Thursday, March 21, 2013


6 months ago we first met 25 year old Elizabeth.  She was being treated for recurrent Tuberculosis.  Unfortunately she developed Hepatitis from INH, one of the five medications in her treatment regimen.  We withheld her medication for a week and then restarted the medication at a low dose and then gradually increased the dose.  At home we would have come up with a replacement drug for the INH but here there are no alternative drugs.  Elizabeth was doing well and sputum tests in January showed no sign of TB.  Last week Elizabeth returned to OPD very sick.  She was jaundiced and her liver was extremely enlarged.  She also was retaining fluid and was in heart failure.  She likely had damage to her heart valves from Rheumatic Fever when she was younger.  Her problems were triggered by the INH medication again.

Elizabeth had a difficult weekend being extremely short of breath.  We prayed all weekend that there would be no power outages as she desperately needed supplemental Oxygen from an oxygen concentrator that requires electricity to run.  We fortunately had fewer outages than normal and we were all encouraged Monday morning when she looked slightly better.  I figured everyday she could manage gave here liver a chance to recover from the INH insult.  Yesterday morning Elizabeth lost her fight and left a grieving family trying to understand why someone so young was no longer with them.  Elizabeth, like so many people here, endured a terrible illness with great dignity.  She and her family remain in our prayers today.

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