Guatemala

Guatemala
My home for the next 6 weeks!

Monday, July 26, 2010

Blog Catch-Up: Ophth Week and My Last Week Here

Catching up on blogging... here are the last three blogs:

Thursday, July 22, 2010
Last night, every time I closed my eyes, I saw the replay of a cataract eye surgery … it was strange! I guess I had just watched a ton of them!

Yesterday, I got to help Dr. Don Loconte with pre-op and post-op consults. I had the best time! I think I want to be a type of doctor that gets to sit down one on one with her patients in an office. I got to translate between the doctor and the patient. I got to tell the patients where to position their hands, feet, chin, and forehead, in order to look into the eye piece machine for Dr. Don. This was quite difficult. And trying to get the patients to look straight ahead and not look around… wow, tough. I probably said, “Mire recto,” “No mueva la cabeza,” and “Mire la luz” over a hundred times. I would say, “Look at the light,” and some people would look all around. One person even closed their eyes tight! Oh my gosh. Yes, it was frustrating, especially for the doctor, because we couldn’t get good readings on their eyes, but I was getting SO tickled with each patient! I loved to just sit and talk to them before and after the consult. So many interesting personalities!

I got to instruct the patients on how to use the big black spoon to cover one eye and read from the visual acuity chart. You wouldn’t believe some of the things people do! They cover one eye with the spoon. Then, we say, “Now cover the other eye,” and they use their hand to cover the other eye ALSO! And then they say, “I can’t see anything.” Haha!


Saturday, July 24, 2010
So, we had an amazing week at the clinic with our eye surgery team. There were 29 of us, and if you weren’t helping out medically, you were painting the patients’ nails, braiding their hair, or praying with them. It was neat to watch everyone participate.

Last Tuesday, I got my MCAT score back… and I improved and got what I wanted! I was so excited and relieved! The group was so kind and congratulated me and celebrated with me!

I loved translating for the patients all week too. Especially in the OR, where it was critical that I communicate the correct things to the patients. It was my job to relay messages from the doctor to the patient such as, “Please keep still,” “You’re doing a good job,” “It’s almost over,” “Can you see the doctor’s fingers now?” etc. Also, when the patients would muffle something from underneath the tarp, I would have to try to understand what they were saying and translate it for the doctor.

On Thursday, we only had one patient, so afterward, we went out for an excursion. I went to a coffee farm in the middle of the jungle. I saw crazy-looking fruits and a huge tree, which took 55 steps to walk around! Late Thursday night, we played an ultimate Frisbee tournament in the soccer field next to the clinic. It had poured rain all day, so it was super muddy -- we were slipping all over the place and covered in mud by the end of it! It was my first time to play ultimate, and we played past midnight… so fun!

Friday, Macie and I got to travel with the group to Antigua, before they flew out on Saturday. We went with a group zip-lining through the jungle right outside Antigua! We flew over coffee farms and saw the city of La Antigua from above. I got to fly upside down above the trees -- a great time! Our hotel in Antigua was an absolutely gorgeous resort. We had a black infinity pool right outside our hotel room! We went downtown after dinner for a concert in the park, and then came back to hang out around the pool and talk. It was so relaxing and fun!

Saturday morning, we dropped the group off at the airport and said goodbye. :( Dany drove us back to Chicacao. On our way back, we stopped off at a restaurant on the side of the highway for lunch. There were ostriches in a pin right next to the restaurant. We tried to order ostrich burgers from the menu, but they were out!

Today was our last Sunday here! We went to the market and church. I saw my first baptism in the Church of Christ. The baptistery is downstairs below the church, next to the pastor’s kitchen. My “dad,” Papa Pedro, baptized the man, and we got to congratulate him afterwards. Now, I’m waiting for the rain to let up a little, so that I can walk back to my house from Macie’s house.



Monday, July 26, 2010
Today is my last Monday in Guatemala. I am spending this entire week going out with Dr. David Lux to mobile clinics. (I first met him when I was throwing up my first week here.) Today, we went to "Las Margaritas" mobile clinic. I got to talk to Holly on the phone for the first time in a long time... I miss her!

Well, we saw a total of 27 patients at Las Margaritas, which isn't very many. I decided to write down some of the things I saw today, just so that I can remember later...

