Friday, March 7, 2008

Showering

I have found out the only thing you really need to shower is water an soap. Our first night in the hotel in Kampala that is all we had and I still took a shower by filling a bucket with freezing cold water and splashing it on me using soap. Other luxuries include 1. water pressure. and 2. warm water. In our house we actually have water pressure but not warm water. So every morning I get into a freezing cod shower and quickly wash my hair and body. Unfortunately I also develop hypothermia in the process. Another option is to boil water in a kettle and pour it into a bucket in the shower then add cold water to make it warm water and splash that on yourself. I have been too lazy to take that approach but maybe I should start to avoid becoming hypothermic.

The third day on the wards I was starting to get into the swing of things. Being able to recognize malaria in about seconds by the eyes, spleen, and complaints. We also performed a paracentesis (removing abdominal fluid) on a female patient. As we were finishing that the nurse told us there was a patient who's been waiting who is having "hysteria" so she saved her for us too see last. When we walked in she was convulsing and her eyes were rolled back in her head. She had been like this for the past 5 hours. She was in status epilepticus NOT "hysteria". Her oxygen was 80% by this point. The only oxygen available was in the maternity ward and is not portable. We put in an IV and and pushed valium 3 times and it did not break her seizures. That was the only IV medication that they had for seizures. They said they had oral phenobarbital and oral dilantin. But she was seizing and couldn't swallow anything.

At this point her oxygen sat was 48% (we brought a portable pulse ox from the States). Then I got the idea of putting in an NG tube and giving her the other medications that way. They didn't have any dilantin in the hospital so we gave her phenobarbital. At that point it seems like the valium kicked in because she broke. Her oxygen went up to 96% but she was unresponsive. We will see if she wakes up tomorrow. 5 hours of seizures fries the brain. So does 5 hours of not getting enough oxygen. I also had a girl who was 12 I was asked to see. It was obvious she had a fracture of her lower leg. I am not experienced in setting fractures so I splinted it and referred her to an orthopedic specialist who would be able to see her the next morning.

Rafi

3 comments:

Rebecca said...

i'd say boiling the water is totally worth it. cold showers suck and starting off your day with a warm one can be a nice luxury.

|¥|@ยต®¡ said...

Hey! I just want to say that I really admire you for what you're doing. Not everyone would dare to do what you are doing.
You are a wonderful human being.
Keep writing, cause we'll keep reading.
I wish you success buddy!
Love,
Mau

Sam and Rachel said...

--amazing/crazy/must be frustrating not to have the stuff you need but helpful to keep you thinking outside of the box; If you need an ophtho consult, gimme a call
--and I really think your next video should consist of you showering with those freezing buckets of water