Sunday, May 17, 2009


Seeing patients who you thought were going to die get better and go home is a great joy and something only God can do. Mark came to us about a month or more ago. I saw him initially in the clinic and was concerned he had HIV because he was having weight loss, had temporal wasting, fevers, and diarrhea. I admitted him for IVFs and further testing. Thankfully for him, his HIV came back negative, much to our surprise. I wasn't taking care of him in the hosptial, but he was treated for his diarrhea and started on TB treatment for suspected pulmonary TB. He seemed to be doing somewhat better, but then he absconded, left AMA. Thankfully, he returned a few days later to the clinic, so I again readmitted him.
He continued with fevers, had a pleural effusion, and some altered mental status. His diarrhea had stopped at this point, but that was about all I could get out of him as he was confused. Still not convinced he didn't have HIV, I rechecked it. Sure enough, negative again, great, but now where do I go. He was started back on the TB treatment, but he continued with fevers, and was really sick. I consulted Bill to look at his ultrasound as I was seeing something that didn't seem right. Instead of finding something abnormal on his ultrasound, he thought he had abdominal tenderness and was concerned that he had an infection in his abdomen. I continued him on the TB treatment, but also started him on antibiotics. Within a few days, he got better, much better. His fevers started to trend down, his abdominal pain decreased, his mentation improved, he started eating, his temporal wasting disappeared and he seemed to be back to normal.
Given our lab capabilities, we won't ever know for sure if it was an infection alone, an infection plus TB, or what was going on, but the important thing is he is better. He does have a lower abdominal mass on ultrasound that we are watching, not sure if it is a TB granuloma, or some other mass, but we continued him on treatment and sent him home. Some may not think this was a miracle, but to see how sick Mark was on admission and then to see him walk out the door smiling and happy, is a miracle. I am thankful for the priviledge for serving at Kudjip, of being used by God to see frequent miralces in people's lives both physically and spiritually. Pray that Mark would continue to recover.