Thursday, April 24, 2014

One day

So since coming back from Cameroon I have been busy.  I was only back for a week and a half before I left to the coast for the missions annual retreat. A time of spiritual encouragement and meetings. Even though I had just been back for a short time, the time away was much needed as the hospital was very busy for that week and a half. Now retreat is done and I am back at Tenwek. Since December my life has been busy with one event after another, Trip to Lodwar, friends' visit, family visit, Cameroon and then retreat. It was a very enjoyable albeit busy few months. Now things are back to normal, and it is different not to finish one thing and immediately start preparing for the next.
I have been busy at the hospital. Here is just how one day last week went.
7am – meet in ICU to start surgical rounds, however miss rounds as asked to see patient who is hypoxic. Go see said patient and start him on biPAP.
7:30 – Join medical rounds.
8:00 – decide to check on bipap patient before heading to devotions, get distracted by very loud flow meter and go into medical ward. See that they are coding patient and help out.
8:30 – code is done, it did not go well, head up to devotions.
8:40 – get called to another code in the same ward, code said patient. Again unsuccessful.
9:30-11:00 – Check on ICU/HDU patients, enjoy some chai.
11:00 – while seeing an asthmatic in casualty a patient comes in with a swollen neck and difficulty  breathing. Observe him and help rally the troops so we can get him in the OR to put a tube in. 
1:00 – patient has tube in so I go for lunch.
2:00 – patient is out of theater and we are suspecting anthrax. Settle him in HDU and explain to the nurses how his tube needs to stay in.
3:00 – look for patient I was supposed to do spriometry on, can’t figure out what patient it is as the computer charting system is down.
3:30 sit down with nursing students who attended code this morning.
3:45 get paged out of debriefing session as a peds patient has arrived from other hospital, intubated as he has some sort of airway burns.
4:15 get called in casualty that anthrax patient woke up and pulled out his tube, yes the tube that was hard to put in and really needed to stay. Grab some staff from casualty and go to HDU – thankfully, anesthesia manages to get tube in again.
5:15 return to casualty and discover that the 2 year old managed to take out his tube, he is having trouble breathing, we struggle to re-intubate as he is awake and the drugs we are giving him to sleep are not working.
7:00 after anesthesia, with some propofol, comes and gets the tube in we get the patient settled in ICU. He is on my new vent the Servo 300 and I explain to the staff how the machine works
7:35 run home, change and grab stuff for bible study.
7:45-10:00 attend a great bible study with the interns here, we talk about our attitude and being humble.
10:00 come home, realize I forgot to turn on the hot water heater so kill time for 30 min so I can take a hot shower.
10:45 – Go to bed.
11:00 – pager goes off, the nurses are having trouble with one of the vents. Go back to the hospital get the vent working get the patient settled and happy.
12:00 – Go to bed, again. This time I was able to stay in bed until 7am when it was time to go for another day.

So that is just a taste of what life is like. Some days are crazy like the one I just shared others are a lot more calm.  Please say a prayer for us at Tenwek the next two weeks as many of the long term doctors are going to a conference and the hospital will be covered by a few of us here, some recently graduated doctors and visting doctors from the USA. I fear my next few weeks will keep  getting busier.

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