Some kids put beans in the most in opportune places...

  This week has been very full of adventures. There was a three year old who came to the clinic because she had a bean stuck in her nose. She had put it there the night before so it had had all night to swell with nasal ... Snot... So it was quite large by now. At first the mom said it was a rock. Then it started to come out in pieces and we discovered it was a bean because on one of the many attempts it took to retrieve the whole bean I got "bean skin". We had the child on the table and the mom and Mirlene were holding her body and legs. I guess you could say I had her head in a head lock... And that bean was lodged securely! I think we did get it all though.
   Then there is a little boy that we have been following for malnutrition and ear infections for several months. Finally on Monday I wrote a referral letter and told the mom she had to take him to the hospital. I think we finally got the ear infections under control but he still wasn't gaining weight.  We have been giving the mom protein powder and some milk powder that is almost like pediasure and he LOVES it. I wonder if he has a digestion problem. Hopefully they will find out at the hospital and he will do okay.
    Next is a 14 year old girl who is short but has a large stomach and weighs less than 50 pounds. She has had an operation on her abdomen in the past. Mom said they removed a "ball" so we don't know really what it was. She is also a diabetic and her insulin was gone. We don't have any insulin at our clinic. There is not a good way to store it over here since it needs refrigeration and so few people have that available. She eats lots of food but it looks like her body is literally in starvation mode because she can't break down the sugar properly. We did give her some of the oral hyperglycemia medications we have to see if they will help. The mom has nine children and no one to help her so feels she can't take this child back to the hospital right now. We are hoping to get this child some help somehow.
    Then there is a little girl who has a massive belly and is also malnourished. We seriously considered taking her to the hospital in our ambulance but decided to give them one more night. I gave this child lasik and an enema plus de-wormer and an antibiotic then sent her home with some laxatives to take that day yet. This mom did have a working telephone so we took her number and called and checked on the little girl that evening and the next morning. They were supposed to return to the clinic on Wednesday but when we called the mom she said the child was having so much diarrhea that she couldn't bring her. So we told them to come today and even called the mom and talked with her this morning and they said they were coming but never showed up. We aren't sure but suspect we will have to send this child to the hospital too if we can ever get her to the clinic again.
   On Sunday morning while we were in church somebody broke into our house. They chose to break a window that is above the back door and come in that way. The window is only about eight inches tall but as wide as the door but somehow someone got in then unlocked the door. Somebody got cut or hurt somehow because they left numerous smears and drops of blood around. They took some money, Keith's laptop, Candace's phone and a pair of her sandals. I guess they ( the sandals) were too good of a deal to pass up... We don't know who it was and don't know if we ever will. The laptop is the biggest thing, it had a lot of clinic info on it that wasn't backed up to a hard drive.
     Yesterday morning we had a five year old girl come in unconscious. She has cholera! We kept her on IVF's all day hoping the diarrhea would slow down but it didn't so finally about six o'clock Trevor and Zach took her down to Port to the hospital. I was occupied quite a bit with her and our Haitian nurse does pregnancy classes on Wednesdays and there were about 70 pregnant women at the clinic yesterday so we all had a long day. When we sent the child down she was on her sixth liter of IVF's and was not in fluid overload but rather still a bit dehydrated. We don't have a large supply of chux pads to begin with and were using them pretty fast so I finally put a tube in the little girls butt to collect the diarrhea because it was just like water, then attached the tube to a drainage bag. In two hours we had gotten 1600ml out! I didn't go down with the ambulance but before they left I told the mom, who would ride in back with the little girl, what all the tubes were for etc... Trevor checked on them when they were about half way down the mountain and they were ok but..... When they got to the hospital both the rectal tube and the IV were out and there was cholera diarrhea all over the back of the ambulance. When asked why they were out the mom said they were hurting her... So I don't know if she took them out or if she let the little girl do it herself. Never the less... Trevor and Zach had to get bleach from the hospital and clean up the back of the ambulance before they even came back up the mountain. I hope that little girl makes it because she was a pretty smart five yr old. Now we are hoping that there won't be a cholera outbreak...
   Then this morning a nine month old baby came in with retractions, a fever, and decreased consciousness. He was also dehydrated from vomiting and diarrhea. I couldn't find any veins on this child except one in his head so he had to have his IV there. I gave him numerous nebulizer treatments, steroids, and antibiotics and then we started working on getting everything set up for somebody to take him down to the hospital too. So the ambulance went down again today. It's really getting a work out this week, we just pray it won't break down on the road because it has had some difficulties lately.
   I'm tired...