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Clinic & Midterms Week

10/23/2011

Sorry for the long delay, last week was our midterms week. Yes, I know what you are thinking, they actually do work on this trip haha!!! But if you were thinking that, then you are very wrong. First, we assist in saving lives weekly. Yes, some might call us heroes haha. Also, we attend class in the mornings and it is not easy competing academically against a bunch of people who want to be doctors!!! But no worries, we all survived the week and made sure we were well rewarded this weekend. Since we spent most of our time writing long research papers, this weeks blog is primarily going to focus on my clinical experience.

I spent the last two weeks working at the major public hospital in Oaxaca called Hospital Civil. I started off the week working in the OBGYN department. Before you say EWWWW, this was probably my favorite shift because I got to help with the post-labor baby work, which only involved cute babies. Here is a picture of the Labor Ward where a couple of tubbos are looking to shed some weight.

Here is where I spent most of my time in OBGYN. Once here, we gave each baby eyedrops to fight off any bacteria, and a vitamin K shot to help clot their blood, specifically the blood in the umbilical cord. After that we would run through a check list that told us how far along the baby was gestationally. For example, if the baby had several crease lines on the bottom of his or her foot, that would mean they have been developing longer. Smooth feet means the baby was less developed, which is what we saw in premature babies.

Here is one of the baby girls I assisted with. You can see they just finished putting her foot print on her birth certificate.

My next shift was in the Surgery department. Here are my friends hanging out in the on-call room until we are called for surgery. A typical day in surgery meant arriving at seven for class, then following the doctor bed to bed as we went through rounds, and finishing the day with a few surgeries. The classes were cool because they were powerpoint presentations of the surgeries we were going to be doing that day. It helped fill us students in with the process, and put everyone else on the same page. Rounds were exactly like you would see on a medical tv show, like Scrubs. We would go bed to bed, short presentation of the patient's case would be said, and then the doctor would ask everyone questions. After rounds we would go to surgery, but I'll explain more about that later.

Here I am practicing Laparoscopic surgery with there simulator. It was like playing a video game. The objective in the simulator was to put beads on a string. It was really hard but after 10 or so tries I was really getting the hang of it.

Here is a picture of my partners and I with one of the surgeons. He was great at explaining everything he did, and even would pause at moments so we could take pictures.

Here is another one of the doctors we worked with and two of his residents. This was a gallbladder removal and, as you can see, the surgery room is very similar to that in the United States.

This was probably the most interesting surgery I have seen because of my dad's hand accident. Lets just say my day was very lucky. This man got his hand caught in a machine, which took off his pinky and left the rest of his hand severely damaged. Several days after his accident we had to go in and remove the finger next to his pinky because it wasn't receiving blood. I debated showing a picture of the fingers because they they were taken off so cleanly that they looked like a halloween prank, but I decided to not take the risk. Also, just to note, in Mexico they wouldn't have reattached my dads finger. They only reserve that option for young kids.

My last day in surgery I saw a man who broke the top of his femur. You can see where the bone broke in the drawing on the side of the X-ray. This surgery was crazy because they literally had to use a drill gun to drill holes in the bone and screw the rod in place. The surgeons were more like carpenters than doctors haha.

My next shift was scheduled to be in the Pediatric department but, unfortunately, the doctor didn't want students following him around. I was disappointed because that was the shift I was most looking forward to, but it was probably for the best because it doesn't sound like the doctor was very nice. So instead, I was in the Oncology department. The majority of what I saw here was the removal of tumors but here is a CT scan of a person with kidney cancer. On the left side of the picture, right next to the vertebrae, is a normal circular kidney. On the other side is an abnormal, tumor-filled kidney. Unfortunately for this woman, we weren't able to remove this kidney because she reacted badly to the anasthesia, went into cardiac arrest, and had to be resuscitated. Thankfully, she survived but they were unable to continue the surgery.

On tuesday, last week, we went to a restaurant where we were going to learn to make traditional Mexican food. We were split into 4 groups and each group was given recipes of different things to make. Here are all the ingredients that my group was given.

Here is my group hard at work. We were assigned to make Arroz con Chepil, Ensaladas de Acelgas Almojo de Ajo, Pozole de Pollo Rojo, Tejocote en Dulce, and Agua de Jiotilla.

