I woke up today a little later than usual and didn't make it to the morning worship service they do. I've actually missed it quite a few times. It's a pretty fun with the singing, but lately not worth getting up 15 minutes early. I've been staying up later trying to get my presentations ready for tomorrow and so I haven't been sleeping as long. It's shown as I've felt so tired in the office during the morning. Hopefully, my presentation will go well and I can get to bet earlier.
Today was a better day than most, because things stayed busy. The morning looked like it would be slow, but we had a steady amount of patients coming in. One guy that got my interest was a middle aged Hispanic, who had a rash all over his body. It started on his head and had covered wherever his hear was on his scalp. Then it had spread around to different places; his back, chest, and groin. The rash was large scaly raised plaques that didn't quite look like anything I had seen before in real life. I think a previous physician had tried treating him with anti-fungal things, but that wasn't helping at all. It actually looked like psoriasis, but was present in areas where it's not typical although doesn't mean it's not psoriasis. It reminded me the most of mycosis fungiodes, which is a rare T-cell lymphoma that occurs in the skin. I had learned about it over and over from undergrad. on, but have never seen it. I doubt that's what this is, but wouldn't it be cool for me if it was to see it. Of course, it would not be cool at all for this guy. I guess I'll never know though, because Dr. Sierra tested it for fungus, which was negative, and sent him to a dermatologist. I would have biopsied it myself if it had been me because I love that kind of stuff so I was a little disappointed he sent him away.
After this guy left there was a delivery that Dr. Sierra and I went to attend to receive the baby. Again, I had no word from Dr. Lazo that this was going on. While I was in there though Dr. Lazo came and got me to help him with a C-section. All the other doctors were busy so I was the only option. I only helped him as 1st assist for a little while when his wife came in and took over, so it was back to holding a retractor. This was the 3rd c-sectio for this lady and the previous ones had been done very low, so that is where we had to do it. It was such a pain because she had so much scar tissue in there I coudln't tell what was what. Plus the bladder is right there when you do a section that low, which is a real pain to get around so I'm not sure why you would want to that as a surgeon; probably for cosmetic reasons. Well, the section went well and there was actually another c-section right after it! I assisted with that one and tended to the baby after delivery because Dr. Sierra hadn't made it in. I got some good pictures of the surgery thanks to the nurse taking them. At one point she disrupted the surgery and made everyone look at the camera, which I thought was funny. Wouldn't you know it, after this c-section there was another woman who came in labor, so that's 4 deliveries in one day when there has only been like 5 since I've been here. I've been trying to get my presentation ready and the delivery all the suddened happened really fast so I missed that one, but that is okay.
Tomorrow I'm going to be doing a presentation to the staff on post-partum hemorrhage and childhood vaccinations. I was planning on using power point with a projector, but my stinkin' computer crashed and had all my files on it so I'm going to just have to use a white board. It's at 3:30 pm, right in the middle of the work day, so I'm not sure how that is going to work, but I imagine there won't be many people there. It's in the cafeteria so I imagine if nobody shows I can just give the presentation to the cooks.
Another day in Belize down and I think I can officially start counting them down since I'm getting close. Only 5 more to go!
Today was a better day than most, because things stayed busy. The morning looked like it would be slow, but we had a steady amount of patients coming in. One guy that got my interest was a middle aged Hispanic, who had a rash all over his body. It started on his head and had covered wherever his hear was on his scalp. Then it had spread around to different places; his back, chest, and groin. The rash was large scaly raised plaques that didn't quite look like anything I had seen before in real life. I think a previous physician had tried treating him with anti-fungal things, but that wasn't helping at all. It actually looked like psoriasis, but was present in areas where it's not typical although doesn't mean it's not psoriasis. It reminded me the most of mycosis fungiodes, which is a rare T-cell lymphoma that occurs in the skin. I had learned about it over and over from undergrad. on, but have never seen it. I doubt that's what this is, but wouldn't it be cool for me if it was to see it. Of course, it would not be cool at all for this guy. I guess I'll never know though, because Dr. Sierra tested it for fungus, which was negative, and sent him to a dermatologist. I would have biopsied it myself if it had been me because I love that kind of stuff so I was a little disappointed he sent him away.
After this guy left there was a delivery that Dr. Sierra and I went to attend to receive the baby. Again, I had no word from Dr. Lazo that this was going on. While I was in there though Dr. Lazo came and got me to help him with a C-section. All the other doctors were busy so I was the only option. I only helped him as 1st assist for a little while when his wife came in and took over, so it was back to holding a retractor. This was the 3rd c-sectio for this lady and the previous ones had been done very low, so that is where we had to do it. It was such a pain because she had so much scar tissue in there I coudln't tell what was what. Plus the bladder is right there when you do a section that low, which is a real pain to get around so I'm not sure why you would want to that as a surgeon; probably for cosmetic reasons. Well, the section went well and there was actually another c-section right after it! I assisted with that one and tended to the baby after delivery because Dr. Sierra hadn't made it in. I got some good pictures of the surgery thanks to the nurse taking them. At one point she disrupted the surgery and made everyone look at the camera, which I thought was funny. Wouldn't you know it, after this c-section there was another woman who came in labor, so that's 4 deliveries in one day when there has only been like 5 since I've been here. I've been trying to get my presentation ready and the delivery all the suddened happened really fast so I missed that one, but that is okay.
Tomorrow I'm going to be doing a presentation to the staff on post-partum hemorrhage and childhood vaccinations. I was planning on using power point with a projector, but my stinkin' computer crashed and had all my files on it so I'm going to just have to use a white board. It's at 3:30 pm, right in the middle of the work day, so I'm not sure how that is going to work, but I imagine there won't be many people there. It's in the cafeteria so I imagine if nobody shows I can just give the presentation to the cooks.
Another day in Belize down and I think I can officially start counting them down since I'm getting close. Only 5 more to go!
Odd Rash - Any want to diagnose?
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