Fit & adventurous!

 

This is my last hospital week! My time in SA has seriously flown!! This week was an awesome hospital week though because we were on Neuro and we got to see a brain tumor removal as well as repair of craniosynostosis.

Craniosynostosis – cranio (cranium) + syn (together) + ostium (bone)! This is when the cranial bones fuse together prematurely and dont allow the skull to grow. Did you know that the skull actually grows around the brain? So the brain is what is creating the (relative) shape of the head in a normal baby. If the bones fuse together too early, the skull cannot form properly around the brain and the brain doesnt have room to grow. mi_um_cranioall.122235754_std.jpg

This surgery is one of THE coolest surgeries I have ever seen. The procedure is done so the brain has room to grow, but it is also cosmetic as you can see from the above photo. So you have to cut the skull, but not just one cut, you have to make multiple cuts to give the brain room. And it is a relatively short “recovery” time, but the skull doesnt look “normal” for years.  There are a couple of different techniques, but this picture below is similar to the procedure we did. It was very cool and props to all neurosurgeons out there.

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The tumor removal was also very cool, and the first time I saw an exposed brain before (last one didnt go past the Dura mater). This surgery was what I thought brain surgery would be like. It was extremely tedious and long. But when the tumor was finally removed, it was extremely gratifying.

 

We tried to fit alot in this week since it was my last week! We did a moon rise kayak trip! It was recommended by one of the docs at Red Cross. It was sooo awesome! Have you ever watched the moon rise? I honestly never thought about the moon rising.

The guide texted me that day and said “it might be canceled due to rough winds and high waves”. I said “nooo, we are looking forward to this!” and he said “is your group fit and adventurous?!” 😀 Of courseeee! The waves were super rough and it was very difficult, but seriously it was sooo fun!

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CFHI provides students with a driver to and from the hospital and for two weeks I had “Uncle” and “Auntie” (pictured below). They are a 75 year old Muslim couple who had been driving for years and asked me and Zach over for dinner. It was so wonderful and more food than I got the whole trip!! Uncle drove me every morning and since I was by myself for awhile, we got pretty close. He taught me about Islam and took me to a mosque. He taught me about the Apartheid and stories of living through those years. It was probably one of the most valuable relationships I had during my time in SA. 🙂

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One day after the hospital we all went to a rooftop bar. These are really “up-and-coming” in Cape Town! Here is the view!

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I had one more week in Cape Town but this was the end of my hospital experience so I will end the blog here! I wish I wrote more but I hope you enjoyed it! 🙂 Cape Town is amazing. And I feel so grateful to have had this experience! I am so grateful to OUHCOM to provide students with this opportunity!

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Friday we got the day off because the political scene here is pretty bad. Many people dislike the president of South Africa – sounds familiar. And there were scheduled protests for Friday, so we were encouraged to stay inside or far away from the protests. We went to Kirstenbosch Botanical gardens to explore, got lunch and then we hiked Lions Head for the sunset! This was one of the most magical nights!! The hike was actually difficult because it gets very steep toward the top!! But the views are so worth it!


Saturday we did Table! My second time but honestly it doesn’t get old! And this time we did it in 3.5 hours, which is pretty good!!

Skeleton gorge, we meet again.


Then I went straight to the airport because Zach was arriving!!! 😁 picked him up and then we went to see a Stormers rugby game! It was my first rugby game and it was so awesome because they are extremely passionate about rugby here!! Very cool!


Sunday we went to Cape Point, Cape of Good Hope and the spice route!! The spice route was new for me!!


I lovedddd the spice route!! It is a little village with a brewery, winery, chocolatier, coffee roastery, deli, restaurant and shops!! It was the cutest place and it was surrounded by vineyards! We had some food and did a wine taste! We also did a chocolate taste! Then we just chilled at the restaurant until sunset and headed home. It was the besttttt day!!


It’s so nice to be experiencing all of this with great people 🙂

New friends & adventures!

So it’s been about a week and I haven’t had much time to blog since the new students have gotten here!

I’m living with two female fourth Med students from Chicago and they’re so awesome! There are five other male students living in other home stays in the neighborhood. Everyone is nice and friendly and wanting to have a good time here!


They all arrived on Fri/Sat of last week. We went to a braai (BBQ) on Saturday with our homestay family! It was our first “braai” experience and it didn’t disappoint!

Then Sunday we went to Haut Bay market which was really cool! It had music, crafts, and delicious food! We had coffee and shared a bunch of random foods from the market! Then we went to a fruit market not too far from Haut bay.


Went back to our home stay and picked up some of the boys to go to the waterfront! We chilled there by the water and got to know one other over some food and drinks! Then we went to Kirstenbosch for an outdoor concert! We barely made it but it was still cool to see!


