Introduction

This blog will follow me through my travels and experiences working at a clinic in Quetzaltenango (Xela), Guatemala. The clinic sees primarily indigenous (Mayan) patients in a rural mountain community. More than half of the patients are children, and the clinic is expanding its population even more to include more adults. Much of my struggles actually come from the rather universal theme of being a new healthcare provider, in my case, a new nurse practitioner. I'll also try to post plenty of travel stories to keep people entertained, and share some more cheerful stories. I apologize if there's an overkill of clinic stories. Sometimes it helps to tell the stories, even if only for my own sake.

Thursday, November 11, 2010

An update on the girl with petechiae and the heart issues

I was glad to see that yesterday's 9-year old girl was back in the clinic. Her petechiae seemed even more noticeable as I walked into the room seeing her bare-chested for her repeat ECG.

She brought her labs back from yesterday, and here's what they showed.

Renal function (BUN, creatinine) normal.

Platelets 44
MPV 5.6
PCT: 0.025
PDW: 7.2

Coag time: 5 min 7 sec
Bleeding time: 3 in 21 sec
PT 18.3
PTT:33.2
INR: 1.54

RBCs 3.57
Hgb: 12.3
Hct: 34.1
MCH: 34.4
MCHC: 36.0
RDW: 11.1

WBCs and diff normal.

Fibrinogen: 532.

Fortunately her vomiting, diarrhea, and fever had resolved.

Her ECG today showed the same blockage, and some left ventricular hypertrophy.

We referred her to the hospital, mostly due to her ECG.

Despite the low platelets and the presence of petechiae, the mom and girl looked great, the mom was just trying to digest all the news. Apparently the mom's sister died at age 22 of an unknown cause. I hope they are able to find the resources to treat her effectively.
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