Wednesday, June 3rd

This morning we all got up and went to morning prayer before we ate breakfast. Then we went off to morning rounds. We saw one woman who had hemorrhoids which are pretty much varicose veins of the rectum that are divided into two categories. The first is not painful because the nerves are internal and belong to the upper two thirds of the rectum. The other one is painful and they are external hemorrhoids and they are painful because when the nerves fire for external hemorrhoids you can feel them. You can distinguish between hemorrhoids and intestinal bleeding upon examination after passing a stool. If the blood is mixed in with the stool and is a darker red or black, it is indicative of intestinal bleeding proximal to the rectum and if the blood is bright red it is indicative of hemorrhoids and the blood would not be mixed with the stool, it would be separate. 

Then I went to Dr. Clemets clinic and saw a bunch of patients. One of the boys had eczema and you can distinguish this from measles because measles presents with pustulated rash that starts at the head and spreads down to the feet. It is also usually accompanied by a fever as well. Then we did a I and D, incision and drainage of a man's finger who had felon and once we cut under the finger nail a whole bunch of pus came out. Then we headed over to a c section because the baby was in breach position and fetal distress. When the baby came out it wasn't breathing so the nurses slapped it, poured cold water on it, suctioned its mouth, and started ambu bagging the little girl. After about two minutes of them artificially breathing for her she came to life and started screaming. I've never been so happy to hear a baby cry. 

Then we put it under oxygen and I listened to its lungs to make sure we suctioned enough and the baby was breathing sufficiently. Then we went to have lunch. After that we traveled about an hour to a tribal village in the district of Kerala. The road was really bumpy and once we got there we played with the kids before we started clinic. We had clinic in the school house and I did triage and physicals on all the kids. One kid, a nine year old boy, had a previous corneal abrasion which turned into a corneal ulcer and then a nebula. He also had scabies so I might have contracted that as well...we shall see. After we finished clinic we walked down to the river and took some pictures. When we got back from clinic we went to evening prayer, ate dinner, and then played spoons the rest of the night.