Wednesday, April 30, 2014

Resilience and Animalitas

April 30, 2014

In one home, the women dry the corn, maiz.
The evening clinics have been packed: as many as 50 -70 people coming through. When one family member comes in for wound care it's common for 2-4 other family members to come with them.  Grandchildren bring in abuelitos, sons, daughter-in-laws tag along, and of course the smaller children come. If a child is receiving treatment, then cousins, aunts, uncles, parents; it can be as many as 5-7 people tagging along for one patient. The Latin social support is one reason why many believe the Mexicans are so happy.  Its a pleasure for me to see the family love and caring of one's clan.

Our latest tragedy is a 3 y/o boy that was burned with hot liquid (I'm not sure how this accident happened) but his left hand, palm and back, and his abdomen and chest, 23% of his body surface area. This happened last Friday and he was hospitalized for 3 days, then the parents brought him to Don Sergio for continued care. After changing the dressing in the clinic, Don Sergio tells them he will come to their home to reduce transporting the child. These appear to be deep second degree burns: the most painful.  No pain meds are available, other than Tylenol, so our routine will be to lay everything out and change the bandages quickly. The child will soon see us coming and the anxiety will begin. Fortunately, he is healthy otherwise so should heal well, the subsequent psychological trauma will not be known. The extent of the chest burn is not yet determined as the burned tissue has to die off to uninjured tissue (damaged tissue will be removed). In the US, no doubt he'd be in a burn center and appropriate measures taken.

Our Teopisca man, the one who suffered the electrocution injury is doing well. The injuries to his feet are profound, however his grit is so strong and he manages his way through Don Sergio's debridement treatments (removal of dead tissue).  Afterwards he is fine and lets Erick shoot a photo of us.
Resilience and support. This 43 y/o man has his mother by his side during his wound care treatments. They are so grateful for Don Sergio's care.

Another reason the clinic is so packed is many people have basic dermatology questions.  Since I specialize in dermatology, many patients have questions about their skin ailments.  I see a lot of eczema, fungus and sun sensitivity rashes (surprisingly common), the latter in the agricultural worker. The convincing that some of these conditions are not curable but need maintenance for control can be difficult; try telling an agricultural worker to stay out of the sun:imposible (sombreros, guantes y mangas largas).

Bela's garden in full bloom, a Mexican paradise.
My easiest derm case was this young woman with a small child that complained of "tengo animalitas en mi pelo" (I have small animals in my hair). Ah, so easy: lice..and so easy to see along with the eggs. In Spanish, piojos y liendres. When I ask how many people live in her house and do they have the same problem, her response, "Si, todos" (yes, 15 people have it). This young woman is poor, so Don Sergio and I agree to buy the medicine and have the family treated.  I'm not so sure how successful treatment considering the crowded living conditions.

No comments: