Saturday, February 27, 2010

Bittersweet Day

Well...we've reached the series finale for life at "Hue Central Hospital." The rest of this past week was unreal. We witnessed 2 patients coding and the response of the medical staff to the situation. It was my first time seeing a patient code. It is a very difficult experience to watch. The doctors and nurses were great and luckily both patients were fine afterwards. I had the opportunity to see many more patients and teach a number of mothers about breastfeeding and appropriate nutrition for their children. It was wonderful. The doctors continued to be amazing. I was paired up with Dr. Ha on Thursday and Friday. He specializes in oncology and when I met and assessed his patients it was clear how much they loved him. He is one of the most caring individuals I have met here. He also took me down to the infectious disease unit (my favorite) and I saw another case of Dengue fever. He told me that the name Dengue does not come from the scientist that discovered it or the location where it orginated. Instead, the disease was named after a Brazilian dance which he gladly demonstrated for me! It was so funny. We even got him on film doing the "Dengue Fever Dance." Classic moment.

This morning (Saturday) was our last day in the hospital. I worked with Dr. Tan for a short about of time on the GI floor learning all about diarrhea! What a joy. We also got a quick tour of the maternity ward including the labor, delivery, and post-partum units. I was pushing all week for us to get a tour. Ask and ye shall receive, right? It was so great to see all of the mothers and their newborns. Sigh. In the postpartum unit, all of the mothers are in the same giant room together with row after row of beds. It's an incredible sight. After our tour we met up again with all of the doctors that worked with us over the past few weeks and presented them with home-made cards and flowers. As the team leader, I said a few words of gratitude. These doctors have all impacted our lives and we will never forget them. We all exchanged email addresses and decided to stay in contact with them and let them know our plans after graduation. I know that if I ever come back to Vietnam, I must visit some of them. We took a lot of pictures together and then said our good-byes. Some tears were shed (truly!) and many "thank yous" were exchanged. It was such a touching moment.

I spent the afternoon enjoying a little rest and relaxation with some of the other girls at a nearby pool! It was one of the hottest days ever here. We had to pay an entrance fee but it was well worth it. And don't worry...I wore sunscreen and I'm not burned. Everyone else on the trip seems to be so concerned about my fair skin here. But I'll be careful. I promise. Tonight we are going to dinner with the Vietnamese nursing students who will be with us for the next week in Nam Dong. In Nam Dong, we will travel into various villages with the students and work togeth in the clinics there. So tonight is our "getting to know you" night. Should be fun.

We leave tomorrow afternoon for Nam Dong with the entire team and the other nursing students. I am so excited to see what this next week will bring. I can only imagine...

Tuesday, February 23, 2010

Oh IMCI, how I heart thee

More updates this week because I'm able to see and do a lot more. I spent yesterday afternoon learning about the IMCI program which is sort of a triage and diagnosis process for various illnesses and diseases. We had a lecture from one of the doctors after lunch. The culture here is so great because in the middle of the lecture people kept coming in and out of the room to retrieve things, ask our 'lecturer' questions, and he even stopped at one point to answer his cell phone. I've learned to adapt to this and even enjoy the constant interruption. So typical of Vietnam. A few of us got a tour of the main hospital building after that. We have only seen the pediatric hospital up to this point, so it was nice to see where the adults were being treated.

This morning I was paired up again with Bac Si Luong to practice the IMCI program on actual patients. We were followed by approximately 20 other medical and nursing students. It was overwhelming. We would crowd around 1 patient's bed and do the exam. Can you picture this happening back home? It was also intimidating for me as I had 20 sets of eyes watching and analyzing my entire examination. Now I know what Bac Si Hau felt the other day when he did the catheter placement. After we saw 3 patients, I was paired up with Bac Si Chi who is an endocrinologist. She was doing outpatient visits and I saw 4 patients with her who all had Grave's disease. So interesting! These patients all had large goiters and delayed growth and development.

This afternoon we head back to have a tour of the adult ICU and then I will spend time on the pediatric nephrology unit. I'm hoping to see some more kids with nephrotic syndrome and glomerulonephritis. I will keep you updated on how that goes.

