Wednesday, July 25, 2012

Party in the USA

I've been throwing my hands up like Miley in the USA since Saturday night. I figure I should write a final post about my experience in Peru. I may have put off doing this because I feel like that means it is actually over. I have mixed feelings about being back. I was very excited to see everyone and enjoy the comforts of home, but now I feel kind of odd. It's that "post-mission trip feeling" that so many of you have probably experienced as well. First of all, I feel lazy that I'm not doing something beneficial to the world with my time. Second of all, the culture is so different and more friendly in Peru. For example, I stopped by the mall for a short time and found myself thinking "why does nobody want to say hello to me?!" this week. The whole thing just makes me feel like I don't belong in the U.S. a little. Before I left, I prayed for an open heart to show love to all who I would encounter. The thing is, these people of Peru now have a place in my heart that I don't know how to explain/share with everyone here. So here I sit typing this post while listening to Mueve La Pompa (a fiesta favorite)...
Let's rewind, here's what's gone down since my last post-
My final eval went just fine if anyone was curious. Also, we got a good grade on that 25 page paper! That evening, we went to fiesta #87685 (but probably more like 6). Everyone was so tired, but hey what's one more night of Peru "partying"? We started saying our goodbyes, which was sooo sad!
Here we are with Theresa, one of the nurses from the Oklahoma medical mission we worked with in the OR

After staying up too late (as usual), we got up before dawn to head to the Piura airport. Some of the parish staff and nurses we grew close to came along to see us off. After lots of hugs and some tears, we were off. We landed in Lima around 1000 a little unsure of what our next move would be, as our flight was not for 11 hours. We did end up having a tour scheduled (communication with Marquette had been scattered) that took up most of the day. We saw a little of this, some of that. In fact, I was personally invited to an ocean-side fiesta with some Peruvian hippies (yes, they do exist). Unfortunately, 'merica was calling my name.

In front of the governor's mansion

Pacific Ocean- our tour guide called this our "romantic" stop

After the tour, our group split. 8 of the girls were going on to Cuzco and a 4-day hike on the Inca trail to Machu Picchu. I skipped this part of the trip since I am probably still not quite there health-wise to make that and for my "big" plans this summer (more later). Kat & I headed back to the airport after the tour (on a wild and nauseating van ride, thankfully the last). I enjoyed Subway for dinner, which was great. Our flight was a little delayed, but we ended up taking off around 0030 (Saturday). We slept a lot of the way, as well as you can on a Spirit airplane. Spirit Air is advertised as low-fare air, which is true. Getting cheap means sacrificing on the comfort aspect though- not much space, non-reclining seats, no food (not even water on a 7 hour flight). Totally worth it for college students though! We arrived and were through customs in Fort Lauderdale, FL by 0830. I was dazzled by toilet seat covers, Dunkin' Donuts, air conditioning, and use of the English language. I sat in this airport until 4:30 PM, passing the time talking to everyone that would listen on the phone. On the flight to Chicago, I got to sit by a puppy! I was definitely ready to get off the plane and see my family by the time we landed. I finally got to Green Bay, WI at 11:30 PM Saturday night. My first meal home was pizza- exactly what I wanted. 

Since returning, I've just been unpacking/doing laundry, catching up with friends and family, and resting (I am way behind on sleep!). My mother insists I am "so skinny", but really I gained 5 lbs on my trip (too much cake). I have been so blessed by my month in Peru, and I sincerely hope to return. I wish I could say that it will be next summer, but by then I'll be looking for a big girl job and trying to pass the NCLEX (boards/exams to get an RN license), so who knows where I'll be. Anyone looking for a great mission trip (whether medical or otherwise) should really consider going through Sacramento Santisimo! It is a Catholic parish, but I am not Catholic and really enjoyed my time there.
The rest of my summer includes a long weekend at the cottage with my extended family and a gum graft (snatching some skin off my hard palate and sewing it on where my gums should be). I have serious dental anxiety and have already had nightmares... August 3rd is the day. My only hope of postponing is if I brought some of Peru home with me/the parasite is still inhabiting my intestines (I'll find out early next week).

Thanks to all who have read my blog and emailed, I truly had no idea the response I would get! I would love to hear from anyone who has more questions about my trip, I am in the Green Bay area until mid-end of August. Some have asked if I'm going to keep blogging now that the trip is over, and I am fairly certain the answer is no. Simply, my life is not that interesting. There was a time in my life that was pretty eventful, but I'm pleased to say that time has mostly passed.

