Respite

I just got back from five beautiful days on Kauai with my dearest friend. 

Kalalau trail on the Napali coast

Kalalau trail on the Napali coast

One of my oldest friends (we were pen-pals when we were 13!) and her husband and friends have a house on Kauai that they open up to host people in ministry to come vacation on the island. I brought Jessica with me for a little R&R in paradise. 

Rebecca and Lindsey, our incredibly generous hosts  

Rebecca and Lindsey, our incredibly generous hosts  

We had an amazing time, lots of hiking and swimming and talking. 

Waimea Canyon

Waimea Canyon

Beautiful places and good friends are food for the soul. 

Chasing waterfalls.  

Chasing waterfalls.  

This photo is barely edited! Those colors are real!  

This photo is barely edited! Those colors are real!  

Jess graciously obliged all my requests for pictures. 

No place I'd rather be...except Navotas. ;) 

No place I'd rather be...except Navotas. ;) 

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Waimea Canyon State Park is fantastic. The views, the colors, that waterfall in the corner. 

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We met this homeless local on Glass Beach. He wanted to sell us some weed. He was so sweet. Reminded both Jess and I of being in the Philippines. 

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We stayed in the mountains. Gorgeous green views.  

We stayed in the mountains. Gorgeous green views.  

Beach destination along the Kalalau trail

Beach destination along the Kalalau trail

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Thank you so much, Lindsey, for showing us your island!

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My favorite part of the trip is hiking to these epic waterfalls. I made sure to try out the water at each one. 

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Til next time, Hawaii!

Napali coast view

Napali coast view

Day 1 Intro

Commonwealth Blvd. Very busy street that our hotel is on.  

Commonwealth Blvd. Very busy street that our hotel is on.  

It's only 4 pm here in Manila (1am in Boise), and we've already had a full day (thank God!). Going off whatever sleep we got last night (I got 5 hours), we took a Jeepney to the "Love house," one of the safe houses that Wipe Every Tear facilitates. Our 2 nurse practitioners were conducting physical exams on whichever girls were at the house and not in school. These girls have been rescued from sex trafficking, many have come from bars where multiple girls are employed and sold by the hour. 


I met this little guy last year also! His mom was brand new to the safe house last year.  

I met this little guy last year also! His mom was brand new to the safe house last year.  

I know this is a heavy topic. I wish I had more time to go into all the experiences I have with the girls and going into the bars on my previous trip. 

A crowded kitchen at lunchtime at the Love house.  

A crowded kitchen at lunchtime at the Love house.  

I wonder what this dialysis center is like.  

I wonder what this dialysis center is like.  

We spent some time walking around Quezon City today. Two trips to the pharmacy. To purchase medications, you walk up to the pharmacy tech, and tell him what you want and how many. No prescriptions! Not sure how this works with narcotics... Not all drugs are available, they have some "substitutes" that our team pharmacist approved, sort of. She wasn't familiar with all of the options. 

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I have to remind myself "do NOT flush the toilet paper" every time and I still forget! You have to throw all TP in a trash bin next to the toilet. The Philippines septic system is very delicate. 

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Street food. Not for the faint of stomach.  

Street food. Not for the faint of stomach.  

A bridge over Commonwealth Blvd.  

A bridge over Commonwealth Blvd.  

It's very hot. It's more muggy than Haiti. I had to buy deodorant today since my toiletries are in my missing bag---still missing.  

First thing I did this morning was kill a cockroach that was speeding toward my luggage. He was huge.  

First thing I did this morning was kill a cockroach that was speeding toward my luggage. He was huge.  

Side street off Commonwealth Blvd  

Side street off Commonwealth Blvd  

One of my favs that I met last year. She's been through a lot and remains a fearless fighter.  

One of my favs that I met last year. She's been through a lot and remains a fearless fighter.  

Cancer Sucks Still

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There is a cancer center across the street from the hospital. The doctor who spearheaded the project is in town and gave me and one of the residents a tour. My specialty has not played a part in this whole trip so I was so interested to go see this facility. It sounds like Dr. Degenarro (from Miami)  has been spending most of the last 3 years starting this treatment center and getting clinical trials started in Haiti. There aren't as many rules to follow in Haiti as in the US. Weird. 

The infusion room. Four chairs, no pumps, no pillows. The chairs are lined up against those back 2 windows.  

The infusion room. Four chairs, no pumps, no pillows. The chairs are lined up against those back 2 windows.  

This cancer treatment center focuses on breast and OBGYN cancers but sees and treats whatever walks through the door. When Dr. Degenarro gave us the tour, he jabbered on in French to several patients. We met a woman with breast cancer who needed fluid drained from her lungs. He wanted the resident with me to do it. She was getting a Cisplatin infusion through a peripheral IV. Then we met an older man with lymphoma who had been getting the CHOP regime and now has cardiac problems. As we walked into another part of the building, patients stopped him to ask questions and show him paperwork and he willingly stopped and spent several minutes jabbering on with them. One of the women looked 10 months pregnant but since she was a bit older, I'm guessing she had ascites (fluid on the belly). 