This week is a long one and I think some people on the team are beginning to feel it. We have long days at the hospital followed by afternoons of homework and then team meetings in the evening. We don't really have much 'free time.' That has been a challenge for me, but I'm adjusting okay. Luckily, I am surrounded by many encouraging and uplifting women who are in the same boat. We can do this, right? Whatever the situation, I am still completely grateful and overwhelmed to be here each day. What a blessing to wake up in Vietnam every morning and head to the hospital to provide care and education to the people here.

Monday, February 22, 2010

Dengue Fever...is that you?

How is it possible to learn so much in such a short amount of time? I thought my brain would be full by now, but no! I was in the ICU again yesterday and was able to watch an interesting procedure. One of the patients had nephrotic syndrome which advanced to renal failure. In order to receive dialysis, Dr. Hau placed a stent/catheter in her femoral vein. A procedure like this in the States would probably be low-key but in Vietnam it's a whole other story. I watched the procedure along with Kelly (another girl on the trip) and about 15 other people. This included med students, nurses, nursing students, and residents. It was a packed house. The pressure was on for Dr. Hau. After 2 attempts, he was finally successful. Talk about pressure! I know I wouldn't want 15 people watching me as I tried to place a catheter into someone's vein. Sheesh.

Today I was on the GI unit and the infectious disease floor for a bit. What a treat! I worked with Dr. Luong this time. His method of teaching is so great. He basically brings you into the room and says, "okay now, assess the patient and figure out what is wrong with them." Luckily another student was with me and we worked together to determine that one patient had Dengue Fever and another had measles. Two diseases that I may never have the opportunity to see in the States. Dr. Luong provided translation for us as we interviewed each patient, got a history of their signs/symptoms, and did a physical assessment. It's amazing to read about a disease in a textbook one day and see it in the hospital the next.

This afternoon we are going to learn more about IMCI (integrated management of childhood illness) and how to use it properly here in Vietnam. IMCI is a diagnostic program designed by the World Health Organization so doctors, nurses, etc. can easily diagnose and distinguish between a variety of infectious diseases in children. Tomorrow morning we will be in the emergency room in order to use IMCI to diagnose patients. Love it!

In other news: Last night we went out to eat at a new restaurant. Caitlin and I decided to be adventerous and order some Vietnamese delicacies. She ordered the eel and I went for the frog. When in Rome, I guess. As you can see from the picture below, we cleared our plates and went home happy.
Hope you're all doing great. The trip is almost 1/2 way done. I can't believe it!

Saturday, February 20, 2010

Comas, Scalps, and Orlando Bloom?

I think we're finally back in the swing of things here in Hue. I will be working in the pediatric ICU for the next couple of days. It is such a different world here when it comes to medicine. The ICU is quite different than what you would see in the States. I was able to take care of a number of babies this morning and I loved it. These kids had a number of problems including heart defects, pneumonia, cleft lip/palate, bacterial meningitis, kidney failure, and one girl was in a coma after suffering a cerebral hemorrhage. I was paired with another student, Kelly, and we worked with Bac Si Hau. He is a very busy physician, but took the time to explain the disease process for many of these kids. Again, the patience and kindness of these physicians is astounding.

I was able to clean the scalp of a 5 month old boy this morning. His head had never been washed before and it was covered in a lot of dead, crusty skin. This is a common practice in Vietnam as many of the people believe that if the baby's head is washed, their soul will blow away. Very interesting. The cleaning process was sorta gross, but he looked so much better afterwards. One of the many delightful battles we face in nursing...

The past few days have been pretty low-key. It was raining and cold here for a while, but I am a-okay with it. I think everyone else wishes it was warmer, but as you're aware, I do not do well in the heat. It finally stopped raining today and is a bit warmer. I'm hoping this weather holds-out until we leave for the villages next Sunday.

In other fun news: we went out to eat at the most amazing Pho restaurant last night. They had the best food I've had in Vietnam to date. They had these fried pastry dumplings filled with various (and unidentifiable) food. It was a place where only the locals hang out except for one other tourist guy. I swear it was Orlando Bloom! He looked just like him but everyone else disagreed with me. But I will stand by my celebrity sighting. Why wouldn't he be here? I mean, Orlando needs a vacation too, right? Sheesh.

