Medical report March 18, 2007

 This has been the most intense week of the expedition from a medical perspective.

Martin has lost 31 lbs and has stabilized at 220-pound mark where we will try to keep him for the rest of the expedition. This means that he will probably need to increase his caloric intake, and keep taking amino acid and vitamin supplements. His BP has been staying in the 130 over 85-90 range with pulse in the 60s.

His newest complain this week has been dermatitis on the back of his scalp which I am treating with steroid creams. The dermatitis on his feet, behind his knees, and in his groin has cleared up.

He has complained of malaise and mental exhaustion, which is helped by the daily cognitive therapy in the evenings. Martin does not have any other complains, nor has he suffered any other injuries thus far.

One of the new team members who recently came on board was complaining of malaise, low energy levels, muscle aches, upset stomach, stomach cramps and decreased appetite.

He was receiving excellent malarial prophylaxis with Malarone, however he did confirm that he drank tap water at the hotel in the morning, and that he had not received all of the required vaccinations for the travel to the Amazon. His symptoms worsened during the day, he also developed fever, chills and a headache. We took him to the local hospital where he was diagnosed with several infections and sent to a inf. Dz clinic in Manaus which cleared him, so he returned to the boat.

I myself became a pt two days ago after going into an anaphylactic shock because of a severe allergic reaction to a drop of esoteric oil on my skin.

When I arrested respiratorily, they took me to the local hospital Jose Mendez in Itacatiara where I got resuscitated with IV epinephrine, corticosteroids, cimetidine, and fluids. Dr. Garcia saved my life and kept me in the surgical intensive care unit overnight. I am feeling much better two days out from this unfortunate event.

Today, I went on a house call in the jungle when a man came to our boat looking for a doctor who could help his daughter that was bleeding out. A 13-yr old fell on a tree stomp and lacerated her groin. Upon examining the patient, I ligated several arteries and repaired her vaginal walls. The procedure took over 2 hours in unsanitary conditions, however I tried to adhere to sterile techniques as much as possible. I strongly recommended that she follow up in the regional hospital in Parentins in a few days.

Other team members have survived the epidemic of the cold and pharyngitis, and are doing well. Re-assessment of their vital functions showed that several gained some weight back after the initial loss at the beginning of the trip. The atmosphere on the boat is jovial, dynamic and open despite the enclosed conditions and proximity. 

Martin today beat one of his own records.  He swam 4095 km so far which beats his longest swim of the Yang Tze river of 4003 km.