Oh The Things You Will See

Even Dr. Seuss could not have predicted the things one sees on a mission. Sometimes the doctors and nurses are even surprised. Equally surprising is their ability to diagnose and treat some of the conditions they discover. To be on the medical team you must be part Dr. Oz and part MacGyver. This week an astonishing (and sometimes overwhelming) 600 patients were seen in clinic and 26 surgical procedures were performed. Yes, I will say that again from Sunday afternoon until Thursday at 3 PM, our team screened, diagnosed and treated 600 patients and Dr. Hechler performed 26 surgeries.  Many of those patients were first seen in the morning, operated on in the afternoon and went home before 5:00 pm that day. Where else could that happen but on a mission?

Here is just a small sample of some of what our medical team saw:

Dorin, 4 year-old boy.  His mother brought him to the clinic because she said he was getting frequents colds and fevers. She explained to Dr. Hayes that she had gone to a local doctor who had given him a course of the anti-biotic Amoxicillin but she said he wasn’t gettingbetter. Actually she thought he was worse because he was breathing heavier. As Dr. Hayes asked more questions Hannah Keane, a high school senior from St. Louis who volunteered on the mission because of her interest in medical school, noticed something else just by observing. “He really started wheezing more, I could hear it from across the room. And his eyes were really sunken. I have asthma and I get to looking like that a when it’s acting up.” Dr. Hayes agreed and after ruling out pneumonia because his lungs sounded clear. He concluded that her son actually had bronchitis and that is why the antibiotics had not worked. Then came the tough part, what to do? He really needed an inhaler, which we had, but he was too young to be able to effectively use it.  What he really needed is what is called a spacer. It’s a fairly simply apparatus, a long cylindrical plastic tube that has an opening at one end to insert and pump the inhaler in to. The other end has a mouthpiece. The medicine is then pumped into the spacer so the child may then simply inhale it with greater ease and less coordination. Whomever saidnecessity is the mother of invention must have been on a mission trip. Because as Dr. Hayes looked across the room he had a flash of genius. Remember how it’s kinda hot over here in Romania? Well everyone had been encouraged to drink lots of water to stay hydrated. And as Dr. Hayes spied an empty plastic bottle of Borsec water, he had a flash of genius. Using a knife, some surgical adhesive, he fashioned the empty bottle into a spacer quicker than you could say “MacGyver“. With the inhaler affixed, they gave it a trial run with Cosmin. Within five minutes, he was beginning to breathe easier and within 10 minutes he was much, much better. Dr. Hayes instructed the mother as to the appropriate number of puffs he should take and assured her within a few days, once the virus had run it’s course, her son would be much better. Mom was very relieved and Hannah and Dr. Hayes were pretty darn proud of their new invention, and so were we. Another problem solved!

Raluca, 45 year-old woman plus a number of other women her age. Just like in the United States, patients sometimes come in convinced that they have a certain disease or condition. On this mission trip there seemed to be a bevy of adults convinced they had kidney problems. It was as if. In the U.S. we seem to like to self-diagnose ourselves via the Internet, In Romania, one cannot be certain where the misinformation comes from, but it is certainly understandable that a lack of education contributes. Perhaps there was the equivalent of a traveling problem kidney salesman who had convinced them they needed treatment for bad kidneys.  Turns out they were all cases of getting older and back strain.

Anca, 4 year-old girl – This little girls appeared to be fine until Dr. Hayes ran a few simple coodination tests, such a touching yout nose and lifting your leg off the table. When she tried to lifts her legs, she began to tremor and shake. This case was bit more inticate challenging because to determine what the core issues was, we would need a neurologist  to consult, and there wasn’t one on our team. He was however able to make an appointment with a local neurologist so that she could have further testing. This where MMF’s strong relationship with the local community becomes invaluable.

Sabina, 1 year-old girl – This little girl was brought in by both her father and mother in what they believed to be the only chance they had to help their baby daughter. Sabina was born with a series of birth anomalies – a webbed finger; a skin tag on her tongue and Ankyloglossia, commonly referred to as tongue-tie. Sabina’s tongue was literally tied down on the floor of her mouth by a membrane.

Through one of our translators her parents explained that to have the necessary surgeries to repair all three issues, they would have to travel to three different locations for thee different surgeries because there was no one doctor that could perform them all. In addition to putting Sabina through three surgeries, the financial cost would have completely devastated their family’s meager income.  They expressed their gratitude with tears in their eyes when they told Dr. Hechler, “If you could not have helped our daughter, we would have had to sell our home to get her well. You have not only saved Sabina’s life, but you have saved our family.” The goal is now for her to receive follow up care locally and then return next year when the team arrives to that we may track her progress.

NOTE: It is a common belief that, while some of the common birth defects can be attributed to the general to the genetics of the people, many assign blame to the 1986 accident at Chernobyl Nuclear Power Plant in the Ukraine – just north of Romania. Botosani is approximately 600 KM or an eight-hour car drive from infamous site. Laura Conde, our mission coordinator (who by the way, met her husband, Ken Conde, CRNA, in 2005 when she was serving as a translator) was born that same year. “Right after I was born the first wave of ‘Chernobyl babies’ were born. The cloud of nuclear fallout traveled a great distance so you just started seeing more and more babies being born with terrible birth deformities. I was very lucky.”