What is sitting on my chest?
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Ayer, nosotros encontramos un caso unico para los estudiantes guatamalteca (pero para nosotros gringos, hubo...come se dice "bread and butter"?). Un hombre que tiene setenta y cuatro aNos, vino al CEMI en las ocho y media horas de la noche; nosotros acabamos la cena (que fue arros y frijoles negros y guacamole). El hombre nos dijo que tenia mucho consado, palpitaciones de la corazon, y era muy debil por todo el semana pasada. Las sintomas empescieron de repento, y no hubo ninguna otra sintoma como nausea o vomitado o sudor. Haya o no haya dolor de cabeza y mareo. Sin embargo, el segia sentido las sintomas hasta ayer, cuando en la tarde, empiescO sentir como alguna cosa fue sentado en su pecho. La presiOn fue mas fuerte, y no sabe si algo ayudO o danO. Hubo paso al ambos brassos, pero no hubo paso al collo o mentOn. VinO con sus hermanos.
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Sin embargo, nosotros tenemos muy emotionado por que el tenia "cosas muy interesante" (pero, lo siento ahora que tenemos emotionado por estas cosas). El tenia el lado de corazon de ciento y cuarente y era irregular. Tenia todavia la presiOn.
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Nosotros eramos muy listos para este caso!. EmpiescO oxIgeno, pero no hallamos la aspirina! Entonces, yo requierdI que la aspirina fue proxima de microonda (no se por que). Dimos atenolol tambien, y ultimo (despues de una hora de hablar!) convencemos su parientes tomar el al hospital. Ojala que el hombre sea bien!
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Durante de hora en que convenciamos su familia, nosotros gringos tenemos un discutada muy interesante...buscemos en el libro de Sabatine la criteria como "TIMI risk score"...el hombre tenio ses puntas, y si el viva en la populatione de Brigham y Mujeres hospital, el tenga en chance de morir de 16%...
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Yo acabado encuentro que el hombre no revuelve al CEMI. Creo que muchas veces occure eso. Que lastima. :(
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Yesterday, we encountered a case unique for Guatemalan medical students (but for us gringos, it was...how do you say "bread and butter"?). A man who was seventy-four years old came to CEMI at 8.30 pm; we had just finished dinner (which was rice and black beans and guacamole). The man told us that he had profound fatigue, palpitations, and was very weak for the last week. These symptoms began suddenly, and there was no other symptom like nausea, vomiting, or sweating. There may or may not have been a headache and lightheadedness. Anyway, he continued to feel these symptoms until yesterday, when in the afternoon, he began to feel like something was sitting on his chest. The pressure was very great, and he did not know if anything helped or made it worse. It was passing toward both arms, but not to his neck or chin. He came with his brothers.
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Anyway, we were really excited because he was a "really interesting case" (but now I feel bad that we were excited for this reason). He had a heartrate of 140 and it was irregular. He continued to have the pressure sensation.
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We were ready for this case! He began on oxygen, but we could not find the aspirin! Then, I remembered that the aspirin was next to the microwave (I have no idea why). We gave him atenolol also, and finally (after ralking for a whole hour!) we convinced his relatives to take him to the hospital. I hope that he is okay!
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During the hour that we were convincing the family, we had an interesting discussion among the gringos...we looked up in Sabatine the criteria for the TIMI risk score...that man had 6 points, and if he lived in the population that made up the study from the Brigham and Women's hospital, he would have a 16% mortality rate...
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I just found out that that man did not return to the hospital. I believe that this happens a lot. It's a shame. :(
Thursday, February 28, 2008
Monday, February 25, 2008
Imagenes
Bienvenido a CEMI! Los cuartos de clinica estan en el lado izquierda, y la calle de la farmacia esta en el lado derecha.---
Welcome to CEMI! The rooms for the clinic are on the left, and the pathway to the pharmacy is on the right side.
La jardIn!
The garden.
Casual arboritas?
Random little trees.
Mi favorita rosita. No necessita proteccion, porque ella tiene muchas espinas :)
My favorite little rose. She doesn't need any protection because she has many thorns :)
TOP: Mi Cuarto. / My Room. BOTTOM: El dormitorio comUn. (Es verdad, la televisiOn tiene HBO!)
Dia numero uno.
