I would have enjoyed Quito more if I hadn't gotten really sick on the morning of day 2. Fever, chills, body aches and a wicked cough.
I'd been running a 3 day temp of about 100-101.5 until today when the tylenol finally kicked in. I also went to the doctor, dx: pneumonia.
So, after being tested for swine flu- results on Wed, I am confined to bed -taking my atbx (amoxil) and my expectorant.
I am missing home more than ever!
Monday, July 13, 2009
Thursday, July 9, 2009
Who knew?
Learned a lot about Bolivia tonight from film night with the international office. There were us 4, one more American, a 6ft gal from Canada, eh and an Austrailian girl with dreds. (there are actually more americans here but these undergrads left before the showing...) Anyway, learned lots about Goni, an expresident of Bolivia living in exhile outside DC and about the American influence (and actual consulting from Americans for foreign ministries) and how this affects a campaign, for better or worse. I also learned to never discount the leader of the coca workers (cocaine plant) because even if he doesn't actually win the election, he will ultimately win one way or another.
Check out: Our Brand is Crisis.
Check out: Our Brand is Crisis.
2 hemispheres, 1 moment
Spanish moment of the day: Our morning bus rides are typically uneventful. It´s a short ride really only about 5 or ten minutes. I think thus far, the most eventful occurence was Brits juice box being stolen as we pushed thru the crowd to get off the back of the bus, like salmon swimming upstream, as people tried to load the back of the bus to avoid paying the whopping $0.25 fair. But today we were in for a treat. An older man, probably in his 50s with white longer hair and matching white linen outfit serenaded the bus with his Spanglish version of hotel california by the eagles, complete with air guitar accompaniament (sp?) and hand percussion on his cheeks. We aren´t sure if he actually new all the words or just made simlar noises but I know I clenched my teeth not to giggle at the man trying to sing his way to a daily living. I wonder if the Eagles are planning on a Latin American Tour?
Headed to Quito tomorrow for the weekend with the international students and of course the other three. It may be a full weekend but will well be worth it to stand in 2 hemispheres in 1 moment. (secret fact: the actual line isn´t where the tourist spot is, it´s a little further down the road)
Headed to Quito tomorrow for the weekend with the international students and of course the other three. It may be a full weekend but will well be worth it to stand in 2 hemispheres in 1 moment. (secret fact: the actual line isn´t where the tourist spot is, it´s a little further down the road)
Wednesday, July 8, 2009
Un milagro en calle 3era y rio vinces
A couple days ago I experienced a miracle. I was prepping myself for a chilly shower and the temp was pretty chilly (compared to what it had been all day) as I cautiously put my head under teh water, careful not to let the water touch anything else I realized, oh my goodness, the water is almost tepid. I decided I could withstand tepid water enough to actually take a proper shower. All of a sudden I realized... the water is getting warmer and warmer and yes, even hot! I rushed thru my shower afraid that it would disappear just as quickly as it had appeared. I was astonished. My host sister had told me that there is no hot water in the house, so how did this happen. After much contemplation, I decided to ask my mother if this was normal... long story short (and sparing you the spanish) there's a switch hidden behind the door in the kitchen (like a breaker box). Turn it on 20min before you want hot water. Good to know... so now, so long as no one flips the switch off whlie you are in the shower, there is warm water.
I decided not to write about clinic yesterday, I was really frustrated and decided it was better to wait and write when I had a better day. I hate feeling like I speak like a 4yr old and I constantly fear sounding stupid - which I do. I have been at the school doing "control excolar" which are basically complete physical exams head to toe, ins and outs, height weight ppsych soc questions, the whole works. The first day, the day I didn't write, was very frustrating for me, I couldn't convey what i needed to convey. I alone..no doctor or nurse at the school to help me... little 10 and 11yr olds who don't speak any english.... I have to convery the whole puberty thing and what happens and what to expect and all the changes and about how they can become pregnant. Today was much better. I was able to do everything on my own and better yet they understood me. I only hope for the same success when I give the sex ed talk in the coming weeks.
Going to Quito this weekend. Quito is where the equator is. I remember learning Latin American Capitals and I would tell myself, "don't Quit at Ecuador, you're half way there" to remember the capital. There are tons of things scheduled, which I am looking forward to. Also going to Otavalo where apprently there are a lot of artisans. Quito is 8hrs away by car but luckily we are taking a flight which is only 30min. yay!
