Thursday, 15 September 2011

Born into darkness

Born into darkness

Today did pretty much a little bit of everything:

1. Watched a c section which was performed due to the mother having past history of cervical tear. Both mum and the little boy doing fine though baby was born covered in meconium (a sign of fetal distress.

2. Talked to senior doctor about patient mentioned yesterday. He took my concerns seriously and agreed to examine her with me. No findings on examination but he has stopped all her drugs except magnesium trisilicate (an antacid) in case some of her newer symptoms are a drug reaction and as requested a barium swallow x-ray and also an Hb test. I'm really glad her symptoms are at least still being investigated now.

3. Went to child check up clinic. Didn’t gain much here to be honest - all in Swahili plus seemed to just be weighing kids. Didn't stay long.

4. OPD. Most interesting case today: A young man with VERY obvious jaundice (bright yellow eyes) probable diagnosis = a form of viral hepatitis.

Also I think I successfully diagnosed chronic kidney disease, probably not a great diagnosis for a patient here though as so little they can do. But hopefully with the condition at least known about they might be able to give some drugs to slow the progression / avoid certain drugs which damage kidneys.

Final part of the day was in maternity late this evening where I delivered my 3rd baby (admittedly with a reasonable amount of help from the midwife as the baby didn't pop out quite so easily plus had cord around his neck). Birth occurred during one of the common powercuts so he was born by torchlight! But he was healthy and cried instantly :). Mother was very young (only 16) and not married which is still quite stigmatized here so I hope they will both be ok in the long term.

Halfadoc x

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