Morning Rounds

We received a warm welcome from hospital staff as we climbed up dozens of concrete stairs to reach the hospital after disembarcing on the riverbank. Everyone greeted us with a besito. We toured the hospital, which was larger then I remember from the pictures we had looked through. We transported a man on our rapido boat who was diagnosed with diabetes ten years ago and developed shortness of breath last night, with frothy sputum.We later diagnosed with a heart failure due a slowly progressive heart attack... he's doing well but receiving a stent which is standard of care in the US is not an option here. We were also radioed about a 4-year-old girl with a possible bowel obstruction. She had been picked up from her canoe where she traveled with her mother and the local technico by the hospitals emergency boat. She had a severely distended abdomen, no urination or stool in days, vomiting, and she cried, “mommy, but it hurts so much” as she rubbed her inflated belly. She was rehydrated, given antibiotics, an enema, and was scheduled for transport to Iquitos in the morning. The inpatient ward housed Daisy who has a leishmaniasis ulcer on her arm. One man has a colonic mass 13cm up, which has caused a chronic bleed. His hematocrit when he arrived was a mere 16. He is receiving daily blood transfusions until he is stable enough for transfer to Iquitos. Another patient had a tree fall on his leg and a branch pierced through his thigh… his open wounds are recovering well. 38-year-old women had so much lymphatic fluid around her lung that it had collapsed and was compressing her heart. Her chest tube is being pulled as I write, and she too will be transferred to Iquitos tomorrow. A 1.7kg baby born at 34 weeks at home was admitted at 10 days old for having a fever and cyanosis. Currently off antibiotics, feeding like a champ, and gaining weight. The list goes on…

Toni