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Mis dia numero uno empesce con !pum!. En la viaje de Nueva York al Guatemala Ciudad, conosco un hombre que esta de Guatemala Ciudad, pero el trabaho en Nueva York. El me dice todos los avisos sobre Guatemala, me da el nUmero de telEfono, y tambien el me da una brazeleta de amistad. Cuando llego al aeroporte en la ciudad, casi inmediatamente Gloria y Hiu-Fai me ven, y nosotros salimos junctos. Yo veo el equipaje cuando ellas usan el baNo -- !de repente! -- oigo me nombre. Luisa y Regina, dos estudiantes de Universidad Francisco Marroquin, estan alli para nos recoger y manejar al Centro de Emergencia por Maternales y Infantales (CEMI), donde vivamos. Voy con Regina, y nosotros somos perdidos dentro de media hora...pero llegamos al CEMI pronto. Entonces, Regina traiga me al centro mercado, donde ella me da cuatro aguacotes para regales (que cuestan dos quetzales, como vienti y cinco cents de EEUU). Tambien, cambio dollares por quetzales, y compro frijoles negros y tomates.
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Tan pronto como llegamos al CEMI otra vez, conosco Mario, otro estudiante, y el me pregunta por ayuda -- el necessita assistir tres partos, y tambien hay un hombre con sangre de cabeza.
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El me dice curar el hombre...asi entro la cuarto y introdusco miyo, !pero el hombre es muy emborrachado! Apperentamente, el tomO siete tazas de alcohol pura, entonces el cayo y de su cabeza con la tierra. En el cuarto, la enfermera esta provechIssima, y ella me trae toga esterIl y implementos de cirugia, y ella empesce flujo intravenoso. Irrigo todo la cabeza, entonces corto la pelo cerca de herida, pero sigue sangrado. Pongo mucho precion sobre de herida, pero le duele. Por eso, inyecto anestesia antes de proceder. (No se cuantos pesos tiene, pero supongo es menos de ciento kilogrammas; por eso, uso menos de cinco millilitres de 2% lidocaine). Entonces, coso la herida y traigo el hombre al espAcio de rehabilitaciOn.
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Despues de la actividad, yo finalmente voy al mi cuarto y desembalo mis cosas. ?Que es por la cena? Aguacotes y tomates, ?como na?
----------------------------------------
My first day begins with a bang! On the way from New York to Guatemala City, I meet a man who is from Guatemala City, but who works in New York now. He gives lots of advice about Guatemala, gives me his telephone number, and even gives me a Friendship Bracelet. When I arrive at the airport in the city, almost immediately Gloria and Hiu-Fai see me, and we leave together. I look after the luggage while the girls use the bathroom -- when suddenly -- I hear my name. Luisa and Regina, two students from the Universidad Francisco Marroquin, are there no pick us up and drive us to the Centro de Emergencia por Maternales y Infantales (CEMI), where we are to live. I go with Regina, and we are lost before a half hour is up...but we arrive at CEMI soon enough. Then, Regina brings me to the central market, where she gives me a gift of four avocados (which cost two quetzals, which is like 25 cents). Also, I change dollars for quetzals, and I buy black beans and tomatoes.
---
As soon as we get back to CEMI again, I meet Mario, another student, and he asks me for help -- he needs to attend to three pregnancies, and there is also a man with bleeding from his head.
---
He tells me to attend to the man...so I enter his room and introduce myself, but the man is really drunk! Apparently, he drank seven shots of pure alcohol, and then he fell and hit his head against the ground. In the room, the nurse was incredibly helpful, and she brought me a sterile gown, instruments for surgery, and she starts intravenous fluids. I irrigate the whole head, and then I cut the hair around the wound, but it continues to keep bleeding. I put a lot of pressure over the wound, but that causes him a lot of pain. Because of that, I inject anesthesia before proceeding. (I don't know how much he weighs, but I suppose it is less than 100 kg; so I use less than 5 ml of 2% lidocaine). Then, I sew the wound and bring him to the recovery area.
---
After the activity, I finally go to my room and unpack my things. What is there for dinner? Well, avocados and tomatoes, of course!
