Wednesday, October 8, 2008

Last Post From Samoa....:( Sad to leave

I can't believe..i now i keep saying this..that my 6 weeks of elective in Samoa have come to an end. It has flown by and really sad to leave such a lovely and friendly place!
We are off to start ur travels on Friday....we fly into Auckland and have 5 days in the North Island and then fly to Christchurch where we have a few days either side of our bus tour. We are going on a seven day tour of the South Island which sounds great! We will have to get used to the weather! I cant believe that im no that brown after 6 wks here...but my excuseis ive been inside working hard all day so no time to sunbathe lol!
Considering its rainy season now..looking out of the internet cafe window..you wouldnt know it..though it mainly rains in the evenings!
This weekend we went to a beach down south of Upolu called Aganoa. It is a black sand beach. It was almost deserted meaning that we had the beach to ourselves! Im not quite sure why this is the only black sand beach in Samoa..but one thought is that it is broken up lava from the many volcanic eruptions that Samoa have had, but then i am confused to why there aren't more black sand beaches. The sea was v.rough....we played a game seeing if we could stand up against the waves. Sometimes we managed to...'the force was with us'! and other times a wave sent me crashing along with it...roly pollying!..until in finally came to a halt..washed up on the beach! The wave would drag you in with it..and then the wave before would drag you out..so waves kept sneaking up on us and knocking us off our feet..but was great fun..though i may have brought some of the black sand back with me..accidentally..as half of it wasprobably up my nose and in my stomach having swallowed so much sea water!
Sunday was a complete wash-out...it rained the entire day...so we had a DVD day!
For our last week of the hospital we have continued doing paediatrics in the morning..as it has been really good. Now we have a slight clue what's going on.....we frantically scribble in the notes..check if the kid has a fever etc..and examine them.......and then present our findings to the intern....who most of the time concurs...but occasionally implies to me that i should wash my stethoscope..and possibly my ears out lol..dont worry..im not that bad! In the afternoon we went to A and E..though it was very quiet!
Last night we went in at 5pm..thinking that pts may come after work. It was still dead..which is weird for an A and E, but got to see some outpatients. One guy came in with an infected wound..which had become really infected. I wont go into gory details....but apparently he had something called SSS, (Staphylococcocal Scaled Skin Syndrome). I had never heard of it, but having looked it up, the description fits this gentleman! I then got to put a cannula in him and we then admitted him as he needs IV antibiotics.
So many children come into outpatients with bronchiolitis or pneumonia....that they almost need a separate outpatients just for them!
Yesterday afternoon we went to a place called Sliding Rocks! The guide-book said that it is an 'obligatory visit' for everyone in Apia..so we decided to go in our last few days! Lots of the water had dried up..making it more dangerous to slide. We hung around for about 30min.....i kept sizing up the v.bumpy looking rocks with a bit of water running over them..working out how i could minimise the damage to myself. I was abut to chicken out..when some other people arrived and went to the 5m slide. Having seen him and then a 42 yr old mum do the slide..i decided to go for it! Like always..i couldnt make myself slide..but one false move...and there is no turning back...and i ended up sliding down.....it is over v.quickly..and suprisingly it is so quick that you dont feel all the bumpy rocks! Having done it once..and loved the adrenalin rush..i did it again..but this time went slightly to the left of the stream...resulting in a slightly more bumpy and more frictioned slide..but was still good fun!
I hope everyone is well
It is funny to keep hearing that more friends and family are reading this blog. I didnt expect it to have much circulation..and ive never been good at English but it great to hear that everyone is enjoying reading the trials and tribulations in Sarah World!
i wont have anymore to tell everyone when i get back..as everyone will be telling me what ive done..which is good..as i ll need reminding! But dont worry..i havent written everything on here..and for years to come..ill remember Samoa and things will pop up in conversation..like what has been happening since i went to Mexico last summer!
Love to everyone
and truly thanks for everyone's best wishes and love
Sending love back over the ocean..hope its not a choppy ride!
xxxx

Friday, October 3, 2008

Either the Samoans have tough skin...literally...or we the English are wimps!