Con amor,
Esperanza

"Give me Your eyes for just one second
Give me Your eyes so I can see
Everything that I keep missing
Give me Your love for humanity
Give me Your arms for the broken hearted
The ones that are far beyond my reach
Give me Your heart for the ones forgotten
Give me Your eyes so I can see"



Thursday, July 19, 2012

This will likely be my LAST post from Peru! It is crazy how fast the last month has gone, although at the same time we have done a lot and I'm ready for some rest.
Yesterday, I was with the Oklahoma medical mission in the OR from 8 AM-8 PM. A surgeon and anesthesiologist came down with the team to do hernia sugeries (a hernia is an abnormal sac that protrudes through the abdominal wall that may contain intestines, tissues, etc.). They have been doing 7 or 8 surgeries every day (which is a lot for the same team to do at once). It was a very interesting day but also a very long day. In the U.S., a patient will have different nurses for preop, surgery, recovery, and postop. Here we stick with once patient all the way through their time at the clinic, then take on another when he/she is discharged.
Here's a little summary of what we do where-
Preop: Check the patient in, take vitals, start IV's (I started my first "real" one here, but have practiced on several willing amigas before this), give meds (ex. Zofran for nausea), and get all paperwork in order.
Surgery: Mostly watching, some assisting but nothing huge. The surgeon and anesthesiologist were explaining things as they happened. My first patient had a laryngospasm when coming off the breathing tube- closure of the throat so that no air can pass through. He did eventually wake up with no problems
Recovery/Postop- Anesthesia slows everything down in the body, so it is important to maintain good vitals. Immediately, the patient receives oxygen via mask and is on continuous pulse oximetry. We take vitals every 15 minutes for an hour. Slowly we get the patient to sit up, drink some water, and have some crackers. Pain management is also very important (mostly just with Ibuprofen here). Some patients throw up, others are dizzy. Eventually the patient sits in a chair, at which time we bring in the family to talk about how to care for the patient once he/she leaves us.
Last night we went to a "fancy" place for dessert and cappuccino and stayed up too late doing homework.

This morning I was with social services, which today meant building a house. We were with a group of missionaries from California. The houses are made mostly of bamboo. It was a fun way to end my time here!

The three Marquette nurses who joined in on construction today


The team with the family we were building the house for- this was our progress when we left at noon. The CA group will go back to finish it this afternoon.

All I have left now is our final evaluation with the clinical instructor (in literally 5 minutes)... wish me luck!
Our flight departs from Piura tomorrow morning at 0800. I will be back in the U.S. at 6 AM Saturday morning, and in Chicago at 6:30 PM Saturday. I am excited to see some of you when I get back, especially my little dog ;) I recently received some pretty cute pictures of him via email from my family & realized that I miss him a lot!
¡Hasta luego!
Love,
Hope


Monday, July 16, 2012

Our Last Week Begins

I have an unexpected amount of time tonight, I decided to stay home from the fiesta that is happening tonight to catch up on some rest... plus our paper and presentation are completed!

Today some of us left at 0730 to help with a village clinic set up by a traveling medical mission from Oklahoma. I spent most of the morning playing pharmacist- handing out pills, constituting liquid meds, & teaching the patients how to take their new meds. It was fairly busy with just 1 doctor seeing patients. Lots of parasites (more on that later), respiratory infections, some pneumonia and asthma, and lots of runny noses.  In the afternoon, more doctors came to work and we were VERY busy. I switched to intake (where we do vitals & short health histories) and took more blood pressures in 4 hours than I can count. We saw over 100 patients today! One that stood out in particular was a 30 year old woman with severe lordosis & scholiosis. In the U.S. this would have been surgically corrected during childhood, but we are in Peru. It was very sad to see, her growth was majorly stunted and she was having significant pain.
After a 10.5 hour day, we headed back to the parish with plans to return to this village tomorrow.

