Bouquets and Bedsores

I am starting to feel like myself again, now that I am recovered from the worst jet lag I have ever experienced. I was feeling functional enough until I got to the Nairobi airport at 7 am. Customs took me a good 2 hours because I made friends with a lovely Scottish lady names Clare and her two precious children, Emma and Harry (pronounced 'Arry). She was traveling alone with the children(brave lady) and I had some time to kill, so we partnered up. Between the two of us we got two huge luggage trolleys, a stroller, 2 sweaty, tired children, and two even-more tired adults, through customs and visas. After I sent them on their way I had 3 more hours until my last little flight......and I hit the wall. Hit it and slide down it, turned to a pile of mush at the bottom. I somehow managed to drag myself onto the flight. The attendant had to wake me up to tell me to put my seatbelt on ;). Again, dragged myself off the plane, stumbled into waiting ambulance, in and out of consciousness back to Maseno (and that should be impressive to those of you who know the road). Just when I was starting to question my judgement to undertake such a ridiculous journey.......there were my children, waiting on the porch in their new Christmas outfits. And this was waiting for me on my bedroom door:

Now I am quite enjoying myself and managing to stay busy. I came home after a particularly long day this week to find this lovely site waiting for me. I had told them I love flowers, and now every unfortunate bush in the general vicinity of our house has been completely ravaged by small, determined hands.

Arranging flowers in my strangely-limp-mzungu hair has also become a favorite activity. I like to spend a few minutes in my favorite chair on the porch right when i get home as the sun is setting. Thats when they descend on me :) Naomi gently puts the blossoms around my face, while Arnold likes to securely matte the greenery and twig bits to the back of my head.......To each his own, I suppose.

On the clinical front I am keeping busy and learning quite a lot. There are some new Daktaris here that I really like. I can now confidently diagnose gangrene from 5 feet away with just my nose. I am currently treating a woman with the wort pressure sores I have ever seen.....and probably ever will. When I first saw them, it was only the last 7 years of learning to control my gag and gasp reflex that kept me quiet. I do love the challenge of a good wound though-the possibility for fresh new skin, the different ways to care for it to keep it clean, uninfected, and healing. I now see her everyday, and feel like I have met her whole family and know them by name. She's paralyzed for the waist down, so she needs to be repositioned frequently. Her aunt is a teacher, and runs home on her breaks between lessons to reposition and clean her since they couldn't find anyone to help at home that could manage her medical needs. Wow. And you thought home health in the US was hard to come by....... I am training two of her aunts to do the dressings at home, so she can get back to her life.

I spent the better part of today helping in the theatre (operating room), between c-sections and wound debridements. I've also had two palliative care cases, which are pretty rare here, so I've gotten to use what little expertise I have.

We had a patient that was pregnant with twins and had pre-eclampsia (dangerously high blood pressure). Apparently our anesthesiologist doesn't like pre-eclampsia c-sections (who does??) and won't do them. The initial consensus was to let her try to deliver naturally and see how it went(nooooooo!), but after much discussion we finally decided to refer her out. For all the Downton Abbey fans out there, that is how poor Sybil met her demise. Before she left, I gave her some pads and reusable diapers (thanks Em!) and she was delighted.

Other than that, I have just been working in the hospital, tackling the never-ending list of projects that needs to be done at the rotary house (like fix the shower so my visitors don't get scalded), and hanging out with my ragamuffins.

All my love,

Jessie

 

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