The Clinic has been busy the last month or two. Plenty to keep us hopping! Yet most of it has not been stuff to “write home about”. Mostly physical exams, well-child check-ups, immunizations, colds, flues, and allergies. The whole rash of broken bones we seemed to be having several weeks ago has died down and everyone seems to have healed up well. There has been little need for hausik runs and no MedEvacs. It’s been a calm busy (if that makes any sense!), which is just fine with us! We still praise God for His healing and for using us in so many lives.
However, there are two cases that have been unique these past weeks. Two women came to us two days apart with the exact same concerning symptoms: on-going tiredness, abdominal pain, ascites (abdominal swelling), and very sick. Both of these women are national women who have been a part of our ministries here and it was difficult to see them so sick, not knowing what it was other than “bad”!
The first woman came in towards the beginning of the week and was seen by the doctor. We took histories, drew blood, snapped some x-rays, looked with abdominal ultrasound, worked up several tests. Nothing. The doctor studied out anything he could find to try to pinpoint what was going on without success. She returned mid-week for a follow-up appointment, feeling worse than she had previously but still up walking around and doing okay. The abdominal pain was a bit worse on Friday but no cause could be found. When she returned on Monday, her abdomen was large, rounded, tight, full of fluid, and painful. Her blood pressure remained very low despite IV fluids and antibiotics. And we still had no answers. After ultrasounding the abdomen again and still being unable to determine a cause other than “infection” of some sort, we transported her to the hausik. By the time we arrived, her blood pressure was recovering to normal levels and was more stable but she was still very sick. The possible causes were a short list and none of them encouraging. She would probably need surgery to discover the cause. Even with that, her time was probably very short.
Meanwhile, another woman came in two days after the initial visit of the first with very similar complaints. We again took histories, drew blood, snapped some x-rays, looked with abdominal ultrasound, worked up several tests. Nothing. The doctor continued to study out anything he could find to try to pinpoint what was going on without success. There were a few options but none that could be the definitive answer. We treated for some symptoms but rescheduled her for a follow-up appointment the next week, hoping to have discovered some answers by then. And indeed we did.
We received the news that the first woman had not needed surgery after all! The doctors there had made the diagnosis of Abdominal Tuberculosis, started her on medications, and sent her home. Typically, Tuberculosis is very common in this country but instead of the bacteria lodging itself in the lungs, it lodged in the abdominal cavity leading to a lesser-known Abdominal Tuberculosis—not unseen in this country but much less common than that which is found in the lungs. In fact, these were the first two cases our doctors had ever seen and they happened within a few days of each other. But this diagnosis is a good one as it means recovery is fairly good as long as the full course of antibiotics (treatment with 4 antibiotics simultaneously for up to 8 months or more) are completed. We were then able to make a diagnosis and start the appropriate treatment with the second woman. Both are doing remarkably better with most of the ascites and pain gone! They’ll both be following up with the TB clinic in town.
Our God hears and our God sees and our God heals! Praise Him for the wonders He has wrought!