Ultrasound machine  

Ultrasound machine  

Dr. Degenarro works with an OBGYN oncologist who is Haitian. He explained that mammograms usually show that there is indeed a mass and the next step is to ultrasound and biopsy it. Since they do not have mammography, they skip straight to ultrasound and even showed us the biopsy needle...there is one and they just sterilize it. This Haitian doc does the ultrasounds in this room in the picture above. 

Oncology infusion is my normal daytime job so it's fascinating to see how one does it in another country!  I know my infusion nurse friends will appreciate this! 

Today was my last work day in Haiti! I know more stories and experiences will eek themselves out of me in time. Thanks for tuning in!  

 

Third day with this gal. She's a trooper. I love her pouty lips and sassafras toddler personality.  

Third day with this gal. She's a trooper. I love her pouty lips and sassafras toddler personality.  

The Little People

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The strange world of sick little people in a developing country. Peds is a whole new world for me. The unit is the size of your living room, crammed with 12 cribs, and 1-2 parents, grandparents, sisters, friends, cousins, whoever. PLUS doctors, nurses, interns, externs, attendings, residents. So. Many. People. In. Your. Living. Room.

The babes are adorable.  But if you want to know what's wrong with them, you have to decipher the chart, as it is in French. One of the biggest problems I've seen is hydrocephalus. It means fluid is on the brain. 

Example of hydrocephalus  

Example of hydrocephalus  

We have about 4-5 babies in Peds with this illness. You don't see this in the developing world because it is diagnosed very early and a shunt is placed that drains the fluid from the brain to the abdomen. A team (from Europe) came in today to the hospital to perform this very surgery. They came into the unit, examined babies and measures heads. I don't know how many they will be able to do before they leave. There was a whole line in the parking lot, full of parents with hydrocephalus kids, waiting to be se by the surgeon.  

How medication arrives at the beginning of a shift. Better doubl check! The patients do not wear any sort of identifiers. This system is fraught with mediation errors.  

How medication arrives at the beginning of a shift. Better doubl check! The patients do not wear any sort of identifiers. This system is fraught with mediation errors.  

I spent most of the day figuring out how to give three antibiotics with the minimum usage of saline. This was the best idea I had. 

I spent most of the day figuring out how to give three antibiotics with the minimum usage of saline. This was the best idea I had. 

I had a patient, 10 year old girl, who fell out of a tree and broke her radius (forearm). She never got it set and it eventually became so infected that she came into the hospital for multiple surgeries and debridement. The stigma for an amputee in Haiti is worse than a useless limb so they will try to save it as much as possible. I watched the local wound nurse do her dressing change today and almost vomited. There is only one layer of skin and bone left of her forearm. She is one tough chick. 

This guy. So adorable. He sat in my lap during down time for almost half an hour! He loves to fist bump.  

This guy. So adorable. He sat in my lap during down time for almost half an hour! He loves to fist bump.  

By the end of my day, I was thinking "OHHH MAAA GAAAA STOP CRYING!" Peds is truly a different world than adult nursing. Such a wonderful day of challenges and new experiences and stories!  

Day off blues

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We got a lovely day off today at Hotel Visa Lodge. The organization coordinator decided it was safe for us to leave in a group and the hotel is a 4 min drive from the hospital. Lots of pool time, beer, and naps! My mother will be happy to know I did 3 rounds of SPF 70. :) Unfortunately, they dyed the pool green and now we have green hair and suits. 

View of Port-au-Prince from the pool. The airport is pretty close out there.  

View of Port-au-Prince from the pool. The airport is pretty close out there.  

My new friend Meredith who met me in the Miami airport. This is her 3rd trip here to work at the hospital.  

My new friend Meredith who met me in the Miami airport. This is her 3rd trip here to work at the hospital.  

Team members relaxing. There are a total of 17 of us volunteering for the week. Mixture of 1 Doctor, 3 residents, many nurses, 2 EMTs, and 1 speech therapist. 

Team members relaxing. There are a total of 17 of us volunteering for the week. Mixture of 1 Doctor, 3 residents, many nurses, 2 EMTs, and 1 speech therapist. 

All the women from the team in the van, driving back to the hospital.  

All the women from the team in the van, driving back to the hospital.  

This little guy can see into our kitchen area of the residence hall. He keeps motioning us to come over so I did...with my camera.  

This little guy can see into our kitchen area of the residence hall. He keeps motioning us to come over so I did...with my camera.  

Back to the grind tomorrow!