"Do you have HIPAA?" "um. Like the giant jungle animal that resides in water?"

Woke up this morning to the sound of a mosquito buzzing by my ear, I "Mr. Miyagi'd" the crap out of it and started my day. Did not expect to have the day I had, that's for sure. Started with seeing our new admissions. 2 y.o., posterior urethral valves with severe reflux, signs of chronic cystitis and evidence of renal dysfunction. The urethrogram done was so obvious it practically smacked me in the face. This kid's ureters look like loops of bowel that's how dilated they are and they are lit up like a christmas tree from the reflux.
Another admission: 5 y.o. boy with signs of intestinal obstruction, I performed a Digital Rectal Exam....and out came a worm. No I did not stutter..yes a worm. Im still scratching my head and wondering how the heck I kept down my breakfast after seeing that. By the way that's not such an abnormal finding..since worms are pretty common here.
yet another admission: prune belly syndrome..5 day old baby, mom noticed that the belly was distended. On exam the babys stomach feels like a water balloon with large lumps on either side. Furthermore, I couldn't appreciate any testes. The syndrome is comprised of complete abdominal muscle defect (hence the pruny look of the abdomen bc there is no real structure), bilateral undescended testes (testes in bangla are "beechi" the english translation is seeds, which is quite appropriate i suppose), and hydroureteronephrosis, the two lumps felt on either side were massively enlarged kidneys. I can't upload pics on this site from the computer i'm using, i will try to get an album on facebook of some of this stuff as soon as I can.

The latter half of the day I spent doing follow up work on the remainder of our patients. One in particular had to be seen by the general peds team, the baby is 6 days old-came in because of an anorectal malformation, is blind in one eye, is found to have shortness of breath and cough over last two days. Well..I wrote out the referral/consultation request and then put it in the chart..I thought that was the end of that..turns out you have to physically walk the patient over to the department, have them seen, wait with them and then report back. Clearly..it is taking some time to figure out the system here.

Starting a new project today..compiling a list of most common supplies needed by patients. The hospital is government run, which means here that the building is supplied, the beds are supplied and a handful of some common things used on the floor. However, even normal saline, or nasogastric tubes are left to the patient to supply! This is quite the walking contradiction since most of the patients are dirt poor and that's why they came to this hospital to begin with. Many times the residents and attendings will pool together some cash to help out some of the needier of the needy..but that's inconsistent at best. I am donating money on behalf of my family and Drexel but on my return I'd like to start a actively running fund for common supplies required.