This is what makes it all worth it!

As we were preparing for the day, we got word that Christian, the young boy with the seriously swollen leg may have Osteomylitis (an infection of the bone) No obvious fractures seen. The hospital had started antibiotics and was advising surgery to drain the infection. However the family has great distrust in doctors and was considering signing him out of the hospital against medical advice and pursue ¨traditional cleansing¨ which involves cracking eggs and sacrificing a guinea pig. Nick, Jonathan, Juan and I set off for the hospital to try and pursuad Padre to allow the hospital to treat Christian.
The rest of the team heading to San Juan to set up for the day´s clinic.

Upon arrival to the hospital - I was amazed at the different practices from the US. There is a locked steel door that blocks visitors from entering the inpatient care area. Christian´s mother was outside the door, and not being allowed in because his father was already in the room visiting. Amazingly, us 4 : Three of which are ¨Americanas¨were allowed to pass through.

As we entered Christian´s room there was obvious tension. Padre was reviewing the process of getting Christian out of the hospital with the nurse. Nick went into action. We stressed the seriousness of the infection, the possible complications of septic shock, endocarditis (Infection spreading to the heart), amputation and even death. Padre was not phased. He really couldn´t get past the distrust. He actually signed the papers in front of us and the nurses started to ready Christian for discharge.

We pleaded desperately. We forced him to look at the leg closely and we accept that couldn´t ¨make that up¨. Then we asked ¨what must we do to earn your trust?¨
Nick was a quick thinker and pulled up pictures of Darwin´s recent successful heart surgery - and offered to have Darwin´s family come to the hospital to testify to our geniune concern and intentions. I think that was the selling factor, and with a slow nod the Padre agreed to allow the doctor´s to treat Christian. The hospital had already agreed to cover the cost of the surgery. So we agreed to split the cost of the medications and supplies with the family. The final decision maker was that Nick would accompany Christian to the operating room (fortunately he knew the orthopedic surgeon who was willing to let Nick assist).

Medicine in this country is so different. The doctor prescribes medicines and supplies for the inpatient, then the family has to take the prescription downstairs to the cashier and pay for the meds/supplies and bring them back up to the patients room. So that´s what we did.

Juan, Jonathan, and I joined the rest of the team in San Juan late morning. It was a very busy day - 100 patients!! Lots of geriatric patients - 80+ years old!!
Nick showed up a little after noon with the most incredible video of the drainage of Christian´s leg. They felt confident that the bone looked OK!! Obviously the drainage is being cultured so the antibiotics can be customized to the bacteria. But the outlook is good. He´ll need one more draining and cleaning in a couple days then hopefully home on antibiotics for several weeks.

The whole day was filled with a new positive energy and I couldn´t be prouder of the team, than I am tonight!!

The lady with the goiter also was able to get a biopsy yesterday, and we should have those results by Monday. The pregnant lady from Monday did not show up for her ultrasound.

Well I may have missed some cases, I´ll try to review more tomorrow.
Thursday is our last day of Clinic and it comes with good energy.

Adios,
Terry