Tuesday, March 11, 2008

Another Death...

Things sure do get personal here in Honduras. I mean, I know its all about building relationships here, but that makes it so much harder when things go bad.

A 22 year old lady named Keylin has tetralogy of fallot. For the nonmedical among you that is a combination of several severe heart defects. Keylin was one of my first patients when I was on call here. She about scared me to death because she was so hypoxic and then I nearly put her into pulmonary edema trying to rehydrate her. (some of you may have heard of that crazy call night) Anyway, I've known her since the second week of my stay here. Turns out she was pregnant. That is most often a death sentence for a person with her heart condition and we doubted if she would even make it half way through her pregnancy. However, even in that hypoxic state, her baby miraculously grew and her heart tolerated the stress of pregnancy. She was having preterm contractions at about 30 weeks and after many hours of hard work, Leon (our cardiologist) and John (nurse midwife) got her into the hospital in the large city of San Pedro Sula. She has been cared for there and received nearly weekly visits from John and his wife, Penny. Somehow, she made it to term and delivered a healthy baby boy. That is amazing considering her condition!!! We were all so excited. Then this morning I saw Penny crying in the hall. Keylin died early this morning just three days after delivering her baby. We don't know all the details yet, but with her heart condition she most likely had a pulmonary embolus.

It is just crazy. We never thought she would make it through her pregnancy but she did. We thought for sure the baby would not grow in that hypoxic environment, but he did. We all breathed a sigh of relief when the baby was finally delivered and all was well. Now our breath is taken away at the shock that she has died.

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