Today is National (actually, I think it is International) Women's Day -- "Journée de la femme" as they say here in Mali. Special cloth is made to commemorate important days -- people will have outfits made out of the same cloth and wear it as a sign of solidarity. And "Journée de la femme" made the cut with it's own special purple and yellow cloth displaying the logo of a woman and child and March 8, 2011.
So, happy day to all you "Femmes" out there!
Gracie and I sitting in the lady's section at church Sunday.
Ladies waiting for clinic visits at the hospital.
We saw another sad (although very interesting) case today in clinic. A little girl (10 years old or so) returned with her family. We saw her about 3 weeks ago for right arm weakness and a mass around her right shoulder blade. She went home with ibuprofen and instructions to return in 1 week. It was only after numerous phone calls (yes, many folks here have cell phones -- or at least friends/family with one) that she finally returned to clinic 3 weeks later.
They said she got “better” with the ibuprofen so they didn’t come back. What our exam showed though was no where near better -- unfortunately it was quite worse. She can no longer move her legs, she cannot stand. In fact she can only sit upright if she props herself up using her left arm. Her right arm remains weak. The “swelling” around her right shoulder blade did seem better -- but now she has a fullness in the front of her neck on the right side.
After seeing her on the first visit, we put our heads together trying to figure out what was causing her symptoms. We were suspicious for a brachial plexis (bundle of nerves that innervate the arm/hand) tumor or rhabdomysarcoma (muscle tumor). We were eager to see her in follow-up (which is why we kept calling and asking for them to return) -- but today it was very sad to see how much worse her condition has become.
Most likely it is some sort of aggressive cancer. What type? How we wish we knew. Without imaging it is nearly impossible to determine the source of her “mass” and evaluate her spinal cord. Her symptoms suggest that her spinal cord is being compressed. This makes us suspicious that she has a tumor originating from a nerve (or nerve sheath). Our initial concern for an aggressive rhabdomyosarcoma also remains a possibility.
So what is the plan? Well, we are going to start empiric chemotherapy to see if she has any improvement in her symptoms. Also, in an effort to make a definitive diagnosis, Dean and Jason took her to the Bloc (OR) and did a muscle biopsy from the right shoulder (thickest area of the "swelling"). During surgery things looked normal (at least to the naked eye) -- but they didn’t want to probe too far into this area and definitely didn’t want to venture into the neck (other area of “swelling”) with no one of more surgical expertise present and no image or idea of what was beneath. Dean and I will take the muscle sample back to the U.S. where a pathologist will look to see if there are any abnormal cells present.
And we will pray. Pray for God’s healing and His comfort, for guidance and discernment.
Please pray along with us for Sanata and her family during this time of uncertainty.
DD&G
Praying for your safe return.
ReplyDeleteLove, Papa Jeff