Sorry team, I know there has been a pretty long dry spell here. I’ve had a lot of difficulties with internet connection. Anywho, I’M ALIVE. I survived a roach in my bed in the middle of the night and all! In any case, this week has been business as usual. Pounding charts in the archives while trying to balance being involved on the maternity ward. I have completed about 5 months of research and gone through 450 charts! I’m am very satisfied with what I have accomplished, especially since the charts were in French and I had little to no help.
Since this is my last week, I came up to say goodbye to some of the staff on the maternity ward as they don’t all come in on a daily basis. While saying bye to Madame phillipau, she alerted me to the fact that a case was about to start for an abdominal pregnancy, Grossesse abdominale. THIS IS RARE. 1 in 10,000 births (I looked it up when she told me they have had 4 this year). I had to scrub in! So I changed into scrubs and scrubbed in on a laparotomy to remove the infant. She was 31 weeks pregnant and this pregnancy has been growing in the peritoneal cavity of her abdomen (I.e not inside of her uterus). Like most Haitian women, she did not get prenatal care and she originally presented with abdominal pain and spotting and was found to have an extrauterine pregnancy at 31 weeks. The management for this is immediate delivery as this is life threatening condition. Since the fetus was viable she was given a course of dexamethasone (steroids) for fetal lung maturity and arrangements were made for delivery.
Given the rarity of this case and the fact that they have 4 in a year (hospitals accumulate cases over decades) the researcher in me jumped at the opportunity to write a case series. Madame phillapau was all over it too, I think she saw my excitement and couldn’t resist but to entertain me. She started looking through the registries of all the deliveries but unfortunately it’s about impossible to find the 3 other cases without going through chart by chart. There are no ICD 10 codes and no IT department to pull the charts you want. The archives are also a mess and half the time they can’t find the chart when you do have the name and MRN. Sigh. Unfortunately it’s unlikely I can do a case series but I will definitely do a case report. Research here is very frustrating but I’m hoping that will soon change and that Stony Brook can help them more effectively collect data.
In terms of exploration, I now consider myself a pro at getting myself around Tabarre. I have walked the streets countless times and even went to get some Haitian food in the street last night, NOM. Griot, bananne peze, accra, and patate. I was in Haiti Heaven NOMMMM. I threw a party for Cinco De Mayo and everyone got sou! (That’s drunk in creole) apparently my drinks are very strong compared to Haitian standards. Oh well! Everyone ate chips and queso and drank margaritas. It’s crazy, they had never heard of a margarita or a taco. I enjoy exposing my Haitian friends to things they have never seen or heard of !
Unfortunately, tomorrow is my last day and I’m so sad to leave the patients, the staff I’ve gotten so close to, and my friends at the house.