Liberia 2017

Kwendin #16 | March 3, 2017

A busy day today-­‐-­‐I was at the clinic all day, and there were quite a number of people who had been told to come and meet me.  

The first one I dealt with was the fellow who cut his finger with a machete. He had been getting daily dressings and antibiotics, and the finger was nice and clean. But wide open. Maybe you remember that I removed the dead part of the finger, which was the nail and nail bed, and all the bone almost back to the second knuckle. Which left the soft part of the finger all the way to the tip. I froze it up nicely and folded the soft tissue up over the end of the stump and it fitted just perfect. So I sewed it in place. He should do well.  

I also had a good look at the fellow with the infected inguinal hernia repair from last July, done by someone else. I new it needed more work. So I filled the area with local anaesthetic and probed around. I took out one long stitch and quite a large piece of the mesh that we sometimes use in hernia repairs. The infection would never clear until those things were removed. Hopefully it will now clean up enough for me to sew it closed by the end of next week.  

I saw a series of lumps for excision and have one booked for every morning next week. I know that last year we booked a series of lump excisions on the last day, and I might end up doing that again this year.   I also saw our patients from surgery last Friday. it is now a week and time to get their stitches out. They are all healing well and happy.  

And I saw yet another patient with a huge jaw swelling. But this time it was a young lady (with 2 small kids and an attentive husband) and the swelling looks nasty. I think it is a cancer and I think we may not have any treatment. I will take her to Tappita next week to show Dr. Asaye.  

I have accumulated a small list of people to bring to Tappita next week-­‐-­‐including the fellow with the infected knee, and the lady with the cancer on her nose.  

Besides those patients there were still a long list of people needing to be seen. Kate worked in one room and I in another and we saw quite a few. Spencer and Kristie went off to Tapita to see our patients there and discharge them. When they got back we put each of Kate, Kristie and Spencer in a room with a translator who was capable clinically, and I circulated between them checking on their patients and discussing treatment options. It worked very well.  

In the midst of the morning Kate came to ask me to see a small boy who was not getting better despite several days of malaria treatment. Luah and I looked at him and he was sick enough to need an iv. Luah found all the necessary materials and held the kid tight while I got the iv going on him and taped it so he couldn't pull it out. (Aside: I was taught that any time you put an iv in a child, you must tape it so firmly that you can lift the child off the bed with the iv tubing!) He got some iv fluid and started to perk up, and we switched him to quinine for treatment, and by the end of the day he was much better and ready to go home.  

I depend on my nurses to identify patients who are sick enough that I need to see them. And Kate did that very well in this case.  

We were done about 3 and walked home in the blistering heat. The thermometer on my desk read 98 F, which is inside the house so I am guessing it was over 40C outside. So we had a little time here at home before supper. I cut up a pineapple and two pawpaws and they got vacuumed up-­‐-­‐fresh fruit is very welcome after a hot walk.  

Bob and his team are still working on fixing up the house next door. He showed us at the end of the day and it is looking much better. Amazing what some cleaning and some painting will do to a place! he has lots of memories from the 4 months he lived there back in 1980.  

We salvaged some lamp wire and some LED lights from the previous occupant. One of the lights works just fine and we are using it.  

Although we were not planning to go to Tappita tomorrow, we now have to because of the three patients of ours who (presumably) have had surgery today. Not sure who will go. We will see.  

We are planning a few minutes singing together this evening. I'll try and get this computer battery recharged enough to provide words for the songs. That sounds simple but it is technically challenging here, and I will not write out the details.  

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OK it is now 9 pm and we have had some time singing, sharing and praying together. The team is surprisingly close and able to share what is really going on in our lives. it is such a blessing being part of such a tight supportive group. I really enjoy these people.   The computer now needs even more charging so I'm not all that sure how the letter will go tonight. I'll work at it.  

Dr. John Potts