Medi-Clinic Day 4

Today I began my day doing rounds with Vandghie Badenhorst, who is the main dietician and one of the women at the morning meeting on day one. We began by going into the NICU (Neonatal Intensive Care Unit) and checking on the premature babies. Vandghie taught me the risks of giving formula feed to premature babies as opposed to breast milk. Premature babies are at a greater risk for developing Nectrotizing Enterocolitis; when a child is born prematurely, the blood primarily goes to the more essential organs, such as the heart and the liver. The stomach can sometimes be bypassed, and this results in the low oxygenation of the digestive system. If this is prolonged, part of your gut can die, thus resulting in Nectrotizing Enterocolitis. If this happens, the formula feed should not be given to an infant because it is much harder to digest than breast milk. I also learned about Short Bowl Syndrome, which is when part of the digestive system is removed because it has died, which can result in the digestive system no longer being long enough. This can cause malabsorption. After being in the NICU, we went into the pediatric care unit and checked on some patients there.
After finishing rounds with Vandghie, I met with Anna-Marie and checked on the women I have been checking on for the past few days now (the women with the leaking TPN), who had finally been moved to the Medi-Clinic. She was awake and seemed to be doing very well. She showed us the injection site of the tube, which was pretty interesting to see!
We then drove to one of the out patient facilities and met with a new patient. The patient was diagnosed with HIV and TB. He was very weak and we had to help him up so that he could stand on the scale to be weighed. He has been losing weight rapidly, so Anna-Marie put him on a regular solid foods diet with extra protein at each meal.

We concluded the day by going to the private sector of the Universitas Hospital and seeing the patient (the man with renal failure) that we have been visiting this past week. We checked on him quickly and he seemed to be doing fine and the nurses have been following his feeding plan. I never did actually speak to him, though, because every time I saw him he was asleep. The Medi-Clinic was awesome and I am very sad that today marked the halfway point of my internship :(