Here is a picture of the other groups in the restaurant. My favorite part about the whole thing was wandering around to other tables and eating other group's ingredients haha.

Here was the majority of the final product. Looks good, right? Except, I really didn't enjoy any of it. I think it is called traditional for a reason, meaning they no longer prefer to eat this food in the present. The safest thing on that plate was the tamale, which was practically just corn and no meat. I'm so culturally diverse haha.

Today we went back to the orphanage to play with the kids. It was a lot of fun and really rewarding. This time, because they knew who we were, they all ran and gave us hugs as we walked in. Here is a picture of my roommate Duke and some of the kids playing Pogs. I remember collecting those as a kid.

Here is a picture of everyone starting to settle down after a game of capture the flag. It was Pirates vs. Ninjas and each team won twice.

All the little girls loved to play with everyone's hair. I think they were going for the Whoopi Goldberg look haha. It was another great two weeks and we have two left till we go to Puerto Escondido. I'm really excited. Enjoy the post and please comment. It lets me know that people are reading this haha.

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Molinillos Video

10/15/2011

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I was finally able to download this video. It is how they make these wooden mixers. Its pretty cool so I thought I would share it with everyone even though it is a little late. Enjoy

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Weekend in the Mountains

10/11/2011

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This past weekend was another busy weekend full of events. We got up at 6am and left for a 2-3 hour drive into the Oaxacan mountains.

After stopping for a quick bite of breakfast, we stopped at house that specializes in making Molinillos. Molinillos are very traditional and cultural tools that have been used for years. Look at all the detail and skill put into these oversized rattles. What is funny is you would think these intricate pieces must have a complex purpose, but they are actually just extravagant wisks used for mixing things haha. Regardless of their simple purpose, they are very interesting and appealing to the eye, so I bought one. I feel like it is something that can remind me of the trip and also make me look more cultured when company comes to visit.

Here is one of the many cabins in the mountains, were we stayed over the weekend. The views were amazing from every angle. Whatever direction you looked there were rolling green mountains and thick white clouds.

This is a picture of the center area of the cabins. This is where we learned about traditional medicine in Mexico and how it applies to the medicine they provide today. This is also where we had a bonfire at night. We sat around the fire and roasted marshmallows while listening to a 12 acoustic guitar live band. It was really fun and after the band finished playing, they let me play four song on one of their guitars. It soon turned into karaoke as I played the music of popular songs and everyone else sang. I was told one of my friends video taped it so if I get ahold of that footage I'll make sure to post it.

After our lecture on traditional medicine we went to an actual place where these practices were offered. They asked someone to participate in the traditional medicine technique called limpia; and, thinking it would be harmless, I volunteered. I spent the next five minutes getting beat by some weeds and tickled with and egg. If that wasn't enough, the person then took a mouthful of Mezcal and spit it into my shirt, on my chest and back. It was kind of ironic that they called it a Limpia seeing as, at the end, I had grass stains everywhere and smelt like hard alcohol haha.

After torturing me, they crack the egg into a glass of water and depending on the amount of bubbles that rise up, tells you what evil you have released from your body. Apparently I released my guilt and a grudge that I was holding against a friend.

Here is one of the many beautiful views that surrounded us. There were so many that I struggled to choose which one to include in this post.

Once I was rid of all my evil spirits, we went on a hike into some dark and scary caves, probably so I could get some new evil spirits, like distrust and panic haha.

Don't let the flash full you. These caves were pitch dark and soundless. Also, this was one of the more spacious walkways we walked/climbed through. At one point we had to climb up a slippery wet ladder to continue on.

While in the caves, we often stopped and the guide would show us cool shadows and rock formations that resemble things. This is a picture of a rock that looks like a clown. We stopped and did this every five minutes. It makes you wonder how much time that tour guide has spent in those caves.

Here is a picture where we ate dinner. It was a nice outdoor restaurant that sat next to a stream. You can also see the platform in the upper left corner where we zip-lined across the river. It was a nice desert after we ate.

