Giddy is Gone

So after two days of dressing changes, it was time to debride and cut some more of the dying toe off. This time I was able to make it through the whole procedure without any quiziness! My patient was later that day diagnosed with the most severe form of leprosy due to her stopping her treatment too early back in 07. She will now have to be on treatment for two years which brings its own set of complications such as skin discoloration and hypersensitivity reactions. She is soooo precioius though. Every time we round on her. She cover hers face with her sheet and just hers eyes stick out above the sheet but I can tell she is smiling by the squint in her eyes. I just go up and grab her hand and give it a squeeze...I think she is my favorite patient now...This morning I discovered that she had not taken her medicines and had just stuck them under her pillow for safekeeping I guess. Patient education is huge here. The doctors don't do much of it because they have hired a full time counselor to sit with the patients and take as long as is needed to walk them through how to care for their wounds, take their meds and what signs of infection would need to bring them back to the hospital. We learned that there are no appointments. Patients arrive early in the morning, line up and get a number. If their number is not called that day they have to come back the next day to be seen. The setting is also differnt. The docs sit at desks and the patients come in to see them. Two docs to a room with a shared exam table that has a screen to give some privacy but not much and often private parts are exposed to all in the room. Even AIDS diagnoses are given in front of all in the room. I am sure my next TB skin reaction will be positive as it is more common than the common cold here. I could recognize a TB chest xray in my sleep by now. Yesterday was the most exciting day by far for me as we got our first exposure to the OR. How different! Hannah's blog goes into more detail but I hope to spend more time there suturing which is much more diffilcult without the right sized needles and when the suture falls out of the needle if you don't rethread it every throw! 

Tonight we are headed to the  market which should bring some relief as far as the monotany of our diet...also we are makeing key lime pies for the picnic on Monday which is a national holiday celebrating the Republic forming. Yay for holidays and lots of food:)