Friday, October 28, 2011

Back to Work with Don Sergio

October 28, 2011

Our morning started off waiting for Don Sergio at his museo with a patient with his father and grandfather from Amantanango de Valle. They drove an hour for the son, Maurice, to have his bandage changed.

Sergio arrived on time and entered the museo to do the bandage change. This eight-year-old child's injury occurred when the family was burning trash and he was near the fire. Four months ago the child was standing by the fire and a wind whipped up and burned his left arm, left abdomen and chest. These were superficial and deep 2nd degree burns that are now well healed but will leave him with permanent burn scars. There is one area on his left abdomen that is a bit slower than the rest probably due to the depth of the burn and the natural mobility of the stomach expanding and contracting. Originally the patient went to the hospital in Teopisca and stayed for two days with no proper bandage change. A female doctor told the parents to take the child to Don Sergio. Sergio said the burns were cleaned but very dry. After four months of care the child is doing well.

Thanks to Maricopa Burn Center and Pongratz Prosthetics, the donation of the burn garments are put to good use for Don Sergio's burn patients.

Afterwards Sergio showed me the room he made (he says for me) but obviously its for the patients. Previously this room stored extra artifacts and supplies. He cleaned it out, put a partitioned wall, painted the walls and brought in a work table, shelf and a bench: a model clinic room. He feels this will be better for the patients who prefer others not see their injuries.

The new clinic room Don Sergio made. Thank you all for your donations!

After unpacking and sorting we were off to a poor part of San Cristóbal to see a eight-month-old baby that had been burned with boiling coffee on her right arm, abdomen and right leg 12 days ago. These appear to be 1st degree burns as the child's skin is closed and just fresh pink now.

The stairs we had to climb to get to her home.

The way up included rock climbing.

Our next patient was a lady I had seen six months ago while here with Kieu. She had (and still does) profound lower leg ulcers that are healing slowly. She is quite resistant to compression and Sergio is challenged by this, but he continues to provide care as there is improvement. Kathleen showed her some lymphatic drainage techniques the patient can do and we hope this will help.

Our last patient of the morning was a very large man with a healing full thickness injury to the left lower leg. This was quick bandage change but it may take another month for his wound to close.

"Libre," as Don Sergio would say. This means we are free until 4:pm: that's when we have to be at the museo. We returned to Bela's for Manuela's comida especial, mole colorado, sopa de pan (bread soup) and a unique tasty desert - zapote negro (black zapote fruit).

The afternoon started at 4:00pm and Don Sergio's museo was full with patients. Kathleen (who is physical therapist) worked on a 17-year-old woman who reports her left leg started twisting inward since she was four years old. She had gone to a curandero (healer) who used hot herbs on her knee and leg and left her with significant scarring. She had no concern about the scarring but wanted to know what she could do about her knee and leg. Unfortunately, it seems her leg has been in this shape for so long that training her to do PT muscle exercises may not yield the results she is looking for. She could benefit from a brace that would give her support in addition to engaging muscles that need to be strengthened. This is a challenging case.

Sergio and I saw the burn and wound patients. The saddest case I'd seen in a while... well, since this morning, was a 45-year-old Zinacantan woman with her right foot that appears to be gangrenous. She has uncontrolled diabetes and appeared ill. When I removed her bandage, the smell was so bad the waiting patients scattered widely as if someone lit a fire cracker. We should have taken her in the new room but Kathleen was using it for another patient. Her foot was so swollen, infected, malodorous and weeping that I could not see how we'd be able to help. I whispered to Don Sergio, this patient needs to be admitted in the hospital, get IV antibiotics and get ready for an amputation. He said she's been told and she won't go, she's been there and they recommended amputation so Don Sergio as her last resort. He will try to convince her again. The challenges here are mind-boggling. This is an example of the faith people have in Don Sergio. He knows when to send them to the hospital but the continue to come to him.
Sergio's museo clinic was a full house. (Patients faces are blotted out for privacy reasons.)

We had various other minor wounds (in comparison to the Zinacantan woman) to see and our last patient was a young man who had a tattoo on his right arm. He worked for a local company and they told him he could not have tattoos. Tattoos are looked down upon here in Mexico as many people perceive you are part of a gang (it is difficult to get a job with tattoos). This 20-something-year-old male applied a gel that would help him get rid of his tattoo. The tattoos are gone and now thickened unsightly scars. The gel he used probably caused deep partial thickness wound and possibly full thickness. He's lucky he healed this well.

At 7:00pm the museo was quiet, patients were gone and there were no tourists. Our first day of work was very busy and I was glad to see Don Sergio in good spirits and well rested. His energy level is impressive... for a 70-year-old. Tomorrow we start at 9:15am.

Posted by Patricia Ferrer.

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