen forearm and hardened vein near the IV site. So, her serum toxoplasmosis was negative, but we couldn’t tap her (because of the risk in the case of a lesion), to check for Cryptococcus. Or could the fever be from the infected IV site. So we placed her back on ceftriaxone, increased the steroids again, and added an antifungal. The next morning she was walking around with only a small headache. Thanks God. But we still aren’t sure what is going on in her.
Our young boy with the Sickle Cell Crisis is finally healing well. We were afraid that he may have been developing acute chest syndrome, but he seems to be improving. In the beginning, this young boy was contorted in so many different, awkward positions trying to alleviate his pain; icteric with an enlarged liver and spleen; had a pneumonia; and hematuria. Yesterday he was sitting up smiling, moving without grimacing…usually a good sign. They use Pentazocine (Talwin) here, and it seemed to help. I hope that he continues to improve.
Just as an FYI: For our diabetics, we have Insultard (longacting), Mixtard (similar to 70/30), and Atrapid (regular). For oral agents we have Metformin and Glibencamide, and they also have some sort of traditional herbal drink that helps with glucose control.
This week Milan made his first futbol goal and apparently it was pretty epic. First it was kicked up, next he headed it up, and last he kicked it in. He was pretty pleased with himself as was I. The score was still 6 to 4, them, but a great game nonetheless when he comes home fully covered in dirt and mud. He has given the yo-yos a rest for now and is still passionately trying to master pen-spinning. I don’t know how he manipulates each joint of his fingers to swing the pen around the way he does, but he’s improving every day. That is one thing with Milan… if he wants to learn something, he is relentless…practices with passion. Yesterday for an afternoon snack he had a “mealy cob” and ground nuts. Essentially this is like corn on the cob, but the corn here is different. It is not like our corn in the States, and that’s all I can say. It’s good corn, we like it, but just thicker and hardier I think. And ground nuts are peanuts. They grow underground, hence “ground” nuts. As for me, I’m doing fine. Love it here. How could I not… there are goats all over the place!
Yesterday we met two Lay Mission Helpers who are just beginning while a 3-year mission, teaching secondary school in Kumbo. They were very kind and extremely excited for this adventure in following God’s will. The younger lady will be teaching English and computers while Frank will be teaching English as well as assisting with animal husbandry. I am anxious to read their blogs and hear of their experiences. Frank and I were able to speak to each other in our native languages (Polish and Slovak). That was an unexpected and welcomed surprise!
With the return of Jim there is sometimes not enough space for all of us in the office, so for a few of these latter days, I have gone exploring other aspects of the hospital. Yesterday was the operating room. Sister Martha, who is also a nurse anesthetist, was my guide for the day. Dr. Lazarre (an orthopedic surgeon) was the operating. There were a total of about 5 scrub nurses or nurse assistants in the room. They do not use the term “OR techs”. They use Halothane as their gas and have fentanyl, morphine, diazepam, propofol, thiopental, and a few vials of etomidate, as well as doing spinals. They pray together before each surgery and have a preprinted anesthesia/OR record sheet similar to what we have in the States. The cases for the day were a reconstruction of a varus deformity at the proximal end of the left tibia/fibula; a left hernia; an infected wound debridement; and an open exploration of an acute abdomen r/o obstruction, which ended up being a small intestine volvulus.
Later that afternoon, while Milan was playing cards with the kids in the wards, I went to take a walk with Sr. Hilda on her afternoon rounds to feed the animals. First stop was to see if the dogs’ food was prepared. They eat “fufu”, which is ground corn meal. Next onto the chickens. Sr. Hilda had such a sharp eye for the one chicken who was limping. It was so slight initially, but she picked up on it right away. She opened the cage a bit more so it was easier for the chicken to reach the feed. And then came the cows, all 61 of them. It was wet outside, so it was “slushy”, but I followed her in my sandals as she walked with her lovely knee-high rubber boots. We checked on the baby calves, which were a bit timid, and the older calves which nudged me hard with their heads to get me to rub them! Next we went out into the big field, up on the hilltop, to inspect the rest of the herd and make sure that none of them were acting strange, limping, crying, or lost. She calls them by name: Benjamin, Toffee, Epiphany, and Bamenda are just a few that I remember. And even these big cows came to nudge you to pet them. Some would get jealous if you were petting another one for too long and ignoring them. I was rubbing the heads and necks of 3 at one time. Again she had this meticulous eye, checking over the whole herd. I think that Benjamin was missing, so she went to look for him while I headed back to find my Milan for dinner.
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