BLOGGE(RED) Day 18

Tuesday. Longest ward round ever. Loads of patients. 2 patients with GCS less than 8/15. One vomiting, put in recovery position, then catheter and NG tube. So sad, his eyes were open, it looked like a man screaming for help, trapped inside a lifeless body. Don't know the cause, don't think its a stroke. The other man had a stupid wife who despite our instructions to not feed him as he is virtually unconscious, she kept feeding him and he aspirated his food and the gurgling is audible and his prognosis is poorer. Other patients included young boy with asthma exacerbation, only treated with IV aminophyline and erythromycin, man with epigastric pain and dysphagia but with left middle zone consolidation. Man with known HIV who presented with fever and a dry cough, clinical findings suggest TB or PCP, but the CXR order was written for query cardiomegaly. What the. Had to change that and reorder it. Man with systemic hypertension - 180/104. Do you treat with ACE inhibitors as first line? Our doctor didn't - beta blockade and thiazide diuretics. Frusemide and ACE reserved only for those in heart failure. Do you agree? Patient with oliguria, fever, cough, malaise, nausea. ARF probably. But we can't do U&Es here. Also no facilities for blood culture or LFT. The full blood count is also broken at the moment. Relies heavily on clinical acumen as investigations are limited.

Did not go to Tanga today as usual, because we are going on Thursday for new year's eve. Instead we had chipsi mayai for lunch, as there was no chapati today. Surprisingly we found spaghetti from the local grocery shop! Went home and made pasta with a nice vegetable and tomato based sauce. Turned out really well, we will probably make this for the mzungu dinner next week.

Someone told us about an ice cream shop in Muheza! So we went to get some, I had a chocolate coated vanilla ice cream in a cone - like a choc top. Cost 1200 shillings, around $1 AUD. My 2nd ice cream in Tanzania.

World Vision replied the email I sent them last week regarding visiting my sponsored child Bernald! Gave me some forms to fill in, but they cannot guarantee my visit will happen as usually these documents need to be submitted 3 months in advance, but my visit will be in ONE month! So I will do my best, if it falls through I might try to book a safari instead. But I don't think I'll be able to do both. Spent part of tonight filling in those forms, need to get Dr Sally to certify my passport / drivers licence. And need to print out the forms.... Don't think there's a printer here though...

Watched "The Shawshank Redemption" tonight. It was quite a good film, lots of interesting issues. My laptop's speakers aren't the loudest though so sometimes it was hard to hear what the characters were saying.I'd heard rave reviews about it from all my friends who'd seen it so I made it a point to watch it myself. Now its done!