An older man came in complaining of painful urination. He handed us his lab reports, which said he had an enlarged prostate. Eek. I saw a baby boy with Staphylococcus infection all over his skin. I saw a 5-year-old boy, whose mom had brought him in because of problems with his eyes. I could tell something wasn't right, and Dr. Lux told me the boy had a nervous tick. We sent him off to have a psychoanalysis workup to see if it was a type of neurosis or some other cerebral problem. I got to palpate two people's enlarged spleens... the spleens were huge! You didn't have to be a doctor to know that something wasn't right with a massive bulge in their left side! I listened to Dr. Lux consult a diabetic woman about how to eat. He told her only 5 portions of sugar every day; with sugar including potatoes, rice, tortillas, soda, fruit juice, papaya, bread, cookies, etc. She was shocked that she could only have 3 tortillas at each meal! We also saw a man who came in with a torn cornea. It looked like something had sliced his eye, but he didn't remember ever having been hit with anything. I saw a 3-year-old little boy who had "syndactyly." He only had 4 fingers on his right hand and two of them were fused together. Dr. Lux told me that all embryos start out with their fingers fused together. Then, the cells in between each finger die so the fingers can separate. The little boy is going to have an x-ray to see what bones in his hand he has, to see if plastic surgery is an option. Our last 3 patients were crying babies. Dr. Lux did nothing to them, yet right when they entered the room, they started screaming and grabbing on to their moms. I love little kids and have often thought I would be a pediatrician, but if the very sight of me sends little kids screaming, I don't think I want to do it. It was difficult to hear their lungs and look in their ears. I don't know how pediatricians can make accurate diagnoses without eing about to properly examine the patients! We had some extra time afterward, so I talked with a neighbor girl and got to pet a rooster.

Now, I'm back at Macie's house, drinking coffee while in pours rain outside, waiting for church to start at 6.

Saturday, July 24, 2010

Ophthamology Surgery Team

Monday, July 19, 2010
This morning, I got to walk patients to Dr. Don, an optometrist, for a check-up and then back to their beds. I enjoyed leading the practically blind little women back and forth, trying to get them to position their foreheads correctly in the eye machine, and constantly repeating “No se mueva. Por favor, no mueva los ojos.” Haha, some just couldn’t sit still.

In the afternoon, I got to shadow in the OR. We had an amazing patient named Cesar. He was a Guatemalan, living in the U.S. He flew here on a hope and a prayer that he would be a surgery candidate. He was 47 and already had bad cataracts in both eyes. He was a recent believer, after he entered a church and told the people, “I don’t need food. I need God.” He could hardly see. He spoke English well, and jovially carried on with the doctor while the operation was going on. When the doctor finished, he sat Cesar up in bed, removed the drape, and asked Cesar to look ahead. He looked at Lauren and said, “You’re so beautiful!” and looked at Cal and said, “And you’re so handsome!” It was an amazing miracle to witness this once blind man, seeing for the first time in a long time! When Cesar commented on how handsome Cal was, the doctor joking said, “Oh no! I must have put the wrong lens in!” It was one of the best surgeries to be a part of.

Soon afterward though, we had a patient that was a very difficult case. She was very anxious. She seemed claustrophobic underneath the drape and would not stop moving around. While the doctor’s scapel was in her eye, she squirmed and reached her hand up to her face! We pleaded with her to sit still, but she moaned and loudly complained about the pain, even though the doctor gave her three times the normal amount of local anesthesia. She was so squirmy, we had to have two people hold her arms down, one hold her legs down, and one hold her head down. And even then, the doctor had to pull out early, without inserting the implant. He removed the cataract, but couldn’t replace the lens because she would have jumped off the table in pain. It was a very tense case, and we were all glad when it was over.

In one day, I experienced the blessings AND the hardships that a surgeon goes through each day.


Thursday, July 22, 2010
Last night, every time I closed my eyes, I saw the replay of a cataract eye surgery … it was strange! I guess I had just watched a ton of them!

Yesterday, I got to help Dr. Don Loconte with pre-op and post-op consults. I had the best time! I think I want to be a type of doctor that gets to sit down one on one with her patients in an office. I got to translate between the doctor and the patient. I got to tell the patients where to position their hands, feet, chin, and forehead, in order to look into the eye piece machine for Dr. Don. This was quite difficult. And trying to get the patients to look straight ahead and not look around… wow, tough. I probably said, “Mire recto,” “No mueva la cabeza,” and “Mire la luz” over a hundred times. I would say, “Look at the light,” and some people would look all around. One person even closed their eyes tight! Oh my gosh. Yes, it was frustrating, especially for the doctor, because we couldn’t get good readings on their eyes, but I was getting SO tickled with each patient! I loved to just sit and talk to them before and after the consult. So many interesting personalities!

I got to instruct the patients on how to use the big black spoon to cover one eye and read from the visual acuity chart. You wouldn’t believe some of the things people do! They cover one eye with the spoon. Then, we say, “Now cover the other eye,” and they use their hand to cover the other eye ALSO! And then they say, “I can’t see anything.” Haha!

