U.S. Air Force Major Brian T. Allenbrandt, M.D. was telling us about meeting a 70-year-old man with rather large hands. Shaking the man's hand, he said, he'd noticed it felt “doughy,” and his fingers were larger than most. The man confessed his shoe size and ring size had both increased steadily over the past 10 years. Allenbrandt took in the information, listening to the guttural quality of the man's voice as he spoke. Things started adding up. The man had never been given a diagnosis before, but Allenbrandt was able to give him an answer as to why he had been growing in size: he had Acromegaly.
The case was one of many presented at grand rounds while sailing from Ecuador to Colombia.
HOPE volunteers sat in on a variety of lectures on topics such as dentistry, endocrinology, diet and nutrition, and dermatology. The talks are given by doctors who either educate on a particular topic or share information about unique cases they came across while in the field. Opening this flow of dialogue gives other physicians from the military or NGOs a heads up about certain conditions they may see.
One of the cases in Ecuador that HOPE volunteer Faye Pyles came across while screening patients in pediatrics was discussed. Pyles had seen two brothers, ages 14 and 16, who had Lamellar Ichthyosis. The condition leaves the patient with scaly, dry skin, everted eyelids, and recurrent infections. Both boys were there to be seen for colds. A rare genetic condition that occurs about 1 in every 600,000, there turned out to be a community of 38 people with the disease in Ecuador.
While the majority of these unusual cases aren't curable, it's beneficial for the Continuing Promise doctors to be aware of the conditions they may encounter at the medical screening sites.
“For someone who's new at interviewing or obtaining information, hearing the process of coming to a diagnosis itself can be helpful,” Pediatric Nurse Faye Pyles said. “If you hear that process enough it becomes more automatic for [new physicians]. So the most senior specialist, through their knowledge base, has expanded their capabilities for everyone.”
The exchange of information at the grand rounds is also beneficial to future patients.
“Part of the reason you have these missions is for training,” Pyles said. “The specialists are here to give us the more finite details of how to take care of the special cases or what we can offer the patients in an austere setting. We can provide advice on how to take care of the patient's skin, for example. The whole idea is, you share that knowledge.”
As the discussions wrapped up, the USNS Comfort reached the coast of Tumaco, Colombia. A whole new round of surgical and medical screenings begins tomorrow.
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