Sadly......we leave Samoa a week today. At times it feels like it time has been going very slowly...but weeks have rushed by and now we are in our final week. It is now the 'last time' we do everything.....but im upbeaet as had a great time here...and would definitely consider coming back to visit....though not for another 6 weeks unless i was working in the hospital.......or they discover more tourist attractions lol!
We have hit the hospital hard this week and i have been doing paediatrics in the morning and A and E in the afternoons or evenings.
Now we have been on paediatrics for a while, the intern gives us a file and we go and see patients on the ward round by ourselves. It is scary as she often goes on what we say and find on clinical examination but it has taught me to trust what i think. Eg if i think there is reduced air entry on one side, then i say so. Whereas before i wouldnt have the confidence to and would think it was just me hearing things wrong. I need to get more fine tuned to paediatric heart murmurs but it is so easy to get distracted when you have cute babies staring up at you with their wide eyes and tugging on your stethoscope. I need to learn the Samoan word for vomit and diarrhoea though, as it has lead to some interesting sound effects this week when i try and take a history from patients and ask if they have vomited. It goes like, 'Have you been sick? (Blank Face)....'Have you thrown up/vomited?'...(Blank Face).....'Can you keep your food down?'...more blanks...i then have to precede to pretending to throw up and ask if that has happened to them! I get greeted with an amused/confused smile and they just say 'i dont know again'! So it looks like i need to either perfect the action or just find out the Samoan word!
We did an evening shift last night at A and E. It was suprisingly quiet but perked up a bit later on. We saw a lady who was having a spontaneous miscarriage, many kids with bronchiolitis, and a few patients who needed stitches following rugby incidents, dog bites etc. We watched the doctor do some stitches and he very kindly took the time to show us how to do stitches. The problem then was that there was no one left who needed stitches..so we resorted to practising our stitches with some thread around a drip stand! At about 10.30pm boy came in who had been fishing for crabs..i dont know what you call people who collect crabs...fishing seems a contradiction lol!.Seafooding or something! He had fallen and had a nasty cut on his foot and had severed a tendon, which meant that he was unable to lift his foot towards his body. The doctor repaired the tendon and then we got a go at stitching. Like everything.....when you arent doing it..it looks quite easy..however i soon discovered the toughness of Samoan skin when i tried to get the needle through, whilst trying to avoiding stabbing myself. Throughout my time here, i have commented to numerous doctors about the Samoans high pain threshold. While getting stitches they get given local anaesthetic but at home, if they were in pain they would give some more, here they dont, and just say, 'well it is painful', which leaves pts gripping the edges of the bed and biting their tongue as hard as they can. So they are tough skinned..and also because most walk around bare foot..their skin esp on their feet is very tough. The underside of my feet are literally black....as everytime i wash them...i then walk around and they get black again. I might have to bleach them when i get back!
One last hospital thing.......
