Wednesday, December 5, 2007

If It's Tuesday...

Emmah is spoiling us: we had chocolate cake for dessert last night and pancakes for breakfast today. Ordinarily, we enjoy coffee, tea and toast, cornflakes and perhaps a hard-boiled egg at the beginning of the day -- much more than I ever eat at home. Lunch is on our own, usually leftovers and/or the ubiquitous PBJ. Today Nadia and I packed our lunches because we were invited to go with the hospital's (HIV/AIDS) Comprehensive Care Clinic team to an outlying community. The CCC clinics occur once a month in four separate regions. We were saddened to hear that the stigma of AIDS still prevents people from receiving care; sometimes they will wait until they must be hospitalized because they do not want to be seen attending a local clinic. We were asked to not wear our customary white lab coats into the community for the same reason.
We helped set up discreet areas in a small Anglican church and saw 33 patients over the course of several hours. Most were returning for follow-up care and refills of their free (PEPFAR) antiretroviral drugs. In one corner, an ongoing "Human Rights" counseling session reminded participants, "You have a right to an education, you have a right to work, you have a right to marry; you do not have a right to infect someone with HIV."
In another corner, the patients were privately registered, tested (CD4 counts, not the more expensive viral load tests) and referred to a third corner, where a clinician evaluated their current status. They were then referred to the fourth corner, where the makeshift pharmacy distributed appropriate meds: antibiotics, four antiretrovirals, anti-TB drugs, etc. - plus some supplemental food.

ARV's are begun here when a CD4 count is 350 or below; multivitamins are begun at 500. Septrim is prescribed prophylactically for anyone who has HIV. Two thirds of our patients today were female, many of them children. A 29-year-old widow was encouraged to bring her three children in for testing; their HIV status is unknown, and they could benefit from free medical care if they should (unfortunately) "qualify."
One eight-year-old came in with her grandmother, who was clearly overwhelmed by caring for several kids whose parents had died. Oprah had not taken her antiretrovirals as prescribed, and her CD4 count had dropped from 629 to 328 in one month. They both needed encouragement as much as appropriate medication and supplemental food.

It's time to go help Jessica and Ruth. At Dr. Hardison's suggestion, I am now using weights to strengthen their quadriceps. "Three stones" (in two plastic bags, one per leg) is no longer an archaic measurement to me!

Advent blessings, and thank you all for keeping us all in your prayers.


Bob said...

Dear Good and Gracious Dianne,
Your ongoing commentary is wonderful and inspiring for all to read and share this opportunity with you. My thanks to you for taking the time to put your thoughts (well worded in every way) down for yourself and others.
We are very cold today -- temp around 20(?) and windy. All is well at church, though we have a number of folks who have been ill or in need of various procedures and so forth -- I will be sure to keep you busy upon your arrival home once again in terms of nursing care. The usual parts of life continue -- special town meeting tonight which actually met since we had a quorum; St. Andrew's Day with piper and great food; Nancy Rogers is "back in the saddle again" after her fall from her horse -- thankfully a full recovery is in the making; Joy and John Washbrook are off to visit their son Luke in Switzerland; funeral for Peggy Berry went very well with their whole family of 35 present minus just one who is in the Navy in the Pacific flying choppers; John Nevin has died and we will have his funeral on Friday the 7th . . . and on and on.
You are in our prayers at all services and in our hearts all the time. As I read your words it is clear to me that your heart is truly singing . . . May prayer is that you continue to love the tune.
Bob Edmunds

Anonymous said...

Dear Dianne,

Thank you, thank you, thank you. We had a lovely stay in your comfortable and beautiful home. Dick wonders if you are missing it. My response was, "I'm going to miss it!" We saw many of our St. Andrew's friends out and about on Saturday and we went to both serives on Sunday. You are in everyones thoughts and prayers. Your blog entries are very thoughtful and moving in addtion to providing us with a window into another world. I copied your blog to Word and forwarded it to Varian. She is unable to read the blog as is.

Love and Prayers and Thank You.