From Mark today:
"We have been having a great day off. I got up before a late, 730, breakfast and had a quiet time. After breakfast we went into a small once weekly market int he next town and I bought 3 mangos for 8 Limpera. One of which I ate. It was amazing!! They won´t last long.
After the market we headed for the border, where we swam across a small slow moving river into a neighboring country that shall not be named. Very fun. I put on sunblock, but midday sun still got the best of me. Pink face, neck, and arms. So much for waterproof spf 30.
After a quick nap in the hammock overlooking the town, trying to escape the sun and heat, I´m walking into town with some of the staff docs to attend a church service. It promises to be hot as well. I hope there are more tortillas for dinner when we get back. So no, we´re not having too rough of a time of it down here! "
Sunday, April 20, 2008
Saturday, April 19, 2008
PHONE CALL!!!
Hey all!
I was totally surprised this afternoon when my cell phone rang and Mark was on the other end of the line!! He had purchased a calling card and was borrowing a phone from one of the doctors stationed there. He sounds great- relaxed and happy! (In fact, he said when the urge to check work email came over him, he climbed into the hammock and ate a banana!) They had a rather quiet day, and he was headed out for a walk (with lots of water this time) as soon as it cooled off. Tomorrow is a day off for them and sounded like they had some fun activities planned. He also spent some time in the clinica kitchen today learning how to make tortillas from the ladies who run it. By report, it is much harder than it looks, but he was able to pat out and bake a few on his own! I'm hoping for a lesson when he returns.
I'll keep you posted on more emails as they come...
Bess
I was totally surprised this afternoon when my cell phone rang and Mark was on the other end of the line!! He had purchased a calling card and was borrowing a phone from one of the doctors stationed there. He sounds great- relaxed and happy! (In fact, he said when the urge to check work email came over him, he climbed into the hammock and ate a banana!) They had a rather quiet day, and he was headed out for a walk (with lots of water this time) as soon as it cooled off. Tomorrow is a day off for them and sounded like they had some fun activities planned. He also spent some time in the clinica kitchen today learning how to make tortillas from the ladies who run it. By report, it is much harder than it looks, but he was able to pat out and bake a few on his own! I'm hoping for a lesson when he returns.
I'll keep you posted on more emails as they come...
Bess
Clinica
From Mark:
"Today was steady all day, but really never over busy. I was based here in the clinica and saw patients on my own instead of precepting which was fun. I am on call now tonight, so we´ll see what happens. I was not scheduled for tonight, but as no attending was scheduled somehow, I took it. That was so the local docs get a bit of a break while we´re here. They´re pretty much on q3 call when no brigade is hanging out."
"Today was steady all day, but really never over busy. I was based here in the clinica and saw patients on my own instead of precepting which was fun. I am on call now tonight, so we´ll see what happens. I was not scheduled for tonight, but as no attending was scheduled somehow, I took it. That was so the local docs get a bit of a break while we´re here. They´re pretty much on q3 call when no brigade is hanging out."
Thursday, April 17, 2008
Crazy
From Mark this morning
"I've been working on rolling my R's the whole trip but to little avail. One of the interpreters told me to use the word Perro for practice because it positions the tongue forward in the mouth. I wondered what the locals thought of me on my walk. I think it was something like "look at the crazy gringo walking around with no water muttering 'dog, dog, dog, dog'."
"I've been working on rolling my R's the whole trip but to little avail. One of the interpreters told me to use the word Perro for practice because it positions the tongue forward in the mouth. I wondered what the locals thought of me on my walk. I think it was something like "look at the crazy gringo walking around with no water muttering 'dog, dog, dog, dog'."
The long walk
From Mark last night:
Call was uneventful throughout the night. We had one patient come in early in the morning with stomach pain which was concerning given that she had been shipped out 4 days ago for an emergent appendectomy. Concerns for infection, perforated bowel, gallbladder issue that could have previously been misdiagnosed as an appy. After the docs taking the xray themselves, developing the xray in the darkroom, and giving some mild pain meds, the patient recovered over several hours as was able to go home close by.
I did not stay for the xray, but instead, loaded into the back of a pickup, rolled through the cobblestone and paver streets of Santa Lucia out onto rutted dirtroad leading to a school about 40 minutes away but likely only a few miles up into the hills really. We continued our childhood screening and intervention initiative. Thankfully, very few significantly anemic children. Vitamin A, multivitamins with iron, and albendazole deworming was given for all. I went with one child, a resident doctor, and an interpretor to visit the home of one of the children who lived close by and was diagnosed with asthma. We explained the medications and possible contributing factors to the mother, and she agreed to come to the clinic in about 2 weeks. Many homes have a slow burning cooking fire inside the small 1 or 2 room houses, and we have seen a lot of children and adults with respiratory symptoms.
I took along one of the soccer balls and a pump to the school. The boys and a few girls went crazy over it, careening around a school yard that had large rocks, cement blocks, exposed random metal pieces and trash thoughout it. I asked someone to check to see if we had brought along suture material, but amazingly, the boys just dusted off their various falls and kept playing. Whenever I got the ball, they would call¨Marco!Marco!¨ A great time. I left the ball and pump with the school caretaker for judicious use.