We went to take a kid with meningitis..the one i mentioned a few posts ago..who we saw in Savaii. We went to take her for a CT..which is a recent addition to the hospital here in Apia. The doctor sedated the kid and then we took her down to CT. The only problem was we couldnt actually get into the CT room as the door had become jammed. The doctor we were with asked us if we were any good at picking locks..to which i had to admit that i didnt have any experience..apart from that fact that i managed to break the key in my lock on my bedroom door at uni this yr...its still in the lock..oops.
She then got a knife and tried to open the door..but she only succeeded in breaking off the knob! So we were stuck. We took kid back to the ward. About an hr later we got a call saying the door had now been prised open. The problem now was that the kid was no longer sedated and was very irritable and screaming. We gave her some more sedative and the CT was done. We don't know the results yet, as there was no radiographer there so it wont be intepreted until Monday which would be 4 days.
Also saw an emergency Caeserean Section yesterday, as we went down to be part of the neonatal resus team. The baby came out after a bit of tugging and we took it to the other room. We helped warm the baby, and as it was cyanosed the doctor bagged her, and she asked what the baby's heart rate was. It was pretty cool that i could feel the unmbilical cord and calculate the heart rate from feeling the umbilical cord pulsating..no need to even feel a radial pulse or the heart.
Sorry for not much non-hospital news
Mamma Mia was good the other day. The great thing about the cinema here is that there are no adverts. At the scheduled time, there is about 5 minutes of trailers for upcoming films and then the film just starts. This means you have to arrive early for the film as opposed to in England when one purposefully arrives late to avoid the adverts!
We are now planning NZ and looking forward to travelling there...though i am very sad to leave Samoa!
Faafetai (Thank you) for all your news etc while ive been here
hopefully ill be able to write once or twice more before i leave..but i dont know what will happen in NZ while travelling. You may just have to wait until i get back to hear about that....this could take years lol
I could start telling you about the Samoan tatoos! lol..just trying to think of non-med stuff as probably bored most people to death by now..and not there to resucitate everyone!
The men get a tatoo which is from thei belly button to their knees, literally like a pair of shorts. It takes approximately 48 hours and is done over a period of 1 to 2 weeks. It is worn as a sign of courage and manliness really. Some women also have them but they get a lighter tatoo with stars etc and not all coloured in like some men. Tatooing is massive here and its hard to find a Samoan without one.
There is also an fascinating cultural tradition here where if a family only has boys, the last one is brought up as a girl. They do all the womanly tasks...yes..like cooking, cleaning.....etc. for all the sexist men out there....Jonathan etc! not mentioning any names lol!
They try and look like women but they are not like the fafafinas here, who are transvestites. We treated a man in outpatients yesterday who was a man, but had female traits. So he was one of the ones who has been brought up as a woman. It said on the medical notes, Male, but i didnt know whether when asking questions to his friend, whether to say he or she, as i am unsure if they change their names etc. There are many of these men, who you see around town and though you can tell they are men, they aren't transvestites and will dress in t-shirt and shorts, but there faces are feminine and they will paint their nails and change their hair etc
An interesting point to leave on..and im going to try and find out more about it....
I better start getting my woolies out for NZ..though from what ive seen on the BBC website..the weather has been pretty good in England!
Much Love
Sarah xxxx