On Monday we did a full guided tour that CFHI organizes for each group. We had a guide, Colleen, who narrated the tour for us and gave us insight to all of the stops that we made! It was very informative and gave a lot of history of South Africa and apartheid. She grew up here so we got her personal story as well! We got to stop at some local cafes to try different foods like their special dried apricots, samosas, and these little doughnuts!

We also got insight about the poverty here in South Africa..it’s amazing that if you come here for just vacation, you would miss the areas of poverty but they are numerous. It’s a stark difference from the waterfront to the townships.


Tuesday was the new students orientation and first day in the hospital! There are only three of us at Red Cross, but there are plenty of other international students! Tuesday’s are tut days! (“Tutorial” or lecture days)..so we went to lectures and saw some cool cases!

We went into the city after work to get food at an Eastern Bizarre! It was really good! And then we walked around the city to get everyone familiar with the area! After this we went to Camps Bay beach to watch the sunset!


Wednesday was a full hospital day. We all got to scrub into a case this day! I got to first assist an orchiopexy -which is when a male is born with an undescended testicle, and the surgery helps bring it down and secure it into the scrotum. The doc that we mainly work with is awesome! He loves to teach and explains procedures step by step, which is awesome because I am slightly more familiar with female anatomy at this point of my career! 😉

We planned to go to an outdoor movie but it was very windy! It is frequently windy here in Cape Town! So instead we went to a movie in this old fashioned theater! It was really cool! It has all critically acclaimed movies and we saw Nocturnal Animals. It was a pretty good thriller!


Thursday was a short day at the hospital because we have afternoon meetings but we got to round and see a Nissen fundoplication and gastrostomy. I have seen one or two of these in the states on adults but not on children! This was done because the child had a esophageo-pulmonary fistula – which is an abnormal passage way from the esophagus to the trachea/lungs. The surgery helped to give the esophagus a break for now and the gastrostomy (attached the stomach to the abdominal wall) allows them to feed the child through the stomach and bypass the esophagus. The surgery was a great one to watch! A lot of anatomy!



We had our weekly afternoon meeting which just is a check in on how the week has gone. And then we went out for “First Thursday” which is a huge art gallery festival! It was really cool! Art galleries all over the city were open for viewing and all the restaurants had food/drink specials! There was also some live music! So we jumped around from gallery to gallery and sampled some local champagne and wine before sitting down to eat at a really cool pizza place!


The weekend is packedddd! The next blog post should be a good one! 🙂

Tiny parts, huge miracles

Pediatric surgery is seriously awesome. I wish I had had more exposure to it in the states, but super grateful I get to experience it now! The hospital staff is really great here and super friendly in the OTs (operating theaters). The attendings (counselors) and residents (registrars) are awesome and they love to teach!


(View from the OR…amazing.)

Monday I was able to see another anoplasty, but this was a “redo” of a previous anoplasty that did not take. This was similar to the last anoplasty I had described.

Then I was also able to watch a choledochal cystectomy plus choledochojejunostomy. Sooo… Choledochal = chole (relating to bile) + dochal (duct) = bile duct! cyst removal

Choledochojejunostomy = bile duct + jejunum (part of intestine) + ostomy (creation of an opening) = attaching the bile duct to part of the intestine!

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So basically we had to remove the cyst and then once it was out you needed to attach the bile duct back to something! Well unfortunately in this little baby’s case the bile duct was paper thin, so it took an extremely long, tedious amount of time to dissect a part to attach to the intestine. And as you can see in the photo, they have to cut the jejunum and attach it to itself. Then they attach the bile duct (or whatever remnant is left) to the jejunum as well! And also as you can see the pancreas/pancreatic duct Are still attached and therefore everything meets in the jejunum (bile + pancreatic enzymes + digested material). Prettyyyyy crazyyyyyy. And amazing! And this procedure only took about 7 hours! (Sarcasm.)

Then I got to see another Mitral Valve replacement which was really cool because it was a 5 year old little girl who had ALCAPA (anomalous left coronary artery from the pulmonary artery) which I have only ever heard of from studying for boards but never thought I would see!

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In the photo – note the BLUE left coronary artery in the photo on the right. That means that blood is NOT oxygenated. And so this child had a heart attack at 4 years old. This condition caused her one heart valve to become very stenotic (stiff and barely moving) and that is why she needed a valve replacement! I am unsure what the rest of the plan is for this little girl because I am fairly certain she will need more surgeries to correct this. Amazing to see the extremely small valve outlet in the heart and then the opening with a new valve!!

Later in the day, I went to a radiology conference where I saw two diaphragmatic hernias (there is a defect in the diaphragm that allows the intestines protrude up into the area where the heart and lungs are!) . I saw tuberculosis spread to the kidneys – which they said is the only case of that they have seen here (and they get a ton