Tuesday, December 26, 2017

Merry Christmas!

One of the PT's had a birthday and we took group photos after the party!

The weeks are starting to blur together so its getting harder to remember what has happened the previous week! I had to look at my photos to remember what has happened! I'll get to what I've been up to but first...a patient update!

The first week I got here a woman named Claudine with a massive thyroid goiter arrived. She was admitted as a special case because the doctors didn't think that she would survive until the general surgery rotation that starts in January because the tumor was restricting her airway. She was admitted for 3 weeks prior to her surgery because her blood levels were unsafe to operate right away. She was such a trooper, and everyone started referring to her as Mamma Claudine. I saw Claudine a lot during her time here because she was admitted to the C ward, which also houses the plastics patients that are farther along in their recovery. So Claudine had to live in a ward with the rowdiest of plastics patients, all the while not really understanding why she wasn't getting surgery. Of course it was explained to her that the doctors were waiting for her blood work to normalize but I don't think she had any idea it would take as long as it did! The day before her surgery she got moved to a different ward and I just so happened to see her in D ward while looking for another patient. She had just found out that she was having surgery and was SO scared and didn't have her C ward family around. I comforted her and told her I would come back in the morning before her surgery. When I went back the next morning, the OR team was prepping her for surgery, tears were streaming down her face and she was clutching her Bible. I gave her a hug and I told her that I couldn't wait to see her after surgery. Unfortunately, she was discharged before I got the chance to go see her.  On Thursday I walked down the gangway to go out to the rehab tent and saw a bunch of the plastics patients sitting under the tents waiting for their visits. As I was hugging the patients I saw a face I recognized but it took me a minute to recognize Claudine! I just exclaimed "C'est Joli" (It's pretty)Everything about her has changed, her hair, her smile, her confidence...and no doubt she probably feels so much better! She wasn't even my patient but I just love the before and after transformation and I'm so happy for her! I'm so glad I got to see her before she was discharged!
Claudine before surgery

I just love how her sassy personality shines through after surgery. 

Claudine after surgery and after a makeover :)


My favorite part of the week was working with the Carpenter Joe, and his friend GK. We have a young patient named Rubain with a severe deformity of his leg. His leg was so big from elephantitis that he couldn't hold it up on his own. His ankle was completely dislocated and he was walking on his Medial malleolus. His left leg is 17 cm longer than his right, and he has to use a walking stick to move around. Poor thing said he wanted to be able to run like the other boys after surgery, so he can play football with the rest of the kids. The surgeon's plan was to de-bulk the elephantitis to make the leg smaller and relocate the ankle joint and place a pin in it to make it a more functional foot/ankle joint. I knew that he would be non-weight bearing after surgery and  I also knew that he wouldn't be able to  hold is own leg up after surgery which would rule out using crutches. So I asked the carpenter to build a knee walker. I had a pipe dream of a knee scooter but wheels are hard to come by here and wheels are not really functional in a place without sidewalks and smooth surfaces to wheel on, so I settled for a knee walker/platform. I took a rudimentary sketch of what I wanted and I was given a masterpiece! I love that I work somewhere that I can ask a carpenter to build me a custom piece of adaptive equipment!I also got to learn how to use a Japanese pull saw, purely because I was hanging around while Joe and GK were working and asking too many questions.
Joe working on the knee walker, you have no idea how HOT it is in his shop. I'm so grateful for his hard work in the sweltering heat!!
After giving Rubain the knee walker he was SO happy to be able to get up and walk around. I think Joe and GK were even more excited to be able to help a patient in this way. Joe told me several times that helping this patient was his priority and everyone else would have to wait. GK told me that this was the best thing he has done since he has been here, and I'm pretty sure he has much more important things to do... like, keeping the ship running! I'm going to call communications to take a picture of Rubain with the walker tomorrow, I don't have any pictures of him using it since it's a holiday weekend! EDIT: We got a photographer to come take group photos of us up on Deck 7!
At the moment, Joe is STILL working on perfecting this bad boy!
I love this photo because you see how much GK just loves Rubain!

I love how excited Joe is to see Rubain enjoy this walker!!

Don't you just LOVE that smile?!

What a champ!!


Sideview of the knee walker, they even made it adjustable and put a rocker bottom foot on so it's a more functional "heel to toe" type gait pattern.

They've modified it since this but you get the idea! We even got foam from the head engineer and they upholstered the foam!

