in case your brand is schizophrenic

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I don't really know what that means...but it is an awesome billboard on the way out of town towards where church is and it took me almost two weeks to finally get a picture of it! I guess I could have tried to google it, but now you can see the real thing.
So, Its been a few days. What have you missed...Monday was another start to a busy week. Lots of new patients came in over the weekend, and some passed away. It is strange to go in a see a different patient in the bed, or an empty bed/crib, and upon asking the sisters they just say "yes, they passed." I think Africa sees so much death, especially in children, it is not as shocking as in the states. One of the babies wasn't even a patient I was caring for, just one I helped an intern out with on friday afternoon before going home (the one with kaussmal breathing). Anyway, life goes on and in a way it just has to here. We had a kiddo admitted with measles who was well by the time we saw him monday and is now home. We only learn about and see pics of measles (usually) and I had never actually seen true measles so I was kind of disappointed to not see him with the rash, etc... But don't fret, I got to see a 1 year old with measles today as a patient in POPD so now I am educated. He was awfully cute and so miserable, but actually doing well considering so we sent him home with a stat dose of vitamin A, paracetamol (tylenol here), and returning friday to make sure he doesn't develop any complications like pneumonia. Somehow I thought the 1st time I saw a kid with measles it would be a much bigger deal, good thing it wasn't for the kid's sake, but I was suprised. Let's see, Monday also brought an influx of croup! yes, its in Africa too. the 1st baby was sort of a point of contention between myself and one of the M.O's but I stood my ground because I was confident in my diagnosis and the treatment. The baby had significant stridor, and cough, and apnea. Long story short, the baby responded to some adrenaline nebs and steroids and is doing great! I'm not sure why we were suprised to see good 'ol croup here in Africa, but again in a way its nice to see "normal" pediatric things too. The weekend was also apparently time for toxic ingestions... kids were admitted that ate haloperidol, paraffin (wax used to cooking/lamps), dishwsher soap powder, rat-x (which apparently looks just like Smarties candy), and ethanol. They were all fine, but was just crazy how many came in in just 2 days! In POPD that afternoon we saw so many patients. One of the interns admitted a kid with a funny looking xray and his heart beat palpable on the other side of his chest! he was otherwise fine, but what a cool exam. I also got to do some new-mom education which was fun. a mom and auntie came in so worried about a 4 day old male and I got to tell them he was fine! (had resolving caput and subconjunctival hemorrhage from a long labor and delivery). Then taught them how to clean the umbilical stump. Strange how little things can make a day! Throw in some gastroenteritis, pink eye, and otitis media and that made for a busy monday. Since then Raissa has had a 9 year old with abdominal pain...turns out her whole bowel was filled with little stones that she had eaten. She is slowly passing them with the help of some enemas, but ouch is all we can think! still not clear if she has pica, or if nothing else to eat at home. We have a few more babies admitted with respiratory distress who ended up having croup, and baby with direct hyperbilirubinemia who had a HIDA scan, but the results are unclear but "highly suspicious for biliary atresia" yes, that is why we asked for the HIDA scan in the 1st place! (and yes Lauren/Katie, this is the same baby you guys were taking care of!!!). Today was busy as well. lots of rounding and blood draws and then some down time to try to diagnose one of the babies on my ward. For any curious residents out there...he is about 1 year old, was born with "extra skin" and lax skin, face appears droopy, looks sort of like an old man in facial features. Any thoughts send us an email! I spent lunchtime figuring it out but if anyone else has thoughts share them! POPD this afternoon was apparently buses full of admission that came at 4pm! we did as many as we could, but between translating and paper charting, and requisitions for meds and cxr and ecg it takes a lot longer than at the big G. I'll save the interesting cases for another day! We both had to do some reading and studying for tomorrow so good night all. We are heading to the coast this weekend for a mini adventure on our weekend off so we'll hopefully have fun stories/pictures to share!

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