Monday, July 19, 2010

Weekend Fun and Eye Surgery Team

This past weekend, Macie and I caught a ride to Guatemala City, two hours away from where we live. My suitemate for next semester, Jessica Castro, actually lives in Guatemala City! We didn’t really know each other; we had just met once. She graciously invited us to stay at her house and show us around the city. Her family was very welcoming to us and even gave US presents… We had a fabulous time with Jessica! We walked to a nearby mall - it was huge with 5 stories, many restaurants, a movie theater, and a carousel inside. We thoroughly enjoyed shopping around, and then we ended up at an aquarium restaurant. There were fish underneath our feet under the floor, and we got to go inside the huge aquarium with a shark, eel, puffer fish, and a scuba diver! Afterward, we grabbed some authentic Guatemalan coffee and went to the theater to watch “Eclipse.” It was in English with Spanish subtitles… so good! :)

The next day, we took a taxi to the airport to meet the American eye surgery group that was flying in. We rode with them in a bus back to the clinic. Three hours later, we arrived at the clinic in Montellano, and immediately we began eye consults. I helped with the visual acuity chart tests. I instructed the patients to stand behind the line, cover one eye with the spoon, and read me the chart, if they could. We couldn’t use the typical E chart, with all the alphabet letters, because many are illiterate, so we just used a chart with all E’s. The patients had to tell me whether the E was facing right, left, up, or down. I got so tickled watching the patients try to mimic the way the E was facing with their bodies, rather than simply telling me the direction. The consults lasted until 10 p.m. Macie and I decided to stay at the clinic hotel with the group this week, instead of with our host families, because finding a ride from Chicacao to Montellano was such a hassle every day.

Today, I got to observe in the operating room. I saw Dr. Jerry Swale from Illinois remove a cataract from an 80-year-old woman. I was the “translator” in the operating room. I got to forewarn the patient what the doctor was about to do, monitor her pain throughout the surgery, and keep her informed post-op. She was so brave. The doctor had to zoom in and focus his microscope manually because we lacked some equipment that we have in the States. Also, we didn’t have an anesthesiologist, so our patients just received local anesthesia. They were completely conscious and their eyeballs were moving around looking at us, while the doctor cut into their eyeballs… it was creepy! I would have definitely required some anxiety medicine! I saw the doctor slip the cataract out and lay it on the patient’s chest. I got to feel it between my fingers… it felt like a hard booger. Then, Dr. Swale inserted the new lens implant, and that was it. Right after he slipped the new one in, he asked the patient to open her eyes. She was able to tell him how many fingers he was holding up. Before surgery, she could only detect up-close hand movement. Crazy cool.

I’ll be working with this ophthalmology team here at Clinica Ezell through Thursday of this week. It’s already so fascinating, and the people are so kind! Thanks for your continued prayers. Please pray that the surgeries will run smoothly and that we will be able to help the patients, despite lack of certain instruments and machines. Dios te bendiga!!

Thursday, July 15, 2010

Looking for the Beautiful and Unexpected in the Day

I called my mom this morning, and we got to pray together over the phone. She prayed that God would show me something interesting or special today. I appreciated that a lot, and God DID give me something amazing today!!

I went to a mobile clinic today that is an HOUR away, and is basically a jungle and waterfalls. It's very picturesque, and I have been begging my co-workers to bring me up to the waterfall. They said it would be too tiresome, so I figured it was a no.

Then, a little boy, 2 years old, came in the clinic. All the workers knew him and immediately welcomed him. His head was wrapped in a white bandana, and I could tell he was a little developmentally delayed. Soon, I found out that "Domingo" or "Mingo" had had surgery 2 months ago in the U.S. Apparently, he was born with "meningocele," a form of spina bifida, where he had a large bulge on his forehead and back, where a part of his brain and his spinal cord were protruding. Today was just a checkup to see how the scars were healing and to make sure that there was no infection. He was the skirmiest little kid, wanting to grab and touch everything. He had the biggest grin and was just a downright happy kid. I thought, "This is the neat thing God brought into my life today, for sure."

Then, Valentin, the guy I have been working with all week, asked the doctor if he could take me to go see the waterfalls, because I had been asking all day. It was really slow anyways, and so we got to go! We drove halfway up the mountain, which was crazy. I thought we weren’t gonna make it up some of those rocky, steep hills! Then we got out and hiked the rest of the way up. I got right up close to the pounding waterfall, and the mist was spraying us like crazy! I got some pictures, and then we sat down and ate our lunch up there. It was so neat! I was sad that Macie didn't get to go though. :( Just the mist in my face and the roaring of the waterfall was amazing. I thought, "This for sure is my special thing for the day from God!"

