The first day of clinic is always about figuring out what works and what needs help. We were a little short-handed which leads to increased pressure to try and keep up with the patients. In the midst of the stressors, we were being hugged and kissed by the lovely people we have had the joy of serving over the past couple of years. In the moment, things seem so hard but looking back on the day it was actually pretty amazing.
I had the pleasure of handing out toothbrushes to children while Randy spoiled them with candy. The great thing was that both made them so happy. When I saw them walk in with a coloring book, it made me grin thinking of the Girl Scouts who worked so hard to put those smiles on their faces.
Today was a little crazy with a lot of hypertensive urgency and crisis. I had a woman with BP of 193/127 and severe abdominal pain. Sure enough, I found a large abdominal pulsatile mass on exam with a bruit - a possible aneurysm. She was older and not interested in trying to make it to the hospital so all I could do is try metoprolol and have her follow up later in the week. Probably 60% of my patients had a diastolic pressure over 110 (for non medical folks, that's about 30 points higher than what it should be). I would love to hold some educational sessions on a future trip to work with community leaders and involve them in lowering blood pressure through knowledge and community support.
I also had a mother who was 12 days postpartum with abdominal pain after having a cesarean section. She had a 3cm abscess adjacent to the surgical site. I prescribed a strong antibiotic and hoped for the best. As weak as she was from her infection, she still brought her baby in for me to examine. This baby was as beautiful as they come. We have to get mama well ASAP.
The day ended with an interview with the Voice of America Kreyol. Thank you so much Sandra Dominique Lemaire! I had the chance to talk about my experiences practicing medicine in Haiti, The Heart of Medicine, and all the reasons I keep coming back. I will send out their link once it is released.
So, the day held a lot of pressure for many reasons but I also kept finding the "release valve" in the people who surrounded me. #FeelingBlessed