When you first enter A-ward, there are little cubbies on either side that are surrounded by half walls and a curtain door. Each room has two patient beds inside. These are the "isolation rooms," though technically they are not very isolated. You might find a child with TB or measles or some other potentially spreadable infectious disease inside. If there are no infectious cases, the beds are open to whatever patients happen to get put there.
This week I had two precious non-isolation kiddos sleeping in the corner cubby.
This is Taitas. She is one of the smiliest babies I have cared for on pediatrics :). Yes, Taitas is a she. I thought she was a very pretty boy for most of the week. Surprise!
Taitas has been admitted for the second time in a few short weeks. She has a chronic cough and difficulty breathing. The original sickness was thought to be pneumonia, but a follow up x-ray showed a big heart. Taitas probably has some sort of congenital heart disease.
It is difficult to get a true diagnosis for CHD. We have a machine that can do echocardiograms (ultrasound of the heart), but Dr. Susan is the only one who knows how to use it and she has just a bit of experience. A specialist comes up to Mt. Hagen once a year, but it is hard to know when he is coming and we missed sending our patients this year.
So at Kudjip Hospital, kid with a big heart on x-ray +/- heart murmur +/- symptoms = CHD. These patients are treated with ace inhibitors and diuretics, maybe beta blockers and digoxin. Some get better. Some get to the specialist in Hagen for echocardiogram. If their diagnosis is operable, they may be lucky enough to get to go to Port Moresby for surgery by the heart team that comes to the country once a year. Some continue to live with their illness until they succumb to heart failure. Time will tell for Taitas.
Junel sleeps in the bed next to Taitas. She was born at a health center and was brought to the hospital when she was about 2 weeks old because of problems breathing and eating. She weighed only 2 kg (about 4.5 pounds). On exam, the admitting doc found that she had a very small chin, a condition called "micrognathia." Because her chin is so small, her tongue falls back in her mouth, blocks her airway, and causes her to stop breathing. The deformity also makes it difficult for her to breast feed. We placed something called an oral airway, a little tube that goes in her mouth and keeps the breathing passage open. She also has an NG tube for feeding. You can't see much of her face for all of the tape keeping everything in place. So far Junel is still alive and breathing, and she has now grown to 2.5 kg! But these interventions are really just temporary. If this little one is going to survive, she needs to be able to breathe and eat on her own. This week I talked with a surgeon in Mt. Hagen who has special training in pediatrics. I will be transferring the patient to his care on Monday. Please pray for a miracle for Junel, and wisdom for Dr. Ben as he cares for this precious little one!
But what does it say? "The word is near you; it is in your mouth and in your heart," that is, the word of faith we are proclaiming: That if you confess with your mouth, "Jesus is Lord," and believe in your heart that God raised him from the dead, you will be saved. For it is with your heart that you believe and are justified, and it is with your mouth that you confess and are saved.
~ Romans 10:8-10