Missing Rachel

Well, I finally figured out how to access the blog without Rachel's help. As most of you know by now, Rachel made it safely back home to Bluff Park leaving me all alone here in Kenya. After dropping her off at the airport, I thought I was doing pretty good until I got back to our cozy little room and saw her empty little backpack sitting on her side of the bed. I can't believe its already been two weeks. It seems like it was just yesterday that Mr. and Mrs. Vinson were knocking on our back door in Bluff Park to drive us to the airport. I am SO glad we got Rachel home safely, and without even getting sick once (that is much more of an accomplishment than you realize). Anyway, to get my mind off Ray's departure I decided to take her advice and be extra social around the Guesthouse. So the day after she left me and 5 other young med students made the 4 hour round-trip hike to the top of the mountain surrounding Tenwek. The views from the top were beautiful. Although most of the others probably didn't think so, the most fun part was that about half of the way up the clouds rolled in and completely drenched us! We had absolutely no where to take cover and so we finally gave up and continued up in our soaked clothes. That night the two long term missionaries that stay at the Guesthouse threw a World Cup Final party and cooked cupckakes and brownies for everyone (and popcorn for me). It was a good game but was hard to stay up for since it didn't end until midnight over here. The next day was a busy day in the Hospital because I was on call. My cryptococcal meningitis patient finally received his last dose of Amphotericin B. This was an accomplishment b/c half way through his treatment the entire region ran out of AMpho B and it took an entire week for the replacement to get shipped in. Lunch was awesome at the Stanfields house; we had Chicken Pot Pie, Homemade biscuits, and green beans (don't worry Hon and Ray, it didn't have eggs)! After lunch things got pretty busy. Our Tetanus patient (who has severe case of "Lock Jaw) started seizing and gasping for breaths. The resident and I were the first ones there, so I got to "schock" him, while Doug administered CPR. Unfortunately, the patient needed immediate intubation because his Tetanus had caused him to have Larnyngeal spasms, but this was impossible because his Jaw muscle was "locked" up. Its impossible to get his mouth open far enough to even get a straw through. We were about to perform an emergency tracheostomy when his pulse finally disappeared and after 10 minutes of coding him, he passed away. It was really sad, he was only 26 years old. Apparently mortality from Tetanus is fairly common around here and we were told that the Massai's will intentionally knock out their front teeth so that they can be fed through a straw in case they develop "lock jaw" like our patient. Its so funny how the Kenyans tell these stories so "matter of factly" like its no big deal to knock out your front teeth to have insurance against future "lock jaw". By the time we were pronouning this patient, we were frantically rushed up one floor to a patient with TB and alcoholic DTs who was also seizing and not breathing. We ran up there and I bagged him while others did Chest compressions. We finally got him intubated (no "lock jaw" thankfully) and I continued pumping air into his lungs while we administered other drugs to try and get his Oxygen saturation up. But of course this is Africa so something has to go wrong. Whenever we tried to swap the patient to the ventilator his O2 sats dropped into the deadly low zone. Long story short the 3 ventilators in the whole ICU were malfunctioning at the same time, so we had to move the entire ICU down to two floors to the surgery recovery room to keep our patient (and three others) alive. As were were leaving the ICU, I hung a piece of paper on the door saying, "ICU moved down to Surgery Recovery Room". Very official of course. The rest of the night went slightly better, and I am currently trying to figure out a case of ascending paralysis (thats not Guillan-Barre). Unfortunately, diagnosing diseases in Kenya is so much harder b/c we don't have 10% of the available tests we have in the U.S. Well, I just wanted to see if I could post a blog and didn't realize how long it was getting. Sorry for anyone who reads this and gets bored by the medical stuff (Alex and Susan probablty quit reading after the first 3 sentences). Thanks to everyone for your prayers and hopefully I'll have some pictures to add soon (I'll have to ask Rachel how to do that). How do you end these things anyway??