Thursday, February 7, 2013

Family Practice Rounds

Here is a small sampling of the patients we met this week. 
  • 84 yo man looking a referral for colostomy take-down surgery.  He had prostate surgery 3 months ago and suffered a bowel perforation.  He was transferred from the private hospital to the national hospital for repair and ended up needing two more surgeries to correct the injury.  Since then he has formed a fistula between his bladder and bowel.  When I examined him the colostomy looking remarkably well cared for, but his prostatectomy wound had opened up exposing the muscle below.  After spending way more than the family could afford, they were desperate to find a good surgeon who would not gouge them on future surgery.  We referred him to Dr. Tom Hoak at El Buen Samaritano hospital and were relieved to have hope for a good outcome.
  • A 23 yo woman came in with headache and nausea for one week.  She missed her period last week and was wondering if she might be pregnant. She was nervous because she had delivered a baby in August, who later died from SIDS at the age of 2 months.  She was tearful and smiling when we showed her the positive pregnancy test. We prayed for her and her husband and protection for new baby, and she left with a beaming smile on her face.
  • A 53 yo man came from 3 hours away referred by an acquaintance for suspicion of diabetes.  He presented with all the classic symptoms: thirst, frequent urination, blurry vision, fatigue. He has one brother who "used to be diabetic".  But they threw me a curve when they said the blood sugar reading today was only 101 (normal).  I went to confirm  with Manuel and he said, "Noooo, five hundred and one!"  We spent time going over diet and medications and seemed relieved to have found a diagnosis.  Sheri spent time with his family going over the diet in-depth.  Before leaving, they brought me a beautiful bouquet of mixed flowers! 
  • 17yo girl who presented last month with galactorrhea (milk production) and irregular periods for about 6 months.  No headaches or vision changes. She returned today with her labs showing an elevated prolactin level.  The milk production has stopped, but we will repeat the level in a few months.  Unfortunately she will probably need an MRI which will be expensive.  If if comes to that we will talk about referral through the national hospital system for further workup. 
God is good to give us staff and medical supplies to attend to our patients' needs, but he is also so faithful to work beyond our limitations and heal and comfort in difficult cases.  Thank you, Lord!

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