Tuesday, March 16, 2010

A rough day...

Ok, so it wasn't even all that bad of a day. I just think by tonight I was done...emotionally, physically, spiritually...all of it. I pretty much had a little break down in the nursery tonight when I was attempting to figure out what we should do tonight for Fernanda. To be honest I'm having a tough time coping with all the responsibility I feel like I have in the clinic and doing my best to help out in the Baby House/Bercario as well (maybe some of it self-induced, the responsibility that is). Anyway, for now I'm going to spend a little time in James (the book we have decided on for our Bible study) and then get to sleep. But to update you on our day with Fernanda I'm going to let you read over what Erin has to say: (Erin I hope you don't mind me quoting you...you get all the credit! I'm too tired to type out all of this up!)
"Fernanda started very reluctantly with yogurt today. vomitting it up 2x. She did like my 1/2 of a banana i gave her this morning-well half of that half anyway...then held it in her stomach for 3 hrs and vomitted it up on Meghann (another nurse). I DID give her a no vomitting lecture. she must have heard, understood, and obeyed. Next time, I'll be a bit more specific. We haven't done very well on feeds today and she lost another 30 grams (ounce). I find that anytime the staff changes (every 4 days) she seems to go back to the vomitting for 24 hrs and refusing to eat. Never good for us. We did make it to the clinic today and did all the labs. Praise the Lord (and thanks to everyone praying) they managed to get all her labs done in just ONE stick. Seriously. three tubes worth. She did a chest xray and then we got her ppd (for tuberculosis) done. Her labs all looked normal: malaria-neg(3x now); HIV-neg (that's at least 2x now); complete hemogram (to look for infection)-normal with just slightled elevated platelets; Hemoglobin/hematocrit (to check for anemia)-only borderline low; electrolytes-normal; ESR (check for chronic infection indicative of a bazillion chronic infections but most importantly tuberculosis)-only slightly elevated; Chest xray-pretty normal give or take a few spots. So I took them to our Moz doctor that visits us 4x/week and presented her case-history, symptoms, what i've done since arrival, how she's responded, all her lab results, chest xray, and finally, her yellow immunization card that tracks her weight monthly from birth. She looked it over, did a full assessment and felt like Tuberculosis was our best offender (which I thought from the beginning). So the plan is-wait till Friday to see her results of the ppd TB test, see how she does (which she's had a huge fever all day-NOT helping with the gaining weight thing) and then a-start her on the most powerful oral antibiotic we have, despite the fact that her labs don't really indicate a big infection that shouldn't be responding to the 3 round of pretty powerful antibiotics, all from different classes and broad-spectrum that I gave her and then b-start her on TB treatment, even if her ppd is negative (which it most likely will be if her immune system is so shot from the TB and malnutrition that it can't even form a response to the tuberculin they placed under her skin). Please continue praying for her. TB meds would be great if it's her problem, but even then they are VERY harsh chemotherapeutic like drugs that have very harsh side effects as well....for such a sick little one, they are NO fun! And she NEEDS to start eating better and gaining weight!"
Just keep praying please!

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