Tuesday, October 11, 2011

Concrete?

Call me crazy but concrete is not meant for vaginas. Yet tonight that is what I saw. My brain is having a hard time registering this information. I’m honestly baffled.

Let me explain.

Earlier tonight, Tom called for a consult saying one of my old patients was back complaining of something hard prolapsing from her vagina. He investigated and quickly determined he needed a second opinion and gathered the troops.

As I walked with him  toward the clinic (the rest followed a few minutes later) he told me that she was the girl that had the prolapsed hand that miscarried. I couldn’t tell if he was talking about the girl with the incompetent cervix or Biyana. But either way, I’d find out soon enough.

I walked in to see Biyana writhing in pain as one of our health workers finished giving her antibiotics intramuscularly.

Biyana? It’s not possible. I just saw her a few days ago. She was fine. She would have told me if there was something prolapsing then. What was going on?

Donning gloves, I investigated for myself.

Tom was right. A hard, white mass was protruding; it looked like a prolapsing cervix made of concrete.

What in the world?

After the others arrived, we tried to determine what it could be. Tom suggested it was some calcified foreign object possibly left in after her cesarean. I’m inclined to agree.

Perhaps a tampon of some kind? Maybe a strip of gauze?
    --But what if it is her cervix? No... that doesn’t make sense.

Tom reached in and said it’s long, round, and the length of a finger. He tried to remove it but failed. Dennis also examined her. He also failed to dislodge it.

Apparently, the object is firmly attached to the left vaginal wall. They cannot remove it without causing her a great deal of pain and possible bleeding.

Admittedly, I’m at a loss for words. How do we help?

I’m concerned this will have a negative effect on her getting her fistula repaired in a few months. Please pray for her. This is just one more challenge in an already difficult journey.

We’ve started her on antibiotics for an infection that has developed. But tomorrow we refer her (once again) to Wau.

Pray for wisdom for the doctors and healing for her body. Perhaps she’ll somehow get her fistula repaired early. Perhaps.

Pray for her. Thanks.

To understand her background better please read here, here, here and here. Thanks.