Today was a pretty slow day overall. I woke up early and rounded on my patient. That was the amebic dysentery patient that I already talked about in the last post. After I got him discharged the day was pretty darn slow. There were only a couple patients that came through the ER all day. One was a young girl that was diagnosed with bronchiolitis. The patient’s parents had already called Dr. Sierra personally so he was already on his way. I just followed her case from a distance. She got a couple of treatments with the nebulizer and she was fine.
Tonight we had a pretty interesting case come in. The nurses called me about 7 or 8 pm. I ran over and there was 14 year old girl who was dehydrated. It was a little difficult getting a history at first. Initially the mom talked about her fever and vomiting so I was thinking something like gastroenteritis. She looked fairly dehydrated too. It’s funny because she never even mentioned shortness of breath until I asked about it. Apparently she had been coughing a lot the last few days and having difficulty breathing. I listened to her lungs and she sounded pretty wheezy all over and had a definite decrease in lungs sounds on the left side mainly at the base. Dr. Sierra then just happened to be coming back to the hospital because he forgot his cell phone and he popped in. He agreed about the lung sounds. We got a chest x-ray, blood count, and he wanted a creatinine because he had cared for her before and she had a kidney problem. The x-ray showed pneumonia in left lower lung. She looked a bit pale, but I was surprised to see her blood hemoglobin was 6.6! Normal is 12, so she was really low on blood. Then holy smokes her creatinine was 3.6! Normal is 1.1, so that means she was having renal failure! This was getting a little more complicated than I liked. To add to the chaos she had this odd brittle bone disease. She had broken both femurs from a simple fall 3 years ago and since then she hadn’t been able to walk. She had severe scoliosis, her forearms where beginning to twist in ward, and she had on odd shaped pointy chest. All this had happened within the last 3 years according to mom. The sad thing is that they hadn’t done anything about it, so now she is totally crippled for life, when it maybe could have been prevented. That depends on what the problem is, but judging by the family’s poverty, I imagine it could be from malnutrition or lack of vitamin D. Anyway, she was turning out to be quite an interesting case and to really add to the problem, the family was super poor so couldn’t afford many tests. We had to get special permission to admit her from the administrator because they didn’t have the deposit fee required. Luckily, they let her be admitted, but it drives me crazy that the patients have to put down a $500 dollar deposit to be admitted. That’s a lot of money here. I don’t understand why they don’t have a charity fund, especially since this hospital is owned by the Adventist church. Anyway, Dr. Sierra and I talked about it and we obviously transfused her, started her on antibiotics for the pneumonia, gave her fluids, and we are running a few tests tomorrow. Like I said, it drives me crazy we can only do the bare minimum; because there’s so much more testing we need to do. I think we should have sent her to the government hospital in the capital, but they refused to go there. Weird since the health care would have been free there. We’ll see how she is doing in the morning. I think her anemia is related to her kidney failure, but I’m not sure what’s causing that. She really needs to see a specialist.
Anyway, blah, blah about work. Since that’s all I’ve been doing I don’t have much else to write about. I haven’t done hardly anything fun and I’ve been here for a week. I’m having fun working, but next weekend I hope to be able to go someplace cool. Overall, I think I’m going to try and head out to Tikal. Hopefully I can find a tour going on Saturday. It’s hard being a single person to find a tour guide since they only like to take groups. Hopefully I’ll be able to hitch a ride with somebody. Tikal is over in Guatemala, a few miles past the border. It’s the biggest and best preserved Myan ruins in the world, so I gotta go somehow. It’s only $100-$120 bucks for a full day tour. That includes transportation there from San Ignacio, a border crossing fee, entrance into the park, and a provided lunch. I think that sounds like a pretty good deal. On another weekend I would really like to take a bus to Belize City and then take boat to one of the Cayes. The barrier reef of Belize is a ways out from the mainland shore, like 25 kilometers or so. Along this reef some islands are present with villages on them. They are popular tourist spots for going boating, snorkeling, diving, fishing etc. I was thinking about just getting a hotel room out there for a couple days and doing a bit of snorkeling or/and fishing. I don’t really know how to sea fish so I’m hesitant with that, but maybe I could find a cheap guide. There are a few places in my tourist book and one has a package deal for two nights in a hut on stilts on the shore, a fishing trip, meals, and transportation to and from Belize City for like $175 bucks. That is ridiculously cheap! In fact, it must be pretty ghetto living conditions to be that cheap. The place is located on one of the very remote cayes, so that could be a possibility. It’s staying on hut on stilts on the water so that wouldn’t be pretty cool just to say I did it. This is going to be a tough decision. Maybe I’ll put a poll on the blog. Should I stay in the remote hut on stilts with provided meals or go to one of the bigger islands and stay in a semi-cheap hotel where I’ll have all the restaurants, beaches, and lots of options for tours? All two or three of you who actually read this blog can vote and I am bound to follow the recommendation. . .maybe :).
