Salem, MA

Well its been just over a week since I last posted and I figured I should let you all down slowly... (read this very slowly) I am safe and sound in Salem, MA. Are you ok? Still breathing/reading? Good. Well after a dreadful, never ending drive I made it. 21 hours of actual driving time and over 1300 miles crossed. I did it by myself with only the company of the Mazda 3 which doesn't have much to say. I will be the first to admit that I'm not very good company. I am still sane somehow (well I THINK I am still sane but I guess that is up for debate because I am in fact the judge of whether or not I'm sane and I guess I'm somewhat biased). I arrived in Salem last night sleep deprived and hungry. The only problems I had on the drive was a break down in LaCrosse WI (an hour from home) but that was fixed quickly and I was on my way. Other than that, it was an uneventful drive. First thing I did when I arrived last night was check into the hotel being my apartment isn't ready yet, second thing I did was find myself a lobster roll. Totally worth the 1300 mile drive! Its just as busy here as I expected and remembered but I still think I'm going to have a blast! This weekend I hope to really get out and take some pictures. Today I haven't been feeling well (I blame the bad company in the car) so I haven't done much. I took a little walk along the waterfront which was relaxing and other than that I've slept a lot and gotten addicted to the show Lost which I've been watching online. Not a very exciting blog!! Haha sorry, well I start work tomorrow morning so wish me luck!

A few more pics

Well I made it 'home' to MN safe and sound. As I was leaving Houston I was surprised to find an old friend of mine had just come into Houston at the gate directly next time. I could see his plane from my window seat but unfortunately couldn't see IN the window to wave. We missed each other by a matter of minutes! Weird how things work like that. I accepted a position in Salem, MA and its been decided that I start on Tuesday. I'm getting very excited for my next move but not so much for the 21 hour drive out there... Well now that I made it home safely I figured I could put up a few more photo's for you. Enjoy!

The Plaza


The Plaza


This little Alpaca baby thought the camera was more interesting than posing with me!

Watching the women weave was great! They put a lot of time and effort into each piece and do it all by memory.

One of the only pics of the convent that turned out. It was dark so my camera didn't acknowledge the scene. I liked this one because it shows the vivid blue's I love so much!

Heading out, saying goodbye to Jesus, one of the translators for the trip and one of the group that took Carla and I out to the Karaoke bar.

Carla and I. Gypsy chic for the airlines.

My new little friend Carmella!

Out and about singing "oops I did it again" with new friends

What day is it?

So I just typed a nice blog with everything I wanted to say... than when I went to publish it, it disappeared! So its not been the best of mornings but I will try again. I'm currently stuck in the Houston airport. I missed my connecting flight by 5 minutes! What a bummer. Customs was moving a bit slower than I had hoped for. So here I am online wasting a few hours before the next flight. By the time I arrive home I'll have been traveling for 23 hours and will be in desperate need of a shower and a nap.
My last few days in Arequipa were perfect. It was warm and sunny (i have a sunburn to prove it) and I had great company. We did some shopping and went to some great restaurants. I avoided the banana and rum crepes... I really didn't want to get sick again. While shopping I found some great buys. I got a baby alpaca blanket that I can't wait to snuggle into, a few scarves and earrings, some gifts and I also picked up wooden masks to hang on my wall. I realized later that I don't have a wall to hang it on! I'm kicking myself for not buying more jewelery, it is absolutely beautiful. At the same time I'm glad I didn't buy it being I really need to be tight fisted with my money. Having not worked much this last month, the cost of the airline ticket and my upcoming move I am pinching pennies where possible.
Friday night Carla and I joined the translators Fiorella, Gloria and Jesus at the Karaoke Bar. What a blast! It was very trendy and full of people my age being loud, happy and having fun. Being a larger group we got a corner comfy couch worthy of being jealous of. After two pitchers of Pisco and soda we were up for singing Britney Spears "Oops I Did it Again". We may not have been in tune and we didn't get all the words right but we sang with zest! When Carla left I found myself being the only white girl in the bar. Its always a little weird when your unable to speak the language of everyone around you, but it didn't bother me a bit being my friends all spoke English well. I wasn't quite brave enough to put my new Spanish phrases into use. That's probably a good thing!
I'm a little sad sitting here in the airport. Peru was a learning experience and a lot of fun! I must admit I won't miss the church bells at 5:45am, the courtyard noise at 6:30am, and the 1000's of incessant taxi horns at all hours. I won't miss the smell of the fish market, not being able to drink the water, the cute but annoying Peruvian music group that follows you around constantly, people trying to sell their wares to the gringo's and marking up the prices, and I definitely won't miss the poor hospital care. I already miss my friends, the views, the food and shopping and I'm missing my SWAT team and bodyguards. I'm so used to being protected that being all alone in the airport seems a little weird. So Peru is over for now. Its not so hard to leave knowing that I made a difference and that more than likely I will be returning. This trip is already starting to seem like a dream...
My next move? Salem, MA. I move this weekend.

