Back in the Saddle

After a brief trip home for my pediatric boards and to visit friends and family I am back on call. We arrived in Santa Clotilde yesterday after a few days in Lima for meetings and to start the process of getting our permanent Peruvian medical license. Being home was nice, we had a great time seeing friends and family and I ate to the tune of putting back on 11 pounds. I have a renewed energy to work after being able to reflect on our work here in Peru. I have been told and probably rightfully so to not post too many graphic medical pictures, so i will continue to post them, but try to give a warning and post them at the bottom of the articles :)
Don't worry tonight's blog will have no gross pictures, one good one I wished i would have taken today was of the face/skin of the patient listed on Toni's last "guess this rash" blog, he came in today with no rash only some scarred areas that are only a little lighter...kinda like Michael Jackson. Today was busy and we had two very sick patients one who suffered a snake bite in the hand yesterday and came in today bleeding from the mouth and had swelling up to his shoulder. He had a little reaction to the anti-venom and has a purpuric vesicle (purple blister) at the bite site, but now is sleeping with arm elevated, no longer bleeding and swelling improving. My other critically sick patient is a 5 week baby boy with congenital anomalies, born premature and not feeding well. His weight was 1.8kg, now is 1.4kg today. I am not sure if he has long to live, but is responsive getting antibiotics, feeding on newborn formula and mom's breast. Mom and dad's first baby so this is very difficult. I have never seen a sicker kid that I was not expecting to see, in the ICU, ER and with premature babies we expect to see sick kids or at least are not shocked, but when this kid arrived from up river today after a 5 hour boat trip in one of our emergency boats, I was floored. I could show pictures, but they are too sad and too graphic example of malnutrition (see previous comment) to put up. He needs any luck he can get; if he is like some of the other patients from Angoteros he should fair well.  The health technico that brought this little guy gave me an update on the kids that Centro de Salud previously cared for. Yadiera had a congenital heart defect repaired and is growing and doing great per report, and Martha Luz who was born via arm first then was stuck and somehow survived the trip down river and a crash c-section and meconium aspiration is also alive and growing. I was a little afraid to hear the answer when I asked if Martha Luz was doing okay and pleased to hear the report. Okay the power is gonna cut out soon, like it did on me last night during the 4th quarter of the Bears game (yes i did see the game on our DirecTV in the jungle.) I feel like i should get it for free with my plug for it online.  Goodnight and Happy B-day to my sister one day early!

Brian
12 Nov 2012