House call in a Hurricane

The skies have opened up today and the rain won’t stop. We were forewarned that Hurricane Sandy would be paying us a visit, and I wasn’t sure exactly what to expect. I work early on to the sound of rain. Just when I thought to myself that it was the hardest I have ever seen rain pound the earth – it rained harder.

            We spent the day organizing medicines, and teaching English to the eager students. Not as easy as I thought it would be – since I know enough Creole to say please and thank you – helping them translate common phrases is not easy. I go with pictures and actions, and we had a fun morning. In the afternoon, Matt and I debated how to go about making a house call we promised a patient the day prior. A 37-year-old woman came to clinic, carried by her husband. She is unable to walk, and while the story changed several times, it is apparent this started in the last year. She also reports double vision, and leg pain. Medical professionals– help us out here.  We argued back and forth over the differential, in the end I won him over. We’re going with burst and taper of prednisone, if it MS (2 deficits separated by space and time) or polymyositis (lower extremity proximal muscle weakness was the most prominent feature), we might see some relief in a week.

            The roads were rivers, and we stopped even watching where we stepped because there was no avoiding the swampy mess. Luckily the day we left, Lynn equipped us with some rain ponchos, so at least our chests and shoulders were dry. It was actually pretty run running and sliding around. If the medicine doesn’t help her, at least she will get a kick out of us sliding into home at her doorstep. We finally get to her house, and she lives in what looks to me like a doghouse.  She’s got a straw mat on the floor, water and a candle at her side, and most importantly - shelter from the storm. Not a bad gig, all things considered. She is ecstatic to see us. Again – we have few words for communication, but she takes the 60 mg of prednisone we haggled from the nearby pharmacy. We agreed physical therapy would be important, and the only real way to teach her was to sit alongside her on the floor, in the candlelight, and teach basic strengthening for core and quads. I hope future blog posts bring good news about her prognosis, for now – we’re placing our faith in prednisone and prayers.