Sick.

So I spent my day sick in bed. Not cool. I had a few days where I wasn't a 100% while here but today definitely knocked me down. I blame the banana, sugar cane and rum crepe I had last night. The other two who were sick had eaten that same meal. Who knows for sure... I'm finally starting to feel a little better and even ate a little soup so thats progress I guess! Everyone here has been so incredibly great. Bringing me water, soup, crackers and compliments. LoL. I've never been offered so many fluid IV's in my life! I was pretty bummed that I missed my lecture today. I was actually kind of excited to do a presentation. Maybe if I get the chance I will go into the hospital tomorrow and see what I can do. Today was actually the last official day of Cardiostart. They return in September and I may come again if the same people decide to go! We had a successful trip and literally saved a few lives. I hope we were able to leave some good things behind and maybe the hospital is slowly working its way up. So I leave Saturday and a few of us just plan on shopping and sight seeing until then! Oh yeah, Gloria is taking us out to the disco again on Friday night. Hopefully I'm feeling better. Other than that not a whole lot going on except saying goodbye as more people start to leave. Saying goodbye is definitely hard to do but I think I'll see many of them again on future missions. They are all such sweet caring and wonderful people!

This is a long one!

I feel like I keep giving you all a play by play account of my activities in Peru. So before I give you today's experiences I thought I would maybe tell you about some of the little things I experience here that I normally wouldn't talk about.
On my bed stand, in the bathroom, on the table and everywhere possible I have lined up large and small bottles of water. The altitude, dry air and the sun makes us all very thirsty. I keep my toothbrush in my bottle of mouthwash to keep it fresh and from getting wet with tap water. My suitcase is long overdue for a cleaning. On that note I think tomorrow I will send out my laundry. The courtyard in the hotel is very beautiful but it echo's the sounds of my fellow team members waking me up around 6:30 or 7am every morning. I drink two cups of hot Coca tea with a Peruvian bun and jam every day for breakfast. I drink my Coca Cola warm from glass bottles. I feel sad when seeing all the local wild dogs on the streets and on rooftops. Most are very friendly and will sit and wag their tails hoping for food or some love. The colors of Peru make me happy. I will never again see the color azul without thinking of the montestary or ride in a yellow taxi without remember the feeling of immanent death. For me the experience is just as much about these little experiences as it is about the big life changing ones.
Now onto today. I spent a few hours in the Pediatric Ward with a translator. Once again I am astounded by the differences between America and Peru. I had gone down to see what supplies I had that I could donate. One of the student nurses/translators (and my good friend) Gloria asked for me to come and see a patient with her who was blue. By the time I came into the room they had already inserted a breathing tube (which is apparently reuseable here). I asked if they needed help with the 2 month old infant or if I could set up the ventilator. I was informed they don't have ventilators. Basically they take turns squeezing the breathing bag sometimes for days. Not only is this stressful on staffing but its also VERY bad for the patients. This two month old baby is going to die but if he were at home in the states he wouldn't. His parents were unable to afford the drugs to help him relax or to take away the pain and his lungs will be damaged from the prolonged use of a breathing bag. Yes, I dropped a few tears again. I spent a long time in this room. I provided nursing and physician education on different equipment I had found to donate and tried to help in anyway I could. I am going to try and help this pediatric unit, maybe try to email around for a donated pediatric ventilator. This is the largest public hospital in town serving thousands and thousands of people and they don't even have monitors or ventilators for their babies.
On to a happier note so I can leave you in a better mood. We all went out to dinner to celebrate Janine's birthday. I couldn't finish eating my meal due to the fact that I was laughing so hard my stomach had cramped up. Gloria, her mama and another translator, Vincente, decided to teach me some more spanish. I learned very important phrases tonight such as "Dame un beso papasito" (kiss me gorgeous), "Te Quiero" (I love you), "Teine Condon" (do you have a condom?) along with a few more phrases that I am unable to spell! Needless to say I burned more calories than I ingested due to severe laughing spells. Gloria's mamacita suggested I put my phrases to use with the very good looking intern at the pediatric hospital. No mom, I do not plan on putting these phrases into use!! Off to bed, tomorrow I give a pediatric respiratory presentation to the nursing students, nurses and a few MD's. Wish me luck!

