It is hard to believe it is already December! The kids here are excited that "winter" is here because it means closer to Christmas time for them!
Yesterday was a normal Monday. In the morning, I worked on some personal stuff online, organizing pictures, blogging, downloading pictures, etc because my free Microsoft Office trial had run out so I couldn't work on my units from my room.
In the afternoon, I headed out to Batey Madre with Dr. Garcia. It was an interesting day but familiar clinic day to one back home. Isabel was a 77 year old woman with high blood pressure, reading 200/100 yesterday taken manually. It was too high for the automatic cuff to take it. When she went to consult with Dr. Garcia, he was asking her about her medications and she wasn't sure what she was taking so he had her go get them.
She returned with a purse full of medicines. Here they don't come in pill bottles, they come in little packages like the gum that you push thru the aluminum to get out. The come in packages of 10 pills and she had tons of them. She had 4 different blood pressure medications, furosemide (lasix) which is used to help with swelling, and digoxin which is used for the heart as well. When he asked how she was taking each of the blood pressure medications she couldn't tell him. She almost looked embarrassed because she was so clueless. She had about 10 packages that were completely empty that she had kept for no known reason, and other packages of the same medicine some with 1-2 pills missing, others with 3-4 missing, and other not opened, showing that she was just taking them randomly and didn't realize they were the same thing. So, after some discussion with Dr. Garcia, he took away 2 of the BP pills and kept her on 2, and then kept her on furosemide and digoxin. He rubber banded them together to help her try to stay organized and will see her back in a month.
It was eye opening to see this. She doesn't understand how harmful it is for her to have such a disorganized arrangement of her medications. However, I'm sure this happens so often even in patients that I see, and even in patients that aren't 77 and are only taking one medication. Often times it is easy for me to forget that I understand my directions easily but for a patient who didn't study medicine and doesn't know the difference between one pill and another, they can easily get confused. It was a great lesson learned to me more diligent about having patients bring in their medications and reviewing them every visit!
After I got back, I spent some time in the "hair salon" of Nena. I sat on a swing while she did my hair. She was trying super hard to do something cute and kept coming up with things in her head. She was going to pull a large piece in the front to the side and clip it with a barrett, like the ones little girls use, but after several tries she realized my hair was too thick to hold it in. So, she put a front ponytail in my hair instead with a red bow that one of the little girls had received from her Mom. From the salon I had to head to dinner but wasn't allowed to take it down because it was a rushed job and I was told to return after eating quickly. So, I showed up to dinner looking marvelous!
After dinner I headed back over for some torture. Nena started working on my hair, then gave the job over to Joanni, then to Coral who is 12 and pulled harder than anyone and then Joanni again who got stopped finally by one of the caretakers because she could see I was in pain! They pull so hard here!!!
We had movie night and watched Alvin and the Chipmunks which the kids loved. Heather and Julie made brownies which were tasty as well! Ari was sitting in my lap for a little while during the movie and she is the one that had her bad front tooth removed. She looked up at me and said, my tooth is clean now! She is so cute because she keeps saying how clean her tooth is, but she has no tooth there anymore. Today she actually asked me when she was going to get a new one! :) I told her when she was 6 years old!
A couple other random sights from the day. On the way to Dr. Garcia's house we were driving by some local neighbor kids and the little boy had his same yellow tighty whities that he always wears. However, this time his little wee wee was hanging out the top of them and they were just covering the rest of his package. It was quite the sight! On the way back from the batey we drove by a house and on the front porch area was an old car seat that came out of a van or something just sitting on the porch as a couch/resting area! So ghetto but resourceful! :)
Today was a little different for me. I had planned on working on units all day because I have 4 to finish and less than 3 weeks left! AHHH! Where has time gone? But, Jennifer, one of the interns has been having wrist pain for the past 4-5 days since one of the older boys squeezed her thumb really hard. So, I went with her to the clinic for an x-ray just to make sure nothing was broken. There is only one guy in town that can take x-rays and he works in the hospital in the morning. So, we arrived around 9:45 and waited until just before 11 for him to arrive from the hospital to take an x-ray. It was not broken so we headed to the pharmacy to get diclofenac (an anti-inflammatory). You can buy prescription drugs here without a prescription.
Before stopping at the pharmacy we stopped by the Rehab Center briefly to set up another video tour for tomorrow. We are going to do a video tour of the Rehab Center tomorrow with some more interviews! So I spoke with Joanni,the administrator,who is excited for us to come tomorrow to video tape.
We headed back for lunch and went to see the kids but very few were out because they were eating. While we were waiting, Cameron arrived. He is from Michigan and has supported Orphanage Outreach for the past 10-12 years by raising several thousands of dollars each year. He is here for a week and will be working on some painting projects and just hanging out with the kids. I spoke with him some and then headed up for a little siesta.
I worked most of the afternoon on one of my units until 5pm which is my normal stopping time and my favorite time to hang out with the kids. I hung out with Carolina and Erikson (an older boy that lives in town but comes to hang out and help out) as they were reading thru some Dominican school notebook. The book had some religion, teaching the books of the Bible, etc. A little different from American public schools, huh? During this time, about 5 little girls were carrying over a bucket of food scraps to feed to the goats and they were all making goats sounds. It was funny! Joanni came out and I played with her some and we went over to see the goats as well.
After dinner, I spent more time over with the kids just hanging out. Jennifer fell asleep in my lap early on and I took her to go to bed, and then had Luz Maria and Mineli hanging out in my lap. We were just sitting watching a hysterical scene. Several of the 8-11 year olds were acting out people fainting in church. One of them would stand up on a cinder block, touch another persons head, and start screaming, Leave, leave them, Heal him, Get rid of the demons and the person would be helped down by the other kids to lay on the ground. This would continue until everyone was lying down and sometimes they would start "convulsing" on the ground. It was funny, while kind of disturbing, to watch this but it is what they see sometimes at church so it was interesting. They starting getting the little girls to come over so they'd have more people to "heal".
After this ended, they started playing more normal childhood games like Duck Duck Goose, etc. I ended up hanging out with Heather and Jessica and we played a clapping game that is hard to explain but was fun.
Tomorrow we are headed to the Rehab Center to film in the morning and then I'll stay back from the bateyes to try to get some more work done since time is running out! Hope everyone enjoyed their first day of December!
Tuesday, December 1, 2009
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