more goodies

My Boards Buddy struck again! :D She is a wonderful soul. :O

Whilst studying for our OPP practical last week, Hira and I decided to loot the president’s office as a snack break. (I may have failed to mention that he keeps a whole bunch of goodies [cookies, crackers, candy, pretzels, etc.] in his office so if any of us are ever hungry, we can stop by to grab something. He is a wonderful man, in case the last sentence didn’t make that incredibly clear.)

Here are my spoils of war! (He was out of his office, so we didn’t get to say hello.) I managed to show slight restraint.

03/29/14-03/30/14: returning home

I took a picture of every meal I had here. :D (I figured everyone else would have the people + scenery parts covered.) It is my hope that I will one day be able to recreate healthier version of all of em’. :] This is an assortment of some of em’! I love colorful foods. :D

It took a good number of hours to get back, mostly because there were so many hours of waiting in between. Here’s our timeline:

  • 9-10:30 p.m.: traveled from Hato Mayor to Santo Domingo
  • 10:30-3:30 a.m.: hang out at airport in Santo Domingo
  • 3:30-7:30 a.m.: fly back to Boston
  • 7:30-10:30 a.m.: hang out at airport in Boston
  • 10:30-12 p.m.: fly back to Richmond
  • 12-2:30 p.m.: redistribute luggage + drive to Charlottesville
  • 2:30-3:30 p.m: lunch at Zin Burger! :D
  • 3:30-4:30 p.m.: driving back to WV
  • 4:30-5-ish p.m.: obtain coffee/gas/some sleep at Sheetz
  • 5-7:30 p.m.: finally back at school!

The green bottle on the top left is the DR’s version of our moonshine, which they called “gasolina.” Brad was a source of constant worry for our group because he was always losing things/himself and kept unintentionally scaring locals/patients by trying to speak to them in Spanish that would translate into really awkward things, so he made himself a sign.

We got to the airport at 10:30 p.m. and our flight wasn’t going to leave til 3:30 a.m., so there was a lot of lying around and/or sleeping in that time frame.

My seat got taken so I made a compromise.

I’ve missed being able to flush toilet paper and drink tap water and I haven’t combed my hair or taken a hot shower in over a week. I’ve been struck down by “el gripe” and may or may not have typhoid fever/malaria/a couple parasites that I’m hoping the albendazole will take care of, but…it’s a small price to pay for all the experiences and memories I’ve made? (I’m most worried about the typhoid fever because risk of malaria is fairly low and other than my slightly late start due to the Philly trip, I’ve been participating in our Chloroquine Fridays. However, the county clinic completely failed at life at giving me my oral typhoid vaccine properly because they told everyone else that it was a live vaccine and had to be refrigerated/gave it to them in a plastic bag on ice…and for me, they mentioned nothing of the sort and handed it to me in a paper bag, so it was pretty much long dead by the time I realized this. THANKS, GUYS.)

In all honesty, I was originally somewhat regretting my decision to go on this trip because I felt like I should be studying for boards at home instead, but I’m really glad that I went. I learned a great deal on this trip and would love to come back next year, if I can make my vacation dates align with the trip/convince my parents not to disown me for not coming home. (They’ve already been gracious enough to not be angry about my telling them about going on said trip 1 hour before boarding the plane. :x In my defense, I figured it’d be better for them to worry for 1 week as opposed to half a year. They told me not to get dark/tan and not to get sick and I managed to do both.) If I do get to come back at any point, there’s a lot I want to bring with me just to leave there for people.

Coconut Date Protein Shake

Once upon a time, Kroger decided to mark down a whole bunch of their Liberte coconut yogurt (25 cents each! :O!). I’m a huge fan of sales and yogurt, so I bought a bunch of em’. :x Ever since, I’ve been trying to figure out ways to incorporate them into recipes (I’d like to try making curry with it, but I’m still in contemplation on whether or not that would turn out well). Since I’m still on my grocery ban (I really, really need to finish off the stuff in my apartment so there’s less to pack when I move to Kentucky), I figured I might as well continue with this whole eat-everything-in-my-apartment crusade. I need to start actually contributing to church potlucks. :O

I discovered the concept of date shakes from Lappert’s Ice Cream in Sausalito, California, but could not justify spending $5 on a drink, so I decided to make my own!