A few pics

So it takes a long time to put up pics here in Peru. They don't always come through, but here are a few!

Dancing at the disco with our perfusionist Eddie!!!
We did a cardioverison for the grandfather of one of our translators. He was a riot!

Adrienne, Zev, myself, Janine and Jorge checking out an ICU patient
Marissa and I

Doing my best to read to this little man while the docs explain the surgery to his parents. It was a learning experience communication, he speaks spanish I speak English. It was fun!
One of the volcano's from the hotel deck, we can see 3 from here. This is what I wake up to each day!

Peruvian beer! To bad I don't drink beer... I'll stick to the Pisco Sours.

Probably one of the most amazing views I've seen. This is the place that reminds me of Jack and the Beanstalk. Its a bit to cloudy so you can't see the two HUGE volcano's in the back.
Part of the group at the resort in La Joya.

Busy!

It has been a very busy past few days, sorry I haven't updated! So Monday morning/afternoon was great! I got to sleep in all the way until 8am. What a great feeling that was LoL. I spent my day reading on the deck in the sun, shopping, and visiting with two other team members. It was exactly what we needed. I had been getting frustrated with some of the politics of the mission and a morning off to do what I wanted was both relaxing and theraputic for my 2 group members and I. We finished off our little day sipping coffee at this great till French Bistro we had found which faces the montesary and the mountains. Mount Misty was in full form. We went into the hospital around 7pm that night when they were finishing up surgery.
The patient turned out to be a very sick man who initially did very well with surgery but than we started to have some bleeding problems. We brought him back to the OR (always interesting to watch open heart surgery!) and didn't get home till 3:30am. The next morning I was up again at 7:30am. No wonder I feel so worn out all the time! Yesterday the rest of our pediatric team arrived and we did our first pediatric patient surgery which was the first bypass ever done at this hospital. A 4 year old boy with a VSD. Turned out great.
I was bummed last night. The adult team ended up leaving a day early due to a flight change. They are a great group and I'm going to really miss them!! We all worked well as a team and the patients got great care. Hopefully I can end up at their hospital for a few months on assignment! I'm really happy that I was able to join them for their going away dinner. Zev convinced me to try a bite of Cuy at dinner. It is a local specialty, otherwise known to us as Guina Pig. Tastes a lot like chicken but one bite was enough! Alright I better get working again.

