It was the first time that all three of us had been together at ASELSI since November. Isaac was a great little helper. He was in a really good mood all morning and entertained our patients and their children. No one can believe he's only 6 months old. One woman remarked that he's about the size of a one-year-old here. True, true.
First, we saw several new babies. We had been following their mothers through their pregnancies and it's always neat to see the new babies. We had gotten all the genders right on these today - whew! No surprises.
One was Josefina, a woman we've followed for a while. She had 10 children and developed diabetes. She asked us one week whether we thought she should try to get pregnant again. The answer was a definitive NO! She was a recently diagnosed, uncontrolled diabetic and she had had 10 children already (the first one was a c-section and the next 9 had VBAC'd at home). So, naturally, the next month she came in pregnant. We counselled her each time she came in about going to the hospital to give birth. She apparently listened and went to the hospital for a c-section, even bringing the paper we gave her with all her prenatal visit info on it. But they noticed that her due date was still a week or so away and didn't do a c-section. She stayed in the hospital anyway, and VBAC'd again because their weren't enough doctors in the hospital to do it when she went into labor. She lost a lot of blood, though, and even got a transfusion. The baby was 9 lbs, which is an absolute monster around here. She and the baby both look fine now, though she's still a wee bit anemic. So we're helping with some iron and a few things to help her breast milk come in a little better.
We saw a couple of really little babies, too. One was about Isaac's come-home size - just under 6 lbs. Another was a nearly three month old who only weighs 5 lbs and change. THAT baby got entered into the milk program. And, in picture #1 below, you can see Isaac meeting a new buddy (another one of our former prenatal patients).
This past Monday, we got to see Diego, our hydrocephalic baby in Chicabracan. Today, we got another one. This little girl, Rosio, is almost the exact same age as Isaac - 6 months - but is severely hydrocephalic. Mom and Dad said that she had some type of little bag on the back of her skull when she was born in the hospital in Xela, which was removed, but hasn't gotten any treatment since. According to them, the hospital told them that she's just fine. Clearly, she's not (picture 2). So we told them all about the process they'll have to follow to get her her surgery. They indicated that they're interested in going through the process, which starts at the hospital here next to the house next Wednesday. Luckily, after our experience with Diego, we know what to expect. And they seemed reassured when we showed them pictures of Diego and let them know that we've had some success with getting the surgery with another child.
Later was another little boy with a cleft lip (pic 3). He was actually part of the trip in January and was refused by the anesthesiologist as borderline too small. While it's frustrating to be turned down, it makes you feel good that the anesthesiologist cares enough to say that she doesn't quite feel comfortable with this one (meaning that she DOES with the others!) So we'll try again with them in February. The baby doesn't have a cleft palate, just a lip, so he can breastfeed and is actually growing quite nicely. He's already picked up a pound since early January and should be just fine for surgery in February.
Later still was a young man who came in with his mother. He has a tumor on his face and some scarring on his neck. Mom says that he's had three surgeries in private hospitals in Guatemala City to remove neck tumors. The tumors were supposedly benign, but he was given radiation. This tumor on his face has been growing for two years and they have been denied surgery at each of the hospitals they saw for his neck. The docs have all told them that it's a blocked saliva gland and that they don't think it'll heal well. It's hard to argue with three separate doctors on that count, but we gave them the information on how to contact the Hospital Hermano Pedro in Antigua to see if there is an American ENT, plastic, or oral surgery team coming that can take another look at it. With any luck, there will be a doc who has had a little experience with this type of problem and can either help them or confirm what the Guatemalan docs have said. (Pic 4).
Another patient was a 6 month old whose mother brought him in with the classic complaint of cough, fever, and cold. Apparently, he felt bad a few days ago, but you can see in picture 5 that on the scale of sick and not sick, he clearly falls into the "not sick" category. Cute, though!!
We saw a woman who is about 4'6" and weighed in at 200 lbs. She has, not surprisingly, developed diabetes. It turns out that she's a stress eater and her husband drinks and abuses her. So when she's stressed, she eats. Heidi explained that stress eating is a very common thing, but in her case, she is literally going to eat herself to death if she doesn't break this cycle. The woman is a Christian (her husband doesn't go to church but she does) and we prayed together for both her and her husband.
During the last few patients, Isaac had pretty much run out of good, so he and Daddy took a walk outside. They heard a truck with some difficulty starting and walked over to see if they could help. A guy was trying to start a Nissan that made our old Nissan look like a Lexus (and our old Nissan was, at best, a steaming piece of trash). He had the carbureator apart and suggested that Matt hold his hand over it while he started the truck. Being a musician and pretty protective of his hands, Matt suggested that HE could start the truck while the owner held HIS hands in the motor. The key doesn't work, so it was a hot wire job, but Matt wasn't ALWAYS a missionary, so we managed. Isaac sat on the seat next to Daddy and helped by not putting the truck in gear while we worked.
This didn't work, so we tried to push start the truck. We had a slight downhill, but ran out of road before the truck started. Matt's dad had given him a tow rope for Christmas (among other things - don't laugh too hard), so we got the 4Runner and pull started it - which is MUCH easier than push starting on foot! Later, we saw the guy leaving clinic with about 2/3 of our patients from the day in the back of the truck. Yeesh!
Tomorrow, Heidi will be at the Hospital Buen Samaritano while Matt and Isaac play at home.
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