Okay...that's all for now. Wish me luck in the week or so ahead. This begins our marathon hospital and village time. Non-stop, 7 days a week. We won't have another break now until mid-March. Should be fun!

Thursday, February 18, 2010

Back in Hue

The break for Tet and New Years is still in full swing in Hue. We spent our New Years Eve at the Citadel in Hue. Honestly, it was one of the craziest, scariest, and most enjoyable experiences of my life. We walked about 1 mile from our hotel to get there along with thousands and thousands of other people and motorbikes. I have never been in such a large group of people and bikes before. It was touch and go for a bit as we tried to make our way through the crowd. It was like Times Square on New Year's Eve times 10! We survived, however and eventually made it back to our hotel around 11:30 pm in time to watch the fireworks from the balcony. Truly a once in a lifetime experience.

Our group traveled to Hoi An on Sunday because everything in Hue closed down. They even discharged all of the patients from the hospital except those in the ICU. Hoi An was about a 3 hour scenic and gorgeous bus ride from Hue. I saw the countryside, oceans, and moutains along the way. Once we arrived in Hoi An I knew I was in for a treat. It is an ancient town with small buildings, beautiful bridges crossing the river, small narrow roads, and it's even near the ocean. Oh....and there were a ton of tourists too. We spent our first morning (Monday) taking a bike ride along the river to the ocean. And by the way, the bikes had adorable little baskets on the front. Obviously. We then frolicked in the waves and enjoyed the warm sun. We biked back to the hotel mid-day and headed into town for some shopping and site seeing. If you ever come to Vietnam, Hoi An is the one city you MUST see!

On Tuesday we made our way back to Hue. We made a stop at a place called Marble Mountain. Not to be confused with candy mountain ;). It was a large moutain near the sea. We paid our entrance fee and then walked up about a billion steps to the top. What a view! 360 degrees all around on a sunny, clear, breezy day. The ocean in front of us and the mountains and rice fields behind. It was beautiful. I wish I could upload some pictures but I'm having technical difficulties here....sad day. Marble Mountain is also famous because of its many caves. Inside these giant caves there are alters and large carvings. It is a sacred site here in Vietnam and I'm so glad we got the chance to see it.

We are back to our normal routine now in Hue. A lot of places are still closed for the holiday, but we are making the most of it. We head back to the hospital soon and I cannot wait! After Tet, the hospital gets very busy with patients. Hopefully, I will have some great stories to tell. Hue is our home-front for the next week and a half. It already feels like home here even though I haven't been in Vietnam that long. The hospitality and friendly nature of the people here is unmatched. I cannot imagine future where I do not return to this amazing country.

I hope you are all doing well too! I am unable to check facebook or other email accounts while I am here. So feel free to email me at my gmail account or comment on the blog. I would love to hear from you. Here is a link to some more photos from our trip that Bob Catherman has been taking: http://picasaweb.google.com/medrix.robert/VillageMarket?authkey=Gv1sRgCIy5ieG81ayelQE#
Take a gander if you like.

Also: Quick shout-out to my wonderful roommate Melissa who is recently engaged to her boyfriend Jeff! Congrats to you both and I'm so thrilled for you. I cannot wait to get home and hear more about it! Another shout-out to my sister, Brooke because I found the Vietnamese Walmart yesterday. What a treasure. I know you love Walmart so much ;) That's all for now! Until next time....

Saturday, February 13, 2010

Army Hippopotamus: The Mirror of Fashion

My blog title today refers to a t-shirt we saw here in Vietnam. It was incredible. Some things just get lost in translation I guess? Since we spotted that shirt, I've been searching endlessly for one of my own. What a treasure!

So I had one of the most amazing experiences this week. Totally a top 10 moment of all time. On Friday, Julianne (a fellow nursing student) and I finished lunch early and decided to walk to the post office to make our first call home. It was a warm, blustery afternoon around 12:30pm. As we walked down the street the wind began to pick up a bit more and there were leaves and other various debris flying about. Suddenly, I found myself blinded by something. A piece of fabric was covering my face completely and I could not see. I quickly removed the object only to discover it was a pair of men's underwear! What are the chances? One in 10 billion perhaps? And why was men's underwear flying around the city and falling on my face? Only in Vietnam...underwear to the face. We laughed and laughed for a good 4 blocks.