We had a wonderful Christmas celebration on the ship! Complete with friends, overeating, FaceTime family calls, and Carols! The Christmas eve Church services at the Hope Center and on board were fantastic! The bells group played another song, we sang Alleluia(the Cloverton version with Christmas lyrics), and read the Christmas story from Luke. There is a Christmas tradition aboard the ship, we put a shoe out on Christmas eve and it mysteriously gets filled with treats! I woke up to find a lot of candy and cookies, and a wooden Christmas Ornament in the shape of Cameroon! It was so fun to have some presents to open! My sister sent a package for me but it's been at customs for a week so...I'm not sure I'll get it anytime soon!

Christmas morning pastries and coffee

Two of my faves

Christmas Lunch

Christmas lunch

Christmas eve dinner with the rehab gals

Pretending we were somewhere cold!
I tried to make bizcochitos for our Christmas eve party, they didn't taste like legit NM bizcochitos but they were good cookies...I mean good little cinnamon-sugary biscuits. 
This week the first plastics block ended :( But it will start again January 20th. Some of the team went home so we took some photos of the first block team!
The whole gang!

Daily rounds crew!

My partner in crime, Chelsea the OT on the plastics ward. We were taking a much needed coffee break!
The rest of the photos are just photos that are cute and Christmasy!

Sassy little Kari

Zidane is my actual Favorite, ssssshhh!

This is the face you get when dance behind the photographer


Merry Christmas!!
My favorite little buddy Zidane colored this and then said that it was he and I. If you look closely he wrote SiSi underneath the girl and his name under the boy. It's a spitting image of us.

 And...since I work in a hospital and have a lot of healthcare worker friends I want to share this photo because it cracks me up! This photo is on every single bathroom stall wall on the ship, even the bathrooms in my room! Number 8 is the best, but if your urine actually looks like this, I think you're past dehydration and maybe have rhabdomyolisis or kidney failure....but drink up!
I can't believe this but after this week I'm half way! Time sure has flown! I'm hiking Mount Cameroon this weekend and I can't wait! I have 3 days off so we're hiking it over 3 days and hired a tour company to take us. I feel weird hiring people to hike but there isn't really a way to hike it with out hiring these guides. I can't wait to update you on my trip! Until then.. I miss your faces!






Sunday, December 17, 2017

1/3 already gone!


I can't believe I've already been here a month! It has flown by, and I'm already sad that I only have two months left!

We had two celebrations this week. One is called Santa Lucia and its a Scandinavian tradition. The group walked around in white and sang these really beautiful dirge like songs. It was so beautiful! The other was Carols by candlelight, this is an Australian tradition and I even learned the Australian version of Jingle Bells! My favorite part of the night was singing Silent night in every language aboard the ship.  I think there were 11 total? I actually got a little choked up, thinking about all the different cultures/people coming together to love these Cameroonians! I love learning about all of the other countries traditions and sharing about some of the NM traditions. I really miss luminarias and Bizcochos right now! It's the first time I've felt homesick since I've been here...I'm sure I can find bizcocho ingredients here somewhere!
Santa Lucia
Carols by candlelight on the dock
I LOVE the bells!



I didn't take many photos this week but I had so many great experiences. I got my bow photos done, which I was really excited about but they didn't turn out so great. Oh well, maybe some friends and I can go out and take pics another day!
I should've worn sunnies, it was so bright... and its a bad combo of scrub top/wrinkly clothes/squiting/awkward arms. I'll try again. 
On Tuesday I was stretching a patient's neck while I sat on a small metal stool with a very thin layer of upholstery on top.  The upholstery is the same color as the metal so one might assume that it’s all metal...but it’s not. When I stood up my pants were soaked, and I’ll admit I sweat a ton here but this was a little excessive. So I turned to the patient in in the  next bed that speaks pidgin English and asked if the stool was wet. And he said “yes, that’s the one they take in the shower to sit on” 😑 So, I just sat on a used shower chair and soaked up allllll the dirty shower water into my pants. Awesome! SO grateful for the people who wash our scrubs!

The physician on board drained the fluid off of a patients knee, and I got to help! He used a diagnostic ultrasound and gave me a tour of the knee/quadriceps via ultrasound. It was pretty cool, the guy had close to 90 ml of fluid on his knee. Then he injected it with a steroid and numbing agent!

