It has been a busy week. Last week it seemed like there were extra many dirty babies brought in. One was 10 days old and still had crud behind his ears from when he was born. The complaint was that the baby wouldn't eat. He only weighed about five pounds and was probably too weak to get enough milk to sustain him. We sent them home with syringes to feed him with until he gets a little stronger because he did well with swallowing for us just didn't seem to have enough energy to suck also. I hope he makes it. Another one was three months old and had bad skin problems. She had no diaper on and had raw places on her butt, I guess just from not being kept clean. I don't think this little girls' hair had ever been washed and if it had been combed through it wasn't very recently. It was filthy! Just while washing it we got out clumps of hair. We had to wash it several times and still didn't get it as clean as I wanted. This child also had the worst case of thrush I have ever seen in her mouth. Her whole mouth was white! It was to the point she wasn't eating much at all because her mouth was so sore. We ended up giving her IVF's and several medicines to go home with.
The lady with the massive abscess from her tooth came back and the swelling had gone down a lot so we removed the drain. She still couldn't open her mouth even an inch wide. She was supposed to come again today and if she could open her mouth further and if the swelling has continued to go down we wanted to refer her to a dentist to get the tooth pulled. She didn't show up today so we don't know if for some reason she was unable to come or if she chose not to because she was feeling so much better...
One more unusual thing we saw was a lady with a wound to the inside and just above her knee. She had been bit by a donkey! The wound was over a week old already so I couldn't clean it very well because it was so dry so we put a dressing on to help loosen everything up. She has been coming back every few days for us to change her dressing.
Last Friday was an eventful day... About 11:30 a truck drives in with a patient for us. It is a lady who had had a baby at 8:00 that morning. CAUTION! If you don't like reading about blood stop reading now!!!! They think she possibly has another baby inside that isn't being born for some reason and she is bleeding a lot. We get her into the exam room and Githane does an ultrasound to see if there is another baby because there is a mass in her abdomen but it doesn't feel like a baby to us. It isn't another baby but we aren't sure what it is. We question the family where the baby is that was born earlier. It had died. We ask if the placenta was intact and they think it was. But she is bleeding a lot and is already very anemic. We start an IV and get some fluids running then I have to see if I can find anything that would cause bleeding, possibly some retained placenta... Sorry guys. That's just the way it is though... I felt very sorry for the patient but had no other option. She continues to bleed. We give her two shots that are supposed to decrease bleeding but see no change. From what I can guess from feeling is that she has a hole in her uterus. Todd gets to the clinic soon and that's what he thinks too so she needs an emergency hysterectomy and we are three hours from a hospital. Keith and Todd are getting ready to take her down. In between all this we find out from the husband that this lady was warned not to have any more children by a doctor. He is not sure why but she does have nine children already. Then we find out that this lady tried to abort this baby in May so maybe there have been problems since then. We try to give the patient some ensure we have. She takes a little then indicates she doesn't want anymore. Not long after this she hawks out a milk loogy that lands somewhere on my printed scrub top. I don't see where until I feel wetness on my arm. Anyway... The lady starts getting upset saying she is dying etc... We have the stretcher ready to load her in the vehicle that Keith is supposed to be bringing. Meanwhile... We can no longer pick up an oxygen saturation and are unable to get a blood pressure. She died shortly after. It had only been about 30 minutes since I had talked to Keith but he had been unable to get the truck started for some reason. So there is no way she would have made it to the hospital but we were doing our best... A few minutes later Keith drives on the yard, not sure why but I guess it wasn't meant to be that she would go down. Looking back, I think she had probably lost more than half of her blood before she even got to us.
So long... For now...
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