Our lady with the broken arm showed up today first thing in the morning. She's I believe 77, if I'm remembering right, and pretty much just this frail little old lady who was probably semi-terrified about the idea of us yanking her arm around into place. We gave her a shot of some NSAIDs prior to starting, and then gave her a Norco 5 that I had with me. We then gave some local into the area. I then grabbed her arm, supinated the forearm and yanked as hard as I could distally to reset the broken humerus. The pain meds did wonders, but it still was obviously not a pleasant experience for her. We got it as set as we could, and then put our makeshift splint on her to hold it into place. This was about the point we realized the Norco took full effect.....she was pretty loopy ha. She's probably never had anything quite like that, so it definitely hit her well. We didn't have any to prescribe so I gave her two more pills to take home with her. It went rather well and I feel confident it will heal better now.
We also had a guy come in with some knee pain and there was an effusion around the joint space. Dr. Pilch said I should drain it if I wanted to, which of course I said yes. The patient said, "do what you think is best." So we prepped him, injected some local into the joint, and tried to drain some fluid with an 18 gauge needle. Sadly there was minimal drainage of fluid, but we did get a good amount of Lidocaine into his knee, so that'll make him feel better anyway. His brother was with him and afterwards I asked him if he had pain in his knee (which was specified on his chart), to which he said, "ummm, oh no, I'm good." Ha, probably after watching his brother he decided his knee was just fine :)
I think all the college kids enjoyed getting to see some procedural stuff, and helping out with everything too. Needed people to run and snag stuff, help us prep, etc. and they got to get some hands on with all that, which as a pre-medical student, getting to be involved in any of that I remember is great. It was nice to be able to teach them some stuff along the way as well, in addition to learning from Dr. Pilch through the experiences.
Otherwise the pathology was fairly similar to yesterday's group of patients. We had a few with really high blood pressure, but they weren't as symptomatic as the patient yesterday, so were able to treat a little differently. A lot of the kids are there with headaches, which is pretty much just from dehydration. I started asking all the moms, "do your kids drink coca cola?" And they all said, "yes." And then I would say, "STOP DRINKING COKE!" (and make sure they translated it for me ha). The one girl translating kept laughing because I was asking every mom about it. But these kids will drink coke alllllll day long and no water, and they are severely dehydrated and getting headaches and muscle cramps as a result. Then the moms want medication for the headache, but all they need is water.....and no coca cola. Sorry. I love a good cold coke, but not in 1000 degree weather every day.
Tomorrow we will head to a different community, which I'm not sure if they've ever done medical work there or not. They normally do 3 days in one community, but I guess this one was new and they didn't quite have enough patients yet or something like that. Even with seeing 640 patients we finished early today.
Oh, we did have my one asthmatic girl come back and she was pretty bad. Not moving air at all. I had given her a steroid taper, but she didn't take it because it made her feel nauseated.....so yeah, she got much worse. Today we found a nebulizer and gave her a treatment and a steroid shot, and told the family that she really really needs to take the meds. I feel bad for these families because they don't fully understand the severity of these conditions, but they also don't have access to getting care if something really bad happens with an asthma attack (among other conditions). But, glad we were able to help her today.
Anyway, tomorrow we will head to a different community and just have the one day of clinic. It's about an hour and a half away, and we'll see if the pathology differs much. Looking forward to it.
The one guy was calling me "Dr. Honey" because "I've got all the sweets." I keep pulling out snacks, candy, cookies, etc. Yesterday we made s'mores with Reese's peanut butter, and they saw all the other snacks I brought in my suitcase so they're excited. Today he walked in to the pharmacy and said "Estoy caliente!" Which basically means, "I'm sexy!" To say "I'm hot" you say "hace calor," so all the Hondurans had a good laugh and we are calling him "caliente" now ha.
Hopefully you're staying cooler than we are! Thanks for reading. Trying to post a bit shorter on this trip so y'all can read it more easily. I'm going to post a few pictures at the bottom here of the injections we did today, so check those out! Thanks a bunch!
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