For the record, unless myfitnesspal is lying (which I don’t think it is, since I checked the labels), this thing is a frighteningly deceiving calorie-bomb and should probably be used as a meal replacement or post-workout recovery drink. Don’t say I didn’t warn you. :O (At least they’re good fats?)

Coconut Date Protein Shake

~553 calories, 77g CHO’s, 17g fats, 28g protein, 5g fiber, 322mg sodium.

Ingredients:
-7 dates, pitted + coarsely chopped
-4/5 cup unsweetened vanilla almond milk
-6 oz. coconut yogurt
-1 scoop Designed Whey vanilla protein powder

Instructions:
1) Chop dates and put in container with milk and protein powder. Refrigerate for ~10 minutes.
2) Scoop in the coconut yogurt.
3) Blend until smooth.
4) Pour into glasses and enjoy!

03/28/14: beach day

I feel like the title is pretty self-explanatory. :O Pictures of pretty beaches below!

Shannon got two rather awesome panoramic shots–one of the beach and one of [almost] all of us (at the bottom of this post).

I will very much miss this weather. *-* The beach was absolutely gorgeous.

‘Playa Juan Dolio

I’ve never done a beach jumpy picture, so here we (my room) are! :]

03/27/14: day #4 in rural Seibo

Last clinic day! We went to a super, super rural part of Seibo today and managed to see everyone there as well (tis a plus, because I hate having to turn anyone away). We saw 150 patients and I got to witness several pretty unique cases.

We saw a case of what we think was Beckwith-Wiedemann syndrome, as well as several hypertensive emergencies (I took a 224/106 and a 232/118). where one of our doctors did her very first IV Labetolol push while an translator interpreted for her and the patient through the window.

We stopped at a craft market put together by several women in the area after clinic and also set up a makeshift clinic back at the hotel for all the staff when we got back. OMT is a big hit with them because almost all of them had aches and pains of some sort. (We’ve coined a new phrase of”machete back” for the workers in the fields that end up with extremely tight back muscles.)

I’m unfortunately coming down with something that I sincerely hope is just what they refer to as “el gripe.” ( Typhoid fever would suck, but the incubation period is 6-32 days, if I recall correctly, and I think these are the wrong symptoms, so hopefully, I’m in the clear.

We’ve been really spoiled here. I’m sincerely going to miss having our meals prepared for us. ._. I’ve never had people legitimately stressed out that we were still working and hadn’t yet taken a break to eat. This is probably the most salt and sugar my body has seen since junior high. (My salt/sugar intake this week is probably more than I’d have in at least half a year.) My feet are so swollen that I no longer have malleoli. :( Small price to pay though, because the food has been delicious! I’m very much going to miss the passionfruit juice, fresh pineapples and coconuts, and plantains.

This encompasses our entire group, minus two of our Dominican doctors.

03/26/14: field day #3 in rural Seibo

We went to a different clinic today and decided to just keep seeing patients until there was no one left. I shadowed our pediatrician and got a ton more experience in taking histories and performing physical exams in children and babies (as well as some more adults). (I’d never done a physical exam on a child/baby until this trip.) There were a good amount of moments where I just felt completely incompetent, but I think it was good for me, since it forced me to learn and grow.

We had a lot more Haitian patients at the clinic, which was difficult in the sense that most of them spoke mostly Creole, so there was definitely a game of telephone going on with two translators interpreting what was being said.

I think what’s most frustrating about the language barrier is that you have no idea whether your entire message gets across. The differences in enunciations, the nuances in the 2-3 languages, and the terms they have that have no actual English translation make the chances of something getting lost in translation that much higher. I feel like we’re not giving them the best help that we could be, even though we really are doing the best we can with the resources we brought with us. On the other hand, body language is paramount. 80% of communication is nonverbal, so I probably shouldn’t have been so surprised that the patients understood so much off what I was saying to them (I’ve gotten pretty good art pantomining).

We managed to see 196 patients, with at least 20 more that we didn’t have papers for (we gave them multivitamins, toothbrushes and/or condoms, depending on their age).

The mosquitoes (I’m assuming they’re mosquito bites) here have decided that my blood is absolutely delicious, so I’ve been taking it for the team in terms of bug bites. My skin apparently really does not agree with them though, so my legs look horrible. Each bug bite looks like a massive bruise, so I kinda look like I’m being abused again (so what else is new? :[ ). At least we have a whole lot of hydrocortisone & calmodulin cream that I can swipe!

