My heart breaks today. Apparently delivering healthy babies in a 3rd world country isn't as easy as yesterday made it seem. I'm still working in the maternity unit and rounds this morning were very frustrating. Since I had already done this once I knew a little bit more how to jump in today. Unfortunately, the nursing staff seemed like they weren't as willing to help me. They didn't really want to translate for me, instead they just kind of spoke for the patient. When I asked her to ask the patient if they were in pain, she would tell me they weren't with out even asking. This made rounds very difficult. I was actually able to write for some labs and discharge a couple patients. Then we rounded on one patient that looked very sick, seemed to have a fever (we don't have thermometers here) and I was concerned she might be getting septic. We started some antibiotics and gave her a fluid bolus, and I really hope she perks up more by tomorrow. I've told the nurses to keep a close eye on her blood pressure, but it seems they don't really take vital signs that often.
After I got this woman settled I continued rounding and 2 patients later I came across a mom that was readmitted because of possible sepsis, for IV antibiotics. She told me that she had fed the baby and that he was eating well. So I uncovered the baby to access him and words can not explain the gut wrenching shock that overcame me when I saw this malnourished 32 week twin that was 7 days old. I could see his heart beating behind fragile ribs that were so well defined with sunken skin between each one. He was nasal flaring and retracting, working so hard to breathe, most likely because of being malnourished. His skin was yellow and his eyes glowed from jaundice. At home this baby would have been intubated on a ventilator, with nutrition going in through an IV, under bili lights and a warmer at least. He wasn't even a patient here. The mom was the one admitted. Needless to say, with my flip flops kicked on the floor and knees folded indian style on an African bed I nervously stuck this kids rolling dehydrated veins with hope of the ability to infuse mere drops of fluid, something his 7 day old body, had never tasted. After all the commotion, it came out that this 16 year old mom had actually never tried to feed this baby yet. It turns out that mom believed in a superstition that meant that she wasn't allowed to feed the baby until a certain ritual had been performed. If she did feed the baby, she thought the baby would be cursed. We got a translator to help us speak to this woman and we were able to tell her about Jesus and that he could remove that curse so that the baby could eat. We prayed with this woman and she was willing to attempt feeding the baby. We put the baby at her breast and his weak frail body was able to latch only slightly. After a fluid bolus and some maintaince fluids he arroused a little more. I've never been so excited to see a baby swallow in my entire life. Pure joy. We were able to expell milk from mom and feed it to him through a syringe. Just to see him take 5cc made my day. I left him with IV fluids running and I'm terrified that when I go back the entire bottle will be infused. I made sure all the nurses know that he only need to get 3 drops a minute and absloutely no more. My stomach churns wondering what to expect when I find him tomorrow. I have to leave his life in the hands of Jesus, just like it's been for the past 7 days. I pray for this sweet baby to live and be able to come to know the Lord and serve him with his miracle of life. Sleep will be hard. Praying that new life sustains.
My heart breaks today. Apparently delivering healthy babies in a 3rd world country isn't as easy as yesterday made it seem. I'm still working in the maternity unit and rounds this morning were very frustrating. Since I had already done this once I knew a little bit more how to jump in today. Unfortunately, the nursing staff seemed like they weren't as willing to help me. They didn't really want to translate for me, instead they just kind of spoke for the patient. When I asked her to ask the patient if they were in pain, she would tell me they weren't with out even asking. This made rounds very difficult. I was actually able to write for some labs and discharge a couple patients. Then we rounded on one patient that looked very sick, seemed to have a fever (we don't have thermometers here) and I was concerned she might be getting septic. We started some antibiotics and gave her a fluid bolus, and I really hope she perks up more by tomorrow. I've told the nurses to keep a close eye on her blood pressure, but it seems they don't really take vital signs that often. 
After I got this woman settled I continued rounding and 2 patients later I came across a mom that was readmitted because of possible sepsis, for IV antibiotics. She told me that she had fed the baby and that he was eating well. So I uncovered the baby to access him and words can not explain the gut wrenching shock that overcame me when I saw this malnourished 32 week twin that was 7 days old. I could see his heart beating behind fragile ribs that were so well defined with sunken skin between each one. He was nasal flaring and retracting, working so hard to breathe, most likely because of being malnourished. His skin was yellow and his eyes glowed from jaundice. At home this baby would have been intubated on a ventilator, with nutrition going in through an IV, under bili lights and a warmer at least. He wasn't even a patient here. The mom was the one admitted. Needless to say, with my flip flops kicked on the floor and knees folded indian style on an African bed I nervously stuck this kids rolling dehydrated veins with hope of the ability to infuse mere drops of fluid, something his 7 day old body, had never tasted. After all the commotion, it came out that this 16 year old mom had actually never tried to feed this baby yet. It turns out that mom believed in a superstition that meant that she wasn't allowed to feed the baby until a certain ritual had been performed. If she did feed the baby, she thought the baby would be cursed. We got a translator to help us speak to this woman and we were able to tell her about Jesus and that he could remove that curse so that the baby could eat. We prayed with this woman and she was willing to attempt feeding the baby. We put the baby at her breast and his weak frail body was able to latch only slightly. After a fluid bolus and some maintaince fluids he arroused a little more. I've never been so excited to see a baby swallow in my entire life. Pure joy. We were able to expell milk from mom and feed it to him through a syringe. Just to see him take 5cc made my day. I left him with IV fluids running and I'm terrified that when I go back the entire bottle will be infused. I made sure all the nurses know that he only need to get 3 drops a minute and absloutely no more. My stomach churns wondering what to expect when I find him tomorrow. I have to leave his life in the hands of Jesus, just like it's been for the past 7 days. I pray for this sweet baby to live and be able to come to know the Lord and serve him with his miracle of life. Sleep will be hard. Praying that new life sustains.
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