Pediatric Clinic and Suturing

Martes, 15-Julio-2014

Centro de Salud - Cajas Pediatric Clinic

Every Monday, Tuesday, and Friday Dr Franćois visits a clinic outside of Huancayo in Cajas. He brings with him between 2-4 fellows and we are able to help him with physical exams. Emilie, Kaitlin, Erin, and I were able to go with him on a pretty busy day. We saw 8 patients in the course of a couple hours, most of which were less than 1 year old. 

Half of the children presented with fevers and it was interesting to watch Dr Franćois diagnose each child. Throughout the course of the exam, we found several other symptoms associated with the fever. Two of the kids had very elevated heart rates. Another kid had red Herpes spots in his mouth. And the last kid had a severe cold which had reduced her O2 levels to 87% (O2 levels should be around 97%). 

The youngest patient we had was a 26 day old baby. Franćois taught us how to do a well baby check up by listening to her heart beat and respiration, checking for Mongolian spots on her back (which she had), and testing for range of motion in joints. Franćois also told us to count the layers of clothes because many 1st time moms bundle their babies in excessive amounts. This baby was wrapped in 2 blankets and had 7 layers of clothing we had to remove prior to performing the exam! 

The last two kids we saw were very interesting cases. The first was a 9 month old boy with microcephalic syndrome (small head syndrome). The child was clearly mentally delayed due his small head. He stared off into space the entire time and couldn't perform some basic tasks that a 9 month old should. 

The other child was a 14 month old who presented with internal tibia rotation. His mom was concerned because the boy would "toe-in". There are 3 things that could cause the toe-in. First is femur rotation, second is tibia rotation, and lastly is metatarsal inversion. The internal tibia rotation is the least worrisome of the set since it normally corrects itself by age 5. 

It was definitely a successful morning of learning! Thanks Franćois and Cajas Clinic!

Central Market

We finished up at the clinic around 11am and had time to kill before lunch. Franćois goes to the central market very often to get fresh produce and bread so Erin and I asked him to take us there and show us around. The market is by far my favorite place in Huancayo! There are tons of produce venders lined up in an open warehouse who are competing for your business. 

You need to have very small change because they usually can't even break 2 soles. Franćois took us to his favorite venders and made us try some new fruits. I wish we didn't have to be so careful with the produce because I wanted to try everything!! I ended up buying some chitimoya and kaki (persimmons) but plan to return for more goodies sometime later this week.

In addition to the fruits and vegetables, there also are rows of meat stand that have dead and live animals waiting to be slaughtered. All of the meat is just hanging in the open-air market. Guess you better hope your meat is fresh since there isn't any refrigeration going on. 

Once we got out of the main market area, we found several more areas that seemed more like the Sunday market. They had kitchen utensils, blankets, street food venders, and much more. What a fun and exciting place to be!

FIMRC SIHF Reunion 

it's been over a week since we have worked with the other house due to La Merced. David's house left on the first Friday and switched with Carlos's house on Wednesday. They returned to Huancayo on Monday so we are finally together again. We did highs, lows, and future desires for the program since we are half way through. 

Most people's high was being in La Merced and so David's house proposed a plan to return to the jungle at the very end of the program. We had been working on this plan since the day we got back to Huancayo but we weren't sure how well received it would be. Danel said that since we all have strong feelings for going back he'd see what he could do... Fingers crossed!

Suture Class

I've been waiting for this class since they told us about it the first week! We went to the medical school again and met with current med students who taught us how to suture. We sat through a short ppt presentation before going into the lab for the real fun. 

First we were taught how to properly put on gloves and then the needles came out. Each person received a pigs foot (complements on the central market I'm sure) to use for practice. They taught us a simple intermitten knot technique. It called for 4 knots: 2x forward, 2x back, 2x forward, and 2x back. This was a little different than the way Mrs Kopacka taught me to suture but it worked all the same. 

The most challenging portion of the entire thing was not bending the needle. The pigs feet skin had started to harden which made maneuvering the needle very difficult. I ended up flattening out my once-curved needle and had to get a second one... Oops! 

It was a lot of fun and everyone did a great job on their sutures! Everyone kept saying how great it'll be to now know what to look for as surgeons suture up their patients. 

Anticuchos de Corazón 

Aka cow heart! The plan for dinner tonight was to go out to eat Chifa but when we arrived at the restaurant it was closed. So fortunately we were near the picarones restaurant and knew they had cow heart on the menu. Anticuchos de Corazón is a Peruvian delicacy and something everyone should try. It was very lean, tender, and tasted amazing! I can't wait to go back for more picarones and cow heart!!