Mis dia numero uno empesce con !pum!. En la viaje de Nueva York al Guatemala Ciudad, conosco un hombre que esta de Guatemala Ciudad, pero el trabaho en Nueva York. El me dice todos los avisos sobre Guatemala, me da el nUmero de telEfono, y tambien el me da una brazeleta de amistad. Cuando llego al aeroporte en la ciudad, casi inmediatamente Gloria y Hiu-Fai me ven, y nosotros salimos junctos. Yo veo el equipaje cuando ellas usan el baNo -- !de repente! -- oigo me nombre. Luisa y Regina, dos estudiantes de Universidad Francisco Marroquin, estan alli para nos recoger y manejar al Centro de Emergencia por Maternales y Infantales (CEMI), donde vivamos. Voy con Regina, y nosotros somos perdidos dentro de media hora...pero llegamos al CEMI pronto. Entonces, Regina traiga me al centro mercado, donde ella me da cuatro aguacotes para regales (que cuestan dos quetzales, como vienti y cinco cents de EEUU). Tambien, cambio dollares por quetzales, y compro frijoles negros y tomates.
---
Tan pronto como llegamos al CEMI otra vez, conosco Mario, otro estudiante, y el me pregunta por ayuda -- el necessita assistir tres partos, y tambien hay un hombre con sangre de cabeza.
---
El me dice curar el hombre...asi entro la cuarto y introdusco miyo, !pero el hombre es muy emborrachado! Apperentamente, el tomO siete tazas de alcohol pura, entonces el cayo y de su cabeza con la tierra. En el cuarto, la enfermera esta provechIssima, y ella me trae toga esterIl y implementos de cirugia, y ella empesce flujo intravenoso. Irrigo todo la cabeza, entonces corto la pelo cerca de herida, pero sigue sangrado. Pongo mucho precion sobre de herida, pero le duele. Por eso, inyecto anestesia antes de proceder. (No se cuantos pesos tiene, pero supongo es menos de ciento kilogrammas; por eso, uso menos de cinco millilitres de 2% lidocaine). Entonces, coso la herida y traigo el hombre al espAcio de rehabilitaciOn.
---
Despues de la actividad, yo finalmente voy al mi cuarto y desembalo mis cosas. ?Que es por la cena? Aguacotes y tomates, ?como na?
----------------------------------------
My first day begins with a bang! On the way from New York to Guatemala City, I meet a man who is from Guatemala City, but who works in New York now. He gives lots of advice about Guatemala, gives me his telephone number, and even gives me a Friendship Bracelet. When I arrive at the airport in the city, almost immediately Gloria and Hiu-Fai see me, and we leave together. I look after the luggage while the girls use the bathroom -- when suddenly -- I hear my name. Luisa and Regina, two students from the Universidad Francisco Marroquin, are there no pick us up and drive us to the Centro de Emergencia por Maternales y Infantales (CEMI), where we are to live. I go with Regina, and we are lost before a half hour is up...but we arrive at CEMI soon enough. Then, Regina brings me to the central market, where she gives me a gift of four avocados (which cost two quetzals, which is like 25 cents). Also, I change dollars for quetzals, and I buy black beans and tomatoes.
---
As soon as we get back to CEMI again, I meet Mario, another student, and he asks me for help -- he needs to attend to three pregnancies, and there is also a man with bleeding from his head.
---
He tells me to attend to the man...so I enter his room and introduce myself, but the man is really drunk! Apparently, he drank seven shots of pure alcohol, and then he fell and hit his head against the ground. In the room, the nurse was incredibly helpful, and she brought me a sterile gown, instruments for surgery, and she starts intravenous fluids. I irrigate the whole head, and then I cut the hair around the wound, but it continues to keep bleeding. I put a lot of pressure over the wound, but that causes him a lot of pain. Because of that, I inject anesthesia before proceeding. (I don't know how much he weighs, but I suppose it is less than 100 kg; so I use less than 5 ml of 2% lidocaine). Then, I sew the wound and bring him to the recovery area.
---
After the activity, I finally go to my room and unpack my things. What is there for dinner? Well, avocados and tomatoes, of course!
bienvenido!
Hola! Esta "blog" es mi tentativa primera para escribere un diario publico. Nacio de mi viaje (primero?) de Guatemala, para un rotacion de medicina rural. Ojala que coninue escribere en el futuro tambien. Asi, aqui es mi cuento!
Hello! This blog is my first attempt to write a public diary. It was born by my trip (perhaps the first?) to Guatemala for a rural medicine elective. I hope that I will continue to write in the future, too. So, here is my story!
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