CT scan Kenyan style

Photo-0152       A Head CT Scan request signed by a nearby missions MD.  Not what I expected to need for my son less than six weeks after our move to our new home in Kenya.

Photo-0154       At first he thought this was sort of exciting.

Photo-0155       Then we pulled into the parking lot…

Photo-0161       …and saw the hospital linens hanging to dry.

Photo-0156       The final blow was news that he would need an IV to be inserted.  Not a happy camper.

Photo-0160       I’m just there to make sure that a new and clean needle is used.  It was.

Photo-0158       It’s apparently never not a good time to take a phone call.

Photo-0162       An American pediatrician and radiologist to consult with.

Photo-0165       The results are in.  He’ll live.

Getting medical care in Kenya is not too terribly easy as you might expect.  My oldest son, well, had a bump on his head…a big bump.  It was there for about a week, was squishy and seemed to keep getting bigger.  The problem was that he had no idea why he had this bump.  He didn’t remember getting hit.  We saw no evidence of any type of bite or sting.

Within our local community we have an RN with disaster relief care (as in Haiti earthquake) who is married to one of my husband’s co-workers.  She is our front line medical care.  We turn to her for anything more than a bump or bruise.  She’s not on the payroll.  She helps out because she can and she wants to.  So thankful for her.

I sent my son, on his own, on foot, down the road (about a half hour walk) to her home for her to give him a look-see.  Next thing I know, she is calling and asking me if she can aspirate it.  Yep, she called a MD in the US and that was what he suggested.  They thought that we should know what type of fluid was in that bump.  Terrific, I had not expected news like this.  Now I wanted to be with my son.  I felt like such a loser mother.   So this RN and another neighbor get together to stick a needle into my son’s head.  The other neighbor was called into service because we happened to be in a black out and the RN needed someone to point a flashlight at his skull so she could get a better look.  (I am so thankful that I didn’t know all the details until it was over.  I really felt like a loser mother upon hearing all this news.)

Good news…just clear fluid…at least I was told that was good news.  Just wait and see.  No worries.  My son manages to score a ride home because it is now pouring rain.  Repeat…feeling like a loser mother.

That night I worry and pray and worry and pray.  Loser mother insomnia.  I decide to be polite and wait until 9 a.m. to give the RN a call and question her as to whether or not we should do anything else.  I didn’t need to wait.  She called me about 8:00.  (She’s the mother of a young child.  I should have known that she would not be sleeping in.)  Turns out that she was concerned too and took it upon herself to call two other medical contacts in the US.  The consensus was that we needed to know more.  Time for a CT scan of his head.

Well okay then.  The RN here has to contact a missionary doctor serving at one of the many missions hospitals throughout Kenya.  Fortunately she has a good relationship with a MD serving a few hours away.  She calls him, he writes a referral and faxes it to her home, I drive with my son to her home to pick up the referral letter  (this day I had access to a car) and off he and I go to the best local hospital.

I am humbled by even attempting to write about that hospital.  Well trained Medical Doctors do work there.  It was suggested to us that this is the ONLY hospital within the local community that we go to.  It just made me so sad.  The patients in there are fortunate because apparantly they can pay for the services that they need.  There is no medical insurance here.  There is no aid from the government.  You pay or you don’t get the care.  It’s that easy.  Most people can’t pay.

I saw many patients who appeared to be terribly sick.  They had family members with them who looked exhausted and worried.  There were crying babies.  It was NOT the horror scene that you have seen on TV but is wasn’t a well scrubbed, well lit, well signed, and decorated American hospital.  So as I find my way around to where I need to pay (you pay first) I just held the tears back.  I am simply overwhelmed by the injustice of it all.  We could drive to Nairobi and go to a better hospital.  We could buy a commercial plane ticket back to the US and receive treatment there.  If there is ever an emergency well heck, my husband is here with a mission aviation service, we could medevac my son to wherever he needed to go.  These people do not have those options.  I felt selfish for such concern on my part for my son.  A bump on the head did not compare to some of these patients apparent needs.  But he’s still my son and he needs to be seen so we press onward.

First stop, we pay.  To pay you just show your referral letter, the cashier looks up the service, and you pay a set price.  Easy enough.  Just don’t loose the receipt.  It’s stamped “paid” and that’s all the proof that you have that you should be there.  The cashier pointed us to our next stop at the nurse’s counter.

We go to the nurses’ counter and sit and wait.  No one is there.  I see a few people in ‘nurse type clothing’ walk by.  No offers of assistance are coming our way.  I start to get irritated and then I do what I find myself often doing here: I compare how the experience would be different in the US.  Quite honestly, I’ve sat and waited plenty in American hospitals, even in a few ERs.  The difference waiting here is the environment.  No waiting room television.  No free Wi Fi.  No water cooler with paper cups.  No magazines.  Here it’s a dirty floor, rickety chairs, and a few basic health care supplies left out on the counter.  Finally a man in a suit sees us and hurries over.  Being white attracts attention around these parts.  He questions me and leaves to find a nurse.

