Wednesday, June 29, 2011

Might be a little gross.....caution while reading and eating..

I get to see a lot of really cool stuff here (both medical and non). However, in terms of the medical stuff, it's a little awkward to take a picture of someone who has mething worth taking a picture of. However, I took one of this kiddo because I knew (or was really hopeful) that he would look a lot better after treatment and wanted to show him the difference).

He came in with a dental abscess. History is always hard to get here because time is not really a high priority. When I asked him how long this had been a problem, he told me it had been three days. Um...I don't think so. This definitely started more than 3 days ago. But anyway, he came in and his face was H.U.G.E. The tooth that was bothering him was on the bottom on the left side. The whole left side of his face was swollen and it was moving to the right side.

Sorry, I couldn't figure out how to turn it around. You can see that his left eye is completely swollen shut.
I love playing in pus so a part of me really wanted to poke at his face, but I was a little nervous because of all the blood vessels and nerves around there, so we decided to start him on antibiotics and see him in the morning.

The next morning when I went to see him on rounds, his face had started draining on the outside! The infection had literally eaten through his skin and was now draining outside his mouth. Ok. Time to cut. Yes!! Since I really love draining things but haven't done it a ton I had someone come with me who does it all the time.

I got everything ready and went to make the incision. I made a little incision but the release of pressure was so great that the pus erupted like Old Faithful...all over my scrubs. Awesome! But the smell was NOT awesome. Foul! Then came the part that I don't like about I+D's which is the fact that getting as much drainage out as I could was really painful for him. I hate that part.

We left a drain in and when I came back the next day his dressing was saturated with more drainage. Good sign! We continued with the antibiotics and dressing changes and day by day he got better.

You can see both his eyes!!

At this point he was asking to go. This is always a dilemma for us because we know that a lot of times when they go, they will not keep taking their medication. They have a lot of reasons, some of them kind of valid, but whatever the reason, when we have really sick patients, we will occasionally keep them in the hospital just so we're sure that they'll finish their medicine. While this kiddo looks a lot better, he still needs more treatment. However, each day he's here, his bill goes up and since it's planting season, it means that he and his father (who was with him) are not planting their crops. So the dilemma is to send them home before they're ready, or have them abscond in the middle of the night and not take any of their medications with them at all. We decided to let him go with strict instructions to finish his medicine and get that tooth fixed/pulled! Hopefully he will! Anyway, just wanted to share a great success story...... cause I love those!!

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