Saturday, February 18, 2012

Winter Scenes

Snowball fight on way home from church

Streets are used by vehicles and pedestrians alike

Village streets

Our backyard

Thursday, February 9, 2012

On Call

After a day (or make it a week) like this I begin to think I chose the wrong profession.  I should really have an M.D. or R.N. after my name. 

Most Ukrainians I know rush to the doctor at the first sign of a cold.  Pharmacies are on nearly every street corner and practically any drug you want can be purchased without a prescription.  Nevertheless most people admit that many doctors have bought their degrees and many of the medicines in the pharmacies are fakes or ineffective because of improper handling.  That's where I come in.  I have a book on my shelf, Where There Is No Doctor, (which I've fondly renamed Where There Are No Good Doctors).  I also have access to information in English on the internet and a sister who does have a few of those letters after her name (and she actually studied for those credentials).  This is what makes me "qualified" to answer all sorts of questions.

Sunday a mom at church tells me about her two year who was very sick during the night with a high fever, rapid breathing, cough, and what sounds like retracting.  They didn't take her to the hospital because I guess they're afraid that with it being a weekend there are no doctors in and they'll just be sent home (they tell me it's happened before). I promise to come over with some of the medicine I have for Matthew's asthma.  When I arrive I count her shallow breaths at 40 a minute.  She no longer has a fever and her cough has calmed down.  I use my nebulizer but the albuterol is 10 months expired and doesn't have much effect.  I think she could have bronchitis.  I leave them with some albuterol and a baby spacer and teach them how to administer it.  I also give them a steroid suppository to use in an emergency.  Before leaving, I write down the medicines she's taking in order to check the ingredients and dosage on the internet.  It turns out that the one medicine has a concoction of antibiotic, expectorant and something else I could never figure out what.  The amount of antibiotic was 12 times less than what a minimum dose should be - but just right for building up a resistance to antibiotics and creating "superbugs". 

The next morning I call to check on her.  She's better but still breathing fast.  I had talked to my sister for 40 minutes that morning and together we had come up with a plan.  My sister told me how to listen to her lungs with a stethoscope, what sounds might indicate what illness, and what antibiotic and dosage she should be on if antibiotics are needed at all.  I decide to leave the kids with some school work to do on their own and walk on over.  I listen to her lungs and can hear a wheeze. I bring with me a different albuterol inhaler and spacer and give her that.  It makes a marked improvement in her breathing.  Since she's definitely improving and walking in sub-freezing temperatures isn't the best thing for her, I recommend that she use the inhaler every 4 hours.  The mom agrees.  By the next morning she's completely fine.  She probably has a bit of asthma since this a repeated problem but now they have a spacer and inhaler to treat it with.  I'm quite positive the doctor would have prescribed antibiotics which wouldn't have helped at all.

Today was a busy day of being "on call".  An acquaintance called asking me about her sister-in-law's baby who is 2 1/2 weeks old and not gaining weight.  Another friend called asking if I knew what to do for her 7 year old son who stuck his tongue to a frozen pipe and now it's white and swollen.  Another friend discussed with me her 2 year old's symptoms which sound like a urine infection.  Yesterday we gave advice about how to treat gout.

It really would be useful if I was trained to answer such questions.  It's sad that all too often I know more (or can at least find out) than the doctors who really do have those letters after their names.