Saturday, July 16, 2011

"I have air in my testicles"...and yet another translation situation in Honduras!

Honduras July 14, 2011
“I have air in my testicles”

Today was our last day in the clinic in Duyure. I was blessed to go on a food delivery trip to 6 of the families in the village. That was an amazing experience to be welcomed into the homes of these sweet, sweet people. I had several patients I had seen in the clinic that hugged my neck and one even pulled out of her bra my notes that instructed her to return today for her repeat blood pressure!! It was precious.

My little boy patient with the 544 blood sugar yesterday returned this morning with a fasting BS of 99! I was thrilled….but the reality is that this was just one day with increased insulin….and no way to get the insulin on a regular basis. The reality of his situation and so many others breaks my heart.

The patient that stole my heart today was an 83 year old cowboy that came in with a big sombrero, plaid shirt, jeans and a big buckle on his belt . He came walking in and sat right down and plainly said that “I have air in my testicles”! As he very graphically continued to show me, as if I didn’t know where his testicles were located. I happened to have two observers from the education team in my room at the time that were sitting there with their mouths open, about to laugh out loud! My sweet, sweet MaryLeigh the interpreter, never flinched and continued to ask him the questions I was asking. He flat out stated that “I pee straight, but there is air in my testicles”. We don’t do prostate exams, but I symptomatically treated him for a prostate infection

The next patient had a “bump in her anus” and it hurt to sit on the chair, and had told us that she had not had a bm in 15 days!! On further investigation, she has had a bm recently but there was pain and a “bump”. This is an elderly lady and I was worried there might be a fistula or the very least a large hemorrhoid . She had a tiny, tiny external hemorrhoid. We had no Preparation H or Tucks for her. When she left she hugged my neck and said “Mucho Gracious for looking at my butthole”! Of course Maryleigh translated exactly what was said!! Everyone in the room busted out in laughter!

The clinic was being broken down and myself and another provider were still seeing patients that had waited for 10 hours to be seen. We didn’t turn one patient away during our 4 days.

We haven’t had internet for 2 days in the pasada and I find myself grumbling about it. This morning as I am typing yesterdays events I realized that as I silently grumble about the 1 ½ hour ride each way up/down the mountain, the lack of vegetables, the heat, the critters in our cabin etc, and the lack of internet, that in reality I am nothing but a spoiled baby. I didn’t walk 4 hours to get to the clinic with no water to drink, I have enough money to feed my children, and buy their medicine, a car to drive with air conditioning… and thank God I do, so that I can use my resources to be able to serve others that can’t.

"I feel like a cow"...and other funny translations from Honduras 2011

Honduras 2011
Day 3, July 13, 2011
“ I feel like a cow today”

I cried today for a patient that only has salt wrapped in corn tortillas for food. Her son was in the area beside of us with malnutrition and they were working on getting him a nutrition consult and a delivery of food bags that will feed him for one month. I learned from Meridith the local Missionary with Mission Lazarus that salt wrapped in corn tortillas is the food for the “poorest of the poor”. The salt gives them a feeling of fullness and there fore they can continue to work and do their chores. I was devastated and had to look away to keep from breaking down in front of her.

The other patient today that broke my heart was an 11 year old boy with a blood sugar of 544!! Over 126 is not acceptable with a fasting BS check. He is an insulin dependent diabetic and only has ½ vial of insulin left to use until his doctor appointment in September, 4 hours away!! He doesn’t have strips to check his BS daily due to cost. We have no insulin in our formulary. I went to get Dr. Stephens, Meridith and another provider to assess him. No DKA or dehydration. We are working on getting him insulin, but with his newly increased dose twice daily, his ½ vial will not last long at all. Another story that is very difficult for me to absorb!! My heart broke for the mother as we told her we didn’t have insulin but would do our best to find some in the pharmacy in San Marcos. He is coming back in tomorrow for another check to see if his increased insulin was sufficient. I can’t imagine the pain that these mothers experience daily knowing that they are unable to meet the needs of their sick children. We are so very blessed to be able to pick up our prescription at the local pharmacy and go on our way!

The funny story of the day was when my interpreter was giving me the symptoms of my patient and then all of a sudden with headache, stomach acid, low back pain she says “and she feels like a cow today as well”! I guess my face was frozen and then I burst out laughing! Margaret said she swears that what the patient said, but with further questioning, somehow “I vomited today” was translated into “I feel like a cow today”. A much needed burst of laughter indeed! I told her that I too feel like a cow with all of the carbs that I have been fed since arriving in Honduras!!

I am typing this in the dark, since the power and the internet are down tonight, a nightly occurance apparently. At least I didn’t walk 4 hours each way to get here with nothing but a salt tortilla and no water to drink along the way…..and I complain about no hot water! Looking forward to what tomorrow brings. Keep praying for the people of Duyure, Honduras and our safety each day.

Blessings, Dani

Tuesday, July 12, 2011

Duyure Honduras: Day 2

Honuras Medical Mission Trip
Day 2: July 12, 2011

We are in Honduras in the rainy season and had a torrential downpour last night that made travel up the mountain today scary for our bus of gringos….but we made it without a hitch! We started a bit earlier today and had 250 scheduled to see.

I had a new translator today and it takes a while to get in sync with each other and find a flow that works for both of us…but we came together quickly and I was thrilled with our day of seeing patients. I saw lots of ringworm on the body and scalp today as well as fungus on the feet (athletes foot). We had a patient with blood sugar of 408 and BP of 160/102 who walked 2 hours to get to the clinic today! I brought Dr. Stephens in on her consult and we are so limited in diabetes medication that we gave her what we had, but are hoping that Mission Lazarus can find her the Metformin that she needs to help bring her diabetes in control….the Honduran diet is not diabetes friendly at all. Therefore speaking to the patient about a low carb high protein diet is not beneficial. They don’t have fresh vegetables like us and have a bean, rice, corn tortilla diet. The teaching is challenging and frustrating as a provider!

My favorite patient today was a little boy whose mom is very concerned because he doesn’t’ seem to “focus” in class and has a hard time getting his homework. She has taken him to several doctors and no one has addressed his issues. She wanted to know if he was “born this way”? He was clearly not focusing on our visit, but when I asked him what he wanted to be when he grew up he told me a “pilot” and wanted to learn his lessons. This is another case of no way to really change his diet, and put lots of good vitamins and minerals in his body as well as get him the help he needs to be able to focus. I felt so sorry for the mother who clearly wants to help her child learn and do well in school.

Of course as we were getting ready to leave the clinic today, we had another downpour and we were all piled in the bus for our 90 minute ride back down the mountain when we got stuck!!! All the men got out, the women went to the back to weigh the bus down (no jokes please)….and 20 minutes later, several wheelbarrows of sand, some wood planks later we take off and then slide sideways and busted the top off the water line and up shot a flow of water that who knows how long it took to turn it off! When we pulled out of the clinic, the men were working frantically to turn off the water from the street! Seems that nothing is easy!! And we slid back down the mountain!

One scorpion on the back of one of our leaders at dinner and a nice thunderstorm later….we are ready for bed and day 3 of this adventure!!

Honduras Day one July 11, 2011

Honduras 2011
Mission Lazuras and Crosspoint Community Church

Day One: July 11, 2011

Our team over 30 arrived yesterday after a 4 hour bus ride from the airport in Tegucigalpa. As we were pulling into our ranch in San Marcos that is owned by Mission Lazuras we had a flat tire! So we entered the ranch by walking the rest of the way! What a beautiful location we are staying at. I was expecting something like Haiti last year. The pasada (lodge) is the center or our ranch and where we eat our meals, gather to talk, hang in the hammock, have devotionals and can connect to the internet. Our cabins hold ten and have hot showers and a toilet that flushes!! I am thrilled! It is the rainy season here and currently the tin roof is alive with the sound of pouring rain and thunder!
Our clinic is in Duyure and is a 1-1 ½ hour school bus ride up to the top of the mountain. The roads are hairpin turns and I learned quickly to NOT look down! Our lives are in the hands of our driver who is not only navigating the narrow road, but attempting not to hit any number of cows or donkeys that are in the road.
When we arrived today at the makeshift clinic there were probably already 200 villagers waiting for hours and most had walked for at least 2 hours to see us. By the time our day was ending some patients had waited 10 hours or more to see us. No one was angry, mean or rude. We have 5 providers: 2 NP’s, 2 PA-C’s and one MD. The pharmacy is set up with a formulary that is small, but efficient to treat the kinds of cases we are seeing over and over.
We saw over 250 patients today with various chronic and acute problems. I did get to see one pregnant patient today! She was nine months pregnant, and travels two hours to a hospital for delivery! Maybe this week she will come back in labor and I can deliver a Honduran baby!
The poverty is great here, but the spirit and the pride is even greater. I am impressed with how well kept and clean the children are we saw in the clinic today. We are exhausted and a bit smelly indeed, but the smiles and hugs make it all worth while….and give you the motivation to get up tomorrow and do it all over again!

Thursday, July 7, 2011

Heading to Honduras! Sign up to follow the journey with my blog!!

Just a quick note to let everyone know that myself and a medical mission team will be heading to Honduras on Sunday for 7 days in the mountains in San Marcos De Colon. The medical team will be traveling to Duyure each day to set up a clinic in the village.  We expect to see several thousand patients while there.   There will be a construction team  as well going to a different location each day.  I am going with my church and feel blessed to be able to use my skills in one of the 3 poorest countries in the world.   We will be teamed with and staying at their ranch in San Marcos Del Colon at night. Please read their website and learn about all of the amazing work they are doing in Honduras and beyond!!

I am asking for your prayers and support while we are gone on this trip. Although this trip will not be as long or as tiring as my 21 days in Haiti last year, it will be challenging non the less.  Please pray for peace, safety and healing during our journey!!

                                                  Last years Haiti Medial Mission Trip
                                        Delivering a sweet baby boy that they named Daniel!
                                          Check back here often to see updates on my journey!



Deuteronomy 31:6-8

Integrative Family Medicine