More twins...

    On Monday a lady came to the clinic in labor. It was her first baby. We noticed one strange thing with her, her stomach was very lopsided. It was weird looking. She wasn't lying on the table crooked, she just had an odd shaped stomach. Turns out she has a little girl... But she still has a big bump in her stomach. She has twins and nobody knew it until now. I guess that accounts for the oddly shaped stomach. Shortly after she delivered a boy, healthy and hollering. The little girl was breathing good but never really cried. They were both big too for being twins. We don't normally weigh the newborns because it doesn't change the care we give and lots of families don't care that much about it. We did weigh these two though. They each weighed a little over six pounds. We called the dad in the room and told him he had a boy and a girl. Everyone was surprised. The really interesting thing is that there was only one placenta. That isn't supposed to be possible with a boy and a girl but that's how it was. We did some research on it and found out if it happens the placentas must have fused at twenty some weeks. It just isn't supposed to be that way.The family had carried this lady to the clinic on her bed and they have almost a two hour walk. Because the little girl didn't cry right away we wanted them to come back in a couple of days for a checkup. The proud grandma and an aunt walked the two hours here with the babies on Wednesday. They are both doing well. We really commended the family on how clean the babies were too. I think they will do fine. Hopefully they will bring the babies back in a couple of weeks for vaccines so we can keep track of them.

   Tuesday brought another lady in in labor. This was her first baby too. She had a 10 pound boy. He looked so big and had so many fat rolls we had to weigh him too.
     Last week a lady came in with a very swollen arm and shoulder. She had gotten a Depo shot eight days earlier at another clinic. Now it looked very infected. It was hot and shiny and swollen. I got several ml's of pus out but not very much. We gave her two different antibiotics and told her to come back in two days. She didn't show up until this Tuesday - and now she has a hole in her arm. The area is about 1 1/2inches in diameter and probably an inch deep. It doesn't look infected right now, it's just a big hole.

We had thought that she must have been given the shot with a dirty needle but this looks worse than that. Now we suspect the medication must not have been Depo. It had to be some kind of medicine that causes tissue necrosis. I had to clean the wound out before I packed it and I could tell it was very painful. Personally, I can't imagine what that would feel like- just a hole in your arm- clear down to the muscle. We tired to impress upon her the seriousness of this wound and that she has to come back often for dressing changes or she will lose her arm. I don't know if she really understands it or not but she promised to come back tomorrow so we'll see. The second time she came she also brought her nine month old baby with her. The baby is malnourished and only weighs 11 pounds so we gave her some food also. They do live a long ways away from the clinic but hopefully she will return.