Monday, July 4, 2011

Cerebral Malaria in the village

We are praising God for Ledipena's recovery.


Tuesday the wife of Endiles start seizing up from severe cerebral malaria at 0530. The seizures grew bad, she was unresponsive, very hot and with labored breathing (it was her 3rd day of sickness at that point and the second day of no food or drink).

We live in a very remote region: We found out there was no heli, and the floatplane is in inspection and the nearest is 2 days downriver, and the weather was rain. So, no way to evac! And she wasn't stable enough to tolerate the travel. We felt very trapped.

We started an IV and infused the WHO Standard high loading dose for severe cerebral malaria. For tuesday and Wednesday her breathing was labored and she had many seizures it looked several times as if she was beginning to decompensate and die.

At one point her breathing was becoming more and more labored and her seizures were very frequent and we thought she was dying. I exited the room and told Teresa that the lady was beginning to breath her last - but then the Dani evangelists gathered and prayed... and her breathing actually normalized again as they prayed. Amazing.

Early wednesday morning we ran out of IV quinine and fluids. And this at a very critical time.

NOTE: We have enough meds for most cases of most things, and we had enough iv quinine and fluids to stabilize a patient and get them out to Wamena....but not enough meds to keep and treat a critical patient totally for an extended length of time in the village. So, we were prepared. But it was bad timing to try to medivac a patient from Danowage with no heli or floatplane.

MAF air-dropped the meds (flew low over the village and pushed out the padded boxes containing meds - only 2 iv bottles broke but the rest of the meds were recovered intact). This allowed us to continue the quinine dosing and IV fluids (she was severely dehydrated when he found her). We tried an NG tube to deliver meds another route, but too many seizures and she reacted violently.


She is now improving!

Thursday the seizures decreased and we were able to put down a nasogastric tube to start feeding her and to open up the possibility of giving other meds besides just Intramuscular injections and Intravenous IV meds.

Friday morning she began to improve, follow us with her eyes. Then she began to cry for her children. Then talk a few words. We continued iv fluids, meds and oralit and oatmeal through the ng tube.

Now she appears to be recovering. Her mental functioning is slowly coming back.

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