So about those parasites... I have them/it. I am like 98% certain- I've had suspicions for about the last week due to some minor symptoms, but today I have white spots on my face and arm. Apparently parasites can affect the pigments in your skin (temporarily... I think). It really isn't surprising since sooo many people have them and we get so many kisses. I really feel fine so family who are getting worried please don't! I snagged 400mg Albendazole (a 1x treatment) this afternoon at the clinic so I expect to be rid of the problem soon.
Other health concerns include the possible closure of my nosering :( I am sure my family will be so sad to hear this news. I took it out for a night because it was starting to look infected and made the situation worse. I must be running out of interesting things to talk about if I'm mentioning this, lo siento si no le importa.
Thirdly, my blood pressure is in rebellion, which is why I'm resting tonight.

I GOT TO MEET MY FAMILY TONIGHT! :)
They are super cute- a married couple and twin 2 year old girls (but they want more kids). The little girls were very shy but I got to talk with the parents for awhile. The father is very involved in the kids' lives (which is rare) and was very kind.






 Meet my family! 
Missing from this picture are their 5 dogs











I have no idea what the rest of the week will bring with the medical team here. We only have 3 more days in Piura, which is so crazy. This time next week I will be eating pizza instead of chicken & rice...

Saturday, July 14, 2012

Friday Night? Party at Hospice

Great news: we are almost done with our paper. Bad news: we aren't actually done with our paper.
With less than a week left, we are busier than ever. A group of doctors, nurses, and assistants just got here today to do hernia surgeries and some other stuff; we plan on working with them for much of the week (when we aren't giving presentations and doing final evals...). That means much less if any of our usual ventures to hospice, homes, and Pro-Life. Despite being way burned out on hospice, I realized I am actually going to miss seeing those patients. Luckily for me, we ended up having a mini fiesta at the hospice last night... to be honest my initial thought was that I would never be able to eat anything there (cake is at all fiestas) because of the various aromas and duties I have experienced there. The patients that were able (4 of them) came out for cake and music. Felix (he was pictured in a previous post) was absolutely loving it!

I would like to introduce you to Manuel:
He frequently yells, it drives some of the other patients loco. Really adds to the mood of the place.
Week 1: Manuel hits us every time we try to take his blood pressure or temp.
Week 2: We realize if we threaten to tell Padre Joe he sort of listens.
Week 3: Manuel is entirely inappropriate & sassy. But he is blind and can't walk so not threatening.
Yesterday: While I was at hospice in the morning we sang songs (he likes Call Me Maybe & La Cucaracha) At the fiesta he danced with me! (note how tall I look)

After our wild Friday night out, we had a relaxing morning at the spa... sort of. For reasons that will be forever unknown, we visited a "spa" at 9 in the AM. First the lady just talked really fast Spanish for like 20 minutes. Then we all stood up and did what was supposed to be Tai Chi and yoga. I usually like that kind of thing, but this was just weird and confusing. Once we were finally done with that we thought "oh well at least that's over with"... so wrong. We got put into separate areas and had "massages." Some of it was good, but the bad was just too overwhelming. We were put into weird positions and rocked/shoved back and forth. Some girls suction cups stuck to their bodies, others had to hold TENS units in their hands (these deliver a small electrical shock, often used for pain reduction) for "relaxation." It's all about experience I guess.
This afternoon we had off just to work on papers, a lot of progress has been made!

Here's some pictures from the last few days...
Anybody looking for a baby? She is looking for a family.

Braiding on a home visit. This patient had a positive Trousseau's sign (flexion of the hand/wrist when I inflated the BP cuff), which could mean she is very low on calcium.

More home visits

A couple nights ago they surprised us with a little "thank you" party. The dining room was decorated with blue and gold. They sang us a song and gave out cards to each of us. It was very sweet, some people cried. It's going to be hard to leave on Friday!

Papers & presentations are Tuesday night at 8 PM, so I will probably not post until after. We are all hitting the point of being a little homesick, but I think we're also going to be sad when Friday morning comes. I am already dreaming of how I'm going to sit in the Starbucks in the Lima airport for 13 hours...

¡Hasta luego!
-Hope





Wednesday, July 11, 2012

No mas violencia!


