Everyone had a long day today, and everyone did a fantastic job.
I knew it was going to be a long day when I came out for breakfast a little before seven, and saw people already waiting in line. Okay … going to be that kind of day!
It was that kind of day – apparently word spreads fast that there is a clinic team in town. Not just docs, but some labs, a pharmacy, and teeth cleaning also! We also opened up a room for VIA today, which is a very simple way to screen a cervix for pre-cancerous lesions that need to be frozen off. Essentially, you paint the cervix with white vinegar (yes, the stuff you use in your kitchen), and this makes cells that are high in glycogen (aka those that are using a lot of quick energy to divide rapidly, because they are trying to be cancerous) show up as bright white spots. Then you nuke the problem spots with liquid nitrogen guns. Very simple and worthwhile. The problem is, it takes some time, and there are lots of cervixes (attached to women, of course) in the immediate area. In short, we saw 95 people today, and sent away a good number to come back on Thursday for VIA when we open again. Busy busy busy!!
I led another group diabetes visit, which I had done once in Rio Dulce. This one was a little more organized – I had them all get their blood pressures and blood sugars done BEFORE they came to see me – but still took quite a bit out of me. But I must say my little speech in spanish about good diet, good exercise, and taking your medicines is coming along quite nicely. I can even field questions, after having it repeated twice and requesting that the speaker slow down once. We gave metformin, a statin, and aspirin to every diabetic to last six months, and we have their names on a list so we can find them when we come back. I feel satisfied.
Every day has a few diagnoses that seem to appear in clusters, and today it was pelvic pain (helloooo, pelvic exams!) and eye complaints. We washed out three eyes and did God knows how many pelvic exams. We also saw a case of chicken pox, which unfortunately arrived in the middle of a very busy clinic. I expect that some children will now go home sicker than when they arrived….but since there is no varicella vaccine here they may as well get it and have it over with. Interestingly, it is the first case of full-blown chicken pox that I have seen, since everyone is now getting vaccinated in the states. It definitely looks like a miserable experience.
After our clinic, which finished around 6pm (two hours later than normal), I am happy to say that several of us discovered a handy corner bar and enjoyed a round of $3 Margaritas. I am feeling substantially happier. I never like to feel frustrated because patients need care, and I’m afraid I felt like that for the last two hours of clinic today.