This evening, I took my camera and went out to ¨walkaround town¨ I got a Pepsi Light from the tiny cornerstore for 12 limpera, which is about 75 cents, and went walking. My walk took me through the town square about 5 blocks away and then out of the square on aroad Liz Schlaudecker had recommended as heading up to give a good view of the city. My pepsi long gone, I found myself unable to turn around, and an hour later I was about 1000 vertical feet up in the mountains overlooking the city and the valleys beyond, with the volcanoes once again prominent in the background. I passed a wide range of homes, those with a fence and gate, evidence of a pickup in any state of repair, I now find quite elaborate. As I topped the saddle of the ridge, I sat down for a few minutes to soak up the view, the brightly colored birds, and to slow my rate of perspired fluid loss. My return was delayed as a herd of 20 to 30 cattle were driven by me by a man and a young boy who laughed when I took a picture of his cow. Don´t worry, I´ve had an orange soda and 2 liters of water since returning to the clinica.
Call was uneventful throughout the night. We had one patient come in early in the morning with stomach pain which was concerning given that she had been shipped out 4 days ago for an emergent appendectomy. Concerns for infection, perforated bowel, gallbladder issue that could have previously been misdiagnosed as an appy. After the docs taking the xray themselves, developing the xray in the darkroom, and giving some mild pain meds, the patient recovered over several hours as was able to go home close by.
I did not stay for the xray, but instead, loaded into the back of a pickup, rolled through the cobblestone and paver streets of Santa Lucia out onto rutted dirtroad leading to a school about 40 minutes away but likely only a few miles up into the hills really. We continued our childhood screening and intervention initiative. Thankfully, very few significantly anemic children. Vitamin A, multivitamins with iron, and albendazole deworming was given for all. I went with one child, a resident doctor, and an interpretor to visit the home of one of the children who lived close by and was diagnosed with asthma. We explained the medications and possible contributing factors to the mother, and she agreed to come to the clinic in about 2 weeks. Many homes have a slow burning cooking fire inside the small 1 or 2 room houses, and we have seen a lot of children and adults with respiratory symptoms.
I took along one of the soccer balls and a pump to the school. The boys and a few girls went crazy over it, careening around a school yard that had large rocks, cement blocks, exposed random metal pieces and trash thoughout it. I asked someone to check to see if we had brought along suture material, but amazingly, the boys just dusted off their various falls and kept playing. Whenever I got the ball, they would call¨Marco!Marco!¨ A great time. I left the ball and pump with the school caretaker for judicious use.
This evening, I took my camera and went out to ¨walkaround town¨ I got a Pepsi Light from the tiny cornerstore for 12 limpera, which is about 75 cents, and went walking. My walk took me through the town square about 5 blocks away and then out of the square on aroad Liz Schlaudecker had recommended as heading up to give a good view of the city. My pepsi long gone, I found myself unable to turn around, and an hour later I was about 1000 vertical feet up in the mountains overlooking the city and the valleys beyond, with the volcanoes once again prominent in the background. I passed a wide range of homes, those with a fence and gate, evidence of a pickup in any state of repair, I now find quite elaborate. As I topped the saddle of the ridge, I sat down for a few minutes to soak up the view, the brightly colored birds, and to slow my rate of perspired fluid loss. My return was delayed as a herd of 20 to 30 cattle were driven by me by a man and a young boy who laughed when I took a picture of his cow. Don´t worry, I´ve had an orange soda and 2 liters of water since returning to the clinica.
Wednesday, April 16, 2008
Morning News
From Mark this morning:
"Good morning! I worked last night on emergency patients, which were really just urgent care acute issue patients. We finished that about 9pm, missing dinner, but thankfully someone had set aside a few plates of rice, vegetables, and chicken in addition to pretty much an entire pineapple that just melted when you bit into it. No overnight issues, but got called to the clinic just before breakfast that a woman needed to be seen now with severe abdominal pain, before clinic opens at 8am. The resident is across the hall seeing her. We do have a chart system, and were able to find record that she was seen here only a week ago, diagnosed with pancreatitis and sent to the tertiary hospital for appendectomy. Off to field clinic again today."
"Good morning! I worked last night on emergency patients, which were really just urgent care acute issue patients. We finished that about 9pm, missing dinner, but thankfully someone had set aside a few plates of rice, vegetables, and chicken in addition to pretty much an entire pineapple that just melted when you bit into it. No overnight issues, but got called to the clinic just before breakfast that a woman needed to be seen now with severe abdominal pain, before clinic opens at 8am. The resident is across the hall seeing her. We do have a chart system, and were able to find record that she was seen here only a week ago, diagnosed with pancreatitis and sent to the tertiary hospital for appendectomy. Off to field clinic again today."
On Call
From Mark last night:
"I'm still on call tonight. We worked all day in the clinic- a lot of chronic belly pain interspersed with diagnosis of new pregnancy, strange skin rash still not clear diagnosis, ear infection, and checking on the baby that was born overnight- all is well. Strange how we are all working to understand what resources we really have and how to use them or conserve them. Do we really need a pregnancy test? do they really need a full month of antacids? how about 2 weeks. I may be up tonight depending, so I'm off to bed. Looks like I may have a lighter work schedule tomorrow, so may be more email. My Spanish isn't getting any better, but I'm trying it more often. A little boy showed me how to use his homemade wooden top today- slick little toy. I can't make it work, which makes him very happy."
"I'm still on call tonight. We worked all day in the clinic- a lot of chronic belly pain interspersed with diagnosis of new pregnancy, strange skin rash still not clear diagnosis, ear infection, and checking on the baby that was born overnight- all is well. Strange how we are all working to understand what resources we really have and how to use them or conserve them. Do we really need a pregnancy test? do they really need a full month of antacids? how about 2 weeks. I may be up tonight depending, so I'm off to bed. Looks like I may have a lighter work schedule tomorrow, so may be more email. My Spanish isn't getting any better, but I'm trying it more often. A little boy showed me how to use his homemade wooden top today- slick little toy. I can't make it work, which makes him very happy."
Subscribe to:
Posts (Atom)