We've got scanners, yes we do! We've got scanners, how about you? Oh. You don't?

Short post today...

So we have a patient who is 6 years old with intractable (incurable) seizures. When I say intractable, however, I mean that we've only tried three medicines. These are the only medicines we have. My job today was to write a letter to a stranger in the US who might be able to send us some Keppra. Because we don't have in. In ALL of Nicaragua.

My patient's symptoms consist of morning headache, seizure and ataxia (wobbliness). These symptoms are terrifying for physicians because they may herald the diagnosis of a brain tumor. Does she have one? We don't know. Why don't we know? Because the CT scanner is down this week and won't be available until next week. MRI? It's in Managua.

I was asked the other day if my hospital in the US had a CT scanner and the only thing I could say was yes. There was no way I could tell my new friends that not only do we have CT scanners but we have a LOT of them. And a lot of MRI machines too.