soon to be updated

well, it has been a hectic few days and now I leave in the morning for a retreat in Thailand. So, all that to say, I will be updating the blog when i get back after Nov 13th. But, here are a few items that will be blogged so you can anticipate them:
*pus everywhere(papa ware), *moving pharmacy, *new hospital prayer of dedication, *harvest party, *the hospital move, *little friends-abigail, *thailand and cambodia trip.

ok, see you in cyperspace in a few weeks! God bless you!

all the outpatient docs at the new hospital

We had a meeting on tuesday about the new hospital outpatient department. As we were standing there, I thought it would be a nice picture of all of the OPD docs. This is our entire long term doctor staff except for Jim. L-R= Erin, Susan, Scott, Andy, me, Bill, and Stephanie. This is a great group of people to work with, and we are really excited about the new hospital!

a new presenation for septic hip

Michael is another patient on the ward. I admitted him a few days ago. He is a very nice, previously healthy man. When he came in, he had a terrible limp and cried out in pain when you tried to straighten his leg. I examined him and felt a soft thigh, non-tender hip bone, a tender groin however, normal genitalia, and soft abdomen. I did an ultrasound with Erin and we both agreed we did not see any abscess in the abdomen or leg. We started treatment but he was not any better. About 2 days later, Dr. Bill sonoed him. He saw a bit of fluid around the hip and thought maybe that was the culprit. But usually, the have hip pain, which is worse if you rotate the leg internally. This didn't hurt him. But, we decided to try anyways. So Erin and I aspirated his hip using the ultrasound to find the right location...and what did we find?? about 10cc's of pus! He immediately improved. He is not completely well, but is much better. Now, we see him smiling and moving his leg again. Well, now I know about a new presenation for a septic hip...I guess that is one for the next time!

did my patient have a stroke?

This is Pau, one of my current patients on C ward. He was admitted with

a sore on his buttocks, and some weakness. I mostly ignored the weakness, because it seemed to be minor. However, during his stay, he got weaker. In fact, I thought maybe he had a stroke. He seemed to be weak on his entire left side. For a few days, he seemed better, but in the meanwhile had some other issues, including vomiting blood...but that is beside the point. Then a few days ago, he started having weakness on his right side. It presented with the same symptoms as the left. Now i was worried...both sides are weak, and he is getting worse not better! Finally i asked Dr. Bill for assistance, he thought we should get some labs and an xray of his neck to look for problems. Well, he was right...Pau has a lesion of his 2nd cervical vertebrae. The bone looks nearly destroyed and is probably pushing on his spinal cord making him weak. It could be either TB of the spine (Pott's disease), or osteomyelitis (pus in the bone causing destruction). Either way, he needs lots of time, medications, and prayers, that he will recover and regain his strength. He is a very nice man, with a loving family and concerned friends that visit him. Pray for his healing and wisdom for us.

Lazarus

Most of you know the story of Lazarus from the Bible, he was a friend of the Lord Jesus. When he got sick, his sisters begged Jesus to come and heal him. Jesus waited until after he died, then he came. His sisters cried because they thought he would be healed. But, Jesus said this was for God's glory to be revealed. Then Jesus did the most amazing thing, he raised him from the dead!!! Well,I have a patient named Lazarus on the ward, that has been raised from the dead, twice!! Erin initially admitted him, with a pericardial effusion. He then went into tamponade (the fluid squeezed the heart so it couldn't pump). At this point, you have two options, let the patient die, or try a life-saving but life-risking procedure called a pericardiocentesis...ie sticking a needle into the sac around the heart that contains the fluid and removing it. As he was at the brink of death, she did this and he revived! Almost exactly a month later, he had been in the hospital, with little improvement on his TB meds. He went into tamponade again! Her and Bill again, when he was near death, risked doing this procedure, and it saved his life. Now, unfortunately we believe that cancer is the cause of his fluid around his heart. He is a Christian, so we know, that while this earthly life will eventually end, he will have eternal life with Christ in Heaven! Please pray for this family. They have a hard time grasping the problems that he deals with now, and are struggling with the fact that he will eventually die. But, they are very kind and grateful people. Pray also that if there is something we can do to help him, that we would have the wisdom to do so.

my grenade patient and my call night

As we were working on the patient with the exploded grenade, we found where he was having the blood loss...he had a "pellet" hole in both his stomach and his colon. Dr. Jim quickly repaired those areas and we explored for any more problems. Thankfully in his abdomen, that was it. He did lose his 4th and 5th fingers on his left hand, but the rest is salvageable. In the middle of the surgery, the lights went out! You can see the nursing student holding a flashlight for Dr. Jim. (I had the flash on, so it doesn't look as spectacular as it was). He also had my headlamp on, and they kept working. We were grateful, that the maintenance crew was on standby and started the generator for us! So we had power again after only about 5 minutes in the dark. Shortly after that, I was called to B ward, so I left surgery and went to see the laboring mom. She had been pushing for over an hour and was having a hard time delivering the baby. I quickly prayed for help, since I struggle in this department, and then got a vacuum. With only one good pull and the mom's pushing, she was able to deliver a beautiful baby boy. He was blue when he was born, but perked up shortly after with oxygen and stimulation. I was very happy for the mom, and amazed and the Lord's work. I finished up there and headed back to surgery. I was writing in the chart and within 5 minutes, was called back to the ER for a man with abdominal pain. It was in his RLQ and I presumed it to be appendicitis. After admitting him, I discussed with Dr. Jim, who did surgery the next morning and found a very sick appendix. So, a busy but interesting night of call. Please pray for healing for our patients and for strength for Dr. Jim, as he is on call every night since he is the surgeon. Pray also for the grenade trauma patient. He says he used to go to church but doesn't now, pray for an open heart to truly turn to Jesus.

An strange story

I was on call the other night and was called to see a man with an injury to his hand. The ER nurse said he was told a grenade went off in his hand! What?!? We have grenades here (as if bush knives aren't bad enough). When I went to see the patient, he was getting shocky and needed surgery, I quickly assessed him and called the surgeons, Dr Jim and PNG doc, Dr. Felix...our rural medicine trainee. They joined me and agreed, he looked like he needed surgery. What we saw was a young man, maybe 25 with what looked like shotgun pellets nearly destroying his left hand, many on his abdomen, and some on his right hand. We ultrasounded his belly and thought we saw blood, so surgery it was. Here I am getting ready to assist, his pellet-looking abdomen, and Dan--Jill's step dad, here to see the new baby, watching the surgery. (he is a super smart physicist back in Ohio). We got started and were thankful that we did bring him to surgery. We never did find any "pellets", and aren't sure if just a blast of particles could make the injury pattern or not, but we believe him when he and his family explained that he accidently found something on the ground, picked it up, and it exploded. So we wonder if it was a stolen military grenade, or stranger still, a left-over WWII grenade. We probably will never know, but thankful we could help this young man.