Medical Happenings

Joy mentioned I would be updating regarding a patient with likely acute appendicitis. She had been having pain for three days when I first saw her. The local nurse/medical assistant was also there and they really wanted a second opinion. She had all the symptoms--Nausea/vomiting, fever, right lower quadrant pain with rebound tenderness, a positive Psoas sign and it was hoped she could travel the next morning to Tarawa to see a surgeon. The next morning we were advised the plane was not flying. I went to see her again and she felt better. The "local medicine" had been applied--tree leaf extract and special massage to the abdomen. The nurse had called the Doctor on Tarawa and he had advised "an injection" with a waiting period of 24 hours to see how she was doing. The patient declined to do that, wanting to keeep using "local medicine." Two days later I discovered that she had been flown to Tarawa and admitted to the hospital. As of yesterday she was still in the hospital and had not needed surgery yet. I was so concerned she may do very poorly if she had ruptured her appendix. Maybe she just had mesentaric adenitis or maybe the local medicine is more beneficial than western medicine!

Yesterday morning I was asked to come and see a man who had been stabbed in the neck. So Joy and I put on our rain-gear and drove our motor bike the 20 minutes to where he was through driving rain and wind. The injury had occurred 9 hours before and he had been attended to by the local nurse/medical assistant. He had had IV fluids and the laceration sutured. Thankfully he was stable, but he was paralyzed in the right arm completely and had only weak movement of the the right leg. He could feel his extremities just fine. The nurse had ridden her motor-bike (about 45 minute in driving rain!) to "Government Station" where there is a CB radio, to try to get a medical transport out for the man. The doctor in  Tarawa decided to send a plane and a medical team! The problem was the weather. It was so bad we could not tell when the plane may arrive. I was concerned about infection setting in with such a deep wound inflicted with a dirty kitchen knife! We had some soon to expire IM/IV potent antibiotics at the school clinic and so we were able to get that administered into his shoulder muscle and that may make a big difference in his outcome if a deep infection can be averted. The man kept asking me if the injury was serious and if he would get the use of his arm and leg back again! I told him I hoped he would but I could not know at this time. Joy had a prayer with him that he appreciated. I hope we can stop and see him in the hospital when we are there next week. I will give you an update on both of these patients if we can see them.