he's known

Let me tell you about my day...

On Friday, I arose early, before Chad and even before Nede! She, my trainee, had spent the night so we'd be ready. Ready to take "our little guy" to the hospital for his echocardiogram. For 10 days I had been elated that I had gotten a doctor to order an echocardiogram. I had high hopes that he'd then be put on some medications in which would slow his little heart and give him a bit more energy and strength.

We arrived just past 8 and were told the doctor would be there at 10 to do the test. Okay, annoying but I'll wait. In the meantime we chatted, He drew, we sang, I spoke to the "administrator" of the sonography section of the hospital, etc. The time passed.

Nearer to 11 the doctor arrived-- the pediatric doctor. She called me in to kindly inform me that they "don't do echocardiograms here", we'd need to be transferred to Beira where there is a specialist.  Nearly 4 hours away, depending on the enormity of the potholes, would we really have to do this? And, more importantly, what would it be worth? If we find he has cardiac condition needing surgery which is absolutely unavailable, it's not worth it. If we find he needs chronic medications? What if they're unavailable in this country?

What are my palliative care goals for this "little guy" of mine?

With much disappointment in knowing I'm not going to get the medical clarity that I had hoped for, I was in fact pleased that we weren't sent away. Instead, two doctors collaborated and opted for a repeat chest xray (to compare the enlargement of his heart to the one on record from last year). Fair enough-- we were sent off to xray this little chest. The poor, sweet thing had obviously been in this dark, cold room before as he was wiggling out of his shirt before the command was given. Much to my horror, in order to get this shot taken I had to elevate this nearly 40# kiddo by holding his hands extending straight above his head and lifting him up in the air with his back pressed against the back of the xray machine. With my arms trembling and wondering what sort of exposure this was having on my unprotected body, I prayed it would be over quickly before I dropped him and lost the chance for the 1 diagnostic available to us. Phew, we did it!

Much to our delight his lungs have cleared of tuberculosis and his heart has significantly decreased in size! Praise be to God.

Even though I still have unanswered questions regarding this child's health, we celebrate the small things here. But, as I think about it, maybe they aren't small at all. In the 1 year of knowing this child he's gone from SEVERE malnutrition, tuberculosis and weakness (where he couldn't even walk) to now gaining weight, clear of TB, his heart is miraculously diminished in size. I can't explain these things with or without medical diagnoses but perhaps the greatest palliative measure for my "little guy" is that he now knows he's known. We sat with him for nearly 7 hours because we care. And that my friends, may just be what is curing this one little heart!