A nurse returns soon and starts opening drawers to find an IV to insert into my son’s hand.  This is when I start to worry.  I’m no fan of needles but I manage to fake it fairly well in front of my children.  I’ve yet to be caught looking away and swooning while they receive their immunizations.  However, this time I need to pay attention.  I have been advised to make certain that a new and clean needle is used.  Lovely.  So I watch the nurse open a sealed bag and prepare a new needle.  Then she starts to stick him.  I stop her and ask if she could first clean his hand with an alcohol wipe.  “No problem,” I’m told.  She pulls a piece of cotton off the roll sitting on the counter, pours something on it that I hope is rubbing alcohol, and runs it once across the back of his hand.  Good enough.  At this point my stomach is starting to churn, I can’t believe this is happening, my son is starting to express his concern, and I have to find a way to comfort him without grabbing him and running out screaming.

I pull myself together, put an arm on his shoulder and the nurse inserts the needle.  Near miss.  Yep, she missed the vein.  Now he’s bleeding.  He gets that from me.  We’re bleeders. At this moment, from seemingly no where, the scary experienced nurse from hell shows up.  You know the one, not too friendly but highly effective.  She knows about a hundred ways to kill you so it’s best not to complain too much.  Some people are universal.  She is one.  We all move out of her way.  She applies a bandage to stop the bleeding, wipes off his other hand, opens and prepares and new needle, and inserts it into my son’s other hand all before I have a chance to utter a word.  We are sent on our way with no more fanfare.

We stumble through a few halls to find the CT machine.  I have experience with these.  I have a daughter who lives with an arachnoid cyst in her brain and in the last eight years she and I have been to four different Children’s Hospitals for CT scans in the course of her care.  American Children’s hospitals.  Everyone speaks to the child.  Everyone calls me, “Mom”.  Super clean, cute decorations, toys, books, music playing, magnificent fish tanks, everyone is helpful, friendly and upbeat.  In Kenya there is just a CT machine in a room off a main hallway with a guy who runs it. I feel fortunate to see it.  I feel fortunate that it is here.  I feel fortunate to have access to it.  I show the guy our paid receipt and he politely asks us to go into the room.  That’s about the time he takes a phone call.  This is one of those times that my lack of speaking Swahili is a hindrance.  I can’t be noisy and evesdrop on his phone call.  Perhaps it is business…a doctor calling regarding a patient.  Perhaps it’s his mother reminding him to bring home some milk.  Perhaps it’s his girlfriend calling just in time to irritate him before he zaps my child’s brain with radioactivity.  I’ll never know but my imagination was in overdrive.  So while he talks on his phone, my child gets strapped down to the table, moved into position, and the guy and I leave to watch through a window.  Zap.  We go back in to inject my son with some dye through his IV (this is about the time that he ends his call).  Back out and a final Zap.

The man running the CT machine told me that the pictures would be sent to the radiology lab.  Not good enough.  I insist on getting a hard copy for myself.  After an initial look of disbelief, he prints up a hard copy for me and runs a copy onto a computer disc that I had brought along.  Time for us to move on.  We stop at the radiology office and get a doctor’s report of findings that basically says there is a bump but there doesn’t seem to be any major medical issue.  Good news but we are going for another opinion.

Another medical opinion.  I’m not going to pull that off by myself.  So at this point I telephone our friendly neighborhood RN.  She has made contact with a local American pediatrician who is living in the area for two years teaching at a different local hospital (one that I have been advised not to go to for treatment).  He is willing to see us and check on my son.  So the RN leaves her son with a neighbor and drives to the pediatrician’s home.  My son and I meet her there.  Meanwhile the pediatrician has contacted another American MD to come over for the consult.  This second MD is a radiologist.  Good news.  So we all gather around the radiologist’s personal PC in the pediatrician’s living room and read my son’s CT scan.  For a non-medical person, I’ve learned my way around a brain scan.  We all agree.  Big bump.  Nothing causing it to continue to increase in size.  Not a tumor.  Not a cyst.  I believe that they called it a hematoma.  Essentially just a super nasty bruise inside his head but not inside his skull.  The prognosis was for it to be naturally absorbed by his body over the next few months.

After thanking everyone for taking such time out of their lives we leave.  I’m relieved but overwhelmed by the experience.  So I give it to my son.  Yeah, the ‘talking to’ that last for the next week.  I’m sure that he was hit on the head in a way that seemed no big deal at the moment.  A baseball foul ball.  A football tackle with friends.  A wrestling match with his brother.  A direct kick from an infuriated younger sister.  We’ll never know.  He claims to understand the risks and the difficulties and the inconveniences of life in Kenya.  He doesn’t.  He’s a thirteen year old American boy.  Thank God for his innocence a it quickly leaves him.

So now it has been a few months.  The bump is gone.  My son is fine and just as careless as ever.  He has various other bruises over his body to prove it.  He even took a fairly serious tumble over the handlebars of his bicycle.  I couldn’t fault him too much on that since he rode straight into a monster size Kenyan pothole while looking backwards to check on a younger sister riding behind him.  We live with small miracles everyday.  I just try to be aware of them.  Here it is much easier.

– The Lord will protect them and preserve their lives; he will make them happy in the land; he will not abandon them to the power of their enemies.  The Lord will help them when they are sick and will restore them to health.     – Proverbs 41:2-3

3 thoughts on “CT scan Kenyan style

  1. Well, “Grams” is glad to finally hear the whole story about the hematoma…I think! No WAY are you a “loser” mother!! I thank God daily for you, and continue to ask Him to watch over my loved ones across the world.

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