Sorry about the late entry, I wrote it earlier but there was no power, so to keep entertained we danced Kompa in the backyard (or I learned how to dance Kompa in the backyard rather) and talked. It is so beautiful here when there is no power. It is so quiet outside and you can see every star in the sky. Zetwal. So glorious, I could sit out there all night.
Today, I skipped rounds to begin my day bright and early in the archives so as to not get into the same dilemma I had yesterday. I got through about 10 charts and entered as much data as I could before heading up to see MadamePhilippo (head of nursing) to help me out. She sat with me and went chart by chart for the 10 I went through to help me extract more data and clarify things. The acronyms in Creole are what get me. Also the handwritten charts can be challanging. So it took no time at all sitting with her and discussing the charts and having her clarify things for me. I was able to gain some insight into how they manage patients. For one, I came across several charts of pre-term deliveries but the patients did not recieve Magnesium for neuroprotection (to decrease risk of cerebral palsy). I was able to speak to Madame Philippo about this and she had no idea this was even being performed. It is apparently expensive though so this practice will likely not change. We spent a lot of time discussing the charts and I would teach her names of disease processes in English and she would explan it in Creole. For instance, I kept coming across, PAW, in the chart, apparently this is the active stage of labor. Would have never have guessed that in a million years. So hopefully I get faster going through the charts.
I am easily distracted so once I finished speaking with Madame Phillippo, I went to check on the patient from yesterday and the fetal echo she was awaiting. To my suprise, the cardiology team got to her first thing this morning to perform the echo. Seeing the report was my next task. I went back to the cardiology department waited for them to finish speaking to a patient and verbally asked for the report… IT WAS NORMAL! Great news. I trecked back up to maternity to let the nurse and doctor know. No patient’s were in labor so I met my friend Sasha in the peds ER (l’urgent in creole) to complete my consult. It was for a 11 year girl who came in with seizures, right sided paralysis, and vaginal pain/itching. I got a history about her gynecological complaints and completed a very limited exam since she was viriginal. I walked the specimen to the lab to look at it under the microscope and diagnosed her with BV. It was very satisfying since this was a quick and easy thing I could perform to greatly impact this patient.
Next I met Dr. Coulanges. This was the second time we met, but he is very nice. He also speaks some English which is always a plus. He has been working at St. Damien for 1 year but has been out practicing for three years. I did a c-section with him for a woman at 37 weeks with twins breech/transverse. My new word of the day, marasa. TWINS. We discussed the differences between Haiti and the US at great length and even exchanged some comittee opinions. He is also very tall so I operated on my tippy toes.
On my way back up, Rene called me to show me an electronic fetal monittor that was donated to the maternity department. This was such an amazing gift and something they really need. This machine is like the ones we have at home. It has pulse oximeter, tocometer, EFM, and also does EKG. It can hook up an IUPC/FSE as well. The caveat is I have to do an in service with the maternity department and give progress reports to the donors. Happy to do it if it means they are able to better care for their patients. Afterwards, I brought the machine to the maternity department and screamed, “Madame Phillippo, Jwaye Nwel!!” That means, “Merry Christmas!!” She was so thrilled when I came holding the new Electronic Fetal Monitor. I began taking all the wires out and explaining everything. She nodded and smiled throughout, but when I got to the IUPC/FSE (intrauterine pressure catheter and fetal scalp electrode) she looked puzzled. These are internal monitors you can use to measure the strength of contractions (IUPC) and fetal heart rate (FSE). Madame Phillippo was amazed and had never seen this before. They currently dont have the means to begin using them but I hope they can in the future.
By the time I got back to archives, it was 3 pm and they closed an hour later. Hopefully next week I can really power through the charts.
In any case, IT’S THE WEEKEND. Excited to spend it exploring with Mom and Auntie Carine!