Raspberry Almond Bird’s Nest Cookies

Not too long ago, I discovered that there was a such thing as Carrot Cake M&M’s. Yeah, you read that correctly! Carrot Cake M&M’s! I couldn’t find them at Kroger so I scoured Walmart for them (that was a load of fun). I wanted to make bird’s nest cookies that weren’t frighteningly unhealthy, so…I used this recipe for the base (I halved the amount of honey though). To be honest, they taste better without the M&M’s if you put in jam (I think the flavors clashed), so choose either the jam/fruit preserves or the M&M’s!

I’m sorry if you’re sick of seeing this plate, but it’s the only pretty plate I have, so just grin and bear it. :O

Raspberry Almond Bird’s Nest Cookies

(18 cookies) 98 calories, 12g CHO’s, 5g fat, 2g protein, 1g fiber, 51mg sodium!

Ingredients:
-1 1/2 cups almond meal
-2 tsp baking powder
-5 tbsp applesauce
-2 tbsp honey (sub with maple syrup if vegan)
-1/2 tsp almond extract
-1 tsp vanilla extract

(Topping)
-1/2 cup raspberry jam/preserves (or fresh raspberries)
OR
-24 carrot cake M&M’s (optional)

Instructions:
1) Preheat oven to 350 degrees. Line a baking sheet with aluminum foil or parchment paper.
2) In a bowl, combine all ingredients except the raspberry jam
3) Drop batter onto parchment paper in 1-tsp size balls.
4) Bake cookies for 13-15 minutes or until golden.
5) Press in an indentation into the center of each cookie with the back of a teaspoon.
6) Top with a little jam or with M&M’s.

03/25/14: field day #2 in rural Seibo

We returned to the same clinic in rural Seibo to finish the work we’d started. I got to follow/help one of the Dominican doctors that I’d requested the day before because she was fluent in both Spanish and English and I’d seen her taking the time to explain the situations and cases to my friend the day before. Our [entire] team managed to see and treat 157 patients this time, and didn’t have to turn anyone away.

I worked with a friend and got a ton more experience with listening to hearts and lungs, examining ears, mouths, and noses, as well as with reading urine tests (I know that’s not hard, but weirdly enough, I really never actually did one til I came here) and taking more blood pressures. It was a lot hotter and more humid, possibly because it didn’t start raining on the second day. Our coordinator would stop us periodically to remind us to take mandatory water breaks so we wouldn’t get dehydrated. We’re actually working at a clinic in the middle of the sugarcane fields, so some of the patients brought in some for us. :D! I haven’t had any since I last went to HK, so that (among other things) pretty much made my day. :]

Again, the likenesses to clinic were kinda awesome. (I’ve really missed being able to go there and still feel that there is no better reminder of why I decided that I wanted to go into medicine than being able to help my patients.) I think a lot of people end up assuming that I don’t like babies/kids because I have absolutely no desire to give birth to any. This is a fairly incorrect assumption. I think the ones that are raised well (aka have manners and all that good stuff, which is tragically uncommon these days) are awesome.

The ones I got a chance to work with were pretty darn adorable. One little girl (her name’s Carolina) was talking to me and gesturing to my earrings. Since my Spanish knowledge is fairly nonexistent, I kinda figured she was just telling me that she liked them, so I smiled and nodded. She looked so incredulous and happy when I nodded that I realized I’d agreed to give them to her. I cleaned em’ off with an alcohol wipe and her little brother ran with her to the bathroom to put them on. When she came back out, she ran over and hugged me. You cannot put a price tag on happiness. The smile on her face warmed my heart. <3

Random discoveries today include the fact that there are apparently ostrich eggs incubating in the living room (top right in the picture below). I may have failed to mention that there are actually two ostriches living on the property where we’re staying. I’m not really a fan of them because one tried to bite my fingers when I was at a zoo as a child, so I’ve been slightly traumatized by the incident.

