Roseola

Athan is now in the rash stage of an infection called Roseola.
This is a viral illness affecting children between the ages of approximately 6 months and 3 years of age.
The difficult thing about this viral infection is that you are really not sure what is causing the fever until the rash develops – anywhere between 2 and 8 days after the fever starts.
Athan had a fever and was irritable and had some lymphadenopathy, but nothing else to clue us into why he was febrile and irritable.
Then, as is typical, the fever subsided and a characteristic rash appeared.
It is really remarkable as he then had this diffuse rash, so he appeared worse, but the fever and irritability went away.
In a normal scenario, it is somewhat disconcerting to have an irritable child with fever.
Add in the inability to test for meningitis.
Add in further concerns for tropical illnesses – even if we have only been here for a couple of weeks.
We are thankful to God that he is on the mend – now if those mosquito’s would only stop biting!

Ida

Click here for
Ida's projected path

This could get interesting.

Dengue fever

Diagnosed my first two cases of dengue fever yesterday. Seemed indistinguishable from influenza - I wonder how many cases of dengue fever I have missed in Huntsville :).

Per the CDC, dengue fever is characterized by ... "high fever, severe headache, severe pain behind the eyes, joint pain, muscle and bone pain, rash, and mild bleeding (e.g., nose or gums bleed, easy bruising)." It can also be associated with liver test abnormalities (I can order a urinalysis in our lab - one girl had bilirubin in her urine) and a relative bradycardia (ie. patient has a high fever and so an elevated heart rate is expected, but heart rate is often normal).

These two facts and the presence of dengue fever in the area made us think of it.

Treatment is the same except no nsaid's for dengue - I guess in case it progresses to the hemorrhagic type.

Not much difference between influenza and dengue, and malaria for that matter - makes for lots of fun for healthcare workers with limited resources.

Extra DEET for the kids!!

A typical day in Shane's life

4:30a-5:00 – roosters and birds are up – and so am I, on and off
5:30a – sun is up
6:00a–6:45 I am out to run 4-6 miles. I would like to run the Boston Marathon in April and will need to run 20-30 miles/week (regular training would be >50 miles/week) while here to make that worth the effort. My gear (visor, shorts and asics ds trainer’s) is courtesy of FleetFeet.
6:45a-7:00 – stop sweating
7:00a-7:29 – shower, dress, eat. Menu includes pancakes, eggs, peanut butter and toast, bananas, cereal with powdered milk - yum.
7:29a—7:30 – work commute
7:30a-8:00 – singing, bible reading, prayer with office staff. Arturo Ku delivers a short message of good news to waiting patients.
8:00a-noon – Patient care. Some come as far as 2 hours to receive my expertise!
Noon-1:00p – lunch. Our cook, Lucy, makes some local fair for the whole staff. As predicted, it is some form of chicken and rice and beans – but everyday is a variation and every day is very good. Charity and the boys join me for lunch.
1:00p-4 – Afternoon clinic hours.
4p-4:15 – wrestling/karate with my kids
4:15p-5:30 – some sort of afternoon stroll or trip to the local soccer field. The length of the town is 1mile (I know this thanks to my Garmin101) and so it is easy for us to get around on foot.
5:30p-6:30 – Dinner
6:30p-6:35 – I strangle one of my kids
6:35p-7:15 – games (Hudson has gotten quite good at Jenga, Grattan at Perfection), reading, singing, etc.
7:15p-7:20 – I strangle another one of my kids
7:20p-7:45 – showers
7:45p-8:15 – we listen to two chapters from the “Story of the World”
8:15p – bed – eary, very early, but we are up early and lack of A/C just saps you of all energy
11p – I am awakened by something outside – I hope it won’t eat me!

Prayer request

A child who needed the medicine, indocin, died on Saturday. This was a premature baby who had an prenatal artery stay open that was supposed to close - a condition called patent ductus areteriosus (PDA). In utero, this artery shunts blood away from the lungs to the rest of the body - not a problem as the blood is all oxygenated from the Mom. At birth, this artery closes and the blood then goes to the lung as it should. In some infants, this artery stays open and so the blood going to the body does not go to the lungs first - so they get hypoxic, which leads to progressive heart failure.
This condition is fairly treatable in the U.S. with either an I.V. medicine or surgery. Neither of these options are available in Belize - or in most of the world for that matter.
Anyway, we brought some medicine down to close this artery. It was expensive medicine and also time-dependent - ie. the baby needed it within a short time-window or it would not survive.
We were excited to be used by God to be involved in the helping of this child and their family.
We were saddened to hear of the dying of this child, as the timing of our arrival and the ability to get this medicine seemed providential.
God's judgments are unsearchable and His ways past finding out, and so the O'Neill's will trust that He has other things in mind besides the preserving of this one life.
Pray for the parents of this child that they would seek Him amongst their sorrow.

Spanish

I really want to learn more Spanish.
It would definitely aid in taking care of patients in the clinic – usually a family member or office staff can translate, but it is not the same.
It would be helpful to form relationships with neighbors and church members.
But most of all, I would like to learn more Spanish so I could understand the peoples prayers.
Their prayers are earnest, so I wish I knew what they were asking our Father.
They are lengthy, though I don’t get the sense that they contain vein repetitions.
There is also a melodious tone to them, that is music to the ears.
So pray for me that my ability to understand Spanish would increase.

Weather

This is the 10-day forecast.
I am curious to see what critters will be flushed out of their home and into ours!
I am curious to see how Charity deals with five boys being cooped up!
Charity is curious to see how the laundry will dry!