Sunday, September 19, 2010

Holy Macaroni!

This morning at around 8:30 one of our patients pulled in to kilometer 38. The Doc had told us on Friday that we would be having a surgery at 10AM Sunday morning. This patient that had pulled in very early was her. Rachel and I had our breakfast and then headed to our house to prepare for the surgery. In our house we have the pharmacy and a small room called the lab. The Doc said that we would be removing the tumor in the lab.
We cleaned up the lab, wiped down the 1 hospital bed we have, and started to prepare the surgery equipment. At exactly 10 AM sharp the Doc was cutting at her lower back. He made his incision and had me hold his retractors so that he could reach in to pull out the tumor. To tell you the truth, this was the first surgery out of 6 that I started to feel queazy in the stomach. I began to sweat, my head felt funny, and I had to keep looking away cause I was afraid of passing out. Thankfully, this feeling went away after five minutes. When he had taken the whole tumor out we handed him the sutures and we were ready to close up the incision.
He puts in the first stitch then looks up at me and hands me the needle and kelley clamp. Surprised, I look at him and say, "Yo?" he smiles and nods yes.
Sweet!! I come over to his side and I sow her up :) It was cool and crazy at the same time. The particular stitch that I did was the one I had practiced over and over. And it was the same one that I watched the Doc use on every patient. When I did this, I just did it with very little thinking. Crazy! I had always dreamt of this moment and at the same time I had dreaded it. I was afraid I would be too scared and shaky; that I wouldn't know what exactly to do. But with the Doc's confidence I could also be confident in myself and do what I had learned to do.
I love it! I want more ha ha

Friday, September 17, 2010

Clinicas!

September 13, 2010:

Mini clinic – to get our feet wet. The medical group worked along side with the dental group in kilometro 21. Some people came in to get their teeth checked and others came in with fevers, headaches, and diarrhea problems. We signed them up to either see the dental group or the Doc.

Many of our patients had children that were sick or not feeling well. They were having problems with fevers, vomiting, or diarrhea. The majority of adults had problems with dizziness and headaches. In total we had like 10 people. So it was very slow.

I assumed that there would be a huge line wanting to be seen by the Doctor. However, I had forgotten that we were in a very small village and most of them were out working while we where there.

The dental group had about 12 people signed up to be seen. Unfortunately, they were only able to see 6 of them. Some who had signed up didn’t want to wait to be seen and decided to leave. We where there for about 4 hours. I think that for our first clinic it went well. Doc says that tomorrows will be busier and with more people; a more realistic clinic.

September 14, 2010:

First Clinical!! Way different from yesterday. Yesterday was only half a day (10am-1pm) and today we worked from nine to one, then two till 7. A total of nine hours. We started by registering people to see the doctor. I would ask for their name, age, birth date, if they were allergic to anything, if they were taking any meds, and so on. Then after getting their symptoms and problems I would take their blood pressure.

The hardest part of it all was writing down their names. I could almost never catch it the first time and then spelling it was a total different story. Ha ha Bless their hearts, they were so nice and patient with me. At times I just had them write down their own names.

After an hour had passed Pastor Puma came over to help. All this time while I was registering Rachel was at the pharmacy (a table near the doctor with our one box of meds behind her) handing out the prescriptions that the people would hand her. I let Puma take over the registration and I went over to help Rachel out. One of the first things that the Doc told us a few week ago was, “Never hesitate to ask, especially if it concerns a patient.” So, we took him up on that. Considering it was our first real clinic we had no idea what his chicken scratch meant. So every three patients we were asking him, “What does this say?”

We hated having to ask him so many times, but we knew that it had to be done. Going over the meds the week before really helped us out decode some of the meds. If we knew what the problem was, we could figure out what med he had prescribed.

One thing I’m sure about. I like the registration MUCH more. I could talk with each person one on one, interact with them, and at least get to laugh or sympathize with them. Giving meds is such a fast paced process: read the prescription, look for the meds, pack them, write out instructions, and then tell them the instructions. Hardly any interaction.

