Wednesday, February 24, 2010
Carnival
One holiday in many Latin American countries that I had never been aware of is Carnival. It occurs several days before Ash Wednesday and pretty much consists of everyone attempting to get everyone else as wet as possible. Thankfully Shell is a peaceful and friendly town so the people only use water and spray foam with an occasional bag of flour thrown in, unlike more rowdy places where you may have oil-based paint or urine sprayed on you. The kids had a great time joining in the fun with water balloons and readily available foam spray from a nearby store. Poor Jael got the brunt of her brother's attacks but took it with laughter and smiles.
Saturday, February 20, 2010
Carry your Sword
Many times I'm faced with a patient who doesn't make sense. In other words, they haven't read the text book. Something is going on with him or her that doesn't seem to fit the mold of a physical problem. Ms. A was one of those patients. She's currently pregnant with her fourth child, about 22 weeks along. Two weeks ago she presented to the hospital with bleeding. A physical exam and ultrasound had revealed that all was well. A few days ago she presented to my clinic with contraction-like pains. She didn't have a urine infection, and monitoring and exams revealed that she was not in labor. The Holy Spirit prompted me to try to find out the answer to the question, "What is really wrong with Ms. A?". Through a series of questions, we began to talk about the stresses in her life. She related to me that her heart was full of fears regarding the pregnancy.
"There is no fear in love. But perfect love drives out fear, because fear has to do with punishment." (1 John 4:18)
Ms. A told me that she used to have a right relationship with Jesus, and that she had accepted His free gift of salvation. However, she felt that Jesus was far away during this pregnancy. We talked about how Jesus is the only one who can offer perfect love, and how perfect love is the only thing that can drive out fear. We shared a time of prayer together. She recommitted her life to Jesus, and told me that she is going to start going to church again!
"All scripture is inspired by God and is useful for teaching the truth, rebuking error, correcting faults, and giving instruction in right living." (2 Tim. 3:16)
"There is no fear in love. But perfect love drives out fear, because fear has to do with punishment." (1 John 4:18)
Ms. A told me that she used to have a right relationship with Jesus, and that she had accepted His free gift of salvation. However, she felt that Jesus was far away during this pregnancy. We talked about how Jesus is the only one who can offer perfect love, and how perfect love is the only thing that can drive out fear. We shared a time of prayer together. She recommitted her life to Jesus, and told me that she is going to start going to church again!
"All scripture is inspired by God and is useful for teaching the truth, rebuking error, correcting faults, and giving instruction in right living." (2 Tim. 3:16)
Tuesday, February 16, 2010
Morning of Meningitis
(The patients and their families described in this blog excitedly gave permission to share their stories and pictures)
About two weeks ago I was having a pretty busy call. I'm starting to earn a reputation as a "mala espalda", which means "bad back". The reason they call me that is because I tend to be working when most of the sick people come in. In the US, instead of a "bad back", I'd be called a "black cloud". Anyway, it was busy, and at 2 am two girls came into the ER. They were from completely different communities. Rashell is 10 years old, and she lives in an indigenous community deep in the jungle. Miley, age 2, is from Puyo, which is a decent-sized town right up the road. They sell pizza and ice cream in Puyo, so that says a little bit about the differences in their backgrounds.
The resident on call told me about Miley first. That day she had visited a health center in Puyo for fevers, followed by a seizure and left sided weakness. A CT of her head had been performed and was found to be normal. Her doctors there were reassured by this information, she had been sent home. It sounded like she could have been having febrile seizures, which are very innocent--but on the other hand, we were pretty concerned by the fact that she was not moving her left side. We performed a lumbar puncture and drew blood cultures and admitted her for administration of high dose IV antibiotics. Studies of the cerebral spinal fluid confirmed what we had been thinking--she had a probable case of bacterial meningitis.
Rashell seemed even sicker than Miley. She also had been having fevers and had suffered a seizure a few hours earlier. Her dark brown eyes were rolled back and lacked the dance of life that eyes usually have. She made insensible groans with painful stimlation (when the IV was started). Flexing her neck forward also seemed to cause lots of discomfort. Because Rashell's mother, who had died several years earlier, had had a bad experience with a lumbar puncture, the family would not give us permission to draw the fluid from Rashell that would confirm our suspicion--another case of meningitis. She, too, was admitted for high dose antibiotics.
