Busy Wednesday...

Wednesday used to be a bit of a ‘breather’ in between busy clinic days; a day to compose myself, process the first half of the week, gear up for the second half. Well, it’s changed a bit. Wednesday is still REVIEW day but this week for some crazy reason (patients being more sick than usual?!) I had 32 patients keeping me busy all day, which also meant I did not get any admin done! Not that I am a huge fan of admin, but it does need to get done; maybe this weekend??! I must say it was a very interesting day, kids of all ages, with a large variety of conditions; many doing better, a few worse. Let me give you a run down by age:

2 month olds: Twins coming for weight check-up and vaccines. A happy wheezer, coming for third day in a row, finally improving. A baby who is not gaining weight for an unknown reason and needs more tests done.
3 months olds: Boy with a heart defect in a country with no treatment possibilities, coming for check up to see if he’s gaining weight. Girl with cleft lip & heart defect coming for her regular 2 week check-up until possible surgery on the Africa Mercy.
4 months olds: Complex case with encephalocele & hydrocephalus who I had to inform that she will no longer be able to have surgery on the ship. A happy set of twins looking well and gaining weight.
5 months: Bronchitis case finally on the mend after a few days of consecutive follow-up.
6 months: Child with a bulging fontanelle; usually a danger sign but this was a happy & well child! Little girl who was quite sick 2 weeks ago with sepsis due to a widespread skin infection, referred for admission and now discharged and much better.
9 months: Child with pneumonia who is improving. Cleft palate patient coming for her monthly check-up before surgery on the ship in October. Child treated for malaria last week but still has malaria parasites so now starting quinine.
11 months: Another pneumonia case (it’s pneumonia season!) doing better.
1 year olds: Girl who came 4 consecutive days last week with malaria and anemia (Hb 4.5), bravely treating as outpatient, now with Hb 7.0. Another patient coming for her third day in a row with malaria and anemia, slowly recovering. Child with persistent cough and chest signs, possible tuberculosis, trying a second antibiotic and then may need an x-ray. A malnourished child eating only porridge made out of biscuits, gaining 200g in the last 9 months who will need a lot of follow up.
2 year old: Child with many problems including malaria, chest infection, foot drop, malnutrition looking quite ill but there was no bed at NGO hospital so I am continuing to treat as outpatient.
3 year olds: Girl who started malaria treatment yesterday and also had anemia which today dropped to 3.9 and so she needed urgent referral. Child with eye problem referred to opthamologist in town.
4 year old seen yesterday with many malaria parasites, very lethargic but praise God much better today.
5 year old with malaria last Thursday, quite sick, a bit confused, took oral treatment well and now a week later much better besides mild anemia.
6 year old with malaria and anemia and now very painful limbs, possible sickle cell case?
7 year olds: Girl with facial mass since birth wondering if we’ll be able to help her on the ship. Another girl diagnosed with malaria yesterday, very lethargic, lying down on my office floor, looking much brighter today.
8 year old who was very sick 8 days ago (possible with tapeworm?), weighing 14 kg and now much better coming with a bag of bananas and oranges to say thanks.
12 year old with lump on face inquiring about treatment options.
29 year old coming to hear she is booked for cleft palate surgery on the Africa Mercy.

So all in all a busy & productive day!