The next day we woke up, had a big breakfast, and got ready for another full day of adventure. Here is another old church of which the town of Capulalpam was built around. And below the picture of the church is the view from the entrance door of the church. Almost makes you feel like your in heaven looking over the earth.

After visiting the church, we went on a very interesting and Mexico-unique ride in the back of a truck to the top of the highest peak in the surrounding area. We fit 28 people in the back of that truck and held on tightly as we drove for an hour in rough terrain.

The ride turned into a game as we ducked under oncoming branches and tried not to fall off when going through the frequent pothole. Here is a short clip of our roller coaster ride.

When we arrived at our destination, these were the types of tries that surrounded us. Up there, it was very moist and everything was covered in moss.

At the peak, we were 3150 meters above sea level and could see the clouds below us move through the lower mountains. After a very busy weekend, we returned home in the late evening on sunday and recovered for what I am sure will be another exciting week in Mexico. Thanks for following.

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Week 3 Clinic

10/9/2011

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I thought i would start this blog off with a shout-out to my beautiful girlfriend, Hilary. Thank you for all your love and support. Long distance is never easy on a relationship, but with a little creativity (like shown above) and understanding, it has the potential to bring us closer together. Hilary and I will be celebrating our first year anniversary this month, and although I'm in another country, we will have many more anniversaries to celebrate together in the future. I miss you.

Enough of the cheesy stuff...
Last week my roommate, Duke, and I asked if we could follow our medical director, Doctora Magaly, around her hospital at night. She invited us to shadow her once a week at her hospital, Hospital Carmen. Here is a picture of us three.

Surprisingly, within a half hour of arriving, she had us suited in scrubs and ready for surgery.

The first surgery we saw was a prostate biopsy. Interestingly, I have seen one of these procedures done in the US, but the two were procedures were very different. In the US, the procedure was quick, easy, and painless. The patient usually was awake and the surgery was complete in fifteen minutes with practically no recovery time needed. In Mexico, the procedure was completely different. The difference, in my opinion, was most likely due to Mexico's lack of resources and more primative technology. Anyway, the procedure took about two hours and lets just say the patient will probably wish he was a woman for a couple of weeks haha. Of course, these pictures were pretty graphic so I'll let your minds paint the picture instead.

The second surgery we saw was a C-section of a 31 year old women. This was the first picture I took and after, the doctor looked at me and told me to come closer to get a better shot. It caught me off guard because cameras aren't even allowed in the surgery room in the US. In Mexico, the doctors would pause to have us take a picture while they gave a thumbs up haha.

You can't help but be a new person after seeing a new baby enter this world. In Mexico they call it, dar la luz, which means to give light. I can only imagine the majestic experience of seeing your own child enter into this world. As cheesy as it sounds, it makes you feel more alive and appreciative of the life cycle. It makes you think of the many wonders of the world really how amazing the gift of life is. Corny, I know. I told our director the same thing and she said I needed to say that at next years orientation to recruit more students haha.

Here is a picture of the head surgeon, Duke, and I. It must be a pretty powerful feeling to help bring more babies into this world.

Here is a picture of the clinic I spent the last two weeks at. From left to right there is: Julio, the nurse; Daniel, my clinic partner; Doctora Coral, the doctor; and myself. Doctora Coral was very clear and helpful at explaining each case and I learned so much because of her. Because of the Mexican diet, lots of tortillas and carbohydrates, diabetes is a serious issue in Mexico, and that was probably 80% of the stuff we dealt with. Next week, I will start at a new clinic where I will hopefully learn much more. Also, I'll add another blog post of my adventurous weekend in the mountains later this week. Stay tuned.

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First Week of Clinics and More...

10/2/2011

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Unfortunately, my first day of clinical rotation didn't go exactly as planned. My partner, Daniel, and I arrived at our clinic at 8 am sharp and were greeted by all the nurses and staff. They told us the doctor should be in at 9 so we had to wait for an hour to get started. This wouldn't have been a big issue except we ended up waiting 3 hours and the doctor never came. Apparently this is a common occurrence in Oaxaca. Anyways, we called our medical director and she was so upset that she decided to have us go to a different primary care facility the next day.