As predicted, my actual free time is starting to decrease a lot due to homework. Yesterday was my teaching project day (we were assigned dates on Sunday). Like I mentioned awhile ago, I had been planning on talking about violence against women. Initially, I was going to focus on sexual assault since that is where my knowledge mostly lies, but after being here for awhile I realized intimate partner violence (which can be a combo of physical/sexual/emotional abuse) is one of the biggest problems. This is not an easy topic to discuss in this “machismo” culture- where men are dominant and have power/control over women. While violence/abuse is not condoned, it is also rarely publicly discouraged. Then you add in the power and values of the Catholic Church in Latin America (where divorce or permanent separation are usually opposed) and you get a very delicate situation. I really did not know all this when I signed up to talk about this in May. I had to give the presentation in Spanish, which was hard but manageable. The main points I wanted to get across were that abuse is not OK and that there are resources the women can use to escape a violent situation (free legal, medical, & psychological services in addition to Casa Maria). I gave my talk and prayed with them, but no one had any questions... it was very quiet (another thing I expected). I had absolutely no idea if anyone was understanding what I was saying or not. When it was time to say goodbye, we hugged and kissed everyone. Two different women whispered thank you in my ear and said they needed to get help from the church- one was planning on heading over to the parish next week. If even one person is thinking about getting help, then I am thrilled I chose this topic and gave it a shot.

45% of women surveyed in Peru have suffered some form of intimate partner violence.
 20% of girls age 10-15 are sexually abused by family members or neighbors.


Clinical has been going just fine, but since we do a lot of the same stuff I've already talked about (hospice, home visits, clinic, midwife, etc.), you probably don't want the play by play of every single day (unless maybe you are my mom or nama). I had an interesting afternoon at the Pro Life clinic today- our first patient was a woman pregnant with her 2nd child, she had her 4 year old with her. Never in my life have I seen such an energetic kid, and that is really saying a lot. The exam room is very small, and contained 4 adults + him. He slowed down a little to see his hermanita on the ultrasound, but otherwise was a bull in a china shop! I ended up taking him into the hall... literally I was running at my full speed to catch him as he ran back and forth. His mom was actually taking him to the psychologist because she said he had no self control, aka ADHD. We also did some counseling on natural family planning and saw a newborn baby.

This evening was yet another fiesta in a village. Officially it was for the church group that is currently here, but today is also LISA's 21st birthday! Lots of dancing & confetti. And more cake- everyone is so concerned about me losing weight while I'm here, but I really have more cake and ice cream here than I do back home so it's really not going to be a problem!
In other news, I have decided to adopt a family. This means I will give a yearly donation that will cover a good portion of their food, school supplies, or other needs. I also hope to be able to write to them. I haven't met them yet, but will post pictures when I do.

This is the family Marquette sponsors- Christian, Erika, Jessica (named after a student), & Kiara

This is baby Maria- she is 3 months old today! She & her mom live at Casa de Maria

I have high hopes for the next few days being very productive as far as our aggregate project, so I'm not sure when I'll post an update again. Also, all my pictures are on facebook so if you want to see more look me up! Buenas noches!


Saturday, July 7, 2012

Casa Maria y Construcción

Saturday, July 7-
The group of 50+ high schoolers left early in the AM. It is now peacefully quiet, which is strange and kind of nice. There is another group of missionaries from Oklahoma that arrived today, but they are all adults and there are only 15-20 of them.
This morning, we got a good start on our aggregate project. For the project, we take a specific population (through a parish organization) and learn about them so that we can appropriately determine interventions to improve the wellness of that group. This culminates in a 25 page paper & presentation on July 17 (in 10 days, yikes). Our group of 5 students is doing our project on Casa Maria, a transition home for young girls and women who are victims of domestic violence. Casa Maria houses two floors of young ladies- one for university students to live during their schooling (1-2 years), these girls mostly come from Madre del Redentor (the girls' home I talked about in a previous post); and one for women who need shelter from domestic abuse (for a couple months, longer if they are pregnant). While the community knows that Casa Maria exists, few know its location for safety purposes. One woman who has been there for a couple months is totally unable to leave the home because her husband is out looking for her and lives nearby. The women are responsible for cooking and cleaning, but have financial help. They receive all of the parish's free services- especially legal, psychological, and OB/GYN stuff. A lawyer and psychologist visit Casa twice a month. My initial thought is that they need way more psych support than they are getting... support groups? coping technique training? meds? PTSD management? We still have lots more to learn and research.
Also, we helped one of the moms give her little baby a bath :)

Some of the women/children and director of Casa Maria

We officially had this afternoon free. However, some of us heard that there were some food deliveries and a clothing drive, so we wanted to go with social services. In the end, we ended up at a construction site, building a chapel in La Legua. At first we were absolutely no help, but we all ended up doing some hammering walls and pouring concrete floors. 

