Tuesday, December 15, 2009


I met Margareth after she was admitted to the medical ward. She presented with lower extremity paralysis. There are a number of things we worry about in patients like this - tuberculosis, tumors, and guillain barre syndrome (GBS) are some of the most common. As I talked to her I was concerned about GBS as she was describing some SOB and it seemed like the paralysis had started in her legs and was coming up to her abdomen. However she also couldn't feel her legs and her lower abdomend and back, which is quite unusual for anything in my differential. I did a spinal tap to see if she might have protein or wbcs which would help with our diagnosis, instead I got out what looked like urine. I had never seen that before, but didn't think it was good. I have seen clear fluid (water like) and I have seen pus, so I am thinking the yellow maybe an in between stage as it came back with a large number of wbcs suggesting an infection. I started her on antibiotics and have been praying she would get better.
When she first got here she was having fever and chills and her family trying to help her feel better put a warm cloth on her legs to cool her off. Since she can't feel her legs, she ended up getting burned by the warm clothes. Thankfully, that was only a one time thing, and her burns are healing. I would like to say she can now walk again, but I can't. I can say that the infection in her spinal fluid is resolving with our antibiotics, the last tap was clear, no longer yellow. She still can't move or feel her legs, but it isn't getting worse. She is one of the few women whose husband has really stuck by her while she has been in the hospital, which is refreshing to see. Her and her husband, are Christians. Pray for their faith to remain strong and for her to accept whatever the outcome of this illness is - paralysis or healing.
Follow-up: Steven, little boy from the Jimi with abdominal pain - Dr. Jim did surgery and found a huge abscess around his kidney. He continued on antibiotics, but is eating, walking, and doing better. He should be going home this week. Thanks for praying.