Tonight we had a pretty interesting case come in. The nurses called me about 7 or 8 pm. I ran over and there was 14 year old girl who was dehydrated. It was a little difficult getting a history at first. Initially the mom talked about her fever and vomiting so I was thinking something like gastroenteritis. She looked fairly dehydrated too. It’s funny because she never even mentioned shortness of breath until I asked about it. Apparently she had been coughing a lot the last few days and having difficulty breathing. I listened to her lungs and she sounded pretty wheezy all over and had a definite decrease in lungs sounds on the left side mainly at the base. Dr. Sierra then just happened to be coming back to the hospital because he forgot his cell phone and he popped in. He agreed about the lung sounds. We got a chest x-ray, blood count, and he wanted a creatinine because he had cared for her before and she had a kidney problem. The x-ray showed pneumonia in left lower lung. She looked a bit pale, but I was surprised to see her blood hemoglobin was 6.6! Normal is 12, so she was really low on blood. Then holy smokes her creatinine was 3.6! Normal is 1.1, so that means she was having renal failure! This was getting a little more complicated than I liked. To add to the chaos she had this odd brittle bone disease. She had broken both femurs from a simple fall 3 years ago and since then she hadn’t been able to walk. She had severe scoliosis, her forearms where beginning to twist in ward, and she had on odd shaped pointy chest. All this had happened within the last 3 years according to mom. The sad thing is that they hadn’t done anything about it, so now she is totally crippled for life, when it maybe could have been prevented. That depends on what the problem is, but judging by the family’s poverty, I imagine it could be from malnutrition or lack of vitamin D. Anyway, she was turning out to be quite an interesting case and to really add to the problem, the family was super poor so couldn’t afford many tests. We had to get special permission to admit her from the administrator because they didn’t have the deposit fee required. Luckily, they let her be admitted, but it drives me crazy that the patients have to put down a $500 dollar deposit to be admitted. That’s a lot of money here. I don’t understand why they don’t have a charity fund, especially since this hospital is owned by the Adventist church. Anyway, Dr. Sierra and I talked about it and we obviously transfused her, started her on antibiotics for the pneumonia, gave her fluids, and we are running a few tests tomorrow. Like I said, it drives me crazy we can only do the bare minimum; because there’s so much more testing we need to do. I think we should have sent her to the government hospital in the capital, but they refused to go there. Weird since the health care would have been free there. We’ll see how she is doing in the morning. I think her anemia is related to her kidney failure, but I’m not sure what’s causing that. She really needs to see a specialist.
Anyway, blah, blah about work. Since that’s all I’ve been doing I don’t have much else to write about. I haven’t done hardly anything fun and I’ve been here for a week. I’m having fun working, but next weekend I hope to be able to go someplace cool. Overall, I think I’m going to try and head out to Tikal. Hopefully I can find a tour going on Saturday. It’s hard being a single person to find a tour guide since they only like to take groups. Hopefully I’ll be able to hitch a ride with somebody. Tikal is over in Guatemala, a few miles past the border. It’s the biggest and best preserved Myan ruins in the world, so I gotta go somehow. It’s only $100-$120 bucks for a full day tour. That includes transportation there from San Ignacio, a border crossing fee, entrance into the park, and a provided lunch. I think that sounds like a pretty good deal. On another weekend I would really like to take a bus to Belize City and then take boat to one of the Cayes. The barrier reef of Belize is a ways out from the mainland shore, like 25 kilometers or so. Along this reef some islands are present with villages on them. They are popular tourist spots for going boating, snorkeling, diving, fishing etc. I was thinking about just getting a hotel room out there for a couple days and doing a bit of snorkeling or/and fishing. I don’t really know how to sea fish so I’m hesitant with that, but maybe I could find a cheap guide. There are a few places in my tourist book and one has a package deal for two nights in a hut on stilts on the shore, a fishing trip, meals, and transportation to and from Belize City for like $175 bucks. That is ridiculously cheap! In fact, it must be pretty ghetto living conditions to be that cheap. The place is located on one of the very remote cayes, so that could be a possibility. It’s staying on hut on stilts on the water so that wouldn’t be pretty cool just to say I did it. This is going to be a tough decision. Maybe I’ll put a poll on the blog. Should I stay in the remote hut on stilts with provided meals or go to one of the bigger islands and stay in a semi-cheap hotel where I’ll have all the restaurants, beaches, and lots of options for tours? All two or three of you who actually read this blog can vote and I am bound to follow the recommendation. . .maybe :).
How would you like to have surgery here?!
Yikes!
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