Update on the Diabetic Foot

The other day we saw a patient in Chuchipaca with two diabetic ulcers.  I have been very concerned about her and Lisa called to tell me how much better she was.

This is the first time I saw her....................then we started her on some new medicines.

This is after Lisa did her magic!  The tissue looks good and there is less swelling of the leg and foot.  Unfortunately, her blood sugar was higher so I will talk to her more about her diet tomorrow.

It is good to see patients get better!!

Angel and Panajachel

Lisa and I had about 44 patients today.  It was a busy clinic but I enjoy it that way.  It always gives me opportunities to learn.  There are some clinics that I must drive Lisa crazy because I am not sure what to do and I want to learn.

We had a young man that has been having problems with his toe nail for 6 months and wants it removed.  It was infected so we will have him be on an antibiotic for a week and then come back on the 27th to see Lisa.

Another young man lost his eye site in one eye. Not sure if it is fungal or bacterial but we sent him to a university that has an eye clinic.  I hope that they will be able to help him.  We have had good results from them before so that is a good option.

As soon as we were caught up, I hopped on a bus to Solola to the national hospital.  The staff were very kind to me.  One of the office staff took me back to where Angel had been.  The nurse told me that he had just been discharged and I might be able to catch the family at the gate.  When I arrived, they were already gone. 

I called his father and he told me how bad he was.  I found a man who could speak a little K'iche'.  Solola primarily speaks Kaqchikel so I am at another disadvantage. He said that they had just passed Los Encuentros and that Angel could not talk or move.

I just went on to Panajachel since tomorrow I do not not have clinic.  As I was sitting and thinking what to do about dinner, Cesar called me and said he had some bad news.  Angel had died when they arrived at the house.  Such a sad situation.  I hope to go and visit the family on Saturday.

Clinic in Chuguexa and follow-up on Angel

We had a smaller clinic today than usual but it may be because there was a protest in the road or because we were there last week for the IVAA Clinic.  Either way, we had some new patients and that is always a postitive.

We had a man with a blood sugar of 511.  He has been diabetic for 3 months.  He wanted to know if he should continue to take his natural medicine...............I just pointed out that the medicine has not been helping his situation, so why continue??  If you are trying something and it is failing, you need to come up with a different action!!

I told you the other day about a young man  that we had sent to the hospital on Saturday.   I have called the family two times to check on him.  I understood that he was much better and was still in the hospital.  When I called again, I understood that he was still better and should go home on Tuesday.  So, when I called today, I expected him to be home. But no............I was told he was much worse and still in the hospital.  I was so confused so Cesar called the family.

As Cesar talked to the family, I could hear Cesar's responses and I could tell it was not good.  Angel is now is a coma in Solola.  He did not go to Santa Elena, as we thought he was going.

Tomorrow, if we have a lighter clinic than normal, I would like to go and visit the family and see Angel.  I will see how many patients we have and go from there.  It is just not a good feeling to think that you understand and that things are getting better and then to find the opposite to be true.

Please continue to pray for Angel and his family.

Clinic in Chuchipaca ***graphic photo***

This morning Teresa and I drove to Chuchipaca.  Cesar met us there and we quickly unloaded the truck and set up clinic. 

To me, there is nothing more humbling, than to kneel in prayer.  I was not use to it before I moved to Guatemala but it still touches my heart.  When I pray with patients, if they kneed, I also kneel.......and it is so special.

This lady came to us with two diabetic ulcers.  She and her husband told me that they started about 21 days ago.  I cleaned them well, taught them how to do wet to dry dressings and they will go see Lisa on Tuesday.  I really wanted to clean and do more but I was afraid it would cause bleeding and I did not have enough supplies with me.

After clinic, we were asked to visit a young man in his home.  They told us that he is a diabetic and can not walk.  I always enjoy doing home visits and as we were planning on what to take, I was thinking that there has to be more to the story than what we heard.

We arrived and park the truck and started the hike down, down and down until we reach the house.  When we arrive, there are about 7 family members around the bed and everything was in chaos.  I start asking questions and everyone responded in K'iche' to Cesar.  I can tell that Cesar is getting different answers so I finally stop everyone and ask that only the mother respond since she seems to know more of the situation.

He had went to a hospital yesterday in Santa Cruz for a stomach problem but did not tell the staff he was a diabetic.  They gave him some IV fluid and sent him home.  Then all through the night and the morning, he had trouble breathing.  At this point he was in ketoacidosis and breathing 50 times a minute. I told the family that he needed to go to the hospital by ambulance and needed to go now.  Four people pulled out their phone but no one had time on their phone to call.  Cesar loaned his phone so they call.  They called a pickup truck to take him.

I climbed back up to the truck with Teresa and wrote the note for them to take to the hospital.  I think Teresa went with me because she was afraid that I was going to have a heart attack from the hike back up to the truck.  In a few minutes, five guys had wrapped the young man in a blanket and were carrying him to the top.  We put him in the back of truck and they left for the hospital.  

