Tuesday, April 22, 2008
Monday, April 14, 2008
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.
My new little friend Carmella!
Sunday, April 13, 2008
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.
Thursday, April 10, 2008
Wednesday, April 9, 2008
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!
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
One of the volcano's from the hotel deck, we can see 3 from here. This is what I wake up to each day!
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.
Sunday, April 6, 2008
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.
Friday, April 4, 2008
Thursday, April 3, 2008
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.
Wednesday, April 2, 2008
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.
Tuesday, April 1, 2008
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. :)