Tuesday, March 27, 2012


12 year old Levi was brought to the hospital Monday by his mother after finding him unresponsive.  He had been fine before going to bed.  We did a spinal tap in OPD as we admitted him.  Tests revealed he had Cerebral Malaria.  Sometimes coma is the initial symptom with Cerebral Malaria.  Even though he showed little improvement and was having seizures after 48 hours of treatment, I was cautiously optimistic since treatment was begun early in his illness.  Over the last 3 days Levi woke up, began eating and was able to walk around the hospital compound yesterday.  Levi’s mother had a huge smile on her face this morning when she was told he could go home to finish his malaria treatment.

Levi on admission
Levi 5 days later

Wednesday, March 21, 2012


Last week 34 year old Fellicitas was admitted to the hospital.  She had not been seen since last July but had continued to send a family member monthly to pick up her HIV medications.  It turned out she had gained nearly 100 pounds the last year from fluid retention in her abdomen and legs.  She literally was unable to walk.  Testing revealed she has Cirrhosis of the liver from  Hepatitis B and her HIV medications were ineffective with a low CD4 count.
Last week I drained 10 liters of fluid from her abdomen and with diuretics we were able to further reduce her swelling so she is finally able to walk again.  She was able to go home today weighing 53 pounds less than she was 8 days ago.  It was wonderful to see the smile on her face each day as her weight dropped.  With new HIV medications I am cautiously optimistic that Fellicitas will continue to improve and regain a functional life.  Keep her in your prayers.

Friday, March 16, 2012

Dr. Rick

Dr Rick Hourigan is a Family Doctor from Moses Lake, Washington.  Rick and I were partners in the same Family Medicine Clinic and our offices were adjacent to each other for 10 years.  We have enjoyed practicing together.  After our short term mission to Zimbabwe in 2007, Rick suggested I do a long term mission so he would then be able to come and do his own short term mission where he would already know someone.  When Terry and I decided to come to Cameroon long-term, I informed Rick he was now obligated to come and we are again working together, now on the other side of the the world from our old hallway.

Rick planned his trip to be here while Dr Eugene was on Holiday, helping me with the increased work-load.  Timing is everything and it was fortuitous to have Rick here as last week I had my first major illness since being here in Cameroon.  With little preparation from me, Rick was able to step in and do a great job managing the Medical Wards.  The degree of illness of the patients the last 2 weeks has been unusually high allowing Rick to see many things he had never planned on seeing during his medical career.  It has been very enjoyable to have a friend and colleague to work with.  We have 2 more weeks before home beacons Rick.

Tuesday, March 13, 2012


Too many years ago in Medical school we learned that (in the pre-fertility treatment years) that twins occurred in one out of 88 births in the USA.  We are still in the pre-fertility treatment era in Cameroon yet based on my personal experience here the twin rate must be one out of 10 deliveries.  It is not unusual to have multiple sets of twins on the maternity ward on any given day.  Today 2 of the 7 children on the PED’S Ward are twins.

It begs the question why and I can only assume that it is genetics at work.  With a high infant and child mortality rate the chance of a single twin surviving has increased the likely hood of more twins in each succeeding generation.  Whatever the reason, it makes for a lot of smiling faces around the hospital.

Terry admiring Twins
Twins, why do you ask?

Thursday, March 1, 2012


Anita is a 10 year old girl who had open heart surgery last June at the Shisong Cardiac Center.  She has been doing very well and had a routine check at Shisong 1 week ago.  Her Cardiologist restarted some medications that she had taken prior to her surgery.  By the next day she was extremely lethargic with some fever.  She was admitted and all her blood tests were normal and the new medications were stopped.  Over the weekend she woke a little bit but was still extremely weak and could not sit or stand.  Her affect was very strange with inappropriate laughing.  Tuesday with her eyes more open I could appreciate that her eyes were not tracking appropriately.  I did a spinal tap which was all normal except some yeast cells were seen on gram stain of the fluid.  I asked for another test and her India Ink smear showed Cryptococcal Meningitis.  This is almost always seen in HIV patients but Anita’s HIV test is negative.  After only 1 day of treatment she was much improved and is able to sit and talk.  We hope she will continue to improvement daily.  Keep her in your prayers.