A Ray of Hope

So I thought I'd post a few good things.

This morning on my way to the hospital I ran into the mother of a girl I had taken care of on Ward D. She (again) profusely thanked me for taking care of her daughter. She mentioned that the girl is still doing well and that she is now brushing her teeth daily (she had been treated for a horrible mouth infection, likely related to the absence of oral hygiene).

After arriving at the hospital I went to the surgical ward to check on a patient who had been on the medical ward under my care for a couple of days. This was the boy I mentioned on Sunday who I found in profound pain. He finally had surgery on Tuesday and had his wounds drained. When I went to check on him yesterday he appeared to be experiencing a severe allergic reaction - he was extremely edematous, he had urticaria on his trunk and groin and he appeared to have some difficulty breathing. I immediately changed his antibiotics from a penicillin to a cephalosporin, I started him on steroids and I had the pharmacy dig up the benadryl I had brought with me to give to him. This morning he was still alive and much more comfortable (although still somewhat swollen).

When I got to Ward D the charge nurse commented on how well the two lumbar punctures I had done the day before went. He in part attributed my success to the use of lidocaine to anesthetize the area first (what a concept!?!). It sounded like he plans to make lidocaine available for all future lumbar punctures on the ward.

While I was chatting with the charge nurse a father who speaks pretty good English wandered by. He thanked me for my good care. He made a point of mentioning that his appreciation was not just on behalf of his daughter, but for all the patients on the ward.

The other doctor finally showed up and we rounded on the patients together. We were able to discharge a few who had significantly improved. And the patient with the finger cellulitis vs. osteomyelitis showed us how much better her finger was. The cultures finally came back from the fluid I drained off her finger a couple weeks ago. They had not tested for sensitivity to two of the most commonly used antibiotics, although they did test for sensitivity to the antibiotics I would love to use if they were available here. But still, I was pleased that we had positive culture results available. Because so often cultures are not done here out of the belief that they are never positive/useful. (And there was demonstrated sensitivity to at least one of the available antibiotics). There is no guarantee that anyone will draw any cultures after I leave here. But I feel like they're one step closer.

It feels good to see patients get better, to hear appreciation from families and to think that maybe there will be a tiny bit of lasting change...