He is a very, very sick young man.  Please pray for him. We will see what happens.

Calling all Females to Chuguexa

I am not one to usually mention female or male teams but today, we needed all of the females and they did an awesome job!  We did a Pap/ IVVA clinic in Chuguexa.  We have been talking and planing on it for months.  Teresa went with me when we did the class and soon we had more than enough patients on the list

Lisa started the clinic by welcoming and then praying.

Since the Oklahoma Christian University is with us this week, we took advantage of the physicians in the group.  They did our regular clinic in Lemoa and we held this Pap/ IVAA clinic.  The students prepared the patients for their procedure.

Mauri, Cecy and Teresa kept the pharmacy going and also translated as we needed.

Preparing more patients.

It was fun to listen to them talk and giggle together.  You would have thought it was an all-day-pajama party!!  Such an innocent culture at times :)

My first Pap patient was 67 years old.  She has 10 children and this was her first Pap and it was not good.  Not good at all.  She will follow-up with Lisa next Tuesday in Lemoa.

We also had one other patient with post-menopausal bleeding.  She too, will follow-up with Lisa next Tuesday.  Lisa will have a busy clinic the following Tuesday.

We loaded the truck and Nisson and then stopped for one last photo.  Thank you, Sara!!

We unloaded the equipment in Lemoa after.  Thank you very much Oklahoma Christian for your help.  You helped make a great day for us and for the patients.

Oklahoma Christian drives to Las Cuevas

We loaded up the trucks this morning and made our way to Las Cuevas.  It was about 2.5 hr drive. We had an ABC Clinic with the children and families from Las Cuevas and La Palma.

Dental setting up their area.

Manuel and Jennie setting up the pharmacy area. Jennie lives in Xela and will be working with us some.  She will be a great asset for us and today I has some time to sit and talk with her.

 

The La Palma people arrived first so we started out with some of them.  This is Jeanie and Manuel is translating for her.  It is nice to have Manuel with us since he speaks English, Spanish and K'iche'.

After the consult, patients and their family would go to pharmacy to get the medicines that they needed.

Mom and Dad's ABC Child, Noe lives in La Palma.  They have met him on several occasions so they wanted him to have this photo.  When I gave Noe the photo, he was so excited!

Noe is doing very well in school and likes to study.  His father, Agostin, always helps us with clinic. This is Noe and he is in the fifth grade.  At one time, mom and dad could pick him up  but that is no longer possible.

We enjoyed a good lunch...............and then finished with a few patients.

Jeanie found a young girl with a 5/6 heart murmur.  At first she did not think the girl had any symptoms but as she talked with the mom, she found that the girl did have symptoms.  We will follow up with her soon.

Another lady told us she was going to deliver soon.  We could not get a good idea of how many weeks she is but we found a good heart rate, there was a lot of movement and the baby was in good position.  We gave the mother instructions on what to do, so hopefully, all will be well.  We were told that the closest pharmacy is 45 minutes away so we are in an area that does not have a lot of help.

After all patients were seen, we packed the truck and headed pack to Chichi.  We each had a few extra pounds of sand on us and at least 3 pounds in our eyes................but it was a great day!!

Open the Doors for Oklahoma Christian University!

We loaded up the trucks after breakfast this morning and headed off in several directions.  Our group landed in Mactzul V and prepared for a busy day.

Lisa and Kemmel helping to get everything organized.  We had medical, dental and dental checks today.

This is the vital sign section on a roll............

Tomas and his family getting checked in.  Teresa from NC has sent word that when her ABC Child, Everaldo graduates, she will be down again for the ceremony.  He grins big every time I remind him of this.

Aura, the dentist, and the promoters getting prepared in the dental area.

Cesar doing the dental checks on the students.  I was told today that the dental checks have been improving in this area.............that is very good news.

As we waited for the afternoon students to arrive, Lisa and I drove two groups out to deliver a water filter and to check on one that was not working correctly.

One gentleman came today that had significant pain and we think it was due to kidney stones.  He will get an ultrasound done and then see Lisa on Monday or Friday.

Tomorrow, we will head out again in different directions and it will be another good day!

Welcome Oklahoma Christian University!

We have been preparing for the last few days, for the arrival of Oklahoma Christian University from Edmond, Oklahoma.  It is their spring break and several of the 21 returned this year from last year.  That is always a good indication that they enjoyed the work. 

They arrived a little after 12:30 so we had lunch at Santo Tomas Hotel. The salads, mango and french fries.............yum!!

In the afternoon, we had a quick meeting so everyone would understand what we would be doing this week. Lisa explained about the ABC Clinics and different things that are very important for consistency.

Kemmel also discussed the logistics of the travel and expectations.

It was a good time to prep everyone, so in the morning, we can hit the road!