I had hoped to get this new blog post up about a week ago, but there has been a lot going on (as usual)! I was specifically waiting to get a definitive diagnosis on one of our seriously ill patients, a fifty-four year old, wife, mother and grandmother. She had come to us for care complaining of a slight cough, but most concerned with an enlarging, mildly painful mass just above her right clavicle. It had been present for at least 2 months. Upon examination, I noted a group of approximately 5 matted, minimally tender lymph notes in the right supraclavicular region. She is a non-smoker, non-drinker, but her husband is a smoker. My main concern was to make a accurate prompt diagnosis! My differential diagnoses included tuberculosis versus lung or GI cancer.
Having just lost a patient to lung cancer a week earlier, I was determined to do whatever it took to get a final diagnosis and do it promptly! So the next morning my wife Rhome, I and the patient set off on an hour and a half boat trip to the island of Leyte (Ormoc City) where I had become friends with an ENT doctor. He agreed with my possible diagnoses and ordered labs and a chest CT scan. The labs showed normal renal function and the chest CT scan was scheduled for the next morning.
After the CT scan was complete, I was able to meet with the doctor and review the findings. The good news is that there was no evidence for cancer. The "not so good" news was that she has tuberculosis! So the next step was to buy her medications and to council her on her diagnosis and the importance of following and completing her medications.
Although we only had $500 US left before we provided the care for this patient and after all was said and done, we only have $200 US left to live on. Though this has put us in some dire financial straights, we have no regrets and are certain that we did the right thing!
With this case and the next 2 cases we will be sharing with you, we have again been shown that we are indeed here for a purpose and will continue to strive to remain here! These people have no money, they are lucky to be able to buy a sack of rice now and then! They are truly subsistence living and there is no hope of employment on this remote island and without us there is no real medical care!
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The next patient's story is truly very sad! He was a husband, father and grandfather. He had complaints of a cough and progressives shortness of breath for a while and had developed an enlarging mass on the side of his face. Before coming to seek medical care from us, his daughter, Juliet, who works as a housekeeper, in Dubai, had sent money home so that her father could go to Manila and be seen! A chest Xray was taken and a needle biopsy of the facial mass was obtained. The biopsy of the facial mass showed metastatic small cell carcinoma secondary to his lung mass (cancer) seen on his chest Xray! His diagnosis was of course, terminal! However the patient nor his family, including his daughter, did not really understand the meaning of the chest Xray, nor the biopsy of the facial mass. All we could do was to explain his diagnosis and terminal prognosis, provide him with pain medication and get him on oxygen. He passed away just a day after his daughter took the picture posted below!
The good news is that in his final days he did accept our Lord Jesus into his heart!
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Our next patient was brought to our house/clinic one night by her frantic mother and father! They told us she had had a seizure! Upon examining her she had a fever of over 103, was responsive and without focal weakness and had no prior history of seizures. The rest of her exam, except for generalized malaise and some mild dehydration was unremarkable. We learned that her older brother had had a URI a few days to a week earlier. Diagnosis; febrile seizure. We treated her with Tylenol, re-hydration, close observation. we told the parents to come to our bedroom window and wake us up if she became worse during the night and to bring her back to our house/clinic in the morning to be rechecked. She recovered very nicely with no additional seizures and we are all very happy!
I just want to add a couple of additional items before I close this post.
Here on Pilar as I have explained, we are subsistence living, as there are no jobs to be had since it is a small, remote island (~2 1/2 miles wide by 10 miles long)! There is no real medical on the island except for us. If one does not grow it or catch it, or is lucky enough to have a family member working overseas and sending money home, then you just don't have it!
The island, in fact, the whole Philippine archipelago, has been experiencing a severe drought for over a year (due to El Nino)! Here an El Nino causes drought, not cooler and wetter winters! This has meant that much of the corn seed has been used up trying to grow a crop without any results other than no crop ( there is no capability for irrigation)! We have been very blessed to have obtained some assistance from an agronomist and his wife from our church back in Nevada! They are assisting us in locating non-hybrid corn seed to help replenish the stock of seed corn so that, now that the drought has ended, people can begin to plant corn so they can eat and have seed corn for the next planting season! God bless you Jack and Melanie Krause!!!
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Finally, I have been asked by the schools to help with a annual dental hygiene workshop that is put on every February. This is designed to teach the children the importance of good dental care and to try to provide them with a toothbrush and some toothpaste! Many of the children arrive at the schools with just a small guava branch with a few leaves on it as they have no toothbrush or toothpaste! Hope sad is that! It is bad enough that tooth decay is epidemic here and multiple missing teeth are the norm! But as most of us now know, poor dental hygiene causes chronic inflammation, and chronic inflammation of any type leads to an increased risk of stroke and heart disease! No wonder there are so many deaths here from stroke and heart attacks! If anyone can help us locate and obtain toothbrushes (children's) and toothpaste please let us know!!! Perhaps someone has a good hearted dentist or has some connections with one of the companies that manufacture toothbrushes or toothpaste! If you can just lend a hand then we can help the children and, in the long run, save lives too!
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I have mentioned in earlier posts that our non-denominational church back in Carson City, Nevada has offered to help us accept donations (tax deductible) and to help with shipping of medical supplies here to Pilar. So if anyone finds it in their hearts to donate financial aid in any amount, medical supplies, or dental care supplies for the children of Pilar please contact me at pilarchip1@mac.com for details!
May God bless us all, each and every one! Thanks so very much for your prayers, interest, support and getting the word out to your friends, family and coworkers!!!
Until Next Time,
Chip & Rhome Nuttall
Hi Chip and Rhome. Thanks so much for the update. Thank God that the lady now has an accurate diagnosis and can be treated for TB. It's great to hear that the little girl is doing better. And most important, how precious that the gentleman with terminal cancer received Jesus Christ as Savior days prior to his death. That's what the ministry is all about!
ReplyDeleteSpent a long time yesterday with Jack and Melanie, and they are working feverishly on a plan to get corn seed to you in time for the October planting. Pray that God puts the many details together. They are such a blessing and so passionate to help! Also, let us know (if possible) in advance when you'll be on Leyte next, and we can have a 3-way Skype conversation with you.
Let's email regarding the suggestions I sent along yesterday.
We have LOTS of toothbrushes, etc. to send along in the next Balikbayan box!
May God strengthen you each day and provide exactly what is needed for the work there.