The Last Week

I cannot believe that we only have 2 more days left in South America!!!  The time has passed very quickly.  I have very mixed emotions about leaving.  When I am at the clinic and thinking about how many days I have left with the friends that I have made here, I am very sad at the thought that I will likely never see them again.  However, when I am at the apartment and packing, I am extremely excited to go home and see my husband, dog, family and friends. 

Monday at the clinic was actually a much more interesting day than what we have been having.  I saw my first case of Cushing's.  He had the moon face, buffalo hump, and a few other signature signs.  There was also a teenage girl that had drank a little too much alcohol, which led to vomiting.  Since it had blood in it, we had to give her a referral for an endoscopy to check for ulcers.  The scariest case of the day was a mother that had been feeding her baby water mixed with plantain powder for the first 30 days of the baby's life because the mom said she couldn't produce milk; however, I watched the nurse work with her and show her how to help her baby get her breast milk.  This is definitely something that I will never see in the USA.  The nurse was basically pulling/massaging her breast and squeezing milk out much like a baby suckling would do.  What was so strange about the situation was that it was out in public.  I have gotten used to seeing patients just whip out a breast to feed their child in the middle of a conversation, street, grocery store, etc.; but this took it to a whole new level.

Yesterday was a little slower day with a little bit of flu and another pregnant lady.  Listening to an unborn baby's heartbeat will never get old!  In the afternoon we took the chance to go to Fe y Luz.  This place is pretty incredible!  Fe y Luz works with children that have handicaps of some sort and also works with the families of these children to help them learn how to take care of their children properly and deal with their situation.  There are several different types of therapy they focus on: physical therapy, speech therapy, critical thinking type skills, etc.  There are also talks that are given about disease states and other important information for the parents and families.  There are approximately 90 children there every day and 7 staff members, only 4 of which are health care professionals. 

I also forgot to mention a few weeks ago that we went to the Center for Nutritional Recuperation.  This place is also incredible.  Their primary goal is to get the children to the nutritional levels they should be at.  Their secondary goal (however still just as important), is teaching the mothers the best way to provide their children with the necessary vitamins and nutrients.  This center, Fe y Luz, and Centro Medico Hombro a Hombro are all affiliated with FASCA (an association that helps fund the clinics).

Today I was with Mercedes in the community.  I was able to counsel a couple of patients on their medications and listen in on one other patient interview.  We then had to take a gentlemen to the ER at a nearby hospital because his blood sugar was 580!  Unfortunately we didn't get to stick around to see what happened.  In the afternoon, Stella and I participated in the Hypertension and Diabetes group for women.  We gave a brief talk over the two disease states and talked a little bit about the medications that each woman was taking.  According to Maggie (the Peace Corps volunteer) the meeting went really well.  The ladies were asking a lot of questions and seemed to be in tune with what we were saying for the majority of the time.  It was a great experience for the both of us, especially since we love the personal, counseling aspect of pharmacy.

When we got home, we packed a little bit more!!!  I know I already said this, but it is getting so close!!  We will be leaving Santo Domingo around 3:30 on Friday afternoon and should be back in the state around 6am.  I am looking forward to a fabulous last two days at the clinic!

The Last Adventure (seriously this time), theLast Load of Laundry, and the First Bag Packed

I can't believe that this six week rotation is already on its last week; at the same time, I am so ready to get back home. 

We had a short week at the clinic this week because Maricela, who works at the clinic, got married on Saturday.  So we had half of a day off on Thursday and all day Friday off so everyone could help prepare for the wedding.  We decided to take a short day trip to a zoo near Quito.  Thursday we "food-hopped" on La Ronda and tried several different types of food (which were all delicious), and then we saw a couple more churches on Friday morning before we left for the zoo.  It was an expensive taxi ride, but I am glad we went.  Unfortunately, Stella did not get to see her blue-footed boobie, but we did get to see the giant Galapagos Tortoises and some other really cute, and really ugly animals.  We took the same taxi back to the bus terminal and thought we were getting there an hour early...however, there was a ridiculously huge line of people going from Quito to Santo Domingo (why, I am not really sure).  We waited in line for an hour but still got tickets for the 3:30 bus which left about 10 minutes after we bought our tickets.  God has really taken care of us this trip, especially when it comes to catching good taxis and buses. 

When we got back to the apartment we had a nice relaxing night of movies and TV shows.  I enjoyed just chilling at the apartment for a little while since we had been running kind of crazy all weekend.  Saturday we had a lazy day in the morning and then after lunch we actually started packing!!  It's crazy that we are already at this point.  When I think about working at the clinic, it doesn't seem like it has been very long at all, but when I think about being in Kentucky with my husband and family, it seems like it has been an eternity!  Although I dislike packing, I am trying to think of it as a life-size Tetris game where my husband is the prize at the end :)  Saturday night was Maricela's wedding.  (It would be more accurate to say Saturday night and Sunday morning.)  The service started late, as most things do in Ecuador ;) , but it was beautiful.  Of course I did not understand everything that was going on, but I could tell that they bride and groom were very happy.  After the wedding and pictures, we all went to her parents house where the reception was held.  There was A LOT of dancing!  Since I was one of the only people there that had zero Hispanic blood in my genes, I was also one of the only ones that could not dance, not like they do anyway.  Fortunately I couldn't understand what people where saying if they were making fun of me, so I still had a great time.  I danced with a crazy old man, some of Maggie's friends, and another guy that was a little too much for this married girl.  We finally ate supper around 11:15 and then danced some more.  Stella and I were hoping to have cake, but since it was already 1:00 am and the shindig was supposed to continue until 6 in the morning, we decided to not wait around for the cake. 

