Wednesday - Third Day at the Hospital

Even though it was almost two in the morning before I crawled into bed last night, 7:00am rolled around and we were back at it again. The doctor from pediatrics had suggested that we go check out the Pediatric HIV clinic at the hospital this morning so that’s where we started. We were able to sit in on patient consults. They see expecting mothers who are HIV positive and children from newborn to age 18 who have HIV or AIDS. The doctors there do everything from testing for HIV to prescribing the retroviral drugs for the disease. It was interesting to hear the measures that the take to try to limit transmission of the virus from and infected mother to their baby. While most mothers take retroviral drugs and their babies are born HIV negative, the virus can also be transmitted through breast milk and the majority of mothers can’t afford formula for their babies. Its unfortunate, but they have to choose between malnourished children or infecting them with the virus. Luckily, if the mother and the baby both take retroviral drugs during the first six months while the baby is breast-feeding, there is a very low chance that the baby will contract the disease.

            After spending time in the HIV clinic, I went back to pediatrics to catch the last few patients in rounds. For the most part, it was the same story as yesterday. I found one of the new patients interesting because it related to the clinic we had just come from. She was a young baby girl who was showing some signs of jaundice. She was the happiest baby I have seen in the ward yet! The doctors explained that she was born to an HIV positive mother and was still breast-feeding and on retroviral drugs. One of the side effects of the drug for the baby was liver toxicity and that was the cause of her jaundice.

            When rounds were finished we went down to Minor to see if there were any procedures we could assist with. A guy came in who needed a redressing on a wound on his foot. He had apparently slipped and cut himself and it was now infected. We had to numb the area on his ankle with Lidocaine before we started the debridement procedure of removing the infection and dead tissue. Once it was cleaned we dressed it and wrapped it. 

Debridement Procedure

            Just before we left, another man came into Minor to have a wound redressed. We opened it up and he had cut his first two fingers nearly off with a machine. The stitches were not ready to be taken out and I could tell that one of the fingers looked a little infected. I cleaned it well and then called a doctor over just to look at it before I wrapped it back up. The doctor recommended that we make an incision under the nail and drain the infection and then remove the dead fingernail. We informed the doctor that we had never done such a procedure and he tried to convince us that it would be ok and we could do it. Kind of scary to think he was just going to send us on our way with no training. Eventually, rather than just doing it himself, the doctor said to just wrap it up and told him to come back tomorrow to have the nail removed. So I will let you know how that goes tomorrow.

            We left the hospital around 1pm today with the intent to take the afternoon and evening off. So we did!