My news for today is that I think I diagnosed a cholecystitis in our clinic today, and amazingly enough I haven’t seen one of those since medical school. The treatment should be surgery to remove the gallbladder; unfortunately, this woman has no money to get the hospital, and no money to pay for the hospital while she’s there. So we prescribed her ten days of antibiotics and a strict no-fat diet, and maybe she will get better. If not, she should really go to the hospital, but who knows if she will (or can).
Oh, and I led a group Diabetes visit in Spanish! Que bueno! I was quite proud of myself. I talked about diet and exercise (Does gatorade have sugar? Yes. Coca-cola? Unfortunately, yes), and about adjusting metformin. One of the women from the village is a midwife (Comedrona), and we taught her how to take blood glucoses with a glucometer. The idea is that all the diabetics in the village will get their sugars checked by her once a week, and she will help adjust their metformin based on those sugars. In reality, who the heck knows what will happen. It will be a surprise when we come back in September. It is a little scary to leave 6 months worth of medicine (hypoglycemics among them) with people, and not be entirely sure what they will decide to do with them. But I suppose the best we can do is explain what to do with them. One man already had a blood sugar of 512, and so his chances of dying from diabetes are probably greater than his chances of having an adverse effect from improper dosing of Metformin. That’s one way to look at it, anyway.
Tonight I am in Tikal (!), and tomorrow we will go explore the famous ruins. Exciting!!
