Case # 7: Girl with weakness

This girl presented with the chief complaint of weakness especially when she wanted to get up from lying down or squatting. These are her pictures:

The questions are:

1. What are the pathognomonic findings?

2. What is the diagnosis?

Sweat

It’s a hot day today.

I sweat through rounds today. I particularly dislike Mondays as most of the patients would be new admissions over the weekend and (from my experience here) most instructions ordered for already admitted patients on Fridays would generally not be carried out!

Such is the case of a HIV+ man for whom I ordered a CT Brain with contrast on Friday and it still has not been done. Regarding this particular patient, I am a bit miffed with the doctor who treated him at a private medical centre nearby when he first presented 3 months ago with altered behaviour and seizures. The blardy doctor just gave him 2 kinds of antiepileptic and an antipsychotic without investigating why the patient had abnormal behaviour and seizures !!!

To me that is negligence.

Anyway, back to the matter of sweat.

I’m sitting in my room, sweating like a porcine creature because the darn air con compressor died on me. Sigh…

And I can’t go anywhere else to work because I don’t have a notebook. Double sigh…

Mon, 240907 @ 1104

The Black Beauty

It was love at first sight…

Tell you more later…

Burned

My daughter was scalded with hot porridge yesterday. (I would have blogged about this earlier if I still have my notebook…sigh)

I heard a little girl’s scream as I descended the stairs from the sanctuary to the hall below for coffee fellowship after the church service. The menu of the day was porridge (my church is big on eating!). My eyes scanned through the hall only to rest upon the sight of my daughter screaming in great pain. The bowl of boiling hot porridge slipped from someone’s hands and the content spilled all over my daughter’s dress and legs.

Paternal instinct kicked in, I ran down as fast as I could. Next to her were a few adults staring at her in shocked disbelief. Totally immobilized.

I carried my sobbing girl and quickly made for the toilet to douse her with cool water, only to find the door locked (some one was either poo-poo-ing or peeing inside). I turned and carried her into the kitchen and promptly ran cold water onto her scalded legs. Next I scanned her legs to see the extend of the burn. She had first degree burn over the entire right foot, the medial aspect of her right leg and the left ankle. Thankfully, her dress prevented her thigh from being scalded as well.

By now a few church members have followed me into the kitchen. They showed much concern. One poured ice water on her legs, another offered to pour soya sauce, another said cooking oil is best and one mother offered to lather my daughter’s legs with condensed milk. Still another kept saying “Colgate is best”.

I asked for aloe vera and Jonzz managed to get some.

She cried even more when I attempted to apply the aloe vera juice to her wounds.

And then some one suggested this: “I think you should bring her to see a doctor”.

I was about to tell him “But I am a doctor!” (he is new, so I forgive him) when I found myself asking myself, “yeah, why not?”

And off we went to the nearest clinic. SSD cream was applied followed by wet towels soaked in ice cold water. PCM was given. She felt better and stopped crying. (Thanks Dr LC for attending to my kid and not charging me a sen, a true adherer of the Hippocratic Oath indeed).

We got home, she slept. By evening, she was better and there were no evidence that of blisters forming. This morning she had to wear slippers to school because the ’socks hurt her legs’.

I am just thankful to God that it’s over, that it wasn’t any of the other younger (and shorter) kids who might have gotten it worst!

I remember being angry, very angry in fact.

When I thought about it, I was angry mainly with myself because I wasn’t there to serve my girl her porridge. If I had been there, this might not have happened. Instead, I was busy upstairs talking to another church member on ‘which is the best tendon hammer to get and where to get it’!! (her son is a medical student).

I don’t feel angry anymore today, just thankful. And very tired.

Mon, 240907 @ 0816