Butt Worms and Final clinic days

Que Triste!

It's really starting to hit me. Ann is sad too, even though she has another month here.  The thought of not being here forever is a sad one.  She has fallen in love with Nicaragua and claims to be back once she is a real doctor and can do more.  Honestly, I haven't met one person who has traveled here who hasn't fallen in love.  Note: There is a difference between being a traveler and being a tourist.  For everyone I know who has "lived" in the culture, experienced the culture, experienced the people, not one has said Meh, it's okay.  This is a country to have to get into to really see and feel it.  I am grateful for yet another opportunity to do just that.  I hope in my lifetime, I can inspire more people to come down and learn from this great country with her great people.

the crew minus a few
Mario, Dra Villarreal, me, Olivia, Marvin
Ann, Etienne, and Catty

This clinic has been a lot of fun.  Now that we are all friends and understand each other, we have been having a blast.  

I met Dr. Rudy Vargas, finally!  He came in from Alabama with the head of ANF and some family.  They had suitcase of medical supplies for the clinic and for the hospital.   ANF is a pharmaceutical distributor that donates meds and supplies to the clinic.  They also sell drugs to the clinic at a greatly reduced price.  Once we were all introduced, he led us in a prayer to bless the clinic and its patients and those who serve. Dr. Vargas is a jolly man.  Very nice and warm.  My house mom told me that he actually grew up on the same street as the clinic.  Dr. Vargas is a man with a lot of passion for helping others.  

I felt my first goiter.  Gout=Bocio in Spanish. Tiredeo= Thyroid.  I did not know those words when Dra. V told me to feel the patient's neck.  I thought I was feeling for lymph nodes. Oops. But I did end up finding the right thing, even though her thyroid was very obviously enlarged. 

I also helped a child who had an allergic reaction to penicillin.  She was experiencing impetigo all over her skin.  Impetigo is usually caused by the Staphylococcus aureus bacteria. The skin infection/ reaction is itchy and sore.  It is contagious.  According to Dra. V, since penicillin has the S. aureus bacteria as part of its formula, the immune system of this little girl reacted poorly.  She had the crusty form of impetigo, and she was severely irritated by their itchiness. 

Butt worms. Oxiouros. Pajuellas. Pin Worm in english. Gross.  One way to know if you have this butt worm is to literally put a piece of tape on your anus, go to sleep, and check the tape in the morning for eggs. Disgusting. But true. And sometimes, the most reliable source of information you can get. Also if you or your partner is suffering from butt worms, it is a good idea to have both parties take the recommended dosage of medication.  These banditos can exit one butt and enter into your sleeping partner. Pretty sick. 

These worms make your booty very itchy and a person is always moving around, restless, irritated. Little kids will scratch their butts. So in some places of Latin America, if you say "Parece que tiene pajuellas", that can mean a "That person is restless". 

Yeah, so we had some of that.  Imagine being explained that in Spanish and trying to understand.  A lot of acting and hand gestures went into play between that patient and Dra. V trying to explain all this to each other and more so to me... It was hilarious. 

On Monday, Mario and I are going to go spend all of that cash you guys donated on some very important things! I will post some pics. 

Weekend plans:  I will be MIA for 3 days.  Tomorrow I take chicken buses to Managua to meet up with Etienne and Ann. Then together we head north to Esteli and Somoto Canyon, near Honduras. And that is our itinerary.  See you on Sunday night!

Burns and Kidneys

In the hospital, I have seen everything from gruesome injuries to interesting, yet terrifying infections (see Brain worm entry).   Etienne and I saw two armed guards standing outside of the room.  This guys were huge and were sporting some pretty serious guns.  (Note: I am not one who is well versed in guns, but  it looked like an AK47, but was an not an AR15).  We walk into the room and see 6 guys in different beds.  The closet has his ankle cuffed to the bed. The second is laying down and is in some pain. The others are similar.  MRSA is a big problem in these hospitals.  Just as in any hospital, really. We were presented a patient who had MRSA on his elbow.  It looked like his whole elbow was being chewed off.  The man in the ankle cuff was horribly burned.  He had a 1st thru 3rd degree burns that covered 25% of his body.  His neck and shoulder were the worst.  He was in prison when some other prisoner came at him with a very large container of boiling water. The water spilled all down his chest and entire back and splashed his face. The plastic surgeon came in to determine the damage.  She first had to clean the burn.  This guys is tough.  He had to stand up while she harshly rubbed soapy water and some other cleaning agent over and over his burns.  Skin was flaking off and blood started pouring from his neck area.  He grimaced, but did not scream, did not slap the surgeon in the face, and did not throw up.  It was painful to just watch. I don't know what he did, if anything, to deserve that.  But he took that cleaning like a boss. 

FYI: Burn percentages are measured in the Rule of 9's.  So your arm is a 9, leg is 9, so on. You add up all the part and percentages of those parts that are burned.  Here is a picture:

source

The other guy was having trouble moving his legs, arms and hands.  He had weakness in his muscles, due to super low potassium.  The docs were still trying to figure out the cause behind his low potassium.  One of the other men was in there for end stage renal disease which was causing pretty serious pleural effusion.  the attending physician recommended that he go on dialysis, but his family refused it.  I'm not sure what will happen to him, like if he will go home or if the hospital will offer palliative care.  Or why his family refused it.  Many patients have to travel a long way to get to the hospital.  Treatments, like dialysis, are necessary a few times a week or more.  I can understand how difficult a trek like that could be. 

