Today started with a two-hour drive to Tabo, India, to hold a clinic in the local outpatient center. We began the day with a knee arthrocentesis in an 18-year-old gentleman who had fallen off his bike and had persistent knee swelling.

Upon treatment, he felt better almost immediately. We then proceeded with seeing several other interesting patients, including an elderly woman with a mass over her left eye who had been treated with steroids a year ago. The treatment led to improvement, but the condition recurred after she stopped taking the steroids. She hadn’t sought medical attention since, because she was reluctant to make the over 10-hour trip to see a specialist and get a CT scan of her face.

We also saw a six-year-old girl with a very loud murmur, which turned out to be a restrictive ventricular septal defect on echo. Several of my students became very proficient at doing echoes.

I later saw a 48-year-old man who gave a concerning story indicating aortopathy and from a suprasternal notch view we had a good sense that he may have had some significant ascending aortic dilation. We instructed him to make the 20-hour trip to Shimla, India, for further specialty care in cardiology.

Finally, I got an opportunity to troubleshoot some of the issues I’ve had with the iStat machine to see if we can get enough blood from a finger stick to run the tests.

I spoke with the phlebotomist at the clinic and he provided me with the capillary tubes needed to obtain a sufficient blood sample using a finger stick. We ran a few lab tests today, but unfortunately could not figure out how to make it work to obtain sufficient blood from one finger stick. If anyone has any ideas, please let me know!

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