Monday, February 17, 2014

Happy Ending

 She presented with abdominal pain and dizziness after missing a few periods.  The ultrasound confirmed the diagnosis of a ruptured ectopic pregnancy, which is very common here in PNG.  Jim did her surgery, which went well, but complications started postoperatively and escalated to the point where we didn't know if she would survive. 

Post op day #1, she started vomiting up blood and had a bleed of her GI tract.  Post op day #2 she was struggling to breathe and was found to be significantly short of oxygen due to pneumonia.  Jim went away for the weekend and left me in charge of her care.  She seemed to be doing ok on postop day #3, but on postop day #4 she developed another complication.  Her abdomen became swollen, and her dressing from the surgery was soaked in blood.  An ultrasound showed lots of free fluid throughout her abdomen and I was worried she was bleeding inside from the surgery.  Thankfully her blood level was stable, but she was still really sick.
I got her through the weekend and was happy to hand her back off to Jim on Monday.  Thankfully, she continued to get better and better each day and went home without further complications.  I had forgotten about her, but this week Jim came and told me I needed to see a patient in his exam room.  Sina was back for followup, and was looking great.  It was hard to recognize her as the same patient who had almost died a few weeks ago following surgery.  
 
We don't have clothing stores like you think of in the US here in PNG.  Most everyone buys there clothes from people at the market.  There are just piles of clothes or clothes hung up that you can buy for a few kina.  No one really knows what the clothes mean or represent, they just buy them because they are cheap and so they fill a need.  Most of the clothes come from Australia, so you never know what you might find on someone's shirt each day.  When Jim called me in to see Sina, he also wanted to show me her sweatshirt.  It was a DO sweatshirt, which is pretty rare in the US, much less PNG.  I am sure no one over here even knows what a DO is, much less an MD (they don't have that designation either for their doctors). 

Thankfully, Sina is doing well.  Jim and I got to pray for her before she left.  It is always good to have a happy ending.