Hospicio and other thoughts

Greetings everyone!  Right now I am sitting in the casa recovering from dehydration, which I must say is pretty dang scary.  Team Hospicio loaded the Guagua today and I was feeling fine, then all of the sudden as we were standing in the outpatient clinic I felt dizzy and weak all of the sudden and needed to sit down, I felt like I was going to pass out.  One thing that I have learned here is that once you are thirsty, thats when it is too late, and you are already dehydrated.  So Ive been pumping the fluid, both water and gatorade today.

Hospicio has been going well.  I will start with yesterday (Monday) at Hospicio.  We took our residents to the park and walked around, did some exercises and played a game.  This park is absolutely beautiful.  Honestly, I have never seen our residents so happy!  One of them commented on how nice is was to get fresh air and have different scenery because they really do not have the opportunity to leave the complex very often.  I am so happy that I have the opportunity to spend time with them.    They all have their brilliant personalities and quarks about them and are all so wonderful.  Keep an eye on them though, a few of them really want to explore or barter with local street vendors.  After the exercise class, we went to check in with a patient who is s/p hip surgery.  Liz and I checked in with Kenson in the out patient clinic.We saw Emilie for a little bit and waited for our other patient that did not come in today.  Our late morning was a little more frustrating.   We are having trouble understanding why our hip patient is NWB and still has his stitches in and are in disagreement with the nursing staff about this issue, as well as a couple of other things.  It is hard because we really want to help him and are afraid of things like infection and other co-morbidities and are unable to at this time.  The nursing staff is so caring and are really looking after him, as well as their other patients.

Also on Monday we had ILAC clinic, which is where people from the community come into ILAC and we diagnose and treat them.  We had two patients with UE BE amputations that we fit with prosthesis, as well as taught them how to use them for tasks such as writing, picking up a mug and taking a lid off a jar.  Ann, Erin and I were a treatment team.  Thank god Ann speaks Spanish, she rocks my socks off!  Next, the three of us treated a pt with L anterior knee pain, s/p L meniscus scope in January.  She presented with swelling, pain and decent strength.  We worked with her on exercises and wrote up a HEP for her as well.

After clinic, we had dinner and then the PUCC students came to our campus this evening for a lecture and case studies on amputations and prosthetics.  Nicki and I worked on a case with another PUCC student and we discussed the importance of the "Dream Team," came up with a plan of care, patient goals, equipment needed and future issues.  Niether Nicki or I speak Spanish, and the PUCC student spoke very limited English, so we did have some trouble understanding each other.  Sue translated for us for most of the session.

My spanish is coming along and I am able to say a few things.  I am able to understand more, which is nice. 

We have four days left here and I still cannot believe all of the work we are doing with the Dominican people.  Everyday I seem to learn something about myself and something about one of my patients or about the culture.  As most dominicans do not speak English, they are all very understanding because we are at least trying to communicate.  I still rely more on demonstration, especially when working with a patient alone with no translator.

I have made some transformations and realizations during my trip here.  There are so many things that I take for granted in the US, such as electricty, paved roads, personal space, access to good healthcare, screens on windows, relationships, certain foods, clean water, communication, etc.  The dominican people are so simple, so loving and live off of the land, rely on relationships (with God and family on the forefront).  They use the resources they have, which sometimes scares me when the resource is meat - we saw a pig being walked down the road on the way to work the other day, and we see chickens just running everywhere).   Then there is the poor, which is very prevelant here, as well as the rich, with nothing in between.  For example, the Batey's.  These communities strive off of their relationships with their family and with each other and really enjoy life, even though they do not have much to live on.  Reflecting back on my experience at Batey Libertad, I am touched by how wonderful this community is and how loving and accpeting they are of us visiting and learning about their culture and community.  Poverty is apparent to the eye by looking at the housing and the bathrooms and sometimes unclothed babies, but it is not apparent in their hearts, which are so giving, to their community and to us.  I think about how simple life is here and how nice it is sometimes just to be.  I have realized that there is so much I want to give but cannot even begin to give everything that I want to give.  I can only help so much, teach so much, collaborate (with the PUCC students and others at Hospicio).  There are things that make me nervous here as well, revolving around healthcare and how limited their resources are.  For example, in the US supplies like gloves are readily availible and we throw them away after each use.  Here I learned that they may only get one pair a day.  I have been impressed with aspects of healthcare toom such as how caring and knowledgable the staff are at all of the places that I have been, as well as how nice the facilities are and how they are working on improvements to better serve their people.

On another note, we all look like lobsters with the chicken pox - sunburned and getting bites from the "no see-um" bugs.  We are all going to look so great for graduation - hahaha!