One of those fearsome diseases, rare in mainstream west. Our patient last night was not western, nor mainstream, no longer with active TB, but with a bad ankle wound that may harbor the virus. We got picked to work the case based on who would be there that day, and the day we could be fitted for the proper masks. I had no problem with this, I'd done the FIT test several times while in Boston, where it was more common. Even worked a spine case for a patient with osteo tb. The breaks in procedure then were worrisome, but inevitable.
Found out yesterday we would also be wearing the hoods, like the ones they wear for total joint cases. I've done that before, and knew what to do. A lot of preparation went into this, but it wasn't all clearly communicated to everyone involved. Still, we did fairly well. And the hood, with the battery powered air flow, made the thick mask easier. And harder, one of the elastics pressed my glasses down onto my ear painfully, all deep under the hood. Nothing to do but suck it up and do my job. We are not used to highly contagious diseases, not here, not anymore. It wouldn't take much for it to spread. We weren't perfect, but we did a bit better than the Boston hospital, and it was a much smaller case.
My mother always tested positive for tb, and had chest x-rays regularly to watch a spot on her lungs that never grew. Apparently, she'd been exposed when young, but it never took hold. Natural immunity, perhaps.
We got out a bit late, the work is beginning to pick up. Today, four rooms still running until nearly 5, with one just starting. I was the lunch lady, and ran most of the day, eating at 1045 and taking a quick breather again at 1415, running again until 1715. There will be more like this, the time clips along instead of dragging, which is good. New residents, med students rotating through, soon the experienced Fellows will be replaced with the untested Fellows. Back to stumbling newbies and the need to be patient and thorough.
Everything restarting, again.
More rain, cooler breezes, July is June, as June was July.
6 comments:
We're getting new hires here, too, though it isn't TB surgery that we do.
Phil,
It's actually pretty rare for a TB patient to go into surgery at all. Very high risk for everyone involved.
Ah, newbies, gotta love 'em. Can't kill 'em all.
Thanks for talking about this part of your work:
I proofed a book about Ebola last week, and one of the things talked about was the spacesuit–like protective gear the workers wore to care for patients, and how hot they were because in Liberia they didn't get ones with battery-powered air (too expensive/lack of reliable power sources).
omg, can you imagine? I bet you can... The health care workers could only wear the suits for an hour or so before overheating.
And yet, strangers who didn't even know the sick people did volunteer to do this.
Sometimes people are really nice and good.
Fresca,
I think most people, given a chance, will be heroes. The sort to say, "Anyone would do the same." Some just need to be asked. Some just need to find the specific opportunity where they can be brave.
Without the powered air, ugh, a trial. But then, they are sort of difficult at the best of times, and in tropical heat - miserable. With ebola, droplets were the issue. In TB, it's a tiny airborne virus, so the filtration is vital.
Ah, I hadn't thought about that---airborne v body–fluid borne disease.
The Ebola book also featured a young Liberian woman, Fata Kekula, who cared for her sick relatives at home (no room in the clinic) and successfully used plastic garbage bags as protective gear--she did not get infected, and she managed to save 3 of her 4 sick relatives. (Sad one died, but she still managed a better survival rate than the clinic.)
Fresca,
It's one of the nursing school classes. How diseases spread. Fomites, airborne, droplets, intimate contact, highly contagious, minimally contagious.... lot of ways viruses and bacteria get new hosts.
Yeah, sounds like she did a lot of the right things. Staying out of a center with lots of other sick people can be a very good way to avoid secondary infections, for one factor. Part of why newborns and newmoms are sent home from hospital early, reduces the chance of hospital acquired infections.
Actually, a good kid directed book on how infection works would be really interesting.
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