At some points of the morning the Doc would ask for a med and we would have to shake our heads and tell him that we didn’t have it. He would shake his head and move on. We felt so worthless and stupid. But then again no one showed us how to pack or what to pack. He gave us a short list of maybe 15 meds and that was it.

We had our 1 hour lunch break. We snarfed down some food and then went into our pharmacy to restock on meds that were running low and then we grabbed extra meds that he had asked for earlier that day. At two we were back at it. In the afternoon it got a tiny bit easier. We also got to see our first tumor removals. One was on a mans forehead. It was really big. The tumor was the size of two grapes. Then the second one was on a girls hand. Hers was harder to get at because it was much deeper. After their surgeries Rachel and I administerd our first shots. I gave the man his shot on his butt and Rachel gave the girl her shot on the arm.

Now, at night in my bed, I’m super exhausted. And I don’t know if I’ll be able to sleep. My mind is very restless. So many errors, so much improvement, so many knew things. I’m a bit overwhelmed…

But I guess its only my first full day.

September 15, 2010:

Clinic day #2. So yesterday was only half a clinic even though we worked for 9 hours and had 99 patients. Today we were at a new location; Santa Elena. Yesterday we were at Santa Teresita. Because of an unexpected accident we had to start late and we arrived at our destination at 2pm. This time we had a better place to set up our meds and administer them to the patients. We weren’t all crowded in a small room. In fact, Rachel and I had a large table, plenty of room behind us to place our stuff, and the doctor had his own little room. With his own office it gave him more room and it gave the patients more privacy. What was also really handy was the extra room we had to work with. It was a small room with two beds. Rachel and I used this room to give butt shots.

We did the usual of giving out the drugs and asking questions. However, by the end of today I feel like we are much better at reading his handwriting. In only 15 hours we have improved our decoding by 30%. We ended the night with a surgery done on a 4 year old girl. She was so precious and it hurt us all to see her in pain. As the Doc gave her anesthesia she screamed at the top of her little lungs, Lauren held her knees down, Doctor Diana held her arms down, her mommy embraced her baby and tried to calm her, and Rachel and I stood nearby with the tools ready to assist.

I wanted to cry, but I knew I had to be strong. As the Doc worked hard at removing the tumor, mommy cried for her little girl. I now truly know that when a child is in pain, the mommy and daddy are hurting too. Probably more than what we children realize. I love you mom. Thanks for all the hurt you have endured for me and for your endless love. I miss you tons.

September 16, 2010:

Clinic #3. Things have definitely improved. I got better sleep last night and was able to work better. Oh I forgot to mention that these last three days I have been battling the cold. I have no idea where it came form. It’s so annoying because it hit me hard on our first clinic and it has slowed me down. Luckily, I have Rachel and many friends who watch over me. I’ve been taking medication, loading up on the vitamins, drinking tons of water, and staying away from any sweets. Thankfully, today it wasn’t too bad.

When I think that my brain has no more room for new material, I’m always fooled. Today the Doc showed us new things. We were administering different meds, dosages, shots, and so much more. Rachel assisted with a vaginal exam and an infected penis. Hope no one minds reading this ha ha. I administered anesthesia on a middle finger and pulled out its nail for the first time. I also learned how to irrigate ears.

Holy Macaroni! I was shocked with how much, ear wax, crud, puss, and so much more could be stored away in an ear canal. My first two ears belonged to two little boys. A 7 year old and a 10 year old. They were complaining of pain and so when the Doc took a look, he found a blockage of ear wax. I was then put to the task of cleaning them out. I first started by poking a hole in stool softener pills and then squeezing the liquid in their ears. I had them lay down for 15 minutes so the stool softener could work its magic. I then took out a huge metal syringe, pulled in some water, then pumped it in their ear with some pressure. The two boys were easy. But then came my challenges. There was a young girl who had a horrible ear infection mixed with tons of wax. I was to remove as much of it and then wash her ears out. When I removed good size chunks I washed her ears with an iodine solution. Finally I had an elderly fellow who couldn’t hear because he was so clogged with crud. I irrigated both ears several times and got a lot out. At one point he said, "Hey, I can kinda hear you." When I couldn’t get any more out I decided to add more stool softener and had him lay down again. I then gave it another go and was able to get more out. However, when I looked in his ears again there was still white stuff deep in his ears. It was impossible to get it all out. So I asked the doctor to take a look, he shook his head and said there wasn’t much we could do. Meanwhile Rachel was by herself doing the meds. Sadly, we had to let him go home because we were backing up with tons of patients. I felt so bad because he was in so much pain and I was so close to getting it all…

