Monday, June 23, 2008
Beth and I shadowed Dr. Gary today with his HIV clinic. Beth is a premed, so she's been wanting to shadow a doctor here. Dr. Gary has a tendency to leave the room for extended periods of time even when the patient is there, so I got to talk to the patients while he was gone, and I translated for Beth. It takes a long time to get through each HIV patient because he has to fill out like 13 pages every time. There is a new building under construction, and it's going to be for consulting HIV patients. It will expand our AIDS program and will be equipped with computers so the files for HIV patients can be digitized and more efficient. It's been pretty exciting to see the progress of the new building.
The first patient we saw was a non-HIV patient. She had leg pains when walking, so Dr. Gary tested her for sickle cell, and she turned out to be positive. I wouldn't have been able to put leg pain and sickle cell together (and I can't remember her other symptoms, probably headaches), but apparently the increased hemolysis due to sickle cell, combined with dehydration, can cause blockade of blood supplies to the extremities, resulting in pain and ischemia during exercise.
We saw a mother and her 8-month-old boy. The mother was diagnosed HIV positive last time she came, which was couple months ago. At that time she did not want to be a part of the AIDS program, but she changed her mind and came here to register. She probably changed her mind because they were both having diarrhea, and the baby had blood in his stool. We can't be sure that the baby is HIV positive until 18 months old when his immune system is working. Otherwise we could get a false positive because the baby carries the mother's antibodies. But he had adenopathy (swollen lymph nodes), which is one of the first signs of HIV, and he is still being breast fed, so he is most likely positive. He was such an adorable baby, and it was so sad to think that he was born into this world with HIV when he had nothing to do with it.
Another HIV patient we saw was a 38-year-old woman who had been acting very strangely since Saturday. She was also skin and bones, and it was very hard to see her talk to herself and stand up and walk around randomly. I didn't know HIV could cause dementia and other mental disorders. Although watching HIV patients can be depressing, things like this motivate me to become a better doctor and to serve in developing nations.
We had 6 newcomers today: Nadine and Vicky from Canada, and a family of 4 from the States (Chuck, Doan, and their daughters Alyssa and Kelsey). Nadine is a RN (just graduated) and Vicky is a fourth year in nursing school. They will be working at the clinic for 2 weeks. Chuck's family will be working at the new seminary construction site for 1 week. Julie's (RN, former missionary) team will be leaving tomorrow. It'll be sad to see them leave.
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