Pictures!

I feel that I have been writing too many words in my blog so this will be a bit of a picture dump post.

Before the pictures though, I want to share some updates on my patients.
- The patient with the neck mass I was telling you all about ended up going for an I&D on Friday afternoon. I will find out tomorrow the results and diagnosis. I am still annoyed that we continued to treat her with amp and gent and called it appropriate antibiotic coverage.
- Another patient with bronchiolitis (2 months old) I saw my first day of starting. The mother speaks English so I became more interested in following his progression. Even the first day I saw him I thought he could be discharged but he stayed 4 more days waiting for his lung exam to improve as well as his chest xray. Then he spiked a temperature from some infection he caught in the hospital (poor handwashing and patients in close proximity) and so is now staying longer! sigh
- Then there is a 6month old with a large ASD who looks like a 1 month old because of her failure to thrive. She is here being managed for bronchiolitis and waiting cardiology consult on when she can be repaired. I was surprised to see the mother giving her so much table food and that more effort wasn't being put in to increase her caloric intake. It has been so busy on the wards, I have not had a chance to ask questions about her management but will try tomorrow!

Despite frustrations I may discuss, I have been impressed by many things, for example how quickly patients get surgeries and needed procedures. This hospital has all the specialists we have in the US but the resources are limited. For example, on Friday, our 8mon patient who recently had repeat pyelostomy developed carpopedal contraction we think we due to hypocalcemia or hypomagnesemia. But we can't send blood work for calcium or magnesium because apparently it gets "lost" in the lab. They gave the patient calcium through a peripheral IV and he developed bradycardia requiring atropine. There was no magnesium for us to give him. It's crazy that a hospital that has so many different subspecialists can't test a blood calcium level. But they still manage and do their best by the patients using their clinical skills and knowledge, which is always impressive.

Hmm I guess I ended up writing too much again. And so much medical jargon. Sorry! It helps me get out my thoughts. Let me compensate with lots of pictures!

 My room! I keep the mosquito net down all the time to keep from being bitten in this rainy season

 My cloest and clothing rack!

 The large window in room, which I like because of the light though it doesn't provide much privacy.

 

 The kitchen I share

The place I eat breakfast every day with my fellow guest housers

Our bathroom! With the always nice hot water geyser!

 

 Me and Mirna in the entrance way before going out to dinner. The windows in the back are windows to my room (thus the lack of privacy). Mirna is graduate student the Global Health program at Duke. I have gotten so dark already! haha

 

Dinesh in our 3-wheeler (apparently only called a Tuk-Tuk in the west). Dinesh works at Leijay and does many jobs like everyone here but he is also one of the primary people to drive the 3-wheeler. He is also always a source of entertainment.

 We went back to Ijaya Beach this weekend and watched fisherman fishing at the beach!

That's it for now. Will update again soon!