#138 Shanksteps

Shanksteps #138
It’s vaccination week for women 15-50 all over Cameroon. Audrey is out on supervision and I’m taking care of things at the hospital. It’s a long day and 95 deg (still the cool season). I make rounds on all the patients in the hospital (55 in all) and see about 14 outpatients, do one Norplant insertion, and open one abscess. I get home about sundown and find Audrey with her head in her hands. It’s the worst headache of her life. She asks me for a Diclofinac injection (very unusual as she doesn’t like injections). It’s the strongest painkiller we have at the hospital, kind of like injectable Ibuprophen. She has just completed a week of treatment for malaria and is still on typhoid treatment. Over night she is relieved a little by the injectable medication but it only lasts about 5 hours till she needs another. Then the itchiness sets in. She scratches and scratches. Takes dexamethosone and chlorphenirimine to help but they only decrease it a little. The next day w
e tell the district health doctor she is unable to help with supervision. She stays home and sleeps, until the pain is to strong to sleep, and the itchiness is unbearable. I get home again late and she seems a little better. Wednesday, Thursday, Friday. all the same things, all over. Injections, temporary relief, itchiness, injection, force down some food, itchiness, and me coming home late.
Friday evening Im still at the hospital. She calls me and tells me to bring home IV treatment for malaria and typhoid, she can’t handle the headaches or body aches or the weakness any longer. I bring home a nurse with me to start her IV. She looks terrible! Finally the IV is started and the Quinine starts in, Ceftrixone follows. She takes another med to help treat malaria along with the Quinine. I’m called to suture up a woman’s head that is bleeding profusely. She and her husband were drunk on millet wine and he hit her in the head with a stick and now she is bleeding. I follow the trail of blood to the suture room. She is talking up a storm to the man who accompanied her. I throw in a few stitches and it stops. No skull fracture. Throughout the night I wake up frequently to check if Aud’s IV is dripping correctly, to help her to the bathroom and at the different times the hospital calls me in to see another patient. At 2AM the patient that I just repaired his f
ractured patella calls me on my phone. “Cest no va pas, cest no va pas, cest fait mal.” I’m tired and he shouldn’t have my number or be calling me in the night. I tell him to NEVER call me again and to tell the nurse. I lay there fuming in bed, unable to sleep. My subsequent thoughts are, did I miss something? As I cannot go back to sleep because of my anger, I go into the hospital. I check out his leg and find he is still mostly toasted from the Ketamine and Valium I gave him for surgery. But he did come to enough to dial my number. I tell the family not to let him call me again. I sleep for a three hours before its Audrey’s next dose of Quinine.
Sabbath I spent the whole day in the hospital. Went in at 8 when they called. Home at noon, called back at 12:30. Home at 3, make something for Audrey to eat, back in at 3:45. Finally home at 7PM. I’m exhausted. Audrey’s IV isn’t working any more. They call me back in to see a patient with potential for Cholera (There is an epidemic in our surrounding area now). I ask the nurse to replace her IV catheter. He is unsuccessful. But she looks better. Her headache is finally gone that has kind of been there for two weeks and really strong for days. She looks good lying flat, but is dizzy when sitting up. She starts oral Quinine. I get called in to open up a large abscess on someone’s thigh. We sleep well finally.
Sunday morning, our busiest day here at the hospital, because it’s market day. Audrey is still too dizzy to stand for longer than about two minutes. She stays in bed. I go to worship at the hospital. See a few in clinic, then head for rounds at maternity and surgery. After seeing 25 there I go to peds. The ward is full about 27. I get done and head to clinic. About 3PM I have one card left and I feel I can soon breath a sigh of relief and finish the adult ward when the nurse brings me about 14 more cards. 32 in clinic today. I finish and head for the adult ward. 32 outpatients, 62 inpatients- 94 in all. I get home late again. Audrey looks better. The malaria is lessening and the side effects of the Quinine increasing. I have to talk loudly for her to hear me over the humming in her ears. She is more nauseous. She can sit up for about 4 minutes before she feels like vomiting and lays down. I feel quite tired. I think a cold shower sounds wonderful then.slee
p.until they call again. Lord give me strength! Need your prayers, Greg