La Joya

Yesterday was a crazy day with my going back and forth between the two hospitals, but things were accomplished which is always good! Last night a group of us went to a place called Zig Zag for dinner. It was amazing! I was brave and tried the trio of meats... I had Ostrich, Alpaca and Steak. Didn't care much for the Alpaca but everything else was great. Than we headed out to the disco, what a blast!! Our doc's, translators, nurses and I were all out in full form. Nonstop dancing for two hours straight. Zev, the surgeon, was a bit sore this morning from getting jiggy with it (LoL) and our cardiologist Phil gave us instruction on how to properly do the funky chicken. Pictures will be interesting to see :)
Today I went to La Joya. To get there it was about an hour drive through mountains, mines and the desert. I did not expect the desert to be so beautiful. The sand and mountains were multi colored from the copper and volcanic rock. Than suddenly in the midst of the desert we'd come across a patch of green lush farm land that was watered via irrigation systems. Apparently their water comes from the mountains (20 kilometers away) and requires much cleaning before drinking. It made me worry about the poor. We went to the La Joya hospital, last year this little tiny hospital treated over 40,000 patients. A doctor informed me that on a normal 12 hour shift he sees at least 40 patients. The hospital doesn't have proper supplies, drugs or equipment. They can't afford it. The equipment they do have is locked up and only the director has the key... he's rather rude and is rarely there meaning the life saving equipment (including respiratory equipment) is never accessible. The town seems so destitute. People make homes out of branches, cardboard, wood, brick or whatever they can find. One room huts, no plumbing or electricity of course. In the middle of all this is a beautiful resort with step horses, pools, and a green lush landscape. The difference between the poor and rich is outstanding. This is definitely a new experience, one that is unforgettable.

Sorry all no blog tonight! Much to tired. Today was busy a busy day. Ever see a cardiac surgeon and cardiologist dance at the disco? Its a must!

A better day.

So this morning I woke up feeling a little iffy... not sure if I drank some water or what. That's a BIG no no! By mid morning I felt well enough to get back to work, slowly of course. I started stocking my pediatric unit and than headed over to see if they needed help with today's adult post-op patient. Everything is a tug of war still with the nurses at the adult hops ital but its getting better after a long hard talk with the director. All in all things were laid back today which was great. Than over dinner my new adoptive family (a group of people working with me who are all from the same hospital have adopted me) discussed all of the problems so hopefully we can work out the kinks and make a bigger impact here. We want to leave it better than when we came without hurting anyone's feelings. Dinner as usual was amazing and was followed by sangria and chocolate! The Sangria (wine with fruit and juice) led to some crazy antics... I've been informed what happens in Peru stays in Peru!! LoL we're not allowed to get TO crazy with the body guard and 2 SWAT guys following us! Oh yeah, apparently I'm a hot commodity in Peru. One the of the SWAT team guys passed his phone number along to me via the interpreter. To funny. Off to bed for another busy day!

I've had better days.

So today was a success and a failure both. A success because our patient survived his surgery and is currently recovering in the ICU. It was a failure because every step along the way we have been fighting with nursing staff. The administration wants us here, but the charge nurse of the ICU clearly does not want us to be here. I will state again that we were asked to come here to educate the hospital on open heart surgeries and heart valve replacements.
Every thing that I have done this week this charge nurse has disagreed with me. I try to explain things but the language barrier makes it difficult even with a translator. Tonight she did not like how our ventilator was working so instead of working with me to come to an agreement, she took another SICK patient off a ventilator so she could use it on the open heart surgery patient. When I left the ICU tonight, that other patient was not doing well off the ventilator. By doing this she gained control over the ventilator. She discussed nothing about a ventilator change with me or my team. She put the patient on settings that research has shown to be inappropriate. It is so frustrating because we are trying to help her but she has this complex that she is right. In no way are we saying that what she does is wrong, because it is not, but we just want to show her a better ways to do things. Safer ways, more effective ways and ways that are more comfortable for the patient. I won't get into how horrible today was for me, because it was pretty bad. Unless things are changed, and nursing and administration decide together that they want help, I can honestly say that I will be spending the rest of this trip helping people who want help at the pediatric hospital.
Highlights of my day included the amazing views of the volcano's this morning and that I got an arterial line in our patient to measure blood pressure during surgery that the anesthesia doctor and resident couldn't get. They called me in as a last ditch effort before they took more invasive measure, I don't think anyone expected me to get it. Off to bed so I can get up early so I can not teach nurses who don't want help.

The set backs grow...