Oh yeah, and we saw our ulcer patient. He was in a wheelchair, outside enjoying the sun, and accompanied by his sweet mother. Hope.

I am finished for now with shadowing in the Nicaraguan public hospital system.  I have learned many things from being here, and here are some important notions:  1)The resiliency of the human spirit is unbelievable  2) State-of-the-art medical institutions and universities aren't always necessary for training great doctors and nurses. These doctors and nurses work under a lot of pressure in hot hospitals that are in pretty bad conditions and with little resources. They don't have their iPads on hand to google search symptoms and medications. They have to know their stuff. I have a lot of respect for how the have chosen to live their lives.  Especially the ones who could have stayed in the states or Europe but chose to come back to their homes. 3) We have it really good in the US, especially in terms of health care, so quit your bitching and be more appreciative :)  

Thank you my Noni and Ray!!

Noni and Ray have graciously donated to Clinica Alabama and I want to thank you both so much.  I love you and I miss you.  I can't wait to see you soon!

Abrazos!

Rest day

I couldn't stay in the hospital today for risk of getting sicker or more importantly  getting someone else sick.  I do not actually think I have Dengue, but I have stopped taking ibuprofen just in case.  Ibuprofen thins blood and lead to hemorrhagic dengue. I had a high fever last night, got chills, and woke up in my comforter.  There's a first. I have none of the symptoms, I just know them, so I think I have Dengue... Just pain in my  muscles and joints and behind my eyes and in my sinuses and a fever. and med-studentitis

Therefore, upon 20 minutes of research, I have self-diagnosed myself (as of now) with Surfer's Sinusitis. 

I took some pretty big spills into some big waves on Sunday afternoon.  In fact, I got stuck in the totally wrong place for 3 waves.  I had water coming out of my nose all day.  

Or maybe I have the flu. Thank you Future Dr. Kranc for helping me out this morning and last night. 

Dr. V prescribed me Amoxicilin, Acetaminophen, and Ambroxol. So that should cover whatever I have going on.

I will now rest, but I'll keep everyone updated.  Dona Espiranza is also taking good care of me. She just brought me some lemonade concoction that she said will make me feel better. So sweet. If I feel better by 2, I will head to Carita Feliz.  :) 

Here's a picture of Etienne taking a spill.  You can barely see his board in that wave :)

Early am post.

The other day I went to some churches around Granada.  Iglesia La Merced has a huge bell tower that you can climb up to and get some great views of Granada.  Here are some pics. 

Here's the back of a residential area.  This is a tributary that floods into Lake Nicaragua during the rainy season.

And these here are mamones.  They are delicious and very weird. They grow in bundles in trees.

You are supposed to crack them open with your teeth or fingernail.  The texture is like a peeled grape. 

Then you pop it in your mouth and suck all the fruit meat off of it. 

Then you spit out the seeds in the middle. 

There is another variation of this fruit.  It is even weirder but much more yummy.  I'll post about that when I find some again. Have a great day! 

Important Reminder...

Here's a video I found back in the Spring.  Thank you Amanda for re-sharing it with me. Great reminder of what is really important about being human.

Last beach weekend adventure... Part 2: Coco

I left off with Todd picking us up.  So we get to Playa Coco and I introduce the Frenchies to Amanda.  Etienne politely excused himself and headed straight to the beach, board in hand.  I went with him and gave him a quick lesson.  Probably not the best teacher, but I helped out some ;) By the end of the day, he was calling himself Kelly Slater.  

Bob and Claudia showed up around lunch time to join in on the fun.  We started drinking rum and Tonas. At 4, the Frenchies left to go back to Masaya.  The 5 of us and one of the guests next door went to Leonardo's bar for more rum.

One of Leo's sons really wanted my digits.  Everyone helped run interference.  He asked me if Todd and Amanda were my parents.  I said yes, I was adopted.... I am about 10 shades darker than both of them.  Todd is toe-headed.  Amanda has blue eyes.  Bob was my adopted brother.  Haha. Still didn't get him away.  He was nice, super machismo, very buzzed. Obviously, doesn't hold a candle to Mr. Krancyants.

We returned to the beach house, all buzzing. Surfed some waves and whitewater :) and Clau made an awesome dinner.  We ate outside by candlelight, with the sounds of waves pounding on the beach.  Got eaten alive by mosquitos, and crashed hard almost immediately after dinner.

I've never had a better night of sleep. We got up early because there as a blackout and the fans turned off.   We had some coffee, and Todd, Bob and I were off into the ocean by 7:15.  The waves were huge.  I caught one really good one.  Then I got braver and went out with the men.  It took me almost an hour to get out past the break.  It was hard work with that long board. And once I got there, I realized these were a little too big for me. I mustered u some more courage, and I tried to take one in.  Bob was infront and to the left of me.  Just as I was at the peak/crest/whatever you call it, I saw his face.  I looked down. Peed myself alittle, figuratively of course. and stroked backwards super hard.  That wave would have destroyed me. haha.  Eventually,  I found a smaller one and rode that sucker all the way into shore.  It was awesome.  Amanda got pics of the end of my ride.

We had an awesome day.  I am lucky to have people like Todd, Amanda, Bob, and Clau in my life.  A nice family away from family. Great people, living the dream in a great country.  What more could you need?