Joe, seen here with his son Anton, came in with confusion, combativeness, inability to walk, and incontinence. His spinal fluid was compatible with TB meningitis and he was started on a 4 drug regimen along with steroids to reduce the inflammation in his brain. Over the course of about a month, he showed marked improvement and was able to go home using a walker.
No one will confuse Dave for an orthopod but he did learn to put on some casts. Here is a little boy who broke his tibia and fibula playing rugby!! He will be in this longleg cast for a couple months.
Gideon was treated elsewhere for TB in his lungs which responded well. Unfortunately, as he was nearing the end of 6 months of treatment, he had marked swelling of his belly and we drained 15oo cc. of fluid which gave him some relief. TB can cause fluid to accumulate not only around the lungs but also around the heart and in the abdomen. Gideon is now on a 5 drug regimen for resistent TB.
Frank is a student with lymphoma, probably Hodgkin's Diesase. With chemotherapy, his lymph nodes have been markedly reduced and the mass in his chest on X ray has disappeared. Dave gave him 2 cycles of his chemotherapy - Frank has a fighting chance for cure!
Alois is a young man who came to clinic a couple days before we finished. He had a several month history of fevers, night sweats, weight loss, and productive cough. He was rather emaciated and very chronically ill appearing. His x ray was compatible with TB and he was started on the standard 4 drug regimen. Patients take 4 drugs for 2 months and then 2 of the drugs for 4 more months. Thankfully, the drugs are provided free of charge by the PNG government.
Here is his X Ray. The fluffy shadows in the middle lung fields are tuberculosis.
TB and HIV are often seen together. Thankfully, Alois' HIV test was negative.
It was a treat to work with Dr. Erin Meier again. We met her in 2oo7 when she was doing a two year post-residency fellowship through Samaritan's Purse. She stayed on as a career missionary doctor with the Nazarene Church.
With Erin and med students Androuw and Matt.
Ultrasound is a valuable tool in developing countries and we greatly enjoyed the chance to develop our skills at Kudjip. The career docs are all very experienced and were quick to help us when we had questions. Here, Dr. Bill McCoy is reviewing Dave's findings at the bedside. ...Notice how there is not much privacy and how many other patients and visitors crowd around to see what we are doing!!!!
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