It all ended up working out for the best because our new clinic (picture above) was much nicer and in a better area then the first one. Also, the staff was much more welcoming and excited to have us there. Just so you are aware, I do not plan on boring you (my viewers) with all the details of my clinical rotations. From now on I will only include interesting cases from my clinical experience in my blog.

My first day at this new clinic, Centro De Salud Pueblo Nuevo, was very busy. That day they were doing a big promotion on parental planing, meaning the focus of the day was on medicine that would prevent an overabundance of births. We started the day with simple birth control methods, but finished the day with 8 Vasectomies and 12 women who got their tubes tied. We assisted in streamlining the process and prepping all the patients for surgery (took blood pressures, installed IV's, etc.). Don't I look like a doctor all dressed up in my lab coat :) ???

On Saturday our entire group met and went on an 8 hour tour to 5 popular tourist sites. The first place we went was Arbol de Tule, which is the widest tree in the world.

The tree is 58 meters in diameter and over 2000 years old. I didn't get any pictures of them, but we were told that the tree had bumps and branches that resemble animals. Also, this tree was part of the inspiration for the tree at Disney World that contains sculptures of animals in its bark.

Here is a picture of my two roommates and I.

Next we went to a famous carpet house calle La Casa De Tarjetas. Here they showed us the process of making wool and how they dye it different colors.

Here is a picture of the wooden machinery that they now use to make these intricate and masterful carpets. Before the creation of this machinery, the indigenous people would spend years making their rugs. Now, it only takes about 4 weeks to finish a masterpiece.

Here is an example of the detail and skill that is put into each carpet. They said it takes a person 3 years to become a master carpet maker.

Second, we went to my favorite place of the day, Hierva el Agua. This is a hot spring on top of a mountain that, over millions of years, has created a fossilized waterfall of calcium and other ground minerals. If you look to the far right of the picture you can see the waterfall, and right behind me are some of the hot springs.

Here is a closer look of the waterfall with Paul and I. We had a lot of fun showing off in the pools of the hot springs. It felt nice to be back in the water. Remember the days when I was as tan as Paul??? haha We took a million more pictures that I will have to share with all of you when I return.

Next we went to some more Zapotec ruins in Mitla. Although these ruins weren't as cool as Monte Alban, they were better preserved and we were able to go inside of the tombs.

The city was destroyed and abandoned early because the Spanish were taking over and wanted to change the religion of the Zapotec people. A huge battle began and, in the end, there was no winner and more destruction than resolution.

Here Paul and I are going into the dark tombs. It was hard to see and there wasn't much more than tunnels, but we did happen to find an ancient bathroom, or at least something that looked like a bathroom.

The last stop in the trip was at a famous Mezcal house. Mezcal is a hard alcohol that specific to Oaxaca. It turns out that Tequila is actually a type of Mezcal. The only reason they are different is because Mezcal is still traditionally made the same way with a process that involves this stone wheel. Tequila became so popular that they changed its processing in order to release faster to the masses around the world. In the end, both are made from the same elements, the agave plant.

After hearing about the processing, they gave us necklaces with bamboo shot glasses and then proceeded to give us a million small samples. Personally, I am not a big fan of hard alcohol but you know what they say, "When in Rome". Haha It probably would have been a better trip if we went to this place first, but I have no complaints. It was a great day.

Earlier this week we met some people who work at Stanford. After getting to know each other, they asked us if we would be interested in visiting an orphanage to play with some of the kids, so today (Sunday) we went to a local catholic orphanage. I couldn't believe how excited the kids were as soon as we walked in the door. Immediately when I got there I had two kids hug my legs and ask me if I could play with them.

The facility had kids from ages 4-21 with the bulk of them being around 9. We played soccer with them and taught them how to do cartwheels. It was a lot of fun.

Here is a picture of my friends John and Paul with two of the little girls. It tuns out, a lot of the kids actually have parents, but they are from such poor families that their parents couldn't provide for them.

Here is a picture of me and one of the girls I spent most of the evening with. We played tag and she showed me her favorite ball. It was another great week and weekend. I hope you enjoyed. I'll probably do another post around this time next week. :)

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Clinic & Midterms Week

Molinillos Video

Weekend in the Mountains

Week 3 Clinic

First Week of Clinics and More...

Jason Andrade

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