I love it when God answers specific prayers! Thanks for your prayers as well, and God bless you for praying for me!

Tuesday, July 13, 2010

Randomness

So, we’re back in Chicacao! It’s strange, but I actually felt like I was coming “home”! So, I just have some random stuff to blog. I have learned lately to be careful with my accents and pronunciations, because it makes a big difference. For instance, “vejiga” means “bladder” but it also means “balloon,” like the ones your blow up for birthday parties. “Catarata” means “cataract,” like the clouding of the eye, but it also means “waterfall.” “Año” means “year,” like Happy Birthday (Feliz Cumpleaños), but “ano” without the mark above the n means “anus.” Be careful when you’re asking someone how many years they have. :) “Mamá” with an accent means “mother,” but “mama” without a tilde means “breast.” “Papá” with an accent mark means “father,” but “papa” means “potato.”

Also random, but this made me laugh. The letter ‘x’ in the Quiche language makes the “sh” sound. So, I had a patient named “Xirle,” which is pronounced “Shirley.” How weird!

Also, I found this verse that I really like. I’m trying to apply it to how I live each day:
“He redeemed my soul from going down to the pit, and I will live to enjoy the light.” Job 33:28

Saturday, July 10, 2010

Last Clinic Day in Chichi

I worked with Melinda the physician assistant today. I was nervous because she was used to having Paco as a translator, and I’m no Paco. Well, I spilt my water bottle all over my pants before we even got going, so I got to ride in the truck bed on the way to the clinic to air out - so fun! My camera got wet and started acting funny though. “Paxtul 2” clinic was really beautiful with an amazing view from the rooftop of hundreds of avocado trees. Guatemalan Dr. Josephina Lux saw 46 ABC patients (sponsored children), and Sherry and Melinda split all the “sick” patients.

One of our first patients was a 6-year-old boy named Manuel whose mom had brought him in because he was so fearful, he couldn’t sleep at night. Every time it rained, he cried because he was afraid of another hurricane or mudslide. I got to translate for Matt Swale, our prayer leader, as Matt told little Manuel about God and how God is big and takes care of us. Then, a man from the village came and we all laid hands on him. As we did, little Manuel knelt to the floor - it was so precious. We all prayed over him out loud in different languages. It was moving, and I could feel the Spirit’s presence. So cool. I learned many new words today, and Melinda was a hoot to work with. She tried to talk me into going the physician assistant route, and she was pretty convincing. We’ll see; I get my latest MCAT results in 20 days.

Rick told us that we do get to stay with the group tomorrow, and we will ride back to Chicacao early Monday morning. That means we get to shop tomorrow at the Chichi market, the LARGEST market in Central America! Then we will drive to Guatemala City with the group and stay in a hotel Sunday night. Dr. Walter Sierra will pick us up on his way to work at the Clinic Ezell Monday morning.

I am feeling much better! Thank you for the prayers! I told some American nurses here my complaints about low blood pressure and lightheadedness, and they said it sounds like a “vasovagal response.” They told me some things to help, and I can already tell a difference. Such a difference!

Friday, July 9, 2010

Translating in the Highlands

Today was my first day to translate alone in the clinic... it was so exciting!! We arrived in Chichicastenango ("Chichi") Wednesday night. The hotel here is gorgeous and I have a huge room with a balcony overlooking the misty Guatemalan mountains. Pretty sweet. We are also here with 50+ other Americans, which has been such a nice change! Speaking English and hanging around this American medical group has made me a whole lot less homesick. I am working with some really neat people from all over the States.

Thursday, Friday, and Saturday we go out and do mobile clinics. Yesterday, I observed the American and Guatemalan doctors, and they were very helpful, teaching me things. But today, it was just the patient, the American doctor, a Quiche translator, and me. The Quiche translator would translate the patient's complaint from Quiche to Spanish. Then I would translate it from Spanish to English for the American doctor. Then he would tell me what to ask her and the process in reverse would occur. It took a while, but it was SOO neat to be the intermediate. The doctor waited on me to hear what was wrong.

There are a lot of parasites and gastritis here. I'm constantly learning new medical words and keeping my dictionary handy. Today, I got to tell a 42-year-old woman that her stomach pain was because she was pregnant! Crazy that I got to deliver the news! I learned how to put a stethoscope on someone's chest and scratch around on the person in order to locate the outline of the liver!

I am enjoying American company and hearing them voice things I have been thinking about being here. Very refreshing. Thank you for all your prayers. They are heavily appreciated and please keep them coming!