Wednesday, October 1, 2008

Rest of Savaii.....prescribing a McDonalds

First of all apologies it has taken me almost a week to write about Savaii.
I will show everyone pics when i get back and can tell everyone all about it....will bore everyone galore! We went up a mountain called Matavanu. It wasnt as much the mountain/volcano which was great, as the man who ran it. He was called Da Craterman.....and was an amazing guy. He seems a legend in Samoa and was hilarious. He got in the car with us to drive with us up the crater and guide us, but he stopped halfway and pulled some plants and made them into crowns. We all wore the spiky plants on our heads so that we were 'Princesses of Da Crater'! The view looking into the crater was great and photos cant do it justice! Lastly re Savaii, we went on a local bus for the first time. They are very trusting here...it is an old wooden bus rather like the yellow American school buses. You get on and pay when you get off but it is up to the passenger how much they pay, as everyone here is honest! Also there are no bus stops so you can just get on and off wherever you want which is great as it basically is door to door service. However at busy times, everyone has to sit on each others laps so that the bus can hold as many people as hospital. White people in Samoa are called 'palagai' and they are nice and give us our own seats lol unless the bus is really packed!
We were on the bus, which i forgot to mention has subwoofer speakers which pump out the latest music so its like a school disco on the bus lol! The lady in front of us suddenly said something in Samoan to the driver. He promptly pulled over, she got off and went to the street shop, chatted to her friend while we all waited. After 5 minutes she then got back on the bus, thanked the driver and we continued our journey! Luckily that didnt happen to many times as we would never have got anywhere!
We got back from Savaii on Friday afternoon and then went with friends from where we are living to watched the AFL (Aussie Football) final. Some of the med students here are Australian and their team was in the final. I remember trying to learn about AFL when we went to Australia 2 winters ago to watch the Ashes, but had forgotten most of it. We watched it in a sports bar here, and for once it was full of white people. There are lots of Australians who have settled over ehre, so it was packed and a great atmosphere. If only they showed the Premier League here, but it would mean them opening at like 3am in the morning......and hardly any English people here. We always get mistaken for being from NZ or Aus as thats where most white people here are from. There are some other English med students but we havent met any other English tourists as too far away for everyone i think!
We carried on with paediatrics this week so far. We also started going to A and E. As we thought most med students had now left, we thought A and E may be empty and we would get a chance to do stuff. It has been good so far. We got given our own consultation room in outpatients which is same as A and E here. We sat behind our desk and saw the pts. We took as good a history as we could as most of them did not understand what we were asking as there English wasnt great. We then presented the history and examination findings to a doctor who discussed them with us and then we wrote prescriptions which she then signed. I saw a lady with dengue fever but due to language problem, i didnt realise she actually had quite obvious dengue from her symptoms. I then was told to take blood for dengue serology but this cant be analysed in Samoa. The blood gets sent to Australia and results take 3 weeks. As dengue fever is caused by a virus, antibiotics are no good to treat it so the treatment is rehydration, so pts dont need to be in hospital. It is a notifiable disease though and the doctor said that there is an outbreak in Samoa at the moment of dengue. They have had approx 250 cases in the past month, so we need to be very wary of mosquitoes.
Cant remember all my news as trying to condense it all...hmm
back to A and E
we were in A and E again yesterday afternoon It was so quiet, i think we are good luck charms for the Drs and people of Samoa not to get ill lol..or they are scared of seeing us 'palagi'!
As we were about to leave, a mother came in with a 1 wk old baby. One look at the baby, and the Dr rushed her into the resus area. The baby was ashen grey and really cyanosed (blue). It was breathing about 70 times/min and really struggling to get air into its lungs. At one poiont it stopped breathing, but i learnt with babies that need stimulation to breathe so need to tickle their feet etc.
It was horrible with the family standing there watching everyone try to help the baby breathe
The baby's SATS were 69% whe she came in, but gradually went up. I had to hold the oxygen mask for the baby as there were no masks small enough for it. I saw the baby on the ward round today..and she is much better. They think she has neonatal sepsis but with appropriate treatment, hopefully will be okay.
A man then limped in with a stab wound on his leg. It looked like a small but deep stab wound but it had happened about 5 hrs earlier and he was in lots of pain. The Dr showed us how to stitch, so that we will hopefully do it ourselves next time!
Today i went to teaching at 8am where there was a forensice pathologist talking about how to present yourself in court and he then showed some very gruesome photos of how people died which made us med students and all the Drs try hard to keep our just eaten breakfasts down.
I then did paediatrics WR, frantically scribbling everything in the notes. It has got to the point now, when i look at the kid's notes that i can just see my writing from the previous days etc. At least it means i can read it lol!
i then had to admit a child by myself. I took the history and did the examination. I wasnt confident of my examination findings, especially as the 1 yr old wouldnt stop crying. She only had to look at me and would cry! I had multiple listens to her lungs and chest. I then asked the Dr to double check and was pleased that my findings were the same as hers as i thought they were a bit unusual. I then had to write my diagnosis and management plan. It is odd here that no one wanted me to present the history or counter sign my history taking. They just told me to see the kid and take a hx, examination and admit her. Hopefully i did it right and did my best, and hopefully the kid who i diagnosed with pneumonia will start getting better on IV antibiotics.
I nearly forgot about the McDonalds! It was funny today on WR. There is a kid in the hospital with typhoid. he is doing really well but his dad said today that he didnt like the hospital food so wasn't eating. So the Dr prescribed him a McDonalds. She told the dad to take him to McDonalds and then come back to the hospital. So i will see tomorrow if that did the trick!
Off to see Mamma Mia at the cinema tonight....ive already seen it in Brighton, but like it, and will be good to tap the feet to again. Going in to A and E tomorrow eve so hopefully will be busier and may get to do some suturing........Samoans beware
Keep facebooking, emailing etc
Sarah xxxx

Sunday, September 28, 2008

Savaii Continued!

