So what is your diagnosis then?
No necrosis evident. Good profusion at the site of the injury but poor profusion and water retention in lower extremities. Doc fired off a battery of tests but I'm out of the loop there. Smells like he's sleuthing for latent chronic.
We are happy to hear your perspectives, experiences, and we would love to learn from your encounters to adjust our own care, perceptions or whatever....however, it is imperative that you present it in a professional manner for that bonus learning to occur.
I would ask tolerance as well s extend apologies if needed.
It is difficult for much of the medical world to grasp 3rd world medical practice where the hierarchy chain often doesn't exist. Well over half the people I encounter have limited or no access to medical care. Between extremely poor education standards, or no education at all - as my mother in law, for those who are at or below poverty level with basic health care there is usually a queue starting around 03:00, and there are thousands, tens of thousands of stateless people who risk deportation, getting locked up in refugee camps, or press ganged into illegal logging that simply have no access to medical care at all. The governments could not care less about those people. They are cheap labor if they stay in line and healthy, nothing more.
So the NGOs enter the picture. And other stop gaps like field health care workers who often can't send the patients to a regular hospital and deal directly with the physicians who often offer advice and sometimes medication gratis.
It's a major jump shift from the medical world I knew in the States. A whole heck of a lot of free form thinking on your feet and working out how to get a person medical care without trying to get them into a system that doesn't want them. And people like me cultivate relationships with certain doctors out of necessity both ways. These docs aren't in it for the money obviously. They want to provide care and often throw niceties and even the book out the window.
So what I mentioned about my doc being angry was an understatement. He doesn't just go through the motions. His patients aren't on an assembly line*. He doesn't get perks for pushing meds or specialist diagnostics. And he, and the numerous others with the same mentality appreciate the efforts of people in the field so they can make the connections and often make a real difference.
Take that gal in my other post Alternative EMT stuff. Probable CVA. She's hill tribe. Non citizen. Ice cubes chance in hell she will ever get a scan and diagnosis. That would probably be a years wages. Dozens and dozens of people who need diagnostics and treatment that will never happen. Got HIV? Tough. You can't afford medication. Renal issues? Better hope you won't need a kidney transplant. Amputations? Get by without that part. And on and on and on.
*And that doc, also being an entomologist, knows that for every medically significant spider bite there are several thousand more likely causes. There are only around 10 species of spider that even possess medically significant venom and around 5 that can cause necrosis. Paraphrasing him: "Diagnosing a spider bite without seeing and identifying the spider is like diagnosing a gunshot wound without finding the bullet or having an exit wound".
