Well, it’s been over week since we’ve been back…….home? I don’t even know anymore. We’re back to
where most of our junk is. J We jumped right in. The day after we got here, we took a break
from cleaning up the rat poop that seemed to invade every corner of our house
and went to see the girl kiddos we’ve been working with. We chatted with them for awhile and they
ooooh’d and ahhh’d over Ben. As we were
getting ready to leave, one of the Auntie’s brought a 9 year old girl…..we’ll
call her “Aminata” over to me. They said
she that her “belly hurt.”
The complaint of a “belly hurting” is probably one of the
most common complaints I get when working with 50 little kids. It is usually vague, non-specific and sounds
suspiciously like what my sister would say when trying to get out of going to
Kindergarten. (Sorry Lis, called out on the World Wide Web).
But this was different.
This girl had tears coming down her cheeks as she walked towards
me. I asked how long this had been going
on, asked about other symptoms, and did an exam. All the little tests I did in school for
appendicitis seemed to be positive. They
told me that she’d been sick for a couple of days so I didn’t want to sit on it
and decided to take her to the hospital right away. We’re very fortunate that to have a new
emergency outpost near our house so I took her there. They did an exam, gave her some pain medicine
and called their supervisor. After some
discussion, they decided to let her sleep overnight (treat her for the malaria
that of course she had as well) and the next morning she would go with Nicole
to Freetown to the bigger hospital where they would do a more thorough exam,
blood work, etc.
The next day she and Nicole went to the capital and spent
the day at the hospital. They couldn’t
find anything definitive and thought it might be because she had received some
pain medicine. She was vomiting and dry
heaving most of the way to Freetown but by the time the doctor saw her, she was
looking better. They sent her home and said we should bring her right back if
she started having the pain again.
Then next day, Friday, I went to check on her and she looked
much better. She wasn’t doubled over in pain and wasn’t in bed. Great! Maybe it was just a virus or
something. However, the next night I got
a call that she was vomiting again and was crying in pain. I went back to see her and she looked like
she had the first night I saw her. My
initial thought was that maybe her appendix had ruptured which was why she felt
better the day before but was now developing some peritonitis. It was Saturday night. I knew that if I took
her back to the hospital in Freetown, unless she was in danger of dying THAT
NIGHT, they would sit on her and wait for someone to see her in the
morning.
I decided that I’d take her back to my house so I could
watch her closely overnight. Marie was
thrilled to have a “buddy” to sleep with her that night. (One of her biggest
nighttime complaints is that it’s not fair that both Daddy and I have a “buddy”
to sleep with and she’s all alone in her room.)
Aminata spent the night and the next morning…..looked better!! She
wasn’t in obvious pain anymore, although her belly was still tender in that
right lower quadrant. I hemmed and
hawed, trying to decide what to do. I
kept thinking about a girl I’d taken care of in the village several years
ago. She had had belly pain that I just
couldn’t figure out. I treated her for
everything I could think of. I asked the
surgeons to look at her, but they didn’t think it was a surgical case so I told
her parents to just hold on for a couple of days. The American doctor was
coming and he could help me figure out what was going on. She died the night
before the doctor got there. That was
rough. I couldn’t go through that again.
I decided that instead of taking her to the hospital in
Freetown, I’d take her to a hospital closer to our house. They have two doctors there, one being a
recently arrived American surgeon. He
did an exam and decided that he didn’t think it was appendicitis. She wasn’t in enough pain, and it had been
going on for so long that if it WAS, she would be much sicker by this
time. He gave her several different
antibiotics as well as some worm medicine.
I took her back to our house where she was able to eat a little
and then played with Marie for awhile before I took her back home. The next day, she was doing well but then
that night I got another call that she was crying in pain. They gave her some Tylenol and the next
morning when I went to check on her she was still crying in pain and wouldn’t
eat anything. Grrrrr. What is going
on? That night when I went to check on
her again, she was still crying. I
decided to take her back to the hospital the next morning. This was so weird! She’d been on the
antibiotics for 3 days and I thought she should have started feeling better by
now.
The next morning when I went to get her…..she looked better
again. No longer in obvious pain. Now I didn’t know what to do. Do I take her
in when she looks better than she had looked when I originally took her
in?? What I needed was a dang CT machine
to give me a definitive diagnosis! Nary
a one to be found in the country. With
my previous patient in mind, I decided to go ahead and take her back in, just
because she’d been complaining of so much pain the day before.
They wanted to do some more tests, one of which was a stool
test. They gave me a container that was
about the diameter of my pinky finger (MY PINKY FINGER!!!!) and told me to put
some of her stool in there. I just
looked at them. Excuse me? Can you
please explain to me how I’m supposed to get THAT from THERE to THERE!?!?!? Well,
I can now explain it if you ever need to know!
Let’s just say that it was done using a pit latrine, an empty water bag
and a stick. No gloves of course.
We waited for the doctor for a couple of hours…..and I
started to get a little suspicious.
There was ZERO sign of pain. She
was happy as a clam, snuggling up to me, laying her head in my lap, watching
the pictures and videos on my phone. I
started to feel like I MIGHT be getting played.
I knew that it would most likely be several more hours before we were
able to see a doctor so……I decided to peace out. I could always bring her back if I needed to
(and find out the results from the hard earned stool test) but honestly I felt like kind of an idiot
bringing her back because she looked so much better than the first time I
brought her in.
As we left, Aminata asked if I was taking her back to my
house but I told her no, I was taking her home.
A few minutes later she told me she wanted to go play with Marie. Hmmmmm…….I told her that she was sick, so she
needed to go home and rest. I stayed at
her home for awhile to make sure she was ok and there were a couple other
things (such as requests for cookies after just complaining of nausea and
deciding that she WAS in pain…..but only when I was paying attention.) that made me think this sickness might have
been extended just a little bit. I think
I’ve been well played by a 9 year old.
I was annoyed at first, of course. I was annoyed with the kiddo, but I was also
annoyed by myself. ER nurse rule
#7: Your patients lie to you. (For example: Excuse me sir, I noticed that
you cannot stand up straight, are covered in vomit and reek of alcohol. How much have you had to drink tonight? Patient:
ONE BEER I SWEAR!!!!!!!!!!) But
this was different. This precious little
one didn’t feel good and because of that got some extra attention, extra one on
one time. And she wanted more. Can I really blame her for that? She just wants what Every. Child. Wants. To be loved and important to someone. Not because she’s one of the crowd, but just
because she’s HER.
Thank you Lord, so much for the privilege it is to care for
these little ones.
