A little bit of this and that...

I have a nice long post coming up about Clinica Alabama probably this weekend.  I keep forgetting to do this everyday, like I said I would.  So family and friends, this one is for you so you know I'm still here and haven't expatted/ faked a mysterious disappearance... yet. ;)

I've been hanging with the docs the past few days. And next week Frenchies and I get to venture to the big hospital.  One of the students, Aurhencuruvru (something beautiful in French that I don't know how to spell), is a 6'3'' man who not only forgot his white coat but also scrubs.  I, too, did not bring my white coat.  Since I am bit over the average height of a woman here, it was difficult to find one that fit me.  Dr. Villareal did bring one to me.  It can fit a teenager in the states.  Not great for one who has broad back and shoulders due to swimming and rock climbing. But it works.  For Frenchie... he could barely find scrubs long enough.  And they still look like high-waters... is that what they are called?  We are supposed to go to the hospital next week, so we might trek into Managua before to see if we can't find a mutant size of  white coat. 

We have had some interesting cases.  They are interesting because the people who come to this clinic are so poor.  So they have conditions that are totally mismanaged, or not managed at all, and would otherwise go unseen. Blood sugars close to 400. Systolic blood pressures close to 200. Diastolic at 100.  Vomiting for 5 days. Parasites for months.  25 year old women who weigh 70 to 80 pounds, not because they have an eating disorders. Abscesses. Unmanaged osteoarthritis. Malformed anterior fontanelles. Completely debilitating ocular conjunctivitis, resulting in near blindness.  Possible breast cancer. Prostate cancer. A variety of things every day. 

I have worked in free clinics in the states.  Even though I saw a lot of the same things, like hypertension and diabetes, most of it was managed.  Or at least the option was there.  Think of one free clinic serving all of Greenville, Pickens, and Oconee counties.  That's kind of like this Clinic.  They get patients from Nadaime, Masaya, Granada, and little towns and villages all around. There are some other free clinics around, but this one is the one to wake up for at 4 or 5 in the morning to get started on a long walk to be there at 8am.  Then possibly have to sit around until 12:45 to be seen. All while being sick. Long day...

Some friends and family have expressed interest in donating to the Clinic.  I will post wither tomorrow or Monday some history on the clinic and ways to do that.  I appreciate all of the support I am getting for this trip.  I have received many thoughtful emails, and I hope that one day you can experience this country.  There's really nothing like it :)

The kids at Carita Feliz on a summer vacation for a week. I did not know this until I walked, rather than bike, to school.  Upon arrival, two of the students in the 4th grade class were riding their bike, and say "Ashley..... Fuiste???  Jajajaja!" 

To pass the time in the afternoons, I have been spending my afternoons sick.... and also exploring the streets.  So kind of good timing for whatever bug crept it's way inside me- los banditos. Whilst exploring, I got a little obsessed with the wooden doors and iron gates. I take after my papa :) I live in a city obsessed with these creative doors and sidewalks (just wait for it) and paint jobs.  So colorful, just like her people. I took like 50 pics of doors, but I'll spare you..

Also here is video of the endless rain monsoon of today.  You'll notice 2 buckets.  Those are filled from today, and they will be used tomorrow for cooking, cleaning, washing, and drinking. Free water!! Thank you mother nature! Click This.

Iglesia  de Xalteva

color and horses

another Mombacho.. love a good Cloud Forest

This is a papaya. I usually can't stand the taste of this fruit.
It tastes like a mucous covered dirty sock.
But...
If you score the outside a little with a machete,
and allow it to sit in the sun for a day...
and it's not GMO...
it is juicy and delicious. 

Happy 4th Eve!

The last two days have been 2 of the most tiring days of my life.  I am only in the clinic for 5 hours a day, but we pack in at least a whole days worth of patients and work into a 4 hour time period.  Since we only have two doctors on hand, sometime the other student and I have to perform preventive measures while the patient waits.  For example, if someone has a systolic blood pressure over 155 or diastolic over 95 (healthy <120/90), they get a beta blocker under their tongue.  And if someone’s sugar is over 300, they get an insulin shot.  Over 400, someone walks them to hospital.  Diabetes is surprisingly prevalent.  Surprising because the food they eat seems so much healthier and more natural.  However, the street vendor food is not so healthy. It’s like the most delicious smelling bread doused in sugar and honey as well as yummy Nica doughnut treats.  Thank God for Celiacs, because I would come back diabetic and muy gorda.

Another thing that this clinic lacks, that I have never thought about being a helpful tool, is a scale for babies and toddlers.  Kids get scared seeing a huge scale for the first time, so they won’t stand there for long.  Babies can’t stand obviously.  So we have to weigh them with their mom and then either I or Rachel hold the baby while we weigh mom without her kid. Also, on the note of parenting, we had a 13-15 yr old breastfeeding a 2 year old in the clinic. Obviously, I know teen pregnancy is a thing, especially here, but I have never seen someone so young breastfeeding before. 

 There is a limited supply of gloves, which I think are reserved for the doctors.  We only use them when we are slammed and do all of the diabetic’s blood sugar at once. And we only wear one. Dealing with needles is scary, even if it's for a simple finger stick.  We use the One Touch system and something like this at-home finger pricker.  Our are older versions, and we don't have the option of an automatic release of the used lancet. Needless to say, we are super careful and try to take our time.

Sidenote.  I am sure Anne and my Aunt Denise can relate to this.  We have some really really old people come into clinic.  Fully functioning 95+ year olds.  Every time I do a blood pressure, I think I am going to break an arm because they are so thin!!! I could wrap the BP cuff around their arms 3 times.  One time my dad and I saw the oldest couple in the world in Mexico, but I think these Granadians have them beat.

I helped out in the pharmacy as well.  We get the Rx’s from the doctor, and put the pills in baggies.  On a piece of cardboard cut from a box that onc housed medicine, we write down the name of the drug and the directions: “Un tab, tres veces diario”.  Marvin is the pharmacist.  I am pretty sure that he hasn't gone to pharmacy school.  He volunteers his time in only air conditioned, non-Doctor area in the clinic.  He looks up interactions on the computer while listening to Bob Marley and reggaeton. He's knows quite a bit about the drugs he is prescribing.  And he’s hilarious.

I have also been visiting Carita Feliz a lot.  I am helping the 4^th grade class.  They are a crazy bunch of kids.  Miguel has become a favorite of mine. And 2 other little girls, Maria and Audelis.  They are great dancers. What am I saying, I can;t pick favorites.  I love this class. I tried to take pics today, but Miguel kept taking my camera to take pictures of his mouth.  I am supposed to be helping in pre-school too on some days, but I can't stay away these cuties!

Miguel and Kenner(?). They dont sit still.

Tomorrow, Rachel and I will switch with the French MD’s, and I’ll get the chance to have no clue what’s going on with the Docs.  Rachel is a 4th year med student in England, and she is fluent in Nica Spanish. Then later in the afternoon, I’m taking the Express Micro-bus to Managua to hang out with Bob and Claudia and celebrate Amerrrrka.  Happy 4^th!! 

Here's videos taken by Miguel and David!  They are in the process of learning a new traditional dance. Here are Youtube links for a little beter quality: Video 1  Video 2