Wednesday, May 29, 2013

Peritoneal Dialysis

We are always trying to improve the level of care here at Mbingo for our patients.  Recently, we were able to start a peritoneal dialysis program for acute renal failure.  This was made possible by 2 years worth of donated supplies from the Renal Research Institute in New York.  We hope this will save the lives of some of the patients that have acute kidney injuries by giving them enough time to recover their renal function - usually days to weeks.

We will be teaching this skill to our CIMS residents.  This was a group photo of the residents that we took last week.  We convinced them all to smile...even though most Cameroonians like to be very serious in photos.  The most difficult part of peritoneal dialysis in our setting is actually choosing the right patients that need peritoneal dialysis and are likely to benefit from it.  We hope to find a way to make the program sustainable here at Mbingo after the 2 years of donated supplies are used. We also hope the residents will be able to offer peritoneal dialysis at the hospitals they end up at after their training is finished.

 This is our first patient receiving peritoneal dialysis.  The sterile fluid goes into the abdomen and "toxins" in the body collect in the fluid.  The fluid is then drained out after 4 hours and the process is repeated.  The "toxins" include electrolytes, acid, and other waste products that our kidneys normally excrete.  This 5 year old girl developed acute tubular necrosis (ATN) after malaria and was making almost no urine and was confused from uremia.  Now she is alert and awake and tolerating dialysis well, but we are still waiting on her urine to increase and kidney recovery.  The nurses, Ivor and Gene, have practiced long and hard to be ready to care for these patients and they are doing a great job.

This is Nancy and Dennis Palmer and Patsy and Bill Lawton.  The Palmers have been here for years and Dennis Palmer is the Director of the CIMS Program.  Bill and Patsy Lawton recently came to volunteer at Mbingo for 2 weeks.  Bill is a nephrologist and helped us get our peritoneal dialysis program ready.  Unfortunately, he went home just before we received our first patient, but he had us all well trained.  Patsy is a physical therapist and helped in our PT department.

This is JR and Angela with Tina Slusher.  Tina is a pediatrician from Minnesota with an incredible amount of global health experience.  One of the things that she identified that needed help here at Mbingo were the bili lights (phototherapy units).  Newborn jaundice is a common problem with potentially serious outcomes.  By using a bili light like JR is holding, the high levels of bilirubin in the newborn's blood can be brought down to safe levels.  We already had bili lights like this one before Tina Slusher came, but we learned how to make it more effective.  In fact, she helped us increase the quality of the bili light to five times stronger than it was before.

Technology has changed the way that medicine is practiced around the world and Mbingo is no different.  Well...a little different.  Instead of computers, smartphones, and iPads at the bedside, we use the older Palm PDAs to look up information on medical diagnoses, treatments, and drug dosing.  Each trainee at Mbingo is giving a Palm PDA and it is loaded with useful medical resources.  This is all possible because we are able to get the older Palm PDAs for such a good price.  As you can see in this picture, a house officer and Dennis Palmer are both looking up drug dosing for this patient at the same time.  This greatly improves our ability to quickly deliver higher quality medical care to our patients.

We are excited to show the new roof being added to the outpatient clinic building.  This has been a long time coming and we are still waiting to complete the other half, but we hope we will have the money to do that soon.  Other than it being a generally good idea to have roofs on buildings, it keeps the heavy amount of rain from causing damage to our walls and ceilings...and it looks a lot better.

JR and Chuck recently did a guys hike to the top of this peak in the picture.  It was quite a difficult climb up with plenty of bushwhacking to make a trail, but the view of all the surrounding valleys was worth it.

A couple weeks ago, the other missionaries at the hospital surprised us with a baby shower.  We had great food, some thoughtful presents, and it was a good excuse to get all of us together on a Saturday afternoon.  Angela is now almost 35 weeks pregnant and we will be heading back to the US this week to have the baby there.  We are then planning on returning when the baby is 6 weeks old.

Isaac will be sad to leave his friends here at Mbingo, but is excited about taking the truck, plane, and car rides home to see his grandparents and then meet his baby brother.  Thanks for your prayers for our work here and now as we travel home and for a safe delivery of a healthy baby.

1 comment:

  1. I absolutely LOVE your posts and pictures. It has been a privilege to pray for y'all! Isaac could not be one drop cuter!! I'm eager to see who baby boy will look like :). Love you all!