Ready set DRAIN

Day 2 of work, mosquito bite number 2,005, symptoms of parasitic disease 0.

Have to say..of all the years of travelling to Bangladesh I've somehow avoided the "hole in the ground" toilet..UNTIL TODAY!!! Lets just say..it was a success and I think it was necessary for my initiation into working at Dhaka Medical College Hospital.

Got down to work today...if you get grossed out easily do not read on. Had a 3 year old patient who fell on his right side, developed a large bruise/hematoma which developed into a multiloculated (multi-pocket) abscess...which had to be drained. Well...local anesthetics in this case are not that great..and well, we didn't really have anything on hand to drug the kid...so about four people held him down while I slit a nice big hole into this sucker and squeezed all the blood and pus out!! Then, I stuck my finger in this nice big pocket and ripped apart all the septae which created the multiple pockets..it's a very brutal process but in the end the patient feels MUCH better. Then I stuck a large piece of guaze in this hole in this kid's hip and handed him some antibiotics which cover Staph and Strep. Basically, Think of the largest zit you've ever had, multiply it by about 1000 and then imagine you popping that. We were in a substerile room, i was wearing a rubber gown which I retrieved from a room with a giant dead cockroach in it, which I mistook for a cat because it was so big. Some people may understand this..others may not, but this was by far the highlight of my day...as a medical student in the U.S. we don't really get as much hands on experience as many of us would like. I have a feeling that will not be happening here.


Today's Medical Inventory:
1. unilateral congenital blindness, baby born without palpebral fissure
2. Neonatal jaundice (3 cases), 1/3 was choledochal cyst
3. large hemangioma on scalp of new born
4. hypospadias in 5 y.o. patient, NO circumcision performed so as to save skin for reconstructive surgery
5. SBO vs. APPY (TBD tomorrow, most likely appy based on si/sx)
6. Multiloculated abscess
7. multiple polyposis coli at level of anus in 7 y.o. presenting with RBPR
8. 8 mos pregnant woman, fetus shown to have omphaloceole per u/s, plan is to wait for delivery, determine size of omphaloceole, work in conjunction with pediatrics to determine whether child is candidate for surgery depending on size of defect.