Clinic / Panic

This morning I found myself in the community of La Fe with my team mates Mike and Ashley Troxell.  This is the community they have been serving in, and where I serve with them every other Monday for clinic.  Often times I get children in with parasites, mild skin infections, adults with urinary track infections, this kind of thing.  Today was a totally different story!  Today I was challenged - not only medically, but emotionally as well.

A young 11 year old from a neighboring community and her family heard about our free medical clinic.  They came with their young daughter Wendy, who has a history of asthma.  She was doing poorly yesterday (per mom) but today she was much worse.  She presented to the clinic in obvious respiratory distress.  Although it wasn't "her turn", I took one look at her and bypassed our "normal" check in procedure and put her in front of me for a full assessment.  Her lungs sounded terrible, barely passing air, a quick check of her oxygen levels showed she was in distress.  She was working so many other muscles around her chest to try and compensate for her lungs which clearly weren't working correctly.  Her respiratory rate was anywhere from 40-60 breaths per minute, and her heart rate was elevated to over 150 beats per minute.  I gave her an inhaler, had her use it, gave her some steroids, and put her on a nebulizer treatment immediately.  I frantically looked around for her mom and told her we needed to get her to a hospital immediately!  I was sure this young girl was going to crash right in front of me.  Having worked in a pediatric hospital for 12 years, I had seen my fair share of respiratory distress children, and even had a young 8 year old that died from an asthmatic attack.  To say that I was worried is an understatement.  To say that I was scared was definitely much more accurate.  But there I was, in a village, with no means of transportation, and was waiting for the mother to return with her husband (their house was quite a ways away - and she had run home to get her husband so they could take her to the hospital).  I sat with her while she received her breathing treatment.  I talked to her calmly, asked that she breath with me (to try and slow her breathing rate), and just talked of simple things.  To keep her mind elsewhere.  Her eyes were as big as saucers as her lungs were frantically trying to exchange what little air they could.  Slowly but surely, over the next 20 minutes or so (and three breathing treatments later), her little body slowly started to respond.  She was breathing less often, her heart rate was slower, her other muscles were relaxing, and her eyes were almost back to normal.  I breathed a sigh of relief.  I continued to work with her, and had my team mate come help me do some chest percussion, to help clear her lungs.  By that time her mother had returned.  I explained to her that things were so much better.  But gave her a stern lesson on never letting her daughter be without an inhaler (she had run out of medication).  I gave her an inhaler and told her to return often to make sure she was never without.  Ten minutes after this, after I continued to make her stay in the clinic so I could monitor her - she was laughing, and even coloring some coloring pages I had given her.  She had turned the corner.  I sat down, and my hands started shaking.  The emergency was over, the adrenaline that had kept me going was running it's course.  Once again I had found myself, by myself, with only me myself and I to keep this girl medically stable.  It was a little overwhelming.  Tears wanted to come.  It had drained me - knowing the desperation that these sweet people live on a day to day basis.  Knowing that if I had not been there that day, I shudder to think what may have happened to this sweet little girl.  But God knew - He gave me what I needed...gave little Wendy what she needed...I let her go with the promise she would return in two weeks when I'm there so I could follow-up with her.

I can go a long time again without repeating that, thank you very much!