Clinic: November 17 & 18, 2014

November 17,2014

This morning we had an amazing breakfast cooked by Luh!  There was a delicious spread of bread, purple potatoes, eggs, corn cake, fresh fruit, tapioca rolls, and fruit juice.  So good!

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We met Rildo, the audiologist, this morning.  He is extremely nice and has been great to work with!  He gave us a quick tour of the clinic, and then we started seeing patients at 8:30.  We were a bit slow today as we are still figuring out the flow of the clinic and where everything is.  We saw 3 patients in the morning, and 5 patients in the afternoon.

We had a patient today who reported symptoms that sounded like Benign Positional Paroxysmal Vertigo (BPPV), so we decided to do Dix Hallpike on the table in the extra clinic room.  The patient was a little nervous, but we reassured her that we were right there if she started feeling dizzy.  The Dix Hallpike was negative so we continued testing.  After gaining further information, it seems like she may have Meniere’s Disease.  She has roaring tinnitus, episodes of dizziness, aural fullness, and low frequency hearing loss.  We counseled her about the possibility of Meniere’s and encouraged her to see and ENT for these symptoms.

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Another patient we had today reported that his hearing aid was knocked off when he was hunting and was attacked by an animal!  I have not heard that before in clinic; however, I have seen a hearing aid that has been chewed up by a dog.  We were able to fit him with another hearing aid.  It was great to be able give him another hearing aid right away!  It is wonderful what this clinic does for the people of Parintin’s.  Our patient was extremely appreciative.

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One patient we saw today was more difficult.  He was an older man who had a stroke a number of years ago.  His daughter was the one that brought him in and she was worried about his hearing.  He had severe dementia and was not able to follow directions.  For this reason, we were unable to test him in the booth.  Unfortunately, we didn’t have otoacoustic emissions (OAEs) or auditory brainstem response (ABR) to objectively test his hearing.  However, when we were talking to him in a quiet room he was able to answer some questions.  We think that the main issue with his communication is likely due to the stroke.  We encouraged the daughter to see a physician regarding the stroke and resulting cognitive issues, or to pursue objective testing if she is worried about his hearing.

Midday we took a break to have lunch cooked by Luh.  Once again, it was amazingly delicious.  We had fish!  We named him Fred.  Luh also made us a very yummy lime desert with welcome written on it.  We indeed feel very welcome!

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Dinner was even better than breakfast and lunch if that’s possible.  We had fish pie and another delicious desert.  I love eating and visiting with everyone.  It’s a great way to start and end the day!

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November 18, 2014

Davison is the perfect translator!  He speaks Portuguese, English, French, Italian, Spanish, a tribal language, and Brazilian Sign Language!  That’s right, Brazilian Sign Language.  So there are times in clinic when he is speaking three different languages.  He has been so wonderful.  We would be lost without him.  He’s been teaching us some Portuguese phrases.  I tried one out this morning at breakfast, I’m hungry.  Luh and Vanessa thought my accent was cute/funny.  They laughed a lot haha.  There was cold chocolate (chocolate milk) this morning, very good, and Luh made Dr. Bondurant some pineapple juice since she doesn’t like mango juice.  Very sweet.  I’m thinking about smuggling Luh home with me in my suitcase.  Her food is amazingly good!

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We saw 4 patients in the morning and 4 after lunch.  3 patients this morning had skull fractures, and 2 were in comas!  I’ve never had so many patients with skull fractures.  It was a busy and productive morning.

Our most interesting patient of the day had to be the man who said he had a cockroach in his ear.  He said that while he was working, a cockroach crawled into his ear and that he pulled off one of it’s legs trying to get it out.  Dr. Bondurant bravely took the first look, but alas, there was no cockroach.  The patient didn’t quite believe us.  He noted that the ear canal is quite curvy and asked if it was possible for the cockroach to be hiding behind one of those curves.  We assured him that we were looking at his eardrum and there was nowhere for the cockroach to hide.

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We had two patients who were blind today as well.  One woman became blind after a surgeon accidentally operated on the wrong eye!  She was 90 years old and extremely sharp.  After we fit her with hearing aids, Rildo was counseling the patient and her daughter on care and maintenance.  The daughter couldn’t remember how to tell the difference between the right and left hearing aid.  Her mother said, “Right red, left blue.”  It was a great moment knowing that the patient would be able to use and take care of her hearing aids independently.

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The other patient was an older man who was accompanied by his friend.  His friend reported that he was not able to answer questions very well or follow directions.  The friend stated that he would talk randomly about memories or things he liked to do such as fishing.  We were able to get Speech Reception Thresholds in both ears with Davison’s help.  We decided that we would have him come back another day to fit him with a low-gain hearing aid on the better ear to see how he does with it.

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It has been wonderful working in the clinic so far.  Rildo, Dr. Bondurant, Davison, and I make a great team!  And of course Vanessa and Luh are instrumental in helping the clinic run smoothly!  I love it here!

 

 

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