Sorry about the dash off the other day.........after 4 and a bit weeks in Samoa i should be used to Samoan time. Its rather like the Spanish 'Manana, Manana!' and nothing is done in a rush here. People drive very slowly and cross the road like they have an entire day which is nice but i will find it hard getting back up to normal speed when i get back home. It will be like fastforwarding a tape, getting back to England.
Now picking up where i left off, hmm
well after we made it off the ferry, i dont think i mentioned last time that there was a long queue to get down the stairs off the ferry to get back to the car. Having sat on the floor for the whole ferry journey, we took advantage of the now available seats. After 5 or so minutes, when we realised that there was no longer a queue to get back down into the basement of the boat where we had left our car, we went to collect it. We thought we would have a problem finding it and squeezing between all the cars, but when we got there, the whole basement was empty except for one car with a man from the port authority leaning on it. We soon twigged that this was our car, and as we hadn't returned to our car to drive off, the other cars had had to drive off navigating around our car! It was very embarassing but i think everyone realised it was a tourist's car, as it had a big Budget orange sticket plastered across the back windscreen. We swiftly got back into our car, waved embarassingly at all the staff on the ferry and made a swift getaway off the ferry!
We then drove for about 1 hr to the north of Savaii to an area called Manase, where we were staying in beach fales for 4 nights. These fales (huts) were like the ones i described in an earlier post and were right on the beach an open. They have shutters which you can pull down at night. In these fales they had a cocunut brush which you had to use to clean your feet of sand everytime you stepped into the fale. Although it was literally a thin mattress on the floor, it was a spacious fale and a good place to stay considering it was only 50 tala a night (approx 10 pound) which included the accommodation adn breakfast and dinner.
The following day we headed around the west coast of Savaii to get to the south where the blowholes and waterfalls were. The blowholes were amazing. It was basically a large area of lava with blowholes everywhere. When the waves from the sea came and hit the rocks, the blowholes would spurt steam. You could also throw cocunuts into the blowholes which irritated them. In their anger, they then threw up more steam which was impressive. However they obviously need anger management classes as they wouldnt act on demand when we wanted a photo of us by the blowholes. We had to be quick to try and snap when the blowhole was erupting and i kept missing lol. We then went up an ancient mound called the Pumelei Mound. We thought we had hired a 4WD but it soon turned out we hadnt. We paid the entrance fee to the mound and the owner then told us we wouldnt make it up to the mound in our car. Luckily a truck of Samoans then drove up and kindly offered us a lift up there. It was a fun but slightly painful journey up. We bounced like yo yo's up the track and ducked to avoid the overhead trees. We then went to the Afu AAu waterfalls which was pretty but unfortunately was dry so we couldnt see what was supposed to be an impressive waterfall. However the pool by it was very nice and a good way to cool down!
We then drove back around the East coast of Savaii so in the course of one day had circumnavigated the whole island. This shows how small the island is as we could drive around it in its entirety in about 3-4 hours! Petrol here is quite expensive. It is about 85p a litre which is very expensive considering the average Samoan earns $1.20 tala/hr which is 24p an hour. So paying 85p a litre for petrol is very expensive.
There was a fia fia (show) that evening at our beach fales followed by a beach disco!
The next day, we started out early again following a good breakfast which included deep fried pancakes. They love deep frying food here. Literally most things will be deep fried. Its good but i can see if i lived here permanently that i could end up looking like a Samoan rugby player or Rik Waller!
With our stomachs attempting to absorb the pancake grease, we went to the lava fields to see remains of an old church. We then went to a cave where we saw swiflet nests and the tiniest baby swiflet ever. It was a tiny pink dot and hadnt yet opened its eyes! We then went to a beach for lunch and went to a canopy walkway in the afternoon, where we scaled a 220 yr old Banyan tree. We ended the day watching the sunset at Cape Mulinuu which is the most Western point on Earth. We were therefore the last people on Earth to see the sun go down which was pretty cool, and was a lovely sunset!
Time is running out again..oh dear..i can see it is going to take me the rest of the week to write about Savaii as we saw a lot in a few days and it was all so good!
We went into the hospital in Savaii later in the week. It was smaller then the hospital we are based at here in Apia which is the main island. It is very like going to a GP. There are 3.5 doctors in the hospital. Don't worry, one hasnt been chopped in half, she works part time!
We went to the ward rounds and saw patients ranging from a man who was bitten by a dog. The wound then got infected and went to his bone. To a kid who had had meningitis for approximately 3 weeks before his mother finally decided to bring her into hospital. She was really ill, as she had been having seizures for 3 wks and her meningitis had been going untreated. They took her over on the ferry to Apia. So we will probably see her on the ward round on Monday when we go back to the main hospital.
Bye for now, will try and be back soon and not leave it over a week again, as then i can never keep up!
xxxx

