Although we had been prepared for what was to come, I will have to admit that the experience at National Center for Maternal and Child Health was both eye opening and rewarding.
To start our morning we make our way through the traffic, honking horns, broken sidewalks and dusty construction. Once we arrive, we meet the oncology team to discuss new patients and events that occurred overnight prior to making rounds. Dr. Sandler, I think they missed you; I tried my best to fill your shoes. Although some physicians were on vacation, we were fortunate enough to have Degi, a fairly new oncologist, and Oyunaa, a pediatric resident, as part of our medical team who were able to translate. Rita was also there ready and able to help as well, for which we are truly grateful.
On our first day we rounded on every patient on the oncology floor. A very full floor we must say. There must have been 15 patients in house. There were plenty of teaching opportunities and discussion. Diagnoses included predominately ALL, but also AML, Histicysosis, Aplastic Anemia and a few Lymphomas. The available chemotherapy drugs sound much better than years past, thanks in part to our previous teams’ recommendations. However, there is more work to be done as it was quite heartbreaking seeing so many Leukemic relapses.
With three to four patients in a room at times, it made no difference that there was no air conditioning – these children are so adorable and loving and quickly warmed up to Alex and John. It was truly a heartwarming experience.
Thanks to Dr. Sandler’s initiatives, I do believe that Hepatitis C PCR testing is under development. On a bright note we were able to tour a new oncology building to be completed this fall. The 2015 team should be quite impressed: Oncology alone will occupy 3 floors. The cardiac cath lab will be located on the first floor.
Our laboratory tour was quite impressive and afforded me the opportunity to view slides of a newly diagnosed patient. I was excited to learn that flow cytometry is now available, at least on peripheral blood. Acute Leukemia is now accurately diagnosed as pre-B ALL, T-cell ALL and AML. A future goal might include the ability to perform Methotrexate levels so that high dose Methotrexate can be delivered.
Lots of oncology, but hematology was not to be denied. On day two I met an adorable little girl with 1% factor VIII, on weekly Advate prophylaxis! However, we did learn that recombinant factor is in short supply and what a dream it would be for our Hemophilia Treatment Center (HTC) would be to “Twin” with Mongolia. Missy, are you ready?
The medical team remained eager to learn, always asking appropriate questions and very receptive to our input. It has been an amazing week, such wonderful people to work with. I hope we can continue our Mongolian working relationship.