Saturday, April 16, 2011

Stateside Sabbatical

Mar 27

I made it to Miami but don’t feel very well.  I have been coming down with something for the last week or two.  It’s mainly headache and nausea.  I called Summer and she gave me the details of the patient with the tibia fracture.  She said that the doctors in Sarasota commented that he had gotten excellent care.  They recommended that he be transferred to a medical facility closer to his family in Michigan.  She gave me the phone number of the person making the arrangements and I called him.  He answered and said they were in a van on the freeway in Georgia with destination Southern Illinois University Medical Center.  They had the name of a Dr Gabriel who they wanted to take over his case.  Apparently some family member had been treated by Dr Gabriel in the past.  I made several calls to SIUMC and finally was able to talk to Dr Sands, the 3rd year ortho resident on call for trauma.  I explained that he was going to be getting a patient who had been injured in Haiti and then the strange “twilight zone” transfer by air transport to Florida and then by van from Florida to them.  He agreed to accept the patient.  I called the group in the van back to give them Dr Sand’s name.  The patient was doing well but apparently his wound vac canister was nearly full.  I advised them to stop at the nearest trauma center and “beg, borrow, or otherwise acquire” a replacement canister.  The alternative would be to drill a hole near the bottom of the canister and let some of the liquid drain out  (a very disgusting thing to do) then seal the drill hole and hope the vac would work.  I spent about two hours making all of those phone calls.

28 Mar

I made it in to Appleton but really didn’t feel good.   Whatever this is, it isn’t fun.  I feel a bit nauseated almost all the time and have a headache.  My skin is hypersensititive and I sweat a lot.   I immediately went to bed and slept for about 4 hours.  I tried to call Jeannie multiple times unsuccessfully.  I called Summer also but she hadn’t heard from her either.  I hope she was able to get a flight finally.

29 Mar

I soaked the sheets last night with sweating.  I finally found out that Jeannie is on her way and will be getting in today at about noon.  I’ve been taking Ibuprofen and Tylenol so I can work.  I went back home right after work and promptly went to bed for several hours and once again soaked the sheets.  I have several total joints scheduled this week.  I am also on call for the ER this coming weekend.   I hope I can do the work.  It is really nice to see Eric and Ken and everybody at work again.  Todd is on vacation this week.  It is really good to be back together with Jeannie again.

30 – 31 Mar   1-4 April

This whole week has been pretty much a blur with work and not feeling well.  All of the joint replacements went well.  The weekend wasn’t very busy.  I had a couple of hip fractures and an elbow fracture.  I was able to get a lot of rest.  Life is pretty “Blah” when you don’t feel good.  I decided to finally get some tests done since I seem to be slowly getting worse instead of better.  My guess was malaria but the smears were all negative, at least at first.  I took the full treatment of chloroquine anyway.  Then I thought maybe hepatitis since my liver enzymes were all very high.  I tested positive for hep b but that is due to the immunization.  I don’t have any active disease.

Apr 5 - 9

Finally one of the smears showed malaria.  Dr Brooks put me on malarone which made me even more nauseated.  The night sweats have nearly gone away but I still feel chronically nauseated and have no extra energy.  Dr Brooks wants to retest for malaria with daily smears.  My liver enzymes are coming down which is reassuring.  It has been beautiful weather this whole week.  I wish I could have enjoyed it.  A young reporter found out about our work in Haiti and interviewed me for about an hour.  He condensed it into about 2 minutes for the 10 o’clock news on Thursday.  They emphasized the coffee table book fund raising effort.  Lynne emailed me from HAH and said that she just found out that the hospital has decided to bill every patient for a bed and also for their surgery.  I am surprised since the last discussion with Nathan was pretty clear.  The financial screening process was going to be developed before billing would be implemented for orthopedics.  I knew it was coming since “fee for service” is the SDA hospital model all over the world.  I wish it had been delayed a bit more so that we could have funds in the Indigent Patient Endowment.  It will be interesting to see what the effect will be on the clinics and on elective surgery.  I hope we are not effectively shutting the door on those who cannot pay.  I plan to do my best under the circumstances.  I hope that orthopedists and anesthesia providers who are planning to come and help will not change their plans and go elsewhere.

Dr Brooks said it was ok for me to travel since my malaria smears were now negative.  Tomorrow I return to HAH.  Jeannie is in Southern California for her 40th nursing reunion and won’t be returning for a few more days.

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