Saturday, September 27, 2008

Week in Savaii - Sun, Sea and Hospitalling!

Talofa after over a week!
Got back yesterday from a week on the other island of Western Samoa called Savaii. It is more rural there then here in Upolu so not much internet access. They only had dial-up which was slightly slow. Had a great week on Savaii though.
We went with two Australian medical students who are staying at the same place as us in Apia, Upolu. We decided to hire a car as everyone had said that it was the best way to get around. It was very simple hiring a car. We went into Budget and they asked when we wanted to pick it up and that was basically it! We got a Rav4 which wasnt a 4WD but think it was a 2WD. We then drove to the ferry port which is about an hour away. We thought that we had a car ticket for the ferry to Savaii but it turns out it wasnt a guaranteed ticket. When it came to loading the ferry, they told us to wait in the standby cue. Then followed a nervous 20minutes when car after car drove onto the ferry...and we were thinking that we wouldnt get on and would have to wait another 2 hrs, to be standby again...and never get to Savaii! Apparently there was a big funeral on Savaii that weekend and that was why we had been unable to get a confirmed ticket for the ferry over. In the end we were the penultimate car allowed on. They squish the cars on like sardines. It was slightly nerve-wracking as there was a Chrysler parked just to the right of us, so we had to slither out the car to avoid putting a scratch on the Chrysler..as that would have cost a lot of tala!
By the time we got up to the ferry deck..it was packed..so we sat on the floor for the 1hr15min ride over. It was suprisingly bumpy for what i thought was a big boat called Lady Samoa II. Everyone in Samoa seems to sleep the whole time...so people around us just started taking off their lava lavas (sarongs) putting them over their heads..and lying on the floor..to have a nap during the boat ride. Which left us sitting cross legged on the floor..trying not to whack them everytime the boat went up and down!
Oh dear..internet time is running out....and havent even started telling you about the blowholes....waterfalls, lava fields etc
ill have to leave you on the cliffhanger!
in the 5 min i have left..
the day before we went to Savaii...we went with a group of med students from UCL to an island called Manono. It was about a 20min boat ride, on a little boat. You can just turn up at the port and ask someone to take you across. The boat driver then took us for the walk around the island. We walked around the whole island in 2 hrs which shows how small the island is. We met a family there who offered to cook us lunch for a small price. So after our walk we headed back there. I never thought id get spaghetti hoops here...but the lunch was rice, chicken, fish and spaghetti hoops. So i had rice with spaghetti hoops as my sauce for the rice. They were a lovely family. We had one of the longest goodbyes ever. We all said goodbye and got on the boat..and they continued waving......our boat drove off..and we get waving..getting armache..then one of the guys we were with..took his shirt off to twirl above his head to say goodbye...and the mother of the family..to our shock..took her shirt off and twirled it above her head as well..was v.funny..and was just extra odd..due to the fact that none of the Samoan ladies were swimsuits or bikinis due to modesty so bathe fully clothed..but here in the distance we could see this large Samoan lady waving her tshirt above her head!
to be continued tomorrow/Mon. hope everyone is good
best wishes ande missing you all
xxxx

Wednesday, September 17, 2008

Who let the dogs out?!........Samoa did!