This morning at breakfast I also had another delightful moment. Our fearless leader LaRelle (founder of Medrix) purchased some delicious local fruit for us to try. Quite the variety. I decided to try one called "Mother's Milk." What a name! Anyway, I began to enjoy this new fruit along with some other students. I was almost finished with mine when I glanced down and noticed a small, crawling larva of some sort. Just a little extra protein in my diet for the day. What a treat.

On a more serious note: This week has been amazing. I have learned so much more about nursing and medicine. I was paired up with Bac Si (doctor) Luong for 2 days and Bac Si Thuan for the next 2. Bac Si Luong was the hematologist and oncologist on the unit. Bac Si Thuan is the cardiologist. He was amazing! He taught me how to distinguish between the severities of heart mumurs with my stethoscope. A new skill! Love it. We saw many patients with heart defects that are unable to receive surgery because it is so expensive. It was pretty hard to see. The upside? I was able to sit down with Bac Si Thuan for a couple hours and just talk about his life and learn about his country. We are now friends and plan on staying in contact after I leave. He is an amazing and accomplished physician. All of the doctors here are so hard working and so humble. I've never met a finer group of gentlemen.

Today (Saturday) we took a boat ride up the Perfume River to a Buddist pagoda and then to the emperor's tomb site. 2 amazing sites! So much history. The river cruise was so beautiful. It's so surreal for me. I had to keep reminding myself that I wasn't on the jungle cruise at Disneyland. It sounds nuts, but I kept waiting for the mechanical hippos to pop up at some point. But no...it's real. There are people who live on the river in small boats. It's incredible. I don't think I can begin to describe how different, but great things are here. I'm in love with this country.

Tet begins tomorrow so today is crazy in Hue! It's like Christmas Eve. Everyone is out and about shopping for last minute items and the whole city is decorated with lights and flowers. It is gorgeous. Each family buys a mum plant for their home. It would would be like our xmas tree. If you want to see some pictures, you can view them here: http://picasaweb.google.com/medrix.robert/Report1?authkey=Gv1sRgCNb28OzN0_vuuQE#. Bob Catherman (the co-founder of Medrix) took these photos. So lovely. They have a huge fireworks display at midnight because it's the lunar New Year. We are going to watch from the top of our hotel. So excited!

So Happy New Year everyone and Happy Valentine's Day!

Wednesday, February 10, 2010

Wow.

Am I a medical resident here? Perhaps.

Oh wow you guys. Things here are incredible. I don't even know where to begin. I have already seen and done so much. I spent the last 2 days in Hue central hospital in the pediatric unit. I worked with Dr. Luong who is a hemotologist and oncologist. I worked patients with thrombocytopenia, leukemia, chronic anemia, bone marrow failure, and even some cardiac patients. I saw one girl with tetrology of fallot with severe clubbing and cyanosis. So unique. I can't believe I'm seeing so many amazing things. Tomorrow I switch preceptors and I will be working with the cardiologist. I think I will be seeing patients with congenital heart defects and rheumatic fever. Even though I don't speak the same language as the doctors I am working with we are still able to communicate quite clearly. Medical terminology seems to be the same no matter where you go. I was even able to diagnose a patient today with viral pneumonia. Who am I? Diagnosing patients? Really?

We were able to celebrate Tet (the New Year) with the staff of the hospital for lunch. They setup 2 alters in the hospital. One at the entrance and one on the 3rd floor. The alter was a huge table with food, drinks, fake money, gifts, and incense buring. All of this is for their ancestors. The incense filled the whole hospital with smoke. This is something you would never see at home. I can't imagine a whole hospital (4 floors) filled with incense and thick smoke. After the 'offerings' were made we had a huge feast with traditional foods. Everything was pretty tasty. The only 2 difficult things were the gelatanous squid dessert and the bean curd & tobacco leaf custard. Wow. I was trying to be so respectful, but it was a challenge to get those 2 down.

Aside from all of that, I have been able to enjoy Hue to it's fullest. We've been eating the most amazing food and seeing the incredible sights. Hue is so much larger than I anticipated. Bigger than Boise...if you can believe it. However, no matter where we go we are a giant spectacle. We are so much taller and larger than the people here. We get stared at non-stop. We were out for coffee once and a woman just walked up and stood there next to us. She just stared and watched. I mean, why not? I would stare too.

