Today was our last day of clinics for this year in Honduras, and the Pediatric Medial and Dental Teams spent it in Camalote-Tampuca. It is hard to believe that the week is already done, and we will be flying back to Canada to return to our day jobs on Monday!
The Dental Team, as always, was very busy with extractions, atraumatic restorative treatment (ART), preventative treatment, and tooth brushing education.
One patient, a young girl, particularly needed a lot of dental treatment. The dental clinic was having a rare quiet moment so we were able to offer her more comprehensive treatment.
We started by providing ART fillings with glass ionomer to both of her lower primary second molars. She had carious lesions on these teeth that needed to be filled. Her upper anterior teeth were also carious but not yet cavitated. We wanted to prevent further decay so we treated these teeth with silver nitrate to arrest the caries, and then gave fluoride to assist the remineralization of the enamel. She also had retained roots of her upper first primary molars. These roots were decayed and infected. We were able to remove these root tips from her maxilla to prevent further infection and disease.
Meanwhile in the Pediatric Medical Clinic, 118 patients were seen. There were many cases of skin infection, such as scabies and impetigo that kept the team busy. We also had our second instance in the week of a child presenting with undiagnosed Down Syndrome. These conversations are always difficult, because often the parents hope their child will get better, or that there is a cure. However, as this is a genetic syndrome, it is very important for these families to understand that their child will always have some differences, but that there are ways to support them and their development going forward.
The Rehab Team changed their pace today and did three home visits instead of clinic at CRILE. This was a much needed service to these families who were unable to bring their complex-needs children to CRILE.
The first child we saw was Moses, an 11 year old young man with cerebral palsy, who suffered a secondary brain injury after a severe respiratory infection. He lived in a house with his very caring mother and three siblings. As swallowing is difficult for Moses, he cannot eat solid foods, so Mom has been using formula only for his nutrition. During our assessment, Ashley (OT) was able to educate Mom on how to thicken his formula to reduce his risk of aspiration; Moses responded very well to this change and we were able to see him swallow well!!
We also souped up his wheelchair, so it was more comfortable and safe for him. Dr. Klein provided some insight onto medication on that could make him for comfortable as well. We are optimistic that the changes we were able to provide will help Moses have an improved quality of life, and hopefully keep him safely out of hospital.
Our second patient, Cesar, was a lovely and very smily 3 year old boy also with cerebral palsy. He did not have a wheelchair yet, but we were able to build him a seat with more appropriate positioning for him! This way he will be able to keep his head up and interact with his environment and his family more when he's in an upright position. He also has some rigidity, so we provided him with some AFOs to help maintain his range of motion.
Our last patient, Daniel, was an extremely active 8 year old boy with choreiform movements (non-purposeful rhythmic movements). We think he had these movements secondary to a brain insult in the peripartum period. His twin brother is healthy, and unaffected. Daniel also had a wheelchair, but because of his constant movements while he's awake, it is difficult for him to stay in his chair. Ashley and Sharon's skill with improving and making seating for patients has gotten so good over the course of the week, that we think Daniel's chair may be the best one yet! We were also able to provide the family with an exercise ball so he can continue working on his exercises at home (and we knew he already loved the ball because of his previous sessions with the physiotherapist at CRILE!).