Beth Gullone’s Blog

The Weekend

Friday we went to Hospital Buen Samaritano and saw only about 6 patients.  That is supposed to be an ob/gyn clinic.  The first patient we saw was a 13 y/o girl who had about 28 days of vaginal bleeding.  She had been seen by a private physician earlier in the week and had a workup done including an ultrasound.  They diagnosed her with PCOS (polycystic ovarian syndrome) and gave her a ton of medications.  A nun who helps take care of her brought her to see Heidi because she felt the girl was given too many meds and was throwing up.  She brought along the ultrasound pictures which were really nice, but did not show PCOS and the girl herself did not have any PCOS characteristics.  Our best hunch was actually that she had had a miscarriage, but was probably too afraid to say anything with the nun there.  We saw several other prenatals and someone with a urethral cyst and another with the start of menopause.  The rest of the afternoon we had off.  Annie and I went for a 3 mile run on the outside of town.  It was great except for when the big trucks or buses went by and blew all the exhaust in our face!  It was nice to see the countryside though and get some air.

One thing I forgot to mention about clinic on Thursday, was that one patient said that we are white because we drink a lot of milk and they are brown because they drink a lot of coffee!  That cracked us up.

Saturday we drove again to Canilla to the Ficker’s house.  About 1 hour (13.5 miles) into the drive we had to turn around and go all the way back to town to take another road because a big gas truck had turned over on the road and it may be hours until someone could come and pull him out.  So it turned about a 2 hour drive into a 3 1/2 hour drive.  And no, they aren’t paved roads.

Clinic in Canilla at the Ficker’s was mostly uneventful.  We saw 70-80 patients.  The majority were just routine prenatals, coughs and colds, aches and pains, a few pneumonia, chicken pox.  We did have one 14 y/o girl who had had a cyst removed from under her tongue in August by an American surgical team.  A few weeks after the surgery, the area began to swell again.  It looks like maybe her veins had been affected by the surgery and now she essentially has a big venous pool under her tongue.  Unfortunately we couldn’t offer her anything then and we’re not sure what we can offer her still, but we took her info and will talk to a few more people for suggestions.  The other unfortunate thing was that I forgot to take a picture of her tongue to be able to show others and maybe get suggestions for what to do. 

Saturday afternoon Leslie and Katie and Rachel Ficker took Annie and I to some local Mayan ruins.  It was small but very neat to see.  There was a temple and a soccer field.  Then Rachel, Katie, Annie and I played Apples to Apples. 

Sunday we had another delicious breakfast made by Leslie and then Leslie, Katie, Annie and I headed to San Andres for clinic.  It was a long day.  Between the 4 of us we saw over 100 people.  We saw prenatals, coughs, colds, pneumonia, diarrhea, amoebas, impetigo, warts, headaches, diabetes, etc.  One woman came in at about 24 weeks and hadn’t felt her baby for 2 weeks.  She had a fetal demise.  Another girl was 20 y/o and brought in by her parents.  She probably has schizophrenia.  It was very sad because we don’t have any anti-psychotic meds and there aren’t really good places to refer her to.  And if we did have meds, the girl may not take them or be able to come to clinic regularly to get the meds on schedule.  We felt bad not having much to offer.  At the very end of clinic, a father who didn’t have a number (appointment) asked if we would see his son.  This boy was about 14 y/o and just looked malnourished and dehydrated and ill.  He had been sick for 2 weeks with body aches, stomach pains, diarrhea, fever, sore throat and no appetite.  His heart rate was 120-140 and his respiratory rate was 40.  Both too high for him.  His lungs were clear, his abdomen was diffusely tender but not rigid or like an acute abdomen, his neck was not stiff, his joints/bones/muscles all seemed tender, his throat was clear, and he had a slight heart murmur, no rashes.  We weren’t quite sure what he had, but felt he needed more than what we could offer.  So, we gave him some rehydration solution, and convinced his father to let us drive them back to our house and bring him to the hospital across the street from us.  The boy slept most of the 2 hour drive back to the house.  We talked to the ER doctor and gave her the story and she took over.  Hopefully he was given IV fluids and was admitted, but apparently they don’t often admit people.  And may not have even done any labs on him.  We may try to go over to the hospital tomorrow to see if he was admitted, but we never got his name so that may make it difficult.  He may have endocarditis, rheumatic fever, JRA, lyme disease, etc…  Or he may have just had a bad viral illness and wasn’t able to hydrate himself enough.  The number one cause of death here is respiratory illnes, and the number two is diarrhea. 

Tomorrow Matt, Annie, and I will drive to Panajachel to see Lake Atitlan and spend two nights in Antigua and then on Wednesday we will drive to Guatemala City to pick Heidi and Isaac up from the airport.  It will be a nice break from clinic to do the touristy thing.  So, my next blog probably won’t be until Wednesday night.