How the chapel looked by the end of the day


The fun part of the day was playing with the kids in the area. The scary part of the day was when a 5 year old was bit by a wild dog. From a distance, we heard a scream and looked over to see the dogs way too close to a little boy. He had been running around playing and they chased him. We headed over to make sure he was OK... The dog bit his leg and broke the skin. I cleaned it as best I could with the alcohol wipes available (this wasn't a clinical day so no one really had supplies), put some bandaids on, and told him and his family he needed to go to the hospital to get a shot for rabies. They asked if it was "the pink medicine that goes in your tummy through a needle." So apparently this isn't an uncommon thing in the area- I looked it up after we got back, the vaccine is indeed hot pink and used to be given on the abdomen so as to give several injections in several spots. A few other kids had scars from dog bites. Who knew I would learn something when not in clinical?

 I know I post like a billion pics of Peruvian kids, but they are just really cute.

I am now officially up to date on blogging and am ready for bed, we get to sleep until 9 tomorrow!
¡Buenas noches!


Catching up

I apologize, I realize I'm a few days behind on blogging! Just a heads up- we legitimately have homework now so I'm thinking this might be a consistent pattern.

Thursday, July 5th-
Lauryn & I were in the Pro-Life clinic Thursday morning. A nurse named Cecilia sees patients here all day- many patients are pregnant or in between pregnancies, but we have seen a couple older women post-menopause. I have had a few OB  rotations here now, so I'm starting to feel pretty comfortable with finding baby's heartbeat, understanding what I'm seeing on an ultrasound, and determining the baby's position in the uterus. There is almost no concept of birth control here, as there is no separation between church & state (Peru is very Catholic)... many women have lots of babies very close in age. Unfortunately, it is also very common for fathers to abandon the pregnant mothers, especially if they are young. Cecilia serves as a huge source of support for these women, and refers them to psychological services if needed. We spend a lot of time at the clinic preparing women to be mothers.
Cecilia & I at the clinic

Listening to heartbeat- this baby was all the way on his mom's right side and moved around a lot!
(Don't even pretend you aren't jealous of my animal scrubs)
In the afternoon, more home visits. I'm amused at the things I'm starting to consider normal, such as:
-Chickens running across my feet while I'm taking vitals
-Having to walk around dog fights
-Nothing being clean, much less sterile
-Killing bugs myself
-Blood pressures over 200
-Muchos besos (kisses)
-Everyone wanting me to hold their child
-The paparazzi (everyone taking pictures of the gringas, which is actually an endearing term here I guess)
-Trudging through dirt and sand to get to a patient
- Bug spray as perfume 24 hours a day
I'm sure there are more, I'll add to the list at some point...

Friday, July 6-
We only had clinical in the morning on Friday, and class in the afternoon.  I spent my morning translating for a pediatrician from Arizona. This was interesting because I am still not fluent, especially in medical terms. We made it though, with a little help from a Spanish-English dictionary. My brain was definitely in overdrive from 9-1. By the end of the day I was getting much better than at the beginning. I have added lots of words about breastfeeding, vaccines, cold/flu, and child development to my vocabulary. Shoutout to my 2-year-old at St. Francis Children's Center (I volunteered there last semester) whose first language is Spanish: I appropriately used "kaka" many times (which means poop) thanks to her. I frequently heard "Hope, I kaka" during these last few months.
We mostly saw colds with bad coughs. One girl had recently had toxoplasmosis and came in to make sure she was still doing well. A lot of patients come in with a stack of papers of labwork done elsewhere for us to interpret. A baby came in with hand missing some bones- we took pictures to send to a surgeon who is coming down in August.
Another interesting case was a girl whose mother brought her in because she hadn't been talking much, especially for her age of 7. The ENT (ear/nose/throat doctor) removed some lovely chunks of earwax, so maybe it was partially a hearing problem which is what he thought. The psych major in me is kind of convinced she may have autism... 1. Her mom says she prefers to be alone when I asked if she plays with other kids at school or home. 2. She seems to hear and not respond to her mom. 3. She began talking at a normal age and was using sentences but no longer seems interested in talking. 4. She seemed more fixated than normal on playing with her fingers during the exam and didn't look us or her mom in the eye. OK maybe this is only an interesting case to me. And maybe I am wrong and have taken too many psychology classes/service learning (only one more til I'm done with the psych major).