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Endings & Beginnings

sunny 88 °F

As I write this entry, we're starting to realize that our time here at Loma de Luz is coming to an end pretty soon. In just 2 weeks, Mariel will be in the air headed toward Chicago (and eventually Iowa City) and Ben and his brother will be starting their bro-cation together to the Copan ruins. We're looking back and reflecting on what we've learned, seen, and done here.

At the same time, we're looking forward. On Wednesday, we submitted our residency program rank list, which is now officially set in stone and unchangeable. The weight of the decision was sitting pretty heavily on our shoulders for the last few weeks (and months...) so it feels great to have it out of our hands! Now we, along with every other fourth year med student in the country, will find out where we'll be for the next 3-4 years on Friday, March 16. We're really excited, and luckily would love to end up at any of our top 5 choices so we don't anticipate being too disappointed come March 16.

But back to the now. I wanted to take this time and do a run-down, both for our sake to see it all in front of us, and to let you all know what we're up to. Here goes!

Stuff we've cut open/sewed up
Abscesses - III (one pyomyositis - deep, intramuscular abscess that you see in the tropics semi-frequently)
Skin tags - III
Anteater attack wounds (seriously)
Dog bites
Machete whacks - III (one of which cut into bone, another of which left quadriceps muscle bulging out)
Toenail removal
Laceration repair after toddler fell off a horse
Foreign body removal (from hand)
Skin biopsy
Sebaceous cyst removal
Little toe amputation (ok, this wasn't us who repaired it but it's still pretty interesting! The guy whacked the toe just about the whole way off with - you guessed it - a machete, then the doc just took it the rest of the way!)

Lumps and bumps
Thyroid nodules - IIIII+ (one confirmed cancer)
Pyogenic granuloma (large noncancerous gum mass)
Basketball-sized ovarian cancer

Interesting ER/hospital cases
Ipecac flower ingestion - http://en.wikipedia.org/wiki/Carapichea_ipecacuanha
Enormous lung mass which suddenly the patient bled into and died
Distracted fracture of radius and ulna after falling off of hammock
Seizures in a 2 year old
Seizures disorder in a patient with appendicitis
Barb of barbed wire implanted in tibialis anterior muscle
Known leukemia patient casually coming in with a hematocrit (red blood cell level in the blood) of 12%, normal being near 40%

Patients we've done CPR on: 3, 2 unsuccessful

OB stuff
Deliveries - II (hoping for more!)
Self-induced abortion at 28 wks - (Apparently the patient took some kind of 'abortion pills' - possibly Cytotec sold out of the back door of a pharmacy, since it was in a box of omeprazole - at 7 months pregnant because she decided she didn't want her baby anymore. She was sent to La Ceiba where they have a NICU since these pills basically induce birth.)
Retained placenta after birth, which stayed in as the woman hiked 6 hours through the mountains to get to the hospital
Pre-eclampsia, and full-blown eclampsia with seizures

Clinic patients
Hypertension - a whole lot
Diabetes - another whole lot
Reactive airway disease in small kids - a surprising amount, often leading to hospitalization
Possible hypertrophic cardiomyopathy with outflow obstruction - rare cause of sudden death in young people
Congestive hepatopathy in a CHF patient
Bilateral hydroceles
Malaria (P. vivax) - III
Dengue fever - I
Cleft lip/palate - IIII
And a lot of colds, coughs, pneumonias, UTIs, muscle strains/sprains, renal stones

Whew! No wonder it feels like we've been so busy. We'll have to do another round-up like this in 2 weeks, but for now it's fun to see it all in one place. Cheers!

Posted by vagabundos 06:22 Archived in Honduras

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