I woke up around 6:30 today and decided for whatever reason it would be a good idea to go on run. I think it’s more because I just wanted to listen to my ipod and clear my mind for a while. It’s very relaxing and plus it was a beautiful morning. The clinic was already getting packed with people waiting. Clearly Mondays are crazy regardless of where you are in the world. I was working with Daniella and Dr. Ashik today. There was no water all morning so that dehydration headache kicked in super fast. By the time lunchtime came I thought my head was going to explode. The first patient we saw was a man with uncontrolled diabetes, who had a pressure ulcer on his left great toe. I assisted Daniella in cleaning and debridement of the ulcer. Well Daniella did the debridement, as I watched. I don’t know what it is about feet but I could not be a podiatrist. The man had absolutely no feeling in his feet as she took a scalpel deep into the ulcer, cutting around the skin to approxiate the wound margins. It was like a physcian’s way of giving a pedicure, and he was very happy by the end of it. As Dave said when he came in to observe us, “This man is probably having the best day off! No work, laying in a cold air conditioned OR and two beautiful ladies tending to his feet.” That was the reality of it most likely.
A lot of the pictures today are of some of the patients that came in. There was a high acuity in our clinic today. We saw a lady whose left leg was so infected and actively weeping that the skin was just sloughing off of it. It looked a lot like a scalded skin syndrome. Another child who came in, who was 7 years old but looked more like 2 presented with MASSIVE ascites, and caput medusa from some sort of portal hypertension from an unknown cause. Possibly a TB related problem, but he’ll need a further hospital workup which is where we sent him. It was incredibly impressive to see in such a young child. Later we saw a toddler who came in with a cleft palate, and a teenager with syndactyly (webbed fingers) that we worked up and will also require surgery.
Lunch couldn’t have come soon enough, mostly for the water that I desperately needed. And it was such a cure! I felt so much better in the afternoon. It was like I transformed into Ironman, and Ashik and I just cranked out patient after patient. He’s a fantastic physician. Only 25 years old, with the knowledge of a walking medical textbook.
So switching lanes a little bit, what’s actually very interesting about the Philippines is how prevalent hypertension and diabetes is in this country. I mean, it is also very prevalent in America, but the Philippines doesn’t have the obesity problem our country does. I think the issue draws from their diet choices. They eat a lot of fruits, but vegetables are very limited in their diet. Meat is the largest staple, with a lot of pork and fish. However, the culprit most likely comes from the sauces that they use which are heavily salted. Delicious but heavily salted. I have the edema in my ankles to prove it, and Dan has a little bit of pre-hypertension.
When the day came to an end with yet another ulcer debridement, we walked back to the dorms in a state of exhaustion. Today is my rest day from insanity and I really needed it. The night was absolutely stunning. The night sky was so clear and there was a harvest moon that shined over Sorsogon bay. The power ended up going out with wasactually a blessing as we all stayed out star gazing and enjoying the picturesque night view. I have to pinch myself sometimes to make sure that I’m not dreaming but actually living in one of the most amazing places on earth. Best summer ever.
OMG those kids are beautifu! Get them healthy!
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