Top Left: WV vs. CSA in pool
Bottom: We had lots of company all over the hotel. <3

I did a core/yoga workout outside after we got back from clinic, jumped in the pool for about half an hour and went off to dinner. I’ve been having a lot of trouble carrying bags/boxes from one place to another because some guy will always come along and take it from me. When I voiced this concern to Mike (it’s not that I mind, but they’re kinda ruining my workouts of the day, because there’s nothing else to lift other than my own body weight):
M: I know, Farrah, it’s because you’re tiny and they want to help you. Little do they know, you’re actually stronger than most, if not all of them. (takes box from me and carries it to the van)

Top Left: Chucha! <3 My loyal breakfast-lunch-and-dinner-company! He’d just sit in my lap for pats. <3
Top Right: 3/4 the gang. Sean decided to stay at home to study (and as we found out later, basement-dwelling [playing Halo with Tanner], cleaning fish tanks, and witnessing some really awkward gay fish porn in said fish tank; I shit you not).
Bottom Left: Also from aforementioned bonfire! Mike decided to recruit me to be his partner in crime in carrying two beach chairs to the bonfire. It was a good idea. People were pretty jealous, so we shared.
Bottom Right: Lunch break! (We’re probably vulturing for food again.)

When I was giving Isaac some crap about not helping out with carrying things (one of my roommates ended up having to drag the suitcase that he wouldn’t carry up to our room), Mike teamed up with him to carry me up the hill whilst sitting on a “chair” made out of their arms. It was slightly frightening since the road was super bumpy and Isaac was slightly shorter/not really trying, so I eventually convinced them to let me down.

restart

Yesterday was the first day of my new 101 in 1001! (Here’s my old one. I like to think that I gave it a good run!)

It’s amazing how much can change in the span of almost 3 years. I had to make some changes and revisions here and there, but I’m excited to see how this next one will unfold. I’ve got a lot riding on it (namely, my future [+] career).

03/24/14: field day #1 in rural Seibo

Our first two field days were spent at a clinic in the sugarcane fields with no running water or electricity. We set up a pharmacy, a peds clinic and several rooms with physicians both from the DR and from WV. My assignment on the first day was taking all the vitals with two first-years. (This may or may not have had to do with the fact that I spent so many years volunteering at Paul Hom so they figured I could help speed the process along.)

It was amazing to see the level of trust that our patients had in us, especially with the OMT, given the fact that due to the language barrier, it was hard to explain what exactly it was to them. There are also a surprising amount of similarities between rural Appalachia and the Dominican Republic. The real main difference was just that in the United States, health care is practically considered to be a right and is generally is a lot more accessible.

The likenesses between here and Paul Hom were also pretty striking and gave me even more of an appreciation for just how much of a blessing it was that I’d been able to volunteer at PHAC. The hands-on experience I gained from working directly with patients there has been extremely valuable.

It did feel weird though to be on there other side of the fence in that I used to be an interpreter and was now the one that pretty much understood nothing. I often felt bad because I couldn’t understand what the patient was saying to me. We worked around the language barrier with a whole lot of body language/nonverbal communication and my extremely broken Spanish. I also started picking up words here and there as time went on–for instance, I got very good at saying, “Siéntese aquí, por favor” (Please sit here.) and pointing to the arm while saying “el brazo” and gesturing with my blood pressure cuff.

Since the area is so rural, CSA started telling people in the area that we were coming several months ago and news of this traveled by word-of-mouth. We saw a total of 189 patients on our first day! :]

On the road! [We saw a lot of respiratory conditions because the fields get burned.]

Top Left: 3 of my favorite people on this trip. :]
Top Right: This pretty much sums up the entirety of our friendship.
Bottom Left: Just chillin’ after dinner. :o We actually had a lot more downtime than I thought we would.
Bottom Right: Shannon and I are good at being at or near the front of the line every time. Food is important. :x
I’m also firmly convinced that if my life played to the soundtrack/playlist that’s been playing constantly at the place we’re staying at (Hotel Colinas), life would be more amazing and I’d forever be in an awesome mood. I adore salsa/bachata music. :] Some of the songs I managed to find out the names to (or so the internet tells me) include the following:

  • Antony Santos – Yo Quiero
  • Juan Luis Guerra – La Hormiguita
  • Juan Luis Guerra – El Farolito
  • Antony Santos – Corazon Duro
  • La Sonora Carruseles – Quiereme Siempre
  • Tono Rosario – Que calor
  • Raulin Rodriguez – Esta Noche
  • Romeo Santos – Odio
  • Johnny Sky – With or Without You
  • Fernando Villalona – Copacabana (At the Copa)
  • Frank Reyes – Dejame Entrar en Ti
  • Romeo Santos – No Tiene la Culpa
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