I also had my first splint making trial! There's a little boy here that had both hands repaired from burns and he has K wires in all of his fingers. K wires are used to stabilize the joint and keep it in a functional position while the skin is healing. With both hands repaired at the same time he has been relying on his older sister to feed him. I saw her feeding him and stuffed a fork into his IV board using some Coban, as a temporary solution, then made him a real fork cuff the next day. It probably looks archaic to a real hand therapist but I was pretty proud of myself :)
My temporary fix for Roy to feed himself. 
My first adaptive eating device :)
I've been working with a patient named Ousman who has pretty bad burn contractures and pretty intense surgical repair. Both of his legs were used as graft sites for the abdomen. Needless to say he has been pretty miserable for two weeks. This week we started standing him up, it was so sad and he started getting afraid of just my face! I would walk up for PT and he would start to cry before we started! I felt awful! Well, on Tuesday I got him a walker and through many tears he walked about 20 feet, the ward went crazy!!! Nurses, chaplains, patients, and other caregivers were all clapping and shouting BRAVO!! He even began to smile toward the end, he and his dad were so happy!
The next day, much to my dismay, he was so excited when I walked up and said "marche?!" He threw his covers back and reached up like "Get me out of this bed, ASAP!" He walked all the way to the inpatient treatment room for his wound care session, and I had to choke back tears the entire time! He has had some ups and downs but he is moving so well! He even graduated to a walker with wheels! And the best part... no more tears! I need to get a picture with him!

On Thursday we went to the Ponsetti celebration. It was a graduation ceremony for all the kiddos who have had their club feet fixed over the last few months! It was so fun, we heard testimonies from parents whose children's feet had been fixed, sang, and danced. At the end of the celebration one of the local news reporters who had been filming the ceremony came over to me and said "You shake yourself well." I replied with "What?" Not because I didn't hear him, but I was so perplexed that he said that at midday at the Mercy Ships' Hope Center, not past midnight at a dance club. Well he kept trying to explain what he meant because I had said "what?" He kept saying "You can dance so good"
Ok, sir...I get it. Thank you and Au Revoir. Should I be concerned that there is footage of me dancing somewhere?

After the Hope Center we went to Maison H and got Ice-cream and we all said our Thankful Thursday, I said I was thankful for patients who don't complain. Every day we do rounds when they serve breakfast, and everyday they serve two pieces of white bread with butter, a boiled egg, and a piece of fruit- with either tea or milk to drink. And some of the patients have been here longer than me!! I am continually astonished that none of them complain! They take their breakfast, say thank you, and eat. I am constantly amazed by our patients and how content they are. What an example they are!

 The thankful Thursday turned into goodbyes to Ida and Mama Robyn. Two PT's that are going home this weekend! We will miss them so much!

Rehab team

Someone else has got a good selfie arm!

Ida, Robyn, and I, I hate goodbyes!

Friday we had a proper discharge dance party for Robyn and Ida and it was a blast!
The rehab tradition is to dance when a patient leaves, and the Therapists get the same send off!

This weekend I went fabric shopping and I bough WAY too much fabric but I loved it all and it was SO cheap! Now, to just make room for it in my suitcase! I took most my pictures this week while out at the markets. It's so dang crowded here!
They put EVERYTHING on motorcycles! This tree cracked me up!
Christmas tree shopping Douala Style :)
I got back to the car before everyone else because they couldn't cross the street! I was so happy to see them, we were only separated a few minutes but the central market is so hectic I thought I was lost for life!

Ewa and I  became friends on the chimp outing last week. We were so sweaty and happy with our fabric purchases!

Ewa took the remaining pics of the market while we were there! I love  this one 
I'll master this someday!

So many things to look at! Its hard to shop there because they want to box you in their stall and I don't  like being closed in! Just let me look in peace!

24 yards for $38! 7 different prints! I plan to bring some home but I also want a local Tailor to make me some things!

Another wonderful week has come and gone so quickly and I continue to make new friends. It was hard saying good bye to Ida and Robyn, but we will get replacements in January! My coworkers Tracey and Chelsea leave my same weekend and we are the next to leave! So no more rehab goodbyes for now!



Tuesday, December 12, 2017

Waterfalls, and Kribi, and Chimps...OH MY!

I'm a few days late writing this but I was so tired from the weekend I needed an evening to catch up!

This week was so fun! Most of my patients are doing so well and are moving on to the Hope Center. They are all so anxious to get out of the hospital that they get so excited to go and the excitement wears off on the staff! We take a photo with the patient and send it to the Hope Center with them, the picture is like a little treasure that they walk around showing off. Then they say Au Revoir (goodbye)  Hope Center. nothing is lost in that translation!

