The wireless network at the hospital has a reputation of messing with computers and I was no exception. Luckily their IT guy has been helping us restore our computers with minimal loss.
This week has honestly been one of the most educational weeks of my life. I have been able to witness so many amazing things that continue to strengthen my desire to become a physician. On Tuesday morning Dr. Sable walked in and said, “ have you scribed before?If not you need to learn in the next 10 minutes because I need you.” So needless to say I attempted to learn their database and the art of scribing in those few minutes before the first echo. My 2 years of making it to the finals of the spelling bee obviously did nothing because I feel like I was second-guessing the spelling of every word. But don’t worry; I was given an easy first sentence pronounced at rapid speed- “tetralogy of Fallot with large anterior malaligned ventricular septal defect.” Uh..could you repeat that?
Although this week has been designated for cardiac catherizations, Dr. Sable is in charge of echoing children that need surgery or a catheter procedure and need to be placed with an organization for sponsorship. As I mentioned before, the cath team here is relatively new and only focuses on less complex cases. This means that there are many problems that cannot be fixed in Uganda. There are organizations (Samaritan’s Purse, Chain of Hope, Gift of Life) that sponsor children to go abroad to receive operations. To be accepted there are many steps involved including an echo detailing findings and heart anatomy. The first day there were about 35 patients waiting outside the door to be screened. It is both rewarding and heartbreaking knowing that some kids will receive the chance of a lifetime while more than half will probably never be accepted into one of these programs because they are too sick or too high risk. Some of the patients even mentioned that it was their 3rd or 4th year in a row coming back to UHI hoping to be sponsored.
potentially the most adorable child in the world
If I were to shadow a cardiologist in the US (not that I know any…), I would probably spend a lot of the day seeing children, brought in by worried parents for no reason, who are completely normal. Unlike at home where we are all convinced by WebMD that we are dying for some reason or another (I’m guilty too) and unnecessarily head to the doctor (or in my case my parents room), here you only come to the hospital if you are very sick. I have been able to see so many unique and complex abnormalities this week, including a child with only one ventricle (you should have 2), a child with trisomy 18 (Edwards syndrome), and a child with a Holmes heart. Unfortunately, there was also a child brought in with severe RHD that will probably not make it more than a year. I think in my head I tried to tell myself that if those in Gulu were near a well-equipped and capable medical center then they might be okay. This RHD case was a reality check and made me vocalize what I already knew; once you are in the severely symptomatic stages of RHD there is not much you can do. These children would need valve replacements, which are extremely tricky as well as expensive, and not really an option in Uganda.
In addition to helping screen these children and scribing for their echos, I was able to watch some of the procedures happening in the cath lab. For those of you that are not familiar with cardiac catheterization, they can be done for many different reasons and involve placing a flexible tube (catheter) in a blood vessel, usually the femoral artery, and threading it to the heart, which avoids having to crack the chest (hopefully). They are performed as a diagnostic tool or can be done to fix a less complex problem such as a PDA. Because you don’t crack the chest, there really isn’t too much to see by watching one of these procedures, however I was still grateful for the opportunity, especially because Twalib performed one of the caths I was able to see.
Twalib performing a diagnostic cath on a 7yr old girl
Tomorrow begins the start of “surgery week” and I am really excited about the potential to go into the OR and watch some of these procedures. In addition, a 14 year old boy (Eric) whom we echoed on Wednesday and has been coming to the clinic for 4 years to get sponsored, was chosen to have surgery weekend and I am super excited for him! Most of the children that receive procedures happen to be fairly young and do not fully comprehend what is happening. Eric, however, came in this afternoon grinning from ear to ear; fully aware of the amazing gift he is about to receive. I’ll be sure to keep you posted on how everything goes!
You can end up waiting for 8hrs for an appointment here so many people tend to lay outside
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