Sunday, February 27, 2011

some thoughts about peru

sunset on the rio orosa. view from our boat. lovely.

overall, i am so glad i had the experience to visit peru. my group went to the northern part of peru, started out in the city of iquitos, and then sailed along the amazon and some of its rivers and visited a bunch of different small villages. we all worked so hard, seeing hundreds of patients and then trying to figure out transportation for a select few who needed extra help.

some general observations:
  • kids in the amazon get viral colds just like kids in the usa. and their mamas all want antibiotics, just like mamas in the usa. and we educated a ton about viruses vs. bacteria. some people got it. most didn't.

  • the most common adult complaint was "mareos y dolor in me cabesa". dizziness and headache. you see, we had ibuprofen and paracetamol for aches and pains. drugs that we can buy OTC very easily here. but in the jungle, they were some powerful drugs, and people would lie to try and get the drugs. to them, dizziness and headache was their way of trying to get pain meds, when really they were just dehydrated. and then they'd laugh at us when we told them to drink more water. we would even have a liter-sized bottle of water on the table and say "drink at least this much everyday". most couldn't fathom drinking HALF of that in a day! they would say "i'm not a frog!" honestly, if people would just come and say "i get headache sometimes, and backache, etc, and i just need some pills to get through it", i would give them medicine in a heartbeat. but as it was, a lot of people just lied, couldn't answer questions like "when does it get better" (yes), or "when did it start" (it started when i was born), etc. so if you lied, well, how can i help you? if you are blatantly telling your child what to say to "score some drugs", how can i trust you? and yes, i may be using a translator, but i understand spanish well enough to know that you are feeding words, ha. i'm not that stupid. plus you don't want to just give people drugs willy nilly, because that leads to my next point...

  • a lot of people had NO IDEA how medicines should be used. a lot of folks relied heavily on herbal medicines, which are fine. but when they had a stash of ibuprofen, they would use it for ANY kind of ache or pain. we had several children that reported months of stomach pain. so the parents thought was "my child has stomach pain, let me give them adult strength ibuprofen to relieve pain". very bad idea. so we did a lot of educating. (then come to find out, a lot of church groups go to the area to mission-ize, which is ok i guess, but then they would just shower people with meds to get them to come to the sermons. well, thank you for dispensing medicine without sound medical advice because now you've enabled these people to give their children stomach ulcers. extreme example, but it's true. thank goodness we didn't see any kids actively vomiting blood or peritonitic.)

  • lots of babies, lots of pregnant women. i loved how the women were not shy about breastfeeding in public. baby is crying, pop out that breast and voila! happy baby. not that i would advocate the same amount of "exposure" in the usa, but wouldn't it be nice that mothers could breastfeed in public and people wouldn't gawk or stare or say mean things?

  • the river is everything. people bathe, wash clothes, drink water, clean meat, poop, pee, etc, all in the same place. very little awareness of latrines, or "go downriver for pooping", etc. no wonder everyone had "bichos" or worms in their poop. we saw many huge-bellied children full of worms. lucky for them, everyone got a mebendazole tablet at clinic check in to at least reduce their parasite loads.

  • i am amazed at the number of people who initially would say "i have a headache and dizziness" to try and score some pain meds, and then would turn out to have a nasty STD or UTI, or maybe a huge abscess, or some other major problem. why didn't you tell us about your vaginal discharge x 3 months? or about your chronically infected leg wound? aaaah!

  • but even with the craziness, overall i think we helped a lot of people who truly needed it. for every 4-5 people complaining of HA secondary to dehydration, we helped 1 person who really needed to get their ear infection cleared. or their UTI fixed. or anti-inflammatory meds to relieve them of their chronic arthritis pain. etc etc. such is the nature of these things. and then everyone got medicine for worms. good stuff.
ok, i think i'll stop there for now. it was truly an amazing experience. i'm very glad i got to go. mostly medical problems, but every once in a while i would see a surgical problem and wish i could actually help. so maybe in the future, i could be a medical mission surgeon and have some sort of way to fix people for good. but i can see where setting up medical clinics is much easier, but i think being able to share my (future) surgical skill set with those in need would be intensely gratifying.

Friday, February 25, 2011

back in town!

peru was amazing!!! can't wait to tell y'all about it!


Sunday, February 06, 2011

sunday morning

i tried to put down the knitting, i really did. but now i'm working on a set of hats for a friend who is expecting twins. haha...i can't help myself.

i finalized my rank list and it is doth certified (and green!). i've been getting some wonderful email interactions between some programs that i really liked, and yes, it's great to get positive feedback. but my paranoid self wonders how many OTHER people they are sending these things to, and if i should be more decisive in my emails, etc. i'm trying to avoid saying "you're my number one!" because i think it's cheesy, so i'm saying things like "thrilled, happy, etc", but alas. but i'll do it if i have to, ha!

this next week is going to be HUGE. we're meeting up with some friends we haven't seen in a while, then going to a "social" with my surgery department, and all the while i have to pack to go to PERU!!! oh, and super bowl party today of course. i will be making a king cake because that is how i roll. obviously, i will not be posting while i am out of the country, since we will be internet-less on a boat floating on a river in the middle of nowhere! i can't wait!

last night i made some kick ass mac and cheese. i threw in some sauteed onion, garlic, and mushroom with my lovely blend of mozzarella, monterey, and cheddar cheeses. and we ate it with watermelon radish and arugula salad. i'm glad i only make mac and cheese rarely, because it was so damn good we ate so much. definitely gymming today.

with all that talk about food i'm officially hungry for breakfast. maybe i'll do some fried eggs? biscuits? go elsewhere? alas!

Thursday, February 03, 2011

rank list dilemmas...

last night i had a mini-freak out regarding le ol' rank list. i go back and forth of being confident with my choices to thinking i'm about to make the biggest mistake of my life...ugh. i have a meeting today with my mentor to discuss things a bit. it sucks that you have to make these decisions having only been to a place like ONE DAY. and i'm worried that i'm being seduced by programs because they seem really cool on the outside, but maybe they're not so fun once you're in? and my list needs to be finalized within the week because i'm going to PERU soon! so that increases the anxiety, blah. so compound the rank list worries with the worry that i just won't match and then you've got a really neurotic frylime on your hands...

and one of my gen surg friends at school and i were thinking about having some sort of informal "talk it out" session with the M3s wanting to do gen surgery...people are desperate for help and it seems like there's not a good way to get that help at school. granted, i feel very aware of everything because i 1)psychotically look everything up online, 2) stalked my mentor (ha, he told me to come meet with him for help), and 3) bugged the upperclassmen as much as i could. but i think there's some folks out there that are absolutely clueless, especially with the kinds of questions i've been getting. so maybe after match day we'll have a sit down.

revisiting infectious disease lectures are kind of fun when there's no pressure of looming test ahead. i'm remembering that learning is fun! and also that you should never go ass-to-mouth, and always wash your hands after you poop! yay! yesterday's lectures were all about various things that make you itchy or make you violently poop. fun day. today we're getting some shots...for me i've got to get hepatitis A and typhoid booster. luckily yellow fever is good for 10 years and i had that one done in college.

oh, and i had a really encouraging conversation with an attending i worked with. he referred to my first half of med school crappy-ness as my "achille's heel". i like that phrase. he had some nice things to say about me and some good advice for my future, and it just made me feel good on the inside. it's nice to know that you have some fans in different places, because you never know when interviewers know your attendings and will CALL and TALK ABOUT YOU without you ever knowing, unless you just happen by their office to say hello. so, it's just a good feeling.

alright, got to get ready for's at 9:00..woo! and i think we get a free lunch today. double woo!