We ended the night with two surgeries. A long and difficult hernia removal and a 2 minute tumor removal. The Doc is incredible, he can do anything he puts his mind to. Unfortunately, I wasn’t able to be there for the hernia surgery because I worked on packing up and getting things ready for departure. At 9pm we arrived home exhausted but with higher spirits than the night before. We came home to some delicious homemade GLUTON! Our beautiful friends Jenessa and Hanna had prepared supper for us.


What I’ve notices as clinics go by:

We pack more meds

We have less questions

More responsibility is given to us

We learn new procedures

We come up with more efficient tricks (the Doc is all about efficiency 24/7)

Tonight’s quote form the Doc “Buen trabajo chicas, trabajaron duro, aprendieron mucho, y hay mas que aprender!” (Good job girls, you’ve worked hard, you’ve learned a lot, and there is more to learn) There were hard times, but overall its been a GREAT day.

Monday, September 13, 2010

When the lights go out



September 12, 2010:

No electricity = no light and no water. Luckily for us today was Sunday and we didn’t have to worry too much. Considering that Sunday is our day off, the chicos weren’t with us, some of the team had left to Pucallpa, and some of us girls stayed back. So when it came to make meals we only had to feed six people. Having no water to cook with made it a bit difficult. But since it was only us eating, we decided to finish the leftovers from breakfast.

In the middle of the day with nothing to do, we decided to have a kill fest. We removed everything from our dinner table and brought out the fly swatters. Bernie told us that there are 3 plagues: flies, ants, and cockroaches. Right now we are in the plague of flies. We were fed up with them landing on us while having lunch, so we had to do something about it. 1, 2, 25, 40… they were dropping like flies ha ha.

We were swatting left and right. With a hint of insanity in our laughter we were unleashing destruction on our first plague of the year. When the numbers began to drop we brought out prey to try to lure more. After a good 30 minutes we got tired of waiting for more to land on our table.

Don’t worry. We didn’t leave our yucky mess on the table. We swept the remains off the table and off our floor. We finished the clean up with a thorough wipe of the table. We made sure to use Clorox too.

To our dismay, the second we sat down to enjoy our clean table the swarm of flies began to fly in. We give up. The plagues cannot be destroyed, we just have to endure them.

With no water, no fans, and 100% humidity we were all bathing in our sweat. We yearned for water to bathe in and to drink. The little water we had in water bottles was diminishing fast. We had to make sure to ration it through out the day.

Later in the evening as the sun began to set we decided to play some volleyball. At this point the heat was leaving with the sun. We began to feel a little better.

For supper we had leftovers. Lauren and Rachel also treated us with homemade peanut butter oatmeal cookies. They were so YUMMY!

At night the Doc and others attempted to start the generator. Failure. So they finally ended up going to a neighbors well and drew up some water to last us for the night.

The fun was only beginning. In the complete darkness of our base Hanna and Caleb decided to do some experimenting with their cameras. Soon we had all joined in the fun. We had our headlamps out and we took many cool pictures in the darkness. There were many laughs and so many silly moments. It was the MOST fun I had had with no electricity.

Who says that you can’t fun without electricity. This team can sure turn a disaster into a time of joy J


Friday, September 10, 2010

Inventory, Poking, Sutures, Oh My!






September 10, 2010:

This past week has been “Training Week” for both dental team and nursing team. And when I say nursing team I really mean Rachel and I. The dental team has been learning about anesthesia and extractions. On Monday and Tuesday they had lectures and videos to watch on all the procedures. Then on Wednesday and Thursday they where able to apply all that they had learned. They practiced the anesthesia on themselves and then pulled teeth out of a pigs head.

