Tuesday, November 06, 2007

Not so normal Tuesday in the clinic...

Unlike most Tuesdays, today was hectic; many children at the gate and many ‘interruptions’. Here’s the run down…

0715 - Phone rings. A patient of mine that had surgery on the Africa Mercy has been discharged. The father wants to know if I need to see the child, or if they can go home to Kono. I tell him he can go home.

0750 – I arrive at the clinic.

0810 – I go to the gate to face the line of 60 children; time for triage. I see a girl who looks pale & weak; I’ll see her first. I am asked to talk to 2 other patients; they have tumors. I need to discuss the possibility of surgery on the ship.

0820 – The patients are inside. My first patient is 4 years old, febrile, pale and breathing fast. I take her to the lab to do the history & examination while the lab tech draws blood. We wait for the results.

0845 – Her Hb is 6.7 g/dL. Her blood smear is full of malaria parasites. I send her to the referral center with a letter, hoping they have bed space.

0920 – By this time I have just seen a 2 month old boy with a persistent cough & fast breathing. He is struggling; he needs oxygen. A referral letter is written, a taxi is chartered, and off he goes.

1000 – I see a couple of ‘regular’ patients.

1030 – One of my follow-ups arrives. He’s 5 months old and I’ve been treating him for 2 weeks. He was pretty sick yesterday, today he looks a little better, except for a respiration of 80 per minute! I arrange for a chest X-ray elsewhere. He’s on his way.

1100 – A nurse asks me to see a patient; a 2 year old I saw last week (malnourished, breathing fast, poor condition) that I referred to the TB doctor. He is now on anti-TB drugs and looks a little better; he has a long way to go.

1245 – I have another follow-up case. Usually follow-ups come in the afternoon but I was concerned about this one yesterday and wanted him to come earlier. I diagnosed him with malaria & anemia (Hb 5.6 g/dL =low) and started him on anti-malarials. Today he’s eating & playing. I send him to the lab again.

1250 – I have a 5 minute lunch break while waiting for this child’s results.

1255 – Oh no, his hemoglobin is falling. It’s now 5.3 with the centrifuge and 3.9 with the hemocue. Yikes! I call the referral center; no beds left. The child is stable so I send him home with clear instructions, in case he gets worse. I will see him again on Wednesday. I say a quick prayer.

1300 – I continue seeing patients. There are at least 30 still to be seen. At least there’s another doctor now.

1600 – Children that were in line at 8 am have been seen. It’s now time for the 10+ scheduled follow-up cases. Some are better; some need to go back to the lab, some need other meds.

1630 – The boy I sent for an x-ray at 1030 is back. The x-ray was fine. I’m puzzled by the case; he is again on antibiotics and will be followed-up again.

1700 – The father of the 2 month old I saw earlier today shows up at the gate because his wife & son did not return home. I call the referral center to check if the boy was admitted – he was (so was the 4 year old girl). I tell the father. He seems disappointed that we didn’t give medicine; he is concerned. I explain that the child needed oxygen and stronger medicine. In the end he seems to understand and leaves for the referral center.

1800 – We’re all waiting for the last lab results so that we can send the last few patients home; almost done.

1830 – I’m on my way home.

Of course the craziness didn’t end there. I got home to find out there was no water in my bathroom and so washed my hair under the stand pipe outside, and finished with a bucket shower. I then realized that I missed my laundry slot. Then I went to a movie night at a local restaurant, to watch a great movie that unfortunately finished before it was really over. Then when I got home I had to finish up the October statistics for the clinic. It’s been quite the day!

5 comments:

Eddie said...

Hi Sandra,

How long has the second doctor been there? It's good you have extra help.

God bless you in your work!

Eddie

ellen said...

so you wash your hair outside? i assume with clothes on? so they get all wet to then???

Anonymous said...

Hey San, your day was almost as long as mine :) but then I was in the air. If you want me to bring the movie you did not get to see the end of, let me know. Love
Mama
PS any postings done yet for another doc?

Anonymous said...

PS .... Aren't bucket showers great :)
mama

Sandra's Latest is... said...

Don't worry Ellen...clothes on. There's a stand pipe out by the gazebo...it actually has better water pressure than my shower! So it's a great alternative. And no...my clothes don't get wet... i just lean over, get my hair wet, wash it and don don.

~ Act Justly. Love Mercy. Walk Humbly. micah 6:8 ~