I had lots of visitors from Madhya Pradesh this week! A car literally full of 5 patients, their parents/caretakers, 2 staff, and driver all came up. I met everyone on Monday night, got everyone settled in and tried to figure out what was what and who was who along with logistics with the team since it was their first time in Ahmedabad. After that we got started bright and early on Tuesday morning. Here is who was here:
Apsiba - This is a pre-teen aged girl who needs a heart valve replaced. They already took her to a doctor in Indore and now just wanted a second opinion on what the situation is. The civil hospital doctor did another echocardiogram and then said that 2 of the heart valves need to be replaced. I can't imagine how scary it is to be old enough to understand what is going on and then to go to millions of doctors to try to hear about this surgery over and over! The parents want a third opinion, and then will decide, especially since everyone is giving them a different answer.
Basanti - If you remember, is the rascal of a child who had the clubbed foot, had surgery, and then broke her cast several times. Well she broke it again, this time in record time - 2 weeks! Originally the doctors had said that she would wear the cast for a month, get it off, have another surgery, and then another cast, after which she will get special shoes to wear for about a year. The doctors saw her and decided to take off her cast and put her in these special shoes right away. So this means for now, no second surgery. The doctors took the cast off, and were very upset about the duct tape and wiring that the volunteers there had done in order to prevent her from ripping up her cast again - which obviously didn't work. They said it wasn't appropriate and could mess with the correction (I doubt it, but whatever) . They even made me take a picture before taking the cast off in case there are liability issues. Smart to make me take that picture on my own phone! After that we took her to the Spinal Institute and got her fitted for both her scoliosis brace and her shoes. The brace and shoes need to be worn at all times, except when she showers. I feel so bad seeing her in all of this gear - it's crazy hot here and I know she's a huge pain so I'm sure she will be extra annoying and fussy about being hot in all of this! But hopefully she and her parents are compliant, it will save her a lot of trouble in the long run.
Sonu - This is another little girl with a clubbed foot. The doctor saw Sonu and said that she will need surgery. After she gets admitted they will do x-rays, do the surgery, more x-rays, and then we will know how long she will need the cast, second surgery etc etc. She came with her uncle and grandma because her mom is about to deliver. Her uncle and dadi did not want to stay and get admitted right now because Sonu's mom is waiting to deliver and the dadi needs to be there. I didn't push them because I didn't want them to keep trying to leave or rush things along to get back. Her uncle said he doesn't mind staying but that he can't handle Sonu when she'll get upset, in pain etc., that he thinks she will need one of her parents. I think we all agree that the parents need to be involved in the care and decision making of their children as well. I told the uncle to take their time and come once they know they can commit and stay, in addition to come for follow-ups etc.
Preeti - Preeti is an adorable little girl with spinda bifida. She is 4 years old. She was seen and assessed when she was first born, but the doctors didn't tell them to do anything. Now the spinal protrusion at the base of her back is much larger and is affecting both her ability to walk and control her bladder. The neurosurgeon got an MRI and then assessed that Preeti needs surgery. He said with the surgery there is a chance she will walk and her bladder control will get better, but without the surgery there is no chance, and it's a we'll know once we do it type of thing. When I went to get the MRI, it was 11am, and the lady told me that the child will need anesthesia because she won't stay still, but the time is up for the anesthesiologist so come back tomorrow. I was like what hours does the anesthesiologist work that they are "done" at 11am. She said there are already too many patients in line and by the time they are done the time will be up. I was being very stubborn, telling them that these people came from so far away and are leaving tonight etc etc. The receptionist asked if I was a doctor. I was like well it wouldn't hurt to say yes, right? So I said yes. Then she was like well if you want to administer the anesthesia we have no problem. I was like whoa, I can't take that kind of liability, and I'm thinking in my head what type of regulations they have if they just let me self proclaim myself capable of doing such a thing! Finally the receptionist was like well you can go talk to the anesthesiologist if you would like. So I went back there and waited...I was guessing it would have been some young male and I would use my charm, maybe flirt a little, talk about the organization and convince him. But it was a young woman...I am thinking, okay I am screwed. I went in and talked about the organization, said that I'm from America here to volunteer for a year etc etc...she was actually really nice and said look we stop giving anesthesia at 1pm and it's already 12p and I have 3 more patients, but I will put her in the line and see what we can do. But apparently what I said had an effect on her because she came out in 5 minutes to assess Preeti and get her in! We could not get her admitted right away because apparently there is "vacation" within the department for the next 2 weeks, so no non-emergency cases. Crazy, huh?!
Pankaj - Pankaj is a young teenage boy who slept on the roof with his friends in the village and has a habit of sleep walking and oh what do you know fell off the roof straight on to his head. It was a really bad gash - took a chunk out of his scalp - hair, skin all gone. The local hospital took a look at him and said to get an MRI done. He got an X-ray and CT scan, both of which were normal. The surgeon looked at him and said that the hospital he went to looks like they gave him stitches, which we were unaware of. They cleaned the wound and dressed it. I lectured him and his father a lot on how this was really stupid and should not ever happen again, and tried to scare them into how much worse this could have been.
We managed to get all of these patients in and out within one day which was absolutely nuts! It was me, this local worker, one of the directors, and then a poor student at the spinal institute who got stuck with us. We were one worker short for the 5 patients, all of whom ended up needing different things on different floors at the same time (before lunch, because after that, good luck finding someone who will talk to you). The local worker I had to be careful what I had her do because while she was great, she got pushed around easy and when the nurse said you can't come in with the patient, she said okay and stepped aside. So I couldn't, for example, have her wait around to sweet talk the anesthesiologist. It took lots of coordination and some patients were more complicated or had more questions to ask so we kept meeting up and switching patients, regrouping them, it was like a field trip! It went very smooth overall and I really felt like I know the hospital and its system pretty well to know where to go, when to push, timings...and I even figured out what things could be put in the afternoon priority and which had to be done right away in the morning to save us from needing another day. It worked beautifully. I tried to talk to the parents and families as well and educated them about their child and what they needed to know, and just bonded with them with general chit chat. A few will come back with their children and will be here with me, so I figured if they knew me and realized I am pretty nice, they would not be so scared to come back! Plus it was good Hindi practice ;)
The families were great as were the adorable kids, and I am so grateful to be a part of this organization and get to help these families and children get healthy and become mobile and free of disability!
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