Another Week Coming to an End

Week 3 is finishing up now.  To start, here's a bit of a re-cap from last weekend...the 17th Annual Costal Festival was going on last weekend, and it was a great cultural experience!

People came from all over the region to show their typical dances

 Sara & I also went back to the Finals of the Surf Tournament on Sunday morning.

The beach was CROWDED!

After the surf tournament, Sara, Rodney, and I went on a bird-watching boat trip in a nearby lagoon.  

It was one of the most peaceful things I've done in a long time. 

We met a little friend along the way! 

The bird-watching trip concluded with a beautiful sunset on the ocean.  Click on the link below to see a one-minute version of the ten minutes of video I condensed.  

One Minute Sunset on YouTube

And what Mexican vacation wouldn't be complete without a wonderful Greek meal?  Sara & I decided to make it a tradition to eat Greek food each Sunday evening since this restaurant is SOOOO good!

This week, I was in a clinic close to the airport, and we saw a great variety of pediatric & adult patients.  Sara spent most of her time in the Operating Room, so we were able to contrast & compare very different experiences this week.  The health care system in Mexico has so many good things going for it. Of course, any health care system could use its improvements, but Mexico's focus on prevention is definitely something I want to bring back to the U.S. with me.  

Wrapping Up Week #2

It's so weird to be wrapping up my 2nd week here already!  In some ways, it feels like I just got here, and in other ways, it feels like I've been here for forever.  I've just had so many amazing experiences so far! 

The nurses at the clinic in Copala were so awesome!!!  They taught Sara & I so much! 

And Dra. Yesenia was a wonderful resource...it was so much more calm at this clinic, and she was constantly teaching!

Sara & I had dinner of the Punta de Zicatela watching the sunset...simply gorgeous! 

On Friday night, we went out for the pre-surfing tournament, and I tried TUNA ice cream.  Tuna is actually a fruit here...it's the fruit of a cactus, and it tastes something like a cross between a strawberry & a watermelon.  

We went to the 2nd day of the Surfing Tournament on Saturday morning.  It was great to see how the professionals do it.  

Breakfast after the tournament...Scrambled eggs on the left, French toast in the middle, and fruit/yogurt on the right.  

My First Pap Smear!!!

So, yes, I finally performed my first independent Pap smear today!!!  I'm sure all of you females are thinking, "Poor woman."  Yeah, I feel sorry for her, too, but hey, I played a huge role in the detection of cervical cancer, one of the biggest killers of women in this part of the country.  

But let's back up.  So, Sara & I showed up at the clinic this morning, and it was SOOOOO slow.  The nurses knew that we had come to this clinic in order to get experience doing Pap smears and since no one had an appointment, they went to the town center on our behalf.  They had the person who runs the speaker system for the whole town announce that women could come & get their Pap smears today because there was no waiting line.  

Come on...where else in the world would you just announce over the loud-speaker that the clinic is open for Pap smears???  So, we almost instantly had two women show up, and Sara took one while I took the other.  It was super-sweet of the nurses to do that for us, lol.  

An Easy Sunday

Sunday, Sara & I took a good break and walked along the Andador (a cemented walk-along the coast that is a little more hidden & offers some great views of the ocean).  

We then wen to the faro (light house) in town & got a great overview of the city.  

After spending about 4 hours at the beach, we went for dinner at one of the best Greek restaurants I've ever been to.  I know what you're thinking..."Why would you go to a Greek restaurant on a Mexican beach?"  Well, it sounded really good at the time, and it was DELICIOUS!!!  We finished with Turkish coffee by candlelight watching the waves roll in.  

It was a much-deserved easy Sunday at the beach.  

Sutures & Surfing

Last Friday, I placed my first sutures!!!  I was pretty slow, but at least I was able to do it, AND the patient lived!  

The doctors we were with at Bajos de Chila

And on Saturday, Sara & I went surfing.  For those of you who know me even a little bit, you know that I am not athletic at all.  However, I made it up on the surfboard and actually rode several waves.  

If you ever get a chance to go surfing, I definitely recommend it.  It's a great feeling to be on top of a wave.  (And it's an excellent work-out, too!)

Our instructor, Jeremy, was from Hawaii

Don't let me have a heart attack in Puerto Escondido

Well, this was an "exciting" day...Sara & I were with one of the doctors just seeing patients rather smoothly when we were all called into the IV room to help with a patient who was unresponsive.  

(For those readers who aren't in the medical field, you can just skip to the pictures as this following part may not be interesting.)

So, she was spontaneously breathing (although it was kinda agonal at times & she definitely had an upper airway obstruction), and she did have a heart rate, so no CPR needed yet.  Glucose came back at 248, and her BP was 175/100'ish.  Pupils non-reactive, but small.  Breath sounds clear & HR tachy but strong & regular.  

As we continue the assessment & try to figure out what's wrong (other than her hypertensive urgency), Sara says, "I think she's having a seizure," and sure enough eye twitching, then tonic-clonic little 'ole seizure for about 1 minute.  We had no oxygen, and the only IV/IM benzo we had was expired.  So, we just watched...kind of a long 60 seconds, you can imagine.  

Afterward, we needed to clear her airway, so luckily, this little primary care clinic we were at had suction...but not what you normally think of...they handed me a bulb suction device (like what you use to clean out a baby's nose!)...but it did come in a sterile package, lol.  

But the part that really made me cringe was when the lack of IV meds warranted the use of oral medications that were crushed & dissolved in water, then squirted down this unresponsive woman's throat.  Sara & I both asked, "ummm...is that really going to work?"  The staff responded basically with "Well, do you have a better idea right now?"  Sara & I backed down, lol.  

So, we decided to call an ambulance to take us the 10 minutes to Puerto's hospital.  They don't have paramedics, so the Dra., Sara, and I went with the patient assessing her throughout the trip.  As you can see in the pictures below, there was NO equipment on-board.  

But we did make it safely to the hospital.  She seized again as soon as we got there, but stopped fairly quickly.  We were able to truly suction her airway (good job, Sara!) and get some oxygen on her.  12-lead EKG revealed an inferior wall MI and there was a lot of intermittent ectopy with frequent bigeminy.  

I was told she was later shipped out to Oaxaca for higher level care since Puerto doesn't have an ICU.  We later found out that she lives alone and doesn't do anything to control her HTN or diabetes.  Speaking of higher level care, it's important to know that only 3 cities in Mexico have hospitals which place cardiac stents.  So, please, God, don't let me have an MI in Mexico.  

Although I hate it for the lady, I got to be a paramedic and sort of an ER doc today.  It was a good learning experience for me.  

In the Clinic

I've now finished my 3rd day in the clinic, and it's going a LOT better than it did the first day.  I feel like I'm understanding a lot more of the language and the processes/system.  

Sara (my comrade from Switzerland) & I are acclimating a lot better now.  We can navigate the town (by foot or taxi), are discovering the good restaurants, and can swat at mosquitoes without wincing.  

The health care system of Mexico is quite different from the U.S.  Everyone in Mexico is guaranteed at least some form of health care, and they have to come to the clinic at least once every 6 months being a health adult.  You come every month if you are a child, are pregnant, or have diabetes!!!

A "Health Center" for the Town of Bajos de Chila

A few supplies

The delivery bed

The sign translates to "The baby should be placed on this table after delivery." 

The IV room

The Pharmacy in the Clinic

But of course, no day is complete without watching the sun set at the beach...

Unfortunately, I didn't have time to run home to get my sandals after clinic.