Vietnam is amazing. The culture is unlike anything I have ever experienced. Totally different in so many ways. I can't even begin to describe it. And have I mentioned the heat? Oh wow...seriously intense. I'm a wreck most of the time. Just sweating. That's probably why I'm such a spectacle. They can't figure out how or why someone would sweat that much. It's nuts.

That's all for now. Miss you all!

Sunday, February 7, 2010

I'm here!

After 3 flights, 2 upgrades to business class, 1 tour of Ho Chi Minh City, 8 bottles of water, and 0 nights of sleep...I have arrived. If you think my suitcase was the largest one of the groups, you are correct. If you think I packed more than anyone else, you are correct. If you think I'm sweating more than anyone else, you are also correct.

So how can I sum up the last couple days? I'll give it a go...
The flight from Seattle to Taiwan was just fine. 13 1/2 hours of delightful sitting. We switched planes there for Ho Chi Minh city. When we landed there it was crazy. There was a sea (thousands!) of people outside the airport. Next week it Tet, which is their new year. It's bigger than Christmas. Seriously. So the airport was jammed with people. We made our way through the crowd to hop on our tour bus. A giant, hot pink tour bus. Needless to say, we were not blending in at all. We took a tour of the city and stopped for lunch. We also went to the Vietnam war museum. What an interesting experience. Very sad. Our day there was short as we had to head back to the airport for the flight to Hue. We all got bumped to 1st class and got to go the 1st class lounge. There we were....hot, dirty, sweaty, and gross wandering around this uber-fancy lounge. Kinda embarrassing, but still delightful. We arrived in Hue around 6:30pm on Sunday night. We were all exhausted. We dropped off our stuff at our hotel and grabbed some dinner.

That about sums up the trip so far. It's Monday morning right now (I think). We have a free day today. I plan on going to the Hue market with some of the girls. Should be fun. Tomorrow, we begin our work at the pediatric hospital about 1/2 mile from our hotel. I'm so excited for that.

Please keep in touch with me and I will do the same. You can email me at summervandam@gmail.com Take care!!!

Friday, February 5, 2010

Leaving Today

I've got about a million little errands to run and things to do today. Our flight leaves tonight from Seattle. I am experiencing mixed emotions right now. Excited, anxious, fearful, happy, and overwhelmed probably sum it all up for me.

Luckily, I have the most supportive friends and family in my life. Last night I was able to spend time with all my friends (i.e. my "Seattle family"). They had a bit of a going away party for me and I had a blast! I received cards, hugs, and even small gifts. My awesome friend Cameron packed me a travel bag with magazines, gum, snacks, and hand sanitizer. I also want to give a shout out to Malia for her friendship bread and sweet card. You made me cry! And just a big "thank you" to the rest of you who came out. I'm going to miss you all so much.

That's about it for now. Gotta go prepare myself for the 13 hour (!) plane ride tonight. Byyyyyeeee!!!!!

Monday, February 1, 2010

Friday!

I'm leaving this Friday. Wow. I've been talking and talking about this trip for soooo long and now it's finally here! I can't stop reading over our itinerary...so I thought I would share it. I mean, why not? Here are our travel plans:

1. Taipei, Taiwan. I'm obviously going to count Taiwan as a country I've visited. I don't care if I'm just in the airport for a layover. It counts!
2. Ho Chi Minh City. We'll spend a day there enjoying the sights, I believe.
3. Hue. We'll spend most of our time here working in the pediatric hospital.
4. Hoi An. Two day side trip. See pic below. Looks incredible!

5. Nam Dang. This is where we will work in rural clinics providing health care to one of the minority groups in Vietnam, the Katu people.
6. Hue. Again.
6. Da Nang.
7. Ho Chi Minh City again for debriefing before we leave.

I just know this trip will go by too fast. Don't they always? I will update again once we're settled in Hue. Hopefully I can give you some info by next Monday or Tuesday.

Wish me luck this week as I finish my finals and cram my brain full of as much information as I can on pediatrics and community health care before I go!