Case of the Lunes

lunes = Monday
We finished in clinic early today.. maybe we are getting the hang o fthings now. yeah! Again I was with the ginecologo, Gregg got to go with the Pediatria (you guessed it, pediatrician). Guess she was great and efficient. My gyn patients were really interesting today - although I don´t know when obstetric and gyn patients aren´t. We have only one size plastic speculum in the clinic for everyone, which in reality works 90% of the time, although with no lubricant it can be a challenge still. I am proud to say I am finding the cervix with 100% accuracy now, a long way from not being able to find the land of "os". Today I found the speculum (especulo) exception. A small girl of 16 or 17 (1 child already via C-section) a tiny tiny little girl... [warning: grafic in nature] her opening was about the size of a pencil... I tried gently to eas theunlubed speculum but I could see I was hurting her and more importantly I could feel myself close my legs tighter and tigher as I tried to do the exam. No luck. The ginecologo returned and I try and explain: el esepculo es tan grande. Necessita una especulo mas pequeño. He grabs the speculum and stretches her as if she were going to deliver a baby... she doesn´t make a sound but I can see her scrunch her face ( i actuallywas thinking how the heck did she get pregnant?). He pushes and pushes and somehow manages to get the speculum in far enough to do the pap. As she limped out of the room I could only empathize that being female her would be difficult.

Another interesting patient: 15 yr old girl, was supposed to have a sonogram (ecografia)to determine exactly how many weeks pregnant (cuantos semanas tiene) but she didn´t go and her mom didn´t think it was that important (without the sonogram it´s difficult to tell how many weeks along if the baby has dropped toward the canal and here it´s not an exact science, the obstetrician guess by fundal measurements how many weeks) SO I measure the girl´s belly and as >I do I can feel a tightening... a contraction... she´s term. The obstetrician is not happy. H e went and grabbed the mom and talked really fast. Most of what I caught is : this isn´t a game, she should have had a sonogram and she didn´t now this is her mess to deal with, but she could go into labor at anytime. I felt so badly for this little girl, who look like she was 12. Babies having babies. Que Lastima!



Spanish Momentito of the day: we take 2 buses like I said before, one to get to the bus terminal and then one to the clinic reverse it for the way home. While waiting for the bus to go home (from the terminal) we were all chit chatting. There were a lot of buses there since it was around the noon hour/almuerzo time. I look up and see our bus,#81 in the street a bit, down farther than usual. I think we missed our bus I say to Brit. Then I notice he is waving for us to come on and get on the bus. You know you stick out when the bus driver recognizes you and motions for you to get on the right bus.

For more fun Ecuadorian tales, Nancy is also keeping a blog, more detailed than mine: nespelin.blogspot.com