Sorry for not blogging for a few days
hope everyone is good
trying to think whats happened over past week or so
Think i last wrote that we were going to a beach for the weekend.
Went to Lalomanu for the weekend. Was lovely...but got bit burnt.....and still really red...beetrootish..which in a way is good as hides my embarassement sometimes lol!
was lovely to lie on a beach on sat and sunday and go snorkelling. We stayed in an open beach hut. Literally was a circular shaped hut made of wood..and totally open. It was right on the beach so we had a seaview. Normally you have to pay lots of pounds in a hotel for a seaview. But we paid 14 pounds a night for the hut which included breakfast, dinner and a Saturday night show. At night, it had tarpaulin you could put down, but all night you could hear the sea. It was lovely to sleep right on the beach on mattresses on the floor. The ants for company werent great and the floor was hard, so didnt get much sleep. but listened to the sea and looked out at the darkness of the sea at night, so was great experience!
Started paediatrics this week. Wasnt a fan of the paediatrics (kiddies) rotation at home, but so far in Samoa it has been really good! The intern is lovely and gets us involved. The consultant is quite scary but nice. Listened to a lot of childrens/babies chests.....most have pneumonia. There are a few kids with bronchiectasis and this is what kids in Samoa have instead of cystic fibrosis. For a reason i havent yet discovered..they dont hvae cystic fibrosis in Samoa but they have bronchiectasis. On today's ward round, it was just 3 med students and the intern, so we were like the F1s at home. Writing in the notes, helping make decisions, though i always erred on the safe side. The doctor wanted our help on decided whether she should send kids home. I didnt want the decision on my shoulders..get out clause i know..so we all decided the safest option was to keep the kid in for another night!
Did my first cannula on a child today. It was a screaming kid, but wiht the intern's help, managed to get the cannula in. Then admitted a poorly kid with rheumatic fever. As often happens hear, the family dnt bring themselves or their children into the hosp till quite late, and by then the patients are v.poorly and in a lot of pain. This kid was screaming in agony when the doctor put a cannula in, as she had arthritis in her joints, which is one of the signs of rheumatic fever. So having a doctor put a needle into an already sore and swollen hand...isnt nice
we may be going with some other med students here to an island called Manono tomorrow. Its a 20min ferry ride from Apia and you charter a boat for teh day. Apparently its a lovely little island. Can walk around the whole island in 2.5hrs and there are no dogs in it...yay!
so many dogs here in Apia. All strays. Most have been okay to be honest. was quite scared before i came as heard there was a problem. At night there are lots wandering around...but so far i just walk in the road to avoid them!
We are then going to the other island of Western Samoa called Savaii. We are hiring a car with 2 other med students. It takes about 1hr15min to get a ferry to Savaii! We have heard and read that it is a beautiful island with more to see than on Upolu which is where we are based. We are going to do intense travelling around for 4/5 days, and then go into the hospital in Savaii to see what its like!
The weather here is just really tiring. It has been rainy and cloudy past few days but still so humid!
Hope everyone is good
not sure if will have internet again till pos next wknd..but still get facebooking etc and keep in contact. Apart from if you want to tell me how badly Man Utd are doing atm!
ive heard! lol
xxxx

Friday, September 12, 2008

Murmuring in Samoa!

