Winding Down the Last Week

It’s already our last week at the hospital! This is going to be a long one, so brace yourselves!

This week, we were on Nephrology/ General Peds.

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There were several interesting cases we have seen:

1) A 6 month old girl with Apert’s Syndrome. This is a genetic disorder that causes a premature fusion of skull bones leading to facial deformities, developmental delays and other deformities such as syndactyly (fusion of fingers and toes). She had previous surgery since her head was still wrapped in bandages.

2) A 2 year old girl born with a cleft lip. Her story is pretty sad. She was abandoned by her mom once she saw her deformity. The baby would later develop pneumonia then sepsis and she had to be on a me hanical ventilator. The doctors had trouble weaning her off so she ended up getting a tracheostomy to help her breathe. She has been in the hospital for most of her life, but she gets lots of support from the hospital staff. She has lots of clothes and toys that were donated to her too, and she was affectionately given the nickname ‘la dueña del hospital’ (the owner of the hospital). She is my favorite patient in the unit- her face lights up when she smiles and she gets happy when we visit her 🙂

3) There is a 12 year old boy with Non- Hodgkin´s Lymphoma (NHL). This is a cancer of lymph nodes, the areas of the body that contain immune cells. He has a history of TTP and was diagnosed with NHL in 2013. He had a course of chemotherapy that he didn´t respond to and is currently on paliative chemo. He has several masses with the largest one on his left submandibular area. I also found out by reading his chart that he also has PCP, a type of pneumonia that can happen when the body is immunocompromised. He has Bactrim on board and is also scheduled for biopsy. Since he has failed 4 courses of chemo in the past, they’d like to do a biopsy to be as specific as possible with treatment. He also has been oxygen- dependent with his lowest recorded O2 saturation being 65%.

4) A 6 month old female with bronchopulmonary dysplasia (BPD). This condition occurs in premies that did not develop surfactant yet because they were born too early. Surfactant is the fluid that helps keep the lungs open to facilitate breathing. Oftentimes, these babies will require oxygen for a long period of time. This particular baby has a very audible stridor and is on oxygen for certain time periods during the day.

5) A 3 year old boy who accidentally ingested detergent. Apart frrom some oral pain,  he is doing well. There were no concerns for any internal damage, as imaging did not reveal anything. He will be discharged today.

I´ve seen and learned a lot on this rotation and it´s been great seeing the differences between Peds here vs. the US. On the General Pediatric floor, there are about 12 beds in one large room. At first, I had concerns about HIPAA, especially since one of the mothers asked us about another child’s case (which we didn´t give any information to). But later, it was heartwarming to see how another mother would soothe and hold a crying baby in the next bed over and the kids would play with each other too 🙂

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In addition to clinic, there were several great things we did this week.

On Sunday, we visited the local zoo and got to see some interesting animals native to Bolivia such as llamas and vicuñas.

On Wednesday, our Spanish teacher Jheny took us to the different markets downtown. She had us taste two different fruits I´ve never seen or heard of before: pacay and cherimoya. I didn´t enjoy Pacay too much because it has a fuzzy texture that threw me off (I don´t like cotton candy either!). But I loved cherimoya! The taste reminds me of a mango, but slightly different. There´s even a cherimoya flavored ice cream!

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Top: pacay; Bottom: Cherimoya

Later that day, the Bible study Erica and I attend had a small farewell party for us (called a ‘despidida’). It was so heartwarming! To begin,  the couple who hosted the Bible study every week were very hospitable and sweet. They were always so happy to see us and they loved it when we read in Spanish! This Wednesday, they had a cake ready for us,  along with some tasty empenadas too! And they gave us each a beautiful hanging plaque that had Proverbs 31: 29 on it. They told us that it was nice to see young Christians like us because in Bolivia, it’s very hard to find Christians our age.

On Thursday, our host mom introducecd us to ‘api morado’, a purple corn drink that can be served for breakfast, and oatmeal and fruit can be added to it too. It is really good! Not only is it pretty, it’s also chockful of vitamins and protein too. I brought 2 small bags of it to make some at home =).

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Good stuff!

Jheny then took us to a museum later that day, Museo MUSEF (Museo Nacional ded Etnografia y Folklore) which displays the cultural history of Bolivia. We weren´t allowed to take pictures inside (without paying anyway), but there were lots of interesting things we saw like the different tools and large pots they used to use. There were also replicas of the ancient civilizations of Tiwanaku, the capital city of the empire at the time.

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One of many ‘cholets’. Usually, the first floor houses different businesses (to help generate income), the second floor is for weddings and parties, the third floor has apartments for rent, and the owner of the building lives on the top floor.

On Saturday, Jheny took us to see the ‘cholets’, the super elaborate and extravagant architectural work-of-art buildings designed by cholitas, the indigenous Aymara and Quechua women of Bolivia. In the past, they were discriminated against and weren’t served at restaurants. However, ever since Evo Morales, the first indigenous president came to power, the indigenous people have made great strides in different arenas such as in business, politics, and education. These women who were once looked down upon are now becoming more the forefront of society. This is clearly shown by the amazing wealth they have accumulated and worked hard for over the years and they proudly show it through these buildings as well as their elaborate clothing.

Highlights: learning so much about the culture; going home tomorrow!! 🙂

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