While the dental team poked each other in the mouths, Rachel and I did some poking of our own. First we went over IV’s and then practiced on each other. When our arms were tired from being poked we asked the dental team if they would volunteer. Gladly they did J Following IV’s was injections. At first Rachel and I thought we were only going to have a lecture over the injections… nope. We first went over the technique and then we stung each other: once in the arm and then in the butt. The needle prick wasn’t bad, what really hurt was the sterile water that went in. Boy, that sucker really stung!

At first Rach and I didn’t know why it stung so bad, but then we later learned that the water had no electrolytes, so of course it was going to sting.

The Doc let our poor bodies have a rest and told us that we could wait until the next day for anesthesia. Thank goodness. Ha ha. So the next morning we went over the two types of local anesthesia we would be performing. We had a lecture over deep wound anesthesia and we practiced digital anesthesia on each other. We both chose our left ring fingers and numbed them up.

They got so fat and heavy. The feeling was so weird that it made our stomachs a bit queasy. Not only did we learn how to numb cuts but we also learned how to sow them up. The Doc showed us three different sutures and then the dentist (Dr. Fillmann) taught us how to do them. We learned the simple suture, the Pak suture, and the no-scarring suture. We did all of our sutures on the pig head that the dental team had used for their teeth extractions. I never imagined myself doing such a thing… Holy cow! It was so AWESOME!! I’m so addicted to it. That night I couldn’t stop thinking about it and going over the sutures in my mind.

When we weren’t poking each other we were diligently working in the pharmacy doing inventory. And when we weren’t doing either of those things we had our noses in the med book studying the meds in the pharmacy. The Doc wishes us to know as much as we can about all the meds. He told us that we are his right and left hands, so if he’s busy and something comes up we are to take charge. That’s a lot of responsibility… more than what I asked for. But I guess in the long run it will help us a lot. I just pray that God will lead us both in all that we do.

The inventory alone was a battle we feared we would never win. There was so much stuff in there and very unorganized! We had everything from Love Lube to children’s chewable vitamins. It was our job to go through every single thing and count it. Whether it was capsules, tegaderms, or vials everything had to be counted. So much!! We had to separate things in categories, label drawers, and remove the expired stuff. It took us a total of 38 hours to finish it. But when it was done we jumped and shouted for joy J

I have been told by the Doc that our first clinic is this coming Monday. I’m so nervous. He told us that we would learn how to package up all our tools, meds, and supplies for the clinics. And that we would be able to apply all that we learned on real patients! I’m excited but at the same scared to hurt someone or disappoint the Doc.

I’m super excited for the time when we pack up and start the traveling. Which I think will happen here in a week or two. But at the same time I’m really bummed to leave behind our new friends. Hanna and Janessa will be located at the base and I will miss them dearly. It’s so AMAZING how all of us SM’s have bonded so closely in just a week! We’re a tight knit family already. And it breaks my heart to know that we won’t be all together all the time. And the locals that have been teaching us the Peruvian ways will also be staying at the base L I wish we could all travel together…

Well I guess you can’t always get what you want. But I know God will bless both teams; the mobile and base.

Busiest sabbath of my life



September 04, 2010:

The busiest Sabbath of my life started with some yummy pancakes. After our wonderful breakfast we headed towards Yerbas Buenas; our new home church. I went with Rachel, Chris, and Hanna. We had sabbath school and then followed by a really good sermon from our evangelism leader Puma. He’s an INCREDIBLE preacher and I’m so excited to be working with him! Rachel, Hanna, Chris and I sang “Pass me not oh gentle Savior” in Spanish for special music.

When church was done we went back home to have lunch and to rest up a little. Then at 4:30 we were back at the church for JA – Joventud Adventista (Adventist Youth). We lead out two games: sword drill and 20 questions. We did another special music and this time we sang Mighty to Save. We sang some songs, played more games, and then finally watched a video on codependency in relationships. It was almost 7pm when we returned back to the base.

We snarfed down some pancakes and headed out AGAIN for some juegos sociales (socaial games). When we arrived to Santa Elvita we were greeted by many kids very excited to play. We played many fun games, had a wonderful meal, and finally ended the evening with some goodbye words for our friend Bernie.