Patients

Everyday I round of half of the B ward, which is the medicine ward. I have 15 patients. I round on them in the morning, and whenever I finish I head to the OPD (outpatient department) for the rest of the day (breaking for lunch). Every day is a new adventure with more to learn daily and I am treating a wide variety of illness. And although I lack confidence, I am learning alot of ultrasound skills.

Anna had to be sent to Hagan Hospital (we actually have our own ambulance). She has been with me for a week with abdominal pain. We saw free fluid in her pelvis, and I was treating for PID. Frankly, she never looked very sick, and daily her abdominal pain was rather nonspecific. However a few cultural miscommunications, I finally got a positive urine pregnancy test. Repeating the ultrasound, I found a mass outside of the uterus, which was consist with an ectopic pregnancy. Unfortunately, our only surgeon was ill today, so to get the surgery she needed I had to transfer her.

Monica is another patient who has been with me for about a week. She is elderly, with a very large spleen, and quite cachetic (in fact, as a measure of that, I have personally picked her up to transfer her). Her left lung continually fills up with fluid, which I have had to drain out. The working differential is TB or cancer. We pray together daily (she's pictured on the right with the yellow shirt). Her prognosis is poor, and likely we will not come up with a specific cause of her sickness, but we are treating what we know how to treat here.

I forgot my next patient's name, but she's pictured on the left. She has myasthenia gravis, a disease where your muscles fatigue extremely easily (including your respiratory muscles). I was shocked last week, when her scale book said myasthenia gravis, and even more shocked when I found appropriate medicines to put her on. In the US, we would have consulted neurology, here I am the neurologist. She came back today, and I am attempting to titrate her steroids and neostigmine (we don't have mestidon, and even most of the docs were shocked when I found neostigmine in the pharmacy).