Today we walked around Santo Domingo to see if we could see anything new and different.  After eating a piece of cake at a bakery (since we didn't get any wedding cake last night), we came across a market that was full of clothes, jewelry and other accessories.  It was also a day of "last's" today.  We did our last load of laundry by hand in Sto. Domingo and our last trip to the infamous Shopping. 

Although I am very ready for Friday to get here, I am going to do my best to enjoy the 5 days I have left in South America.  I am hoping for an interesting week at the clinic and a laundry-free week at the apartment! 

The Galapagos Turtles

  

Stinky pigs that looked like wart hogs

The Spectacled Bear

Cute little frog.  All of them hid in the Bromelia

I went all the way to South America to see a white tailed deer.

The buck, in velvet.

My favorite, aside from the turtles.  He looked like a mix between a weasel and a monkey.  The name on the sign was cabeza de mate, whatever that means.

Cute monkey.

Again, all the way to Ecuador to see a turkey.  These were a different type though I think.

Llamas!!!

Hoot owls.

A replica of Jorge.  The 800 year old Galapagos turtle.

The happy couple, Maricela and Renee.

The beautiful bridesmaids.  Starting from the left: Maggie, Barbara, and Lijia.  These are the three of the bridesmaids that we work with at the clinic.

Stella and I waiting to throw roses for the newlyweds! 

Here they come!!

Week 5: The Week of Gripe

This week at the clinic has been a little mundane with a lot of common cold cases.  Monday was a slow day until the afternoon when a child was "hit by a car".  No worries, the child only had minor scrapes, much like he fell off of his bicycle and slid a few inches on rocks.  Dr. Cristian simply cleaned his scrapes, gave him some ibuprofen, and sent him on his way.  The kid was either in a little bit of shock or was afraid he was going to be in trouble because he did not want to leave the clinic, even though he was fine.  My favorite part of the day was the last two patients.  The first patient was 32 weeks pregnant and Stella and I were able to listen to the baby's heartbeat.  It was so incredible!!  The next patient was actually one of the employee's 2 month old baby.  We got to hold him for 20 minutes or so before his parents came in for the appointment.  He was precious!!!  (Obviously I have caught baby fever!) 

Tuesday Stella and I arrived at the clinic a little earlier than normal, only to find out that everyone at the clinic was at a meeting in Santa Rosa and would not be at the clinic until 10.  So we did our best to keep ourselves entertained with reading a chapter in Pharmacotherapy Handbook and/or Facebook.  Then when everyone arrived, we realized that we did not have any nurses to prep the patients before they saw the doctor.  All of the nurses were at another meeting that lasted all day.  Needless to say, it was a little bit busy and chaotic due to the combination of a late start and 0 nurses.  But we pushed through the several cases of gripe and pain and actually finished the day on time.  Our last patient of the day was very interesting though.  When she sat down to talk with us, you could see the pain in her eyes.  It was obvious that she was dealing with depression, which was causing some secondary problems, like stomach upset and neck pain.  Stella did a fabulous job counseling her about her disease state (I pitched in a little on the medications) and helped her understand that medications alone are not sufficient for treating major depressive disorder.  I think she left feeling better about asking for help and talking with someone about her problems, and knowing that there were options available for helping her.

Today was another day of gripe.  We did have one extremely terrifying case this afternoon with a 7 month old baby that was receiving approximately the adult dose of Tylenol in ~14 hours.  When we heard how much the mother was INSTRUCTED to give her child by a DOCTOR, all three of our jaws dropped to the floor.  The mother says she was told to give the baby 7mLs of the concentrated drops every 2 hours because her baby "looked a little fat".  Stella and I were completely amazed that this child was not already dead or in liver failure.  The only logical explanation for why this child experienced the miracle that he did, is that generics are not regulated as tightly as they are in the US and don't always have the amount of drug in them that they are supposed to.  This family is extremely lucky. 

The good news of the day is that we have half of the day off tomorrow and all day off Friday...So we have yet to have our last adventure!!!  We will be going to a zoo near Quito on Friday and then returning to Santo Domingo for Maricella's wedding celebration on Saturday.  We are very excited that our last weekend in Ecuador is going to be full of adventure just like all the rest.

