Day 2
Dear Diary,
As anticipated, Day 2 quite differs from Day 1, it is exciting to see the tools we set up being put to use. Angie is 16 and has struggled to move her right hand properly since she was 10, though you would not be able to tell at a first glance. During their visit a simple smile was sufficient to set her and her mother beaming. Even after we confirmed rheumatoid arthritis, which was her late aunt’s cause of death. Right off the bat we are reminded that we are not here just for the feel-good stories, we also provide much needed information and help to individuals that will have to continue to live with their chronic conditions. They came to us hoping for a different answer, we all wanted to give it to them, I did not expect their smiles to hold up at the confirmation of the news, but they did.
However, it is not all rain and doom, we referred her to a specialist that will be able to prescribe the appropriate medical regimen to continue to manage her condition. The medications to manage the condition have significant side effects. Particularly for such a young patient that will live with it for many years to come, it is crucial for the regimen to be carefully designed, i.e. the type of medication, the dosages, and the timing. The FIP referral will get her on the plan that is best for her. That’s how we can help, but her approach to the problem and to life is something that comes from within and it has left me in awe.
The same X-ray machine brings someone else into our lives, Telma is 60 and has pain in her left knee. She has brought some family with her, I always love to ask about the support team as the answers can be unexpected. Would you have your sister’s husband’s cousin on the support team getting on a bus at 5AM to head over to a clinic for you to get help with your knee? Well Telma (on the right) indeed has Vilma (the middle) as well as her cousin’s wife (a.k.a. Telma’s sister) Loria with her today. The devotion to family should not surprise me anymore, but it does! Our X-ray machine confirms she will need a knee replacement within the next five years, which we will monitor as it develops. Thanks to the X-ray machine, and the expert abilities we are developing while using it, if I do say so myself, we have identified four patients that require knee replacements. The use of the tool has allowed us to eliminate the middle step of referring the patient for an X-ray, before being able to confirm the need for surgery, saving much needed time, cost, and travel.
Don’t ask me how, I somehow end up back in Pediatrics, well I have to start somewhere and the adorable children are beckoning. Guadalupe is 9 and has had a very interesting rash formation for the last two years. Once again it is not the problem that astonishes me but the attitude, she is cheerfully explaining her situation while her abuela lets her do the talking. The rash is visible, not every little girl’s dream, and two years is a long time. This is probably TMI but when I was a kid I had a planter wart and I’m pretty sure it took a decade to get rid of it. I was frustrated; I would not have calmly described the details of a visible rash that nobody had been able to explain for the past two years. The team determines that 10 days of an antifungal should clear it up, and just like that, she is sent on to pharmacy to pick it up.
I am distracted by a little girl in orange in the clinic next door, I invite myself into ENT to meet Marjorie, she is 4 and doing just fine. She is accompanying her mother to her visit, the ice cream may be a bribe, or maybe that is my jaded first-world aunt perspective. Maria (mom) hit her head 13 years ago and ever since she has been getting ear infections periodically, ENT identifies a tympanic membrane perforation that has never healed and refers her for a surgery that will fix the long standing problem for good. I’m sure Marjorie would be very happy for her mom if she knew of the discomfort she has been handling for a long time.
I encounter another mother daughter team, or rather a mother with her daughters. Maybelin is 13 and is here with her mom Zulma and her sister little sister Elvira. Maybelin is quite tall for her age, but her little sister has the bigger personality. While the complex interesting cases have their appeal, I am always intrigued by the cases with the small fixes. A lot of what the team does is provide information that helps improve quality of life. Maybelin has been having irregular and painful menstrual cycles, to the point she struggles to walk, she has started birth control in an attempt to regulate it however results are not always immediate. The team reassures her it is one of the valid solutions to regulate her hormones and normalize her period, however it can take up to a year for this to happen.
Maybelin’s mom is also a patient, how to speak about the children of Guatemala without touching upon the wonderful mothers that played such a part in bringing them to life and the sacrifices that it can entail? 70% of the patients seen in these missions is female, a lot of the help provided relates to women’s health. The Genecology clinic is one if the busiest ones of the day, taking on anything from simpler cases of cycle irregularity, which can be improved through information sharing and medication, to severe prolapses, which will require a referral for surgery. In my non-medical line of work I am surrounded by people who are healthy, or at least pretending to be so. It is eye opening to see how many people struggle with problems of all kinds, in Gynecology these range from socially debilitating problems such as urinary leakage, to scarier problems which require mammograms, for both of which we are able to provide referrals today.
The line up in Gynecology finally starts to thin out and the day comes to a close. As the final patients are being seen, the children get bolder, they have noticed the trinkets some of the teams give out as well-deserved prizes to the little patients. Not all of them are patients but they are little, and they are correct in assuming they just have to ask nicely, and their sweet innocent faces are more then enough incentive! A few of them take their hard-won prizes, such as pages of stickers, and go along distributing them back to our team members, decorating our hands and warming our hearts.
I feel privileged to be here and can’t wait to see what tomorrow will bring.
Ciao for now.
Celestina
Team 884
