Blanca

This was my physical therapy clinic last week.

Unfortunately, it also doubled as an ICU/step down unit for a majority of the week.  When we got to clinic on Tuesday, there was a lady lying on a bench outside.  She was clearly very sick and in distress.  Our team leader is an ER doctor in the US and immediately jumped into action.  Blanca was her name, and they found out she was septic, likely from a kidney infection.  She needed IV fluids and antibiotics ASAP.  They brought her into my room because it was the only area available that had a mat and space to set up the IV.  She had been sick for 5 days.  She had travelled to a medical clinic of some sort, but they had told her she had a virus and sent her home to drink fluids.

Rewind 2 days.  We're unloading our equipment and supplies to set up our clinic for the week in Guitierez Nortes.  Dr. Ries finds out that we don't have any IV fluids.  In my 3 previous years, I have never seen a team use any IV fluids, but they always use it as a scare tactic to make sure everyone drinks enough water - "if you get too dehydrated, the youngest member of the team starts your IV line" sort of thing.  So they do keep some on hand, just in case one of us gringos forgets to drink water.  So Dr. Ries asks Rolando, our Nicaraguan GHO contact, if we can get some.  Rolando travelled back to Managua on Monday and brought back several bottles of IV fluids.  We found Blanca on Tuesday morning.  Her blood sugar was all out of whack as well.  One of the doctors on the team, who is a urologist, randomly put a bunch of insulin syringes in his supply kit for this trip - not something he typically uses, but something that was vital for treating Blanca this week.  I serve a God who sees and a God who provides.

I continued to treat outside my room (PT al fresco, my favorite!) or just inside the door.  Since I was there, I kept an eye on Blanca and made sure everything was going okay.  I'd go grab the doctor when she had completed one medicine or one bag.  By the end of Tuesday, she looked a lot better and was able to walk out of the clinic.  They asked her to come back each morning for more fluids and meds.  Wednesday, she looked great.  I helped her get from the bed to the chair to sit up a bit (acute care PT in Nicaragua - who would have thought!).  Dr. Ries told her the story of the IV bags and encouraged her that God had saved her and had a plan for her life.  He also encouraged her to tell people what God had done.  She walked out of my clinic on Wednesday afternoon before I had a chance to see her or say goodbye for the day.  About 20-30mins after she had gone, I wondered out loud to my translator how Blanca was doing.  He told me she was just outside still - she was standing and talking to all the women who had kind of collected outside of the clinic and was telling them the story of what God had done!  I was amazed not only that she was telling the story, but that she had the strength to stand and talk for that long! 

So Thursday came.  Blanca didn't look as well.  She was nauseous and really warm.  I couldn't find Dr. Ries, but found our medical director, Dr. Fryman who came in and switched up her meds.  She still looked rough.  One of our nursing students took her temperature, and it was over 100deg.  They told her she could go to the hospital in Managua (over 2 hours away) or come back Friday morning and see how she did overnight.  Apparently, sometimes septic patients can have a fever that goes up again before it goes down.  She decided to rest that night and come back to see us Friday morning.

Blanca came back Friday, and she looked beautiful!  All of her vitals were completely normal.  Her labs we could draw were good.  God saved her.

One of my co-workers asked me if I'd seen any interesting PT cases or people while in Nicaragua.  I could only think of Blanca.  She wasn't even my patient, technically, but I watched God perform a miracle in her life, so she will always be the most memorable story from this trip.