Here's some of the gang at our Camerican Thanksgiving celebration (four lovely Canadians joined us...think they just like the food since their Thanksgiving was last month).

These were my contributions.  The pies didn't look very pretty but were very tasty!

Interesting medical week.  Interesting in the medical world is not usually a good thing.  Mine was a mix of good and bad.  I had my first diagnosis of Guillan-Barre syndrome.   It's a postinfectious demylenating, ascending peripheral nerve paralysis.  It starts in the legs-paralysis and loss of reflexes and goes up the spinal cord.  The problem is when it reaches the diaphragm and breathing is paralyzed.  In the States people are put on ventilators for breathing support and IVIG can make the healing process faster.  Then it's just waiting several weeks for the nerves to regrow their sheath and work again.  Unfortunately at the little hospital there is no ventilator (unsure if sending her to the UTH in Lusaka would have helped-may not have vent available and the nurses have been on strike all week).  She came in labeled as meningitis but I only saw her that first day.  Friday, the nurse told me she passed away about 3 days later.  

I saw two different preemies.  Each only one day old.  One was born at 28 weeks by dates but looks about 30-31 by exam.  She is doing perfect besides being very small (2 kg).  The other was a little older, about 35 weeks but only 1.2 kg.  She is very pale likely due to a maternal placenta problem.  I tried getting blood for a hemoglobin and possible blood transfusion but failed.  Praying she can turn the corner.  

My other puzzle is why a 10 y/o boy became mostly deaf after being treated for meningitis.  Part of me was very happy to see his progress from last week.  He could only lay in the bed and was moaning.  This week he was up walking around and smiling.  The problem is he appears to not be able to hear anything.  The antibiotics used aren't ototoxic so I'm wondering if it was the meningitis itself.  Hoping the ENT doctor at UTH can help him.  

The last girl I saw in clinic.  She is school-aged, was totally normal until she had a fever and seizures and now has right sided weakness, can't talk, is incontinent, and has limited understanding.  She is so sweet in her disposition.  She made tears come to my eyes as I examined her and she would lay her head on my shoulder or take my hand to her face.  We need wisdom to know the best steps to help her medically and socially.  

In other news, I spent last night and will tonight playing in an orchestra!  I joined the Lusaka music society and we are putting on Handel's Messiah with the choir.  The orchestra is all comers with a neat outreach music program in a small town, Choma, in Southern Province.  It's an outreach of a Christian group there to help teach instruments to nationals.  We may not sound exactly professional (orchestra at least), but we are playing with all our hearts.  I still get goosebumps as everyone stands and we play the Hallelujah Chorus.  He truly is our King!