Monday, April 20, 2009

We're tired today

I'm a zombie today. I need to get more sleep! Will work on that. In other news: today was slow for me, because most of the patients were Zarma speakers. I translated for one woman this morning, Maimuna. She's a 26 year old Tuareg from Agadez, and she only speaks Tamachek. So, I did alot of miming and smiling, nodding and holding of hands. One of the male nurses in the room is Tuareg, so I could call him over for help when something significant was going on. Otherwise we were pretty quiet.

Maimuna is a gorgeous woman- smooth, golden skin, straight black hair, big black eyes. She was pregnant with her first baby last year; after a 6 day labor the baby was removed, stillborn. She is a small person, very slight, and impossible not to notice. She's here with a few other Tuareg women; they are captivating and warm, and always greet me even though we share few words in common. The surgeons said her fistula is the worst that they have seen yet, but they also said they were able to do a lot of good work on her. I visited her in recovery this evening; she was surrounded by three Tuareg women and two Tuareg men. The men spoke Hausa, so I was able to talk directly with them, which was great. They wanted to know if they could give her yogurt (what is it with men giving women yogurt? Or is this a coincidence?). I like Maimuna's family.

I've continued to have some interesting conversations with the anesthetist. He's been observing some pretty fascinating differences in the ways Nigerien women react to surgery, anesthesia, and pain medication, relative to the way American women react. He says the Nigerien women, hands down, require fewer meds of lower strength, and do not seem to suffer many of the side effects that Americans have. Examples: American women get itchy and scratch alot when they get spinals. Nigeriens do not. Americans get more headaches and neckaches from spinals. Nigeriens don't get very many. Americans feel pain sooner and request sedatives, Nigeriens tend to bear it all. The anesthesiologist showed me all of these pain meds he expected to be running out of; he hasn't even opened most of them! Also, when we do rounds to visit the women in recovery, we keep finding women who haven't even started taking their pain meds yet (there is no nurse to dispense meds, and so the women have to keep track of all of their antibiotics, Percoset, Advil etc. ) They are in pain, but they wait until we come by to start taking them-- these are women who just had all sorts of crazy surgery, and they're not even taking Tylenol! Take that, pain! It's very humbling. I have vowed never to complain about an annual exam, ever again. That's small beans, ladies. Very small beans.

There's more. I was told this afternoon to go tell Bichara (one of my 8 year old girls) and her mother that she'd be getting surgery tomorrow. I went, I told them, I gave them the whole pre-op shpeel. And then, not a half hour later, I was told that no, never mind, she will not be getting surgery. I won't go too much into the details of all of this, but I will say that if the doctors had put their heads together and been honest from the beginning, they could've told this girl last week that surgery wouldn't happen this time around. Instead, they made promises they couldn't keep, and as a result this girl and her family have spent a week living at the hospital expecting surgery. I insisted that the surgeon come with me to break the news, because she is his patient, and she deserves to be told by him. It really sucked. But, Bichara's mom Eki is a tough and composed lady, and she was as gracious as you could expect. Bichara, by the way, has gotten less shy around me and now holds my hand when I'm nearby. I got their phone number, and will try to get Bichara's name on the list for the next round of surgeries, in October. There is some talk of trying to fly her to the US for surgery, because she needs some very specialized work, but I don't know if that will go beyond just talk.

And now, this zombie needs some rest. More news to come. Thanks again, to everyone who reads this blog! It means alot to me to know you're out there.

1 comment:

Anonymous said...

Reading your Blogs have become my daily routine :) :) Really fascinated by your blog RE pain meds.

Krista's Mom