So at first I thought that this trip was going to be a piece of cake for me. I had almost nothing to do with the adult hospital, nursing staff is pretty well educated and prepared. Things that need to be changed won't be changed due to the staff being so set in there ways. Those situations are delicate because you can't be pushy and be all "My way is better than your way". So I pretty much helped where possible and went exploring in all the spare time. Easy breezy! This afternoon I was brought to the 2nd hospitals pediatric ICU for the first time. We are supposed to interview patients on Saturday and start surgeries on Monday. Key word SUPPOSED to. Well I have my work cut out for me. I may have to pull some all nighters trying to get things together. The ped's ICU has nothing I need, I mean NOTHING. They have two vents. One is broken and is so old I wouldn't use it on a kid even if it worked, the other vent is probably older than I am but is still functional. I haven't tested it yet to make sure it doesn't blow out the kids lungs. That is all the ICU has. No supplies... nothing!! So I along with only ONE nurse have to sit down and pretty much build a pediatric ICU from the ground up. We have till Monday. I need to write out everything I need and send it to the appropriate people hopefully by tomorrow so they can send me supplies from Lima. If we get our crate (still in customs) I may find much of what I need, if we don't get it we may cancel the surgeries and focus on ICU growth and education. Thats why we are at this 2nd hospital... to help build an ICU, educate and hopefully do a few surgeries to teach. I must admit its a bit of a load but I'm here so I'll do what I can. The ICU here is brand new which is nice... just not set up.

Its been a long day! It started at 3:30am when the city's sirens started blaring. My group all opened the doors and were questioning what the sirens meant... Earthquake? Attack? Fire? Who knew!?!? We found out at breakfast over our morning cup of coca tea that it is a fire alarm calling the firemen into work. So we all freaked out and lost sleep over nothing! I spent the morning at the adult hospital and sat in on some consults with potential surgery candidates. I decided to stop sitting in the consults when one patient broke my heart. She is a single mother with 2 small children, she cannot afford surgery on her own and there is no one to care for her children when she dies meaning they'd probably end up in an orphanage. When she learned that she was a good candidate and that we'd fix her heart she broke down crying. I, along with a few others, were trying hard to not let her see the tears run. She couldn't thank us all enough. These surgeries that are somewhat common place for me are impossible here leading these people to certain death. For every person we save (hopefully the surgery saves her) there are thousands that die. The town I visit on Sunday is a 15 bed hospital that serves 40,000 people. How lucky are we in the States? Its not that they don't work hard or don't deserve the care, its just the way things are here. Its impossibly sad.

Set Back

So we are having a bit of a set back for surgeries. Cardiostart sent over a crate full of equipment necessary for the surgeries and its not been released by the Peruvian Customs people. We can not perform pediatric surgeries without it and its making our adult surgeries more difficult. So that along with the set back of our Cardiologist stuck in Lima has definitely changed this trip. Our cardiac surgeon Zev is doing his best to make a difference here by assisting in surgeries with local doctors to help with education. Everyone in our group is doing what we can with what we have and providing education. Hopefully we get our crate soon!
With all these set backs we have found ourselves with more free time. Today we went to the Sainta Catalina Convent (Monastery), it is by far the most magnificent thing I have ever seen. Its a paradise surrounded by white volcanic rock walls. My mom and cousin Britta would never leave! It is called a city within a city and it truly is, its huge. It was built in 1579 and has had many reconstructions after earthquakes. The gardens are a paradise and the building has such amazing architecture and history. It was originally for nuns coming from wealthy families and they were each given their own 'house' with servants. I will try to post pictures but it is literally indescribable. We went at night when they light the candles and all the character comes out. because of this my pics may not come out well. Being its only across the street I plan on going back a second time during the day. Its worth every penny. If it weren't for the self mutilation and all the solitude I'd probably consider becoming a nun myself! Some still live there in a closed off section (no more mutilation of course).
Today I met my match... I discovered the worlds best hot cocoa. It was absolutely perfect and this is coming from a chocolate connoisseur!! I wanted to learn how they made it but once again the language barrier got in the way. The nurse who often translates for me became the first one of the group to get ill and be subjected to IV fluids. So far so good in my case, which is surprising cuz I've eaten everything! You only live once. :)
Buenas noches!