Monday, December 19, 2011

Busy Morning in the Hospital Ward


Today, we were very busy in the hospital ward. We saw 5 patients in the ward, 3 outpatients, and 2 home health patients. The ward patients were all very interesting. 2 of the men had strokes. 1 was only 32 years old. Another man was in the hospital due to complaining of stomach pains, but could not move his legs.

If I can find the medical chart, the information in it is very brief. Also, the doctor’s do not have access to CT scans or MRIs so there is not much information regarding their brain. I have to figure out the area of infarct (death/injury in the brain) based on how their symptoms present. I guess I know why our neuroanatomy class was so challenging in PT school. It prepared me for this!

The patient who could not move his legs and was presenting with stomach pains was very interesting. He had clonus in his feet when I pushed up on his heel. He seemed to have normal sensation. He reported control of his bowel and bladder. I do not feel he has cauda equina syndrome due to that. Usually, a CVA does not present with symmetrical symptoms. It leads me to believe he has some neurological disease happening, maybe some sort of demyelination of the nerves. He was able to put some weight through his legs when I stood him with maximal assist of 2 people; however, I had to heavily guard him. Hopefully, through forcing him to weightbear through his legs we can get the circuit between the brain and legs working again!

The other thing I am finding troubling is the incidence of heart disease and CVA in the African population. In the US, African Americans are also predisposed to heart disease. I always assumed it had more to do with people’s sedentary lifestyle and eating habits in the US. However, here most of the Africans are very hard working and have very physically demanding lives. Also, the diet may not be the healthiest here, but everything is homemade and they eat very little processed food. It leads me to believe that it is a genetic issue. Thus, there may be little to prevent it other than medications. That is a sad fact because many of the Africans here do not have access to good medical care to prevent it. If you know me, you know I do not advocate pharmaceuticals. However, I think I’ve been convinced of their use in many instances here (malaria, hypertension, vaccinations)!

I’m trying to find ways to fill my evenings and afternoons since I finish work at 3 pm! I went on 2 walks around the town. Millie had me try killywilly (I’m sure that spelling is incorrect!). It was fried plantains with ginger and pepper seasoning! They were delicious. I’m sure eating them a lot increases your risk of heart disease, but I always figured physical work off set the a bad diet. I’m thinking my logic is poor!

Well, the hospital ward is going to be very interesting this week! I hope I can help these patients make a speedy recovery so they can return home to their families and be more functional!

Love, Kari

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