Day 113: Retention to Relief

...more specifically, urinary retention. Today, I had a very interesting patient case. He's a 21 year old, Afghan Army soldier who had been able to urinate for over 12 hours. He came to the clinic complaining of excruciating suprapubic pain along with an insatiable urge to pee:( Poor guy! After discussing the case and reviewing the history with the medical officer on call, we went ahead and attempted a foley catheter placement to empty out his bladder...multiple times.

You are all probably wondering what can cause this problem...I'm no urologist, but I could come up with a few possible causes for his issue. Foreign body (ouch!), drugs (Decongestants are notorious), or meatal/urethral stenosis (small caliber "plumbing"). Large prostates can also be the culprit, but not in 21 year old males so I spared him the rectal exam. Lucky me!


After discussing the possibilities with the duty officer, we went ahead and did a physical exam (PE's are an uncommon occurrence with the Afghan docs). I'll spare you the pictures, but what I found was a very narrow meatus (pee pee hole) which made it near impossible for me to place any of the catheters we had available (they were all too large in diameter). We ended up sending him to a nearby US hospital who had the equipment for this type of issue. As you can see from the picture above, he was good-to-go in no time! Today, we transferred him to Kabul to see the urologist. Hopefully, they will offer him some permanent relief...

"Comfort, yes, comfort My people!
Says your God." Isaiah 40:1 NKJV

Day 94: Hearts and Minds

One of the token phrases that is often used to describe our mission here in Afghanistan is to "win the hearts and minds" of the Afghan people. The war out here is not just about bombs and bullets, but also about gaining the trust of the local nationals in our presence in their country. Many locals are still "on the fence" when it comes to trusting the abilities of the Coalition and Afghan National Army forces to protect them. Many of them are convinced (or threatened) that trusting the Taliban is the more viable option for the safety of their families. Sounds like a no-brainer right? Americans good...Taliban bad.

For decades, Afghanistan has only known war and well...more war. From the Soviet Union to the Taliban, Afghans have protected their way of life through violence and warfare, and they have learned that they can depend on no one else except themselves.

So what will be my small contribution to the mission? My goal is to produce as many smiles, to shake as many hands, to distribute as many blankets, to build as many genuine relationships, and to impart as much knowledge as I can, with the abilities that God has given me, to win those precious "hearts and minds".


Here are some of the cases I had in the free clinic today...

Farmer with persistent shoulder pain. Diagnosis: rotator cuff tendinitis


A cute Afghan girl who is so good at saying "ahhhh"!

Long history of knee pain. Diagnosis: Mild Osteoarthritis


" 'Comfort, O comfort My people', says your God...A voice is calling, 'Clear the way of the Lord in the wilderness; make smooth in the desert a highway for our God. Let every valley be lifted up, and every mountain and hill made low; and let the rough ground become a plain, and the rugged terrain a broad valley; then the glory of the Lord will be revealed."
Isaiah 40:1,3-5 NASB