High doses of antibiotics are required to penetrate the blood-brain barrier that protects our nervous system. Likewise, we gave these two girls super-high doses of prayer in an effort to fight this potentially deadly disease. Their families were at peace after the prayers, and I went home to rest for a bit.
The next day Miley was doing much better in that the weakness in her left side was resolving. However, she did have another seizure. We began anti-seizure medications and stayed the course. Rashell's status did not change on day 2, and I began to feel less sure that she would ever wake up.
On the following day, Miley's weakness had completely resolved and she was seizure-free! In addition, Rashell was starting to talk, and she even smiled. That dance had returned to her eyes. Praise the Lord! Little by little, they have both recovered completely from their illness, and today is the last day of their high-dose antibiotics.
It is not rare for a person to die from a case of bacterial meningitis. Survivors often suffer consequences such as residual weakness, or even deafness or blindness. I praise the Lord that these two sweet girls have done so well. I thank Him that he gave wisdom to scientists who invented antibiotics. Most of all, I am reassured once again that I can always find peace and hope in the power of prayer to our God Almighty.
About two weeks ago I was having a pretty busy call. I'm starting to earn a reputation as a "mala espalda", which means "bad back". The reason they call me that is because I tend to be working when most of the sick people come in. In the US, instead of a "bad back", I'd be called a "black cloud". Anyway, it was busy, and at 2 am two girls came into the ER. They were from completely different communities. Rashell is 10 years old, and she lives in an indigenous community deep in the jungle. Miley, age 2, is from Puyo, which is a decent-sized town right up the road. They sell pizza and ice cream in Puyo, so that says a little bit about the differences in their backgrounds.
The resident on call told me about Miley first. That day she had visited a health center in Puyo for fevers, followed by a seizure and left sided weakness. A CT of her head had been performed and was found to be normal. Her doctors there were reassured by this information, she had been sent home. It sounded like she could have been having febrile seizures, which are very innocent--but on the other hand, we were pretty concerned by the fact that she was not moving her left side. We performed a lumbar puncture and drew blood cultures and admitted her for administration of high dose IV antibiotics. Studies of the cerebral spinal fluid confirmed what we had been thinking--she had a probable case of bacterial meningitis.
Rashell seemed even sicker than Miley. She also had been having fevers and had suffered a seizure a few hours earlier. Her dark brown eyes were rolled back and lacked the dance of life that eyes usually have. She made insensible groans with painful stimlation (when the IV was started). Flexing her neck forward also seemed to cause lots of discomfort. Because Rashell's mother, who had died several years earlier, had had a bad experience with a lumbar puncture, the family would not give us permission to draw the fluid from Rashell that would confirm our suspicion--another case of meningitis. She, too, was admitted for high dose antibiotics.
High doses of antibiotics are required to penetrate the blood-brain barrier that protects our nervous system. Likewise, we gave these two girls super-high doses of prayer in an effort to fight this potentially deadly disease. Their families were at peace after the prayers, and I went home to rest for a bit.
The next day Miley was doing much better in that the weakness in her left side was resolving. However, she did have another seizure. We began anti-seizure medications and stayed the course. Rashell's status did not change on day 2, and I began to feel less sure that she would ever wake up.
On the following day, Miley's weakness had completely resolved and she was seizure-free! In addition, Rashell was starting to talk, and she even smiled. That dance had returned to her eyes. Praise the Lord! Little by little, they have both recovered completely from their illness, and today is the last day of their high-dose antibiotics.
It is not rare for a person to die from a case of bacterial meningitis. Survivors often suffer consequences such as residual weakness, or even deafness or blindness. I praise the Lord that these two sweet girls have done so well. I thank Him that he gave wisdom to scientists who invented antibiotics. Most of all, I am reassured once again that I can always find peace and hope in the power of prayer to our God Almighty.
Miley and her Mama
Rashell
Friday, February 5, 2010
Avenue of the Volcanoes
Part of the road from Quito to Shell is known as the Avenue of the Volcanoes. Most of the time we don't get to see many of these mountains from Shell with the cloud cover we get from living in the rainforest. However, the other day I went out for an early weekend morning run. I wasn't so sure I wanted to be up exercising on a Saturday morning when I could be in bed asleep, but it was worth it when I got to see Tungurahua blowing ash and smoke into the air. If you come to visit us you'll drive past the base of this mountain where the town of Banos lies, which had to be evacuated several years ago due to lava flow.
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