Our Last Adventure

This weekend was absolutely incredible! We definitely played the roles of tourists!  We saw so many beautiful things that if I were to describe each of them, it would take an hour or more to read the blog.  Lucky for you, I have a few pictures instead :) 

Friday Dr. Cristian let us have the day off so we could explore the capital of Ecuador, Quito.  We started our weekend at the artisan market and finished up our souvenir shopping.  Unfortunately this left me with a lot of things to carry.  After seeing every single booth at the artisan market we walked a few blocks to the beautiful El Ejido park.  We walked around for awhile and then caught a cab to the hostal.  We enjoyed an absolutely beautiful view at dinner at Vista Hermosa.  We sat on the roof and had a view of the Virgin of Quito, the Basilica and several other beautiful churches and buildings of Quito.  Although I was freezing, it was definitely worth the incredible night sky.

The Basilica is the church with two clock towers in the center of Stella's picture, and the Virgin of Quito is the little bitty grey thing on the top of the mountain behind me below, also in the center of the picture.

Saturday we were major tourists and viewed the beautiful, incredibly large city of Quito via a double decker tour bus.  There were a total of 12 "stops", but there was not enough time to get off and actually visit each site like we wanted to, so we only chose a few.  The first stop was the Panecillo, the location of the Virgin of Quito.  The view from here was also spectacular.  We didn't think the view was going to get much better...until we went to our last stop.

 

 

 

The next destination for us was the Botanical Garden.  It was actually a little disappointing, until we got to the rose garden and the orchid greenhouses.  The roses were absolutely beautiful!  Just as spectacular, if not more spectacular, than the Arboretum in Lexington.  Did you know that roses in Ecuador grow straight up?

I think this one is in the Amazonian garden, but I'm not 100% sure.

The beautiful roses

Some of the funny shaped orchids.

One of the two Orchid Gardens

Pretty Orchids

A giant plant that is similar to Aloe

Extremely tall cacti

 

We stopped at the Basilica next and went up into the clock towers and across the top of the church (on the inside, above the rafters) to the steeple where we climbed some "extremely safe" stairs to the top of the steeple.  It was a little nerve racking to say the least, but it was beautiful!!  The inside of the church is full of vibrant stain glass windows of every color of the rainbow. 

The Basilica

Some of the stained glass windows

The view of the steeple from the clock tower

Inside the clock tower

The wooden plank we walked across to get to the steeple from the clock towers

View from the steeple looking back towards the clock towers.  The Virgin of Quito is in between the two towers on the mountain.

Some more beautiful stained glass

The next church we toured was actually a museum of the Cathedral.  It was also very beautiful with many elegant alters and beautiful artwork.  There was incredible artwork in every church we went in.  This church was unique in some of the things that were donated to the church from various places.  For example, they had bones of some of the Christian babies that were persecuted by the Romans as well as the body of an 8 year old that never decomposed because it was covered in a wax during the persecution.  Unfortunately I don't have any pictures of this place because they were not allowed.

 

The final stop was a trip on the Teleferico, or cable car.  It went up to an elevation of 4000+ meters and gave us a view of what we estimate to be 80-90% of Quito.  It was breathtaking (because of the view and because it was really cold!).  After we took several pictures of the view, we had a cup of mocha coffee before returning back down Pichincha (the name of the volcanoes/mountains that we were on).  On the way up, there was still sunlight so we were able to get beautiful pictures of the mountains and city; on the way back down it was dusk so we took some great pictures of the nightlife of Quito.

Going up!

The backwards view.  The white building is where we got on the cable car.

The forwards view.  This isn't quite half-way up the mountain.

The view of just a portion of Quito.

Another view of Quito from the other side of the mountain.

Warming up with our mochas!!  Look at our view!

Cloud covered mountains...my favorite!

Going back down.

 

The nightlife.

 





After we ate supper in La Ronda, we stopped to watch a theatrical dance performance of many different tribes.  It was a very interesting production with a lot of colors, stomping and music.  Again, pictures were not allowed, so you will have to come see it for yourself, except for these few that were snapped before we knew any better ;)

 

Sunday we went to Mitad del Mundo a.k.a. The Middle of the World, or belly button of the Earth as my brother called it (it's an iny in case you were wondering).  There is a beautiful statue/museum at the center of the Earth that has a lot of information about the cultures that surround the area of 0,0.  After calling our family from the center we walked around the shops and enjoyed the scenery.  As you can imagine, tons of pictures were taken from all four sides of the center! 
 

Walking the equatorial line.

The top of the statue/museum.

The view from the top.

We've got the whole world in our hands!

The statue/museum

We also went back to Quito and toured the most spectacular church of all, especially on the inside, the Company of Jesus Christ.  The church was covered in Baroque architecture, gold, incredible paintings, and amazing detail.  This is a must see for anyone in Ecuador.  There are no pictures allowed once you pass the front table so these few don't do this incredible church justice.

Just inside the front doors.

Some of the beautiful atars.

More of the incredible church covered in gold.

Sorry for the white out faces, but this was a last second chance at a picture inside.

This was the only room we were allowed to take pictures in.  The bells behind us are not the originals of the church, but are still very old.  The originals were melted down and used in a war (I believe it was their independence war, but I am not sure).

I know this was incredibly long, but I hope you have enjoyed the pictures.  There are so many more stories and pictures that go with each location we visited, but there isn't a blog big enough to support the wonderful weekend we had full of unforgettable memories!