After several months of noticing that her abdomen was increasing in size – looking like she was pregnant but knowing she was not – my 16 year-old patient finally presented to the hospital with abdominal pain. She was admitted by the medical assistant with the presumed diagnosis of a typhoid induced ileal perforation. One look at her abdomen and I knew that it was a more chronic problem that was causing her pain. Instead of a generalized distention and tenderness of the abdomen which comes from having intestinal contents pouring into one’s abdominal cavity, she looked more like she was 6 months pregnant. On examination of the abdomen, I could feel a large mass that moved when I pushed it and then bounced back into position. The mass was tender. Otherwise the patient appeared healthy. We did an ultrasound to confirm our suspicion and found a large mass with both solid and cystic components. We explained her condition to her and asked for her and her family’s consent to take her to surgery.Read More
We often forget that the fancy medical terms we use in English usually have their roots in Latin and Greek and are actually just simple descriptors. Epilepsy is a classic example coming from the Greek epilēpsia, which is comprised of epi ‘upon’ + lambanein ‘take hold of’.
Mampruli also does that with several sicknesses. For example, stomach issues are described as pukpeeŋŋu – literally, “hard stomach” – and malaria is called dunsidooru or “mosquito sickness.”
There are also several diseases that are simply named after creatures believed to either cause the illness or that reflect the disease’s symptoms. In traditional African medicine, the preventative and/or curative measures can also be influenced by the animal namesake of the sickness. Read More
When plastic surgeon Dr. Taylor comes to BMC as a Samaritan’s Purse medical volunteer, he is always met with interesting cases and puzzles to solve. This young girl was born with syndactyly of both hands. Sometimes, syndactyly only affects two fingers or toes that are fused together. This little one, however, had fusion of all the fingers. Dr. Taylor was able to separate the thumb from the rest of the fingers on both hands.
The wounds were healed nicely and the patient was finally able to grasp things in a claw like fashion with an opposable thumb. That simple ability will make a huge difference in this young girl’s life. She can now pick things up with each hand and will even be able to learn to write.
In December, I operated on a little girl’s forearm. She had developed compartment syndrome after falling and injuring her arm. The child’s family assumed she had broken her arm and brought her to the bonesetter who wrapped the arm tightly. After 2 days, it became apparent that the child’s arm was severely injured and she was brought to the hospital. The arm was swollen and tense, discolored and numb with no pulses.
The muscles in the arms and legs are encased in thick connective tissue compartments (called fascia). When the muscles become swollen within this compartment, the pressure can compress the nerves, blood vessels and even the muscle itself to the point that the tissue begins to die.
Recently, I was able to visit one of my patients in his home, to greet his wife and new baby boy and to pray with them. Over a year ago, I had to amputate his lower leg. He had been shot by armed robbers. The tibia and fibula were shattered and the blood supply to the foot was compromised. The patient first chose to go to the local “bone setter,” and returned only when the foot was already dead. He finally agreed to amputation and healed well afterwards. He was highly motivated to get a prosthesis and did very well with the training. Once he returned from the training center with his new leg, he rode his bike from his village to the hospital (about 3 miles) just to greet me.
When we went to the Baptist church in his village, he saw me and invited me to greet his wife and new baby. The pastor of the church accompanied me and we encouraged him and prayed with them. The best part was when my son asked me which leg was the fake leg!