more interesting cases

So we have had a couple of interesting cases this week. We had a military fire truck crash into a drainage ditch (I am working on getting pictures) when trying to avoid a local cutting them off. This resulted in one of the Marines smashing his left orbit into the dashboard. He was seen at the hospital and sutured up, but followed up to me the next day. His left eye was swollen shut except for a slit and was a deep purple. That was not the interesting part. He had hypesthesia (decreased or lack of sensation) of his left cheek, left upper lip and left gum. He also had a ptosis (drooping) of left upper lip. This was worrisome for a possible orbital fracture with infrorbital nerve entrapment. So I sent him to the hospital for an orbital CT and sure enough he has 3 orbital fractures.

The second case was a female Marine complaining of constipation and feeling of gurgling in stomach. She had also had some nausea some weeks prior. She has been working out like crazy out here and had been on a supplement allowing her to lose 35 pounds. She was convinced that she had worms. She does have a parasite of sorts…..a baby! When I palpated her belly the belly started to palpate me back. She has a fundal height (way of measuring the pregnant uterus) of 20cm. I figure her to be about 20+ weeks pregnant. Oh, she had a positive pregnancy test too. In case you are wondering, we have been gone about 18 weeks, so her pregnancy is legit.

I also had a pediatric consult today. I got a call from a satellite base about a local national 3 day infant boy who has not yet urinated. Feeding fine, no jaundice, consolable, but no pee-pee. I am worried about kidney problems (not making pee-pee) or posterior urethral valves (blocking pee-pee). Anyhow, we arranged for a helicopter to transport the kiddo to an Afghanistan referral hospital. I was about to instruct the GMO over the phone on how to do a suprapubic tap (sticking a needle through the lower belly into the bladder) had we not been able to get the transport.


Transport vehicle for the squadron. Yes, it is an old school bus.

My swing is looking good. I found 3 golf clubs. My mom and Liz sent out a peice of carpet and practice balls.

I was happy to see this small patch of greenery. This is the first green I have seen out here besides the color of uniforms.