Talofa my friends
going to a beach resort for the wknd so just thought id write a quick update before we go. Though i always forget what has hpnd this wk when i try and write!..so ill waffle anyway!
cant remember where i got to last time...hmm
well went into the hospital quite a lot this wk.....doing general medicine
did 3 clinics and 4 ward rounds. Everything is done at Samoan pace which is very slow and chilled..but hopefully learning stuff even though mostly v.passive as not that much practical stuff to do.
I did my first ABG this wk! I was excited anyway! It is an arterial blood gas sample...and it is trickier than taking blood etc. The doctor who is from NZ did one on a v.ill pt who had a septic abortion causing septicaemia. She then needed to do another one later and asked if i wanted to do it. I told ehr i had never done one before..but she explained it and said to have a go and if i couldnt do it, she would do it. It was quite fortunate (for me but not the pt!) that this lady had a GCS of 10.....which means she wasnt fully awake...but not fully unconcious either...
however when i went to put the needle in..she jerked..and i jumped as well with the needle. luckily just avoiding getting a needle stick injury. The doctor hadnt expected the pt to move..but when i started again..the doctor firmly held the ladies hand. The family were all watching..but hopefully my hands werent shaking too much..as had to try and hit the artery in the hand which is not superficial so not like taking blood where you can see the vein.
after getting into the artery..i managed to get the sample..which was then analysed in a machine.
So i was really pleased that now i have done one.....so in the future if asked..i can give it a go....though everyone has their own techniques..and it is v.painful for the pt.
apart from that medically wise....listened to more heart murmurs...now i can hear the murmurs most of the time..which is a start..even if i cant necessarily pinpoint what murmur it is!
saw an interesting case yesterday in clinic of a 16 yr old boy..who has alrady had his aortic valve replaced with a human one. However he came in yesterday and the Drs think the valve is leaking and tearing off. He had lots of the clinical signs of aortic regurgitation.....and you wouldn;t see these signs in UK very often as something is done before that..and especially in a 16 yr old boy...and this is because rheumatic fever is so prevalent here that lots of people have had valve replacements!
we went to the cinema here on Tuesday night
popcorn was as good as England. Saw Babylon. Not sure if its a film at in the UK at the moment. Luckily they showed the film..as the note on the cinema door says that if the management decide there arent enough people in the cinema to make it economical to run the film..they wont run it
and they will then cancel the showing!
but luckily there wre about 20 pple..so it was shown. Was random but actually a good film!
OIn the way back...a security guard shouted out Sarah.as she recog me off the tv..still so embarassed about it!
hopefully my bit of sunburn is hiding my blushing lol!
we went to a Fia Fia and buffet dinner at Aggie Greys on Wedneday night. It is a lovely hotel. Probably the best in Samoa..unfortunately we cant afford to stay there for 6 wks lol..but nice to see how the rich live here!
our waitress there..as she came to serve us..was like..'hey..your the one off tv. I liked your Samoan dance!'
i took that as a compliment lol......and just said thank you..before she went into any more detail and made the embarassement worse lol!
we went to a waterfall on wed morning and also to the Bahai House. It is one of only 7 Bahai houses in the world. It was very interesting to learn a bit about the Bahai religion and it is an interesting structure. It has 9 entrances and is 9 sided..so can be approached from people in all directions!
We are off to Lalomanu this wknd..which is in the south east of Upolu. Should take just over an hour to get there. Hopefully weather will hold up. Seems to rain here a fair bit..but mainly just short showers..which is fine as long as the sun then comes out
Hopefully will stop at a waterfall or two on the way there!
staying in a fale..which is pronounced faleh..and is Samoan for an open hut..so think we are going to sleep right on the beach in an open fale. Might not slee much if the sea is noisy..but will be lovely lying on beach in hut..looking at the stars...
that reminded me that i learnt a few Samoan words this wk!
it was useful sitting in clinic with a NZ doctor..as she knows a few words of Samoan. Pain is Kinga.......and 'nunu' means dizzy
so i could ask if they had pain or were dizzy
its a start lol!
thanks everyone for facebooking etc
keep it up..as i do read it all...and try and reply..but otherwise will try and keep everyone updated here!
hope everyone is good..missing u all
if neone wants to text my Samoan number is
+685 7246805
not sure how much it will cost you
only costs me 4p to text UK
so will text back!
the network here charges the same amount for me to text a Samoan number as it does to text UK so suits me!
sending much love from 17094km away
saw a sign pointing to London today..which said that was how far away it was!
doesnt seem that far when i write it..but seemed millions of miles while we were flying to get here!
toodleloo for now!
xxxx