My friend Assiatou is still here and just as pleasant and sweet as always. Earlier this week I nearly cried when I saw that she had ACTIVE dorsiflexion and plantar flexion(the ability to point and flex her toes)! I was SO surprised, she is 18 and was burned at 6 months so I didn't really count on her having the ability to move after having the contracture for so long.  She will probably be leaving to the Hope Center soon! Today we walked without her splints, and with one real shoe. She continues to use a walker because she's a little scared but she's going to graduate to crutches before she leaves!
Assiatou, with new dressings!

My newest friend Zidan has made so much progress that he gets up with his walker independently now! Zidan had a contracture of the L ankle/foot due to a Quinine injection from malaria treatment. Why they would inject into a shin/leg? I don't know but as I have started to say TIA(THIS IS AFRICA!) Who the heck knows why they do the things they do! Or possibly I'm misunderstanding because the medical record is so brief.
Zidan is SO adorable, he always has a huge smile on his face. I'm slowly picking up some french so I usually walk up to my patients and say "marche" (which is the french word for walk) and that turned into me clapping and saying "marche, marche, marche". Well now Zidan says "marche, marche, marche" every time he sees me, and it has caught on with the rest of the kids on the ward. I'm starting to think that they think my name is Marche!



Zidan before
Zidan before

More before with his great smile

I'm so impressed he could walk!


After his first surgery to loosen the leg from the shin





First time up!

There's the smile!!

This was taken just last week, and I have an even better one for my Christmas card!


I have been learning so much, and not just related to PT but in medicine in general. I love it!
I recently learned that you can shrink Hemangiomas(benign blood vessel growth) with a certain Beta Blocker, Propanalol to be exact. After I learned this I researched it a bit and it was found serendipitously by researchers who were studying hemangiomas. They had a few children in their study with cardiac conditions that required Propanalol and it shrunk the hemangiomas. No one can really explain the mechanism but one study I read suggests that the beta blocker causes capillary vasoconstriction and cell death at the capillary level.  There is no scientific study or proof, this is just a theory. It just so happens that the little girl with the Hemangioma is a DOLL!
Kari! She is full of Sas, She had just been putting her hand up in the photographers face....hence the laugh!
Look at those lashes!
As if the snuggles from the babies weren't enough we got to snuggle and play with Chimpanzees this weekend! We visited a Chimpanzee rescue, the baby chimps are raised by human papas because they were abandoned or their parents were hunted.  It was SO fun! We snuggled and bottle fed the babies and played with the older ones. The older ones would just walk up to you with a hand up and you'd pick it up and either toss them or spin them in circles and they loved it!

I went with a random group and ended up making so many new friends! After the visit to the chimps we stayed the evening on a beach in Kribi.  My favorite part of the evening were the meals at the hotel, not because the food was so delicious(it was :) ) but because we ate at a big table like a big family! We also went on a canoe trip to a pygmy village and visited a waterfall, but after a summer in Hawaii both the beach and waterfall were a little underwhelming. Yes, I am now a beach snob...dang you Hawaii!!


This guy was so particular with the papaya, he carefully spit out every seed. 

This is how they would ask for you to hold them, and if you didn't grab their hand and sling them up they'd just climb up you!

Just chilling

Cheeky little monkeys

Does anyone know what kind of monkey this guy is?

Once the chimps mature they go live on Pongo Songo Island with the other adults. They were so demanding with the bananas, they'd eat them in one bite then clap until we threw more. 

Latex trees-the sap is white and drips out from a scar in the tree. Like Syrup?

Palm Oil Trees

Boat ride to the Chimps-we were so happy to be out of the car!

Papaya!

This guy's name was Miel, and he was the biggest and so tall... he walked around like a human it was so funny!

Just a sweet babe with a swinging chimp in the background!
LOVE!
Just checking to make sure its really empty
Milk drunk

Group photo

New friends!

Kribi fishing boats

I laugh every time I see this picture, I made Chris get in it. I asked if this was his happy face and he said yes. 

Pygmy house construction, I took this because it looks like adobe

Pygmy house, the visit was not what I expected and very depressing so I didn't take any photos of the people. 

Peaceful Canoe ride

We didn't have to paddle!

I keep saying this but week three was just as amazing and the last two, and I'm excited for the rest!
This adventure continues to be amazing and if you're in healthcare and considering it-Apply now!!!