Addendum to Clinical days 2&3

We have lovely man, Mr. Weston, who is hired to cook for us during our stay here.  He seems to be a gentle soul, and has proven himself a fabulous chef.

On Tuesday, while I broke for a bite of lunch from my work at the clinic, he approached me in distress.  He said his wife had awoken in  the wee hours having terrible pain in her leg.  He had just been to check on her and she was still crying and unable to leave the bed.  He asked if I would please go to see her.  I recruited my translator, Gloria, and we followed Mr. Weston to his very modest rent house which is about 100 yards from the clinic compound.  There we found his wife suffering and crying from pain in her right leg.  The leg was swollen and red from the knee down.  I pushed up on the ball of her foot and this exacerbated the pain. Hmmm, a positive Homan's sign, which occurs when there is a blood clot in the deep vein of the leg, also know as a deep vein thrombosis.  As I felt the back side of her leg, I thought I could feel a cord-like area behind her knee.

Being worried about a deep vein thrombosis (DVT), I knew we had to get her to the hospital.  In the meantime I consulted with George and he suggested I give her an injection diclofenac, a medicine not available in the states similar to ibuprofen, but stronger.  This should help her pain and perhaps reduce the chance of further clotting.

When Ray returned from Lilongwe early evening, he had Timeyo drive her and Mr. Weston to the hospital.  They arrived too late to be seen that evening and so boarded overnight and were seen yesterday.  Fortunately, I was wrong and the tests did not confirm a DVT, but instead a cellulitis, which is an infection that is diffuse through the tissue.  She received some IV antibiotics and was discharged in the evening to complete her antibiotics at home.  Hopefully, someone will be able to retrieve them today.

In the meantime, kudos to Ray's wife, Jennifer, who is here with their four small children.  She has taken over the role of company cook and refused to let as subsist on breakfast bars and PB&J, as we have insisted we can do.