The Kenyan Stomach Bug

Much like the American stomach bug... Horrible! I'm not sure what sweet little kiddo I gleaned it from, but this past Saturday night I started vomiting and ended up on my back for about two days! It takes a lot to slow me down (I'm always incorporating movement aren't I Hannah Robey?!) but this bug definitely did it. There isn't good access to hand washing here (few sinks, little soap) so I'm sure it's something I probably got on the ward. However, today I am back to myself and back to work! I am so glad it was short-lived. I continue to be the so-called attending on the wards where I am pleased to report that baby Cecilia is getting better! She had her eyes open and was looking around the room today and is breathing on her own now without support. She ended up needing a chest tube over the weekend when it was discovered that her chest wound was communicating with her pleural space (pus was accumulating between her lung and chest wall). She's doing great though! I'm so thankful. I have other kids that I'm treating for malaria, complicated kidney infections and seizures from hypocalcemic rickets. Needless to say, the learning curve continues! I have a great team and great back up physicians that help me when I'm clueless. One funny thing happened today on the ward- a baby who we just discharged with HIV and TB meningitis to go home suddenly developed stridor on her way out the door (this is after developing a seizure earlier because her HIV meds interfere with the metabolism of her seizure medications). I think to myself, "oh my goodness! This child. She just can't catch a break!" She had impressive expiratory stridor and was suddenly working hard to breathe. I couldn't hear good air movement on her left lung. Started asking mom questions and, no, she hadnt swallowed anything recently. This just started a few hours ago. I was stumped. There are reasons for this but none that would make sense in her right now- she had just been fine!! She did have a tube going from her nose into her belly to help us feed her that she was going home with. "Mom, any problems with this tube today?" As it turned out, the tube had come out earlier! Mom says she just put it back in though. "You put it back in...yourself?! Oh Lord have mercy" is somewhere along the lines of what I'm thinking. I think the mom probably put her tube down her trachea instead of down her esophagus. Suddenly it all made sense! We got the tube out and gave her some breathing treatments which helped her. Mom says she didn't put food down the tube... I'm not sure I will believe it until I see it on her CXR. I really hope she didn't though! Medicine is really like mystery solving. If you ask enough questions enough ways, you can usually find your answer!  I still can't believe she got the tube down her baby though... Goodness gracious. 

That's about all for today. I'm getting ready to work on a project to improve HIV screening on the kids admitted to the hospital and bryan is on call to tonight. Thanks to those of you who leave us messages! We love hearing from you.