The four of us ventured to Mega Maxi today... sounds like a store for women during "there time" but it's like a Fred Meyer or Walmart... only with high end appliances too. I didn't find my mini shampoo and conditioner but I did find a small bag to take to Quito instead of my mochila (bookbag) because it's a little too small for 3 days worth of clothes, but still small enough to carry on. It was less than $5. I also bought some off brand Galak, hahaha (why am I laughing, right? it's a long story which I will save for later... we are all 4 *well at least Brit and me * are addicted to Galak and not just regular Galak - the sanduche kind. Our Spanish class joke is ... We're going to need some more Galak for that. Seriously, google it if you are that curious and just can't wait for the story)
Time for be tengo mucho sueno (and I hate that the computer keyboard at home is an ENglish one, I don't know how to do a tilde - so my words never look right) I'm really tired, it was my host sister's b-day last night - 25. I bought her a small sterling necklace, although having seen her accessory collection it would be like finding a needle in a haystack. She had about 20 people to the house last night for appetizers and home made mojitos... I helped grind the mint although my orange juice was just fine for me for the night. I was afraid I would embarass her amongst her friends since my spanish sucks, but I found a girl, a vet, who needed to practice ENglish and I needed to practice spanish. We exchanged emails too after a long night of talking about medicine and the differences between vet and human med and about our babies... our hubsnads and dogs. It was nice to be able to speak and not worry about how I sounded... just talk (and she helped improve my grammar along the way and I returned the favor)
I decided not to write about clinic yesterday, I was really frustrated and decided it was better to wait and write when I had a better day. I hate feeling like I speak like a 4yr old and I constantly fear sounding stupid - which I do. I have been at the school doing "control excolar" which are basically complete physical exams head to toe, ins and outs, height weight ppsych soc questions, the whole works. The first day, the day I didn't write, was very frustrating for me, I couldn't convey what i needed to convey. I alone..no doctor or nurse at the school to help me... little 10 and 11yr olds who don't speak any english.... I have to convery the whole puberty thing and what happens and what to expect and all the changes and about how they can become pregnant. Today was much better. I was able to do everything on my own and better yet they understood me. I only hope for the same success when I give the sex ed talk in the coming weeks.
Going to Quito this weekend. Quito is where the equator is. I remember learning Latin American Capitals and I would tell myself, "don't Quit at Ecuador, you're half way there" to remember the capital. There are tons of things scheduled, which I am looking forward to. Also going to Otavalo where apprently there are a lot of artisans. Quito is 8hrs away by car but luckily we are taking a flight which is only 30min. yay!
The four of us ventured to Mega Maxi today... sounds like a store for women during "there time" but it's like a Fred Meyer or Walmart... only with high end appliances too. I didn't find my mini shampoo and conditioner but I did find a small bag to take to Quito instead of my mochila (bookbag) because it's a little too small for 3 days worth of clothes, but still small enough to carry on. It was less than $5. I also bought some off brand Galak, hahaha (why am I laughing, right? it's a long story which I will save for later... we are all 4 *well at least Brit and me * are addicted to Galak and not just regular Galak - the sanduche kind. Our Spanish class joke is ... We're going to need some more Galak for that. Seriously, google it if you are that curious and just can't wait for the story)
Time for be tengo mucho sueno (and I hate that the computer keyboard at home is an ENglish one, I don't know how to do a tilde - so my words never look right) I'm really tired, it was my host sister's b-day last night - 25. I bought her a small sterling necklace, although having seen her accessory collection it would be like finding a needle in a haystack. She had about 20 people to the house last night for appetizers and home made mojitos... I helped grind the mint although my orange juice was just fine for me for the night. I was afraid I would embarass her amongst her friends since my spanish sucks, but I found a girl, a vet, who needed to practice ENglish and I needed to practice spanish. We exchanged emails too after a long night of talking about medicine and the differences between vet and human med and about our babies... our hubsnads and dogs. It was nice to be able to speak and not worry about how I sounded... just talk (and she helped improve my grammar along the way and I returned the favor)
Monday, July 6, 2009
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
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
Saturday, July 4, 2009
Clinic Day 2 and el fin de semana
Here's the run down:
I'm with the ginecologo who seemed to have lost his patience with me from yesterday, even though I actually have a clue what he is talking about now and what prescriptions he is having me write. He's hard to understand, but I like the way he talks to his patients, most of whom are young women reluctant to have paps or who forget their oral contraceptives. His notes say something like: last period was (insert date)... her for a consult; forgot to take two days worth of contraceptive pills, I advised to continue taking them since she says she has not had relations.
Interesting that for a society that is nearly all Catholic, everyone is on the pill, although if you forget to take it, just like in the US, you can become pregnant at age 14 or if you forget to take the minipill after giving birth you can become pregnant... like my 3rd patient (age 17) found out as she held her 1 1/2 month old child.
Gregg has been completing "censos" the census. How many people live in the home, their health etc.
Nancy with Dr. Montero, seeing patients
Brit went to a school and gave vaccunas (vaccinations), then to the clinic
When Brit, Gregg and I are finished in our respective jobs we join Nancy. We don't usually finish until 2pm...mostly because we are so slow in figuring everything out. Dr. Montero is very patient despite the mispellings, misunderstandings and slowness of the 4 of us.
Can you imagine being a preceptor with 4 students at once... and they don't speak the same language? I would be pulling my hair out. But not once does he seem frustrated, he just keeps repeating himself and trying to push along. After about a week in our respective positions we will change so we can all experience each area of the clinic.
Everything is free at the clinic. The medicines, the care, the lab. It's amazing they get along with what they have and don't have.
Montero is huge on milestones for kids... we had our first retardacion mental grado 2.... it was sad, the little boy didn't speak. He followed some commands but not all. What type of life will this little boy lead? He has also has some of the worse dentition I have seen here, which is surprising. The dentition here is about that of the pts in the US. I hate to make comparisons to the US... since this place is not comparable but it's interesting to see how things are different and similar between societies.
Nearly all the women I have seen bring their children, one two, sometimes three or four. All are well behaved. No disciplining, no yelling, they sit quietly or entertain themselves. Kids smile when they are tickled and are still frightened of the otoscope.
Spanish moment: (again from Nancy - bless her heart she is trying so hard): in trying to tell a patient this won't hurt (no le duele) she said no duerme (no me sleep).
My mom was going to take me to the beach today to the family beach house, but apparently there were tings to fix and the plumber came so we didn't go as I realized this as the time ticked by, so I tried to study, would have prefered to go to school for this as it was really muggy in my room today, the pages of my book were sticking together. I watched some tv in spanish. Level 9 was the name of the show... it was interesting, I could follow it at least. Awesome lunch today, my host mom understands I don't eat veggies really so made legume soup with blended veggies, it was good and a rice mix with mini sausages and scrambled eggs, yum!! I had two huge helpings. I wasn't a huge fan of the plaintain and fish we had last night. We also had fresh squeezed raspberry juice tonight! Yum again! (la mopa?) Had Yucca bread tonight, it was not filling but will tie me over until morning. Hopefully we are going to a movie tomorrow - it's only $2 here to go to the show. Brit and I went to the mall yesterday, it's only about a 5min walk. We were expecting some good bargain finds but it was uber Americanized. (did I already write about this? having de ja vu) It was the equivolent to the Plaza in KC, I was looking for a Gordmans, Ross or Oak Park mall... Abercrombie, Tommy Hilfiger and high end boutique stores we could hardly afford just to walk into each place, we will beheading down to Las Penas one of these weekends and el malecon by the black market to do out shopping we decided. We did find an awesome set of 3 human body posters in Spanish for $0.86 each - what a steal, I may actually get another set just to have. There is also a Cinnabon (will definitely be eating there at somepoint - it smelled so so good) and then KFC, Burger King, Pizza Hut and a few more local flavor fast food places. I tried a hamburger from a local "burgerville" type place that is a "must try" when in Guayaquil according to the guide books. It was fair, I asked for plain but still had some special sauce on it... not too shabby.
On the home front: Shawn's in Omaha with his parents and aunts and uncles. Hopefully they had good weather to grill and golf. Happy 4th everyone!
I'm with the ginecologo who seemed to have lost his patience with me from yesterday, even though I actually have a clue what he is talking about now and what prescriptions he is having me write. He's hard to understand, but I like the way he talks to his patients, most of whom are young women reluctant to have paps or who forget their oral contraceptives. His notes say something like: last period was (insert date)... her for a consult; forgot to take two days worth of contraceptive pills, I advised to continue taking them since she says she has not had relations.
Interesting that for a society that is nearly all Catholic, everyone is on the pill, although if you forget to take it, just like in the US, you can become pregnant at age 14 or if you forget to take the minipill after giving birth you can become pregnant... like my 3rd patient (age 17) found out as she held her 1 1/2 month old child.
Gregg has been completing "censos" the census. How many people live in the home, their health etc.
Nancy with Dr. Montero, seeing patients
Brit went to a school and gave vaccunas (vaccinations), then to the clinic
When Brit, Gregg and I are finished in our respective jobs we join Nancy. We don't usually finish until 2pm...mostly because we are so slow in figuring everything out. Dr. Montero is very patient despite the mispellings, misunderstandings and slowness of the 4 of us.
Can you imagine being a preceptor with 4 students at once... and they don't speak the same language? I would be pulling my hair out. But not once does he seem frustrated, he just keeps repeating himself and trying to push along. After about a week in our respective positions we will change so we can all experience each area of the clinic.
Everything is free at the clinic. The medicines, the care, the lab. It's amazing they get along with what they have and don't have.
Montero is huge on milestones for kids... we had our first retardacion mental grado 2.... it was sad, the little boy didn't speak. He followed some commands but not all. What type of life will this little boy lead? He has also has some of the worse dentition I have seen here, which is surprising. The dentition here is about that of the pts in the US. I hate to make comparisons to the US... since this place is not comparable but it's interesting to see how things are different and similar between societies.
Nearly all the women I have seen bring their children, one two, sometimes three or four. All are well behaved. No disciplining, no yelling, they sit quietly or entertain themselves. Kids smile when they are tickled and are still frightened of the otoscope.
Spanish moment: (again from Nancy - bless her heart she is trying so hard): in trying to tell a patient this won't hurt (no le duele) she said no duerme (no me sleep).
My mom was going to take me to the beach today to the family beach house, but apparently there were tings to fix and the plumber came so we didn't go as I realized this as the time ticked by, so I tried to study, would have prefered to go to school for this as it was really muggy in my room today, the pages of my book were sticking together. I watched some tv in spanish. Level 9 was the name of the show... it was interesting, I could follow it at least. Awesome lunch today, my host mom understands I don't eat veggies really so made legume soup with blended veggies, it was good and a rice mix with mini sausages and scrambled eggs, yum!! I had two huge helpings. I wasn't a huge fan of the plaintain and fish we had last night. We also had fresh squeezed raspberry juice tonight! Yum again! (la mopa?) Had Yucca bread tonight, it was not filling but will tie me over until morning. Hopefully we are going to a movie tomorrow - it's only $2 here to go to the show. Brit and I went to the mall yesterday, it's only about a 5min walk. We were expecting some good bargain finds but it was uber Americanized. (did I already write about this? having de ja vu) It was the equivolent to the Plaza in KC, I was looking for a Gordmans, Ross or Oak Park mall... Abercrombie, Tommy Hilfiger and high end boutique stores we could hardly afford just to walk into each place, we will beheading down to Las Penas one of these weekends and el malecon by the black market to do out shopping we decided. We did find an awesome set of 3 human body posters in Spanish for $0.86 each - what a steal, I may actually get another set just to have. There is also a Cinnabon (will definitely be eating there at somepoint - it smelled so so good) and then KFC, Burger King, Pizza Hut and a few more local flavor fast food places. I tried a hamburger from a local "burgerville" type place that is a "must try" when in Guayaquil according to the guide books. It was fair, I asked for plain but still had some special sauce on it... not too shabby.
On the home front: Shawn's in Omaha with his parents and aunts and uncles. Hopefully they had good weather to grill and golf. Happy 4th everyone!
Thursday, July 2, 2009
Not sure where to start
That about sums it up. My brain is exhausted. I don't think I have ever thunk this much. I am trying to remember what it's like to be in clinic, throw in some Ecuadorian medicine and culture oh and doing all of this in another language. When I have more brain cells, hopefully tomorrow I can write about it, but today I'm pooped. I can say this though - privacy non existant in the clinic. I did 2 paps today... without lubricant...ouch...and the girls just sorta take everything off from the waist down right in front of you and hop on the table and spread their legs.
The gynecologist (ginecologo) I worked with was patient, which I appreciate but I felt so lost. We also did a home visit for a woman 25years old, gave birth to 7th child 3 days ago and now has fevers chills and abdominal pain - we prescribed antibiotics, pain meds and told her part of the placenta must not have delivered...if not better in 24hrs go to the hospital.
Spanish class - learning how to say things more PC which is nice I can sound more fluent and less like an American trying desparately to speak Spanish. Have already learned some clutch things like what mi papilla is and mi bebida. Almost ever kid has parasites and also gets an antibiotic. The word of the day for me however was "cosita"... never would have picked this up as an important part of the conversation and would have missed entirely the meaning of the conversation about her who-ha area.
The gynecologist (ginecologo) I worked with was patient, which I appreciate but I felt so lost. We also did a home visit for a woman 25years old, gave birth to 7th child 3 days ago and now has fevers chills and abdominal pain - we prescribed antibiotics, pain meds and told her part of the placenta must not have delivered...if not better in 24hrs go to the hospital.
Spanish class - learning how to say things more PC which is nice I can sound more fluent and less like an American trying desparately to speak Spanish. Have already learned some clutch things like what mi papilla is and mi bebida. Almost ever kid has parasites and also gets an antibiotic. The word of the day for me however was "cosita"... never would have picked this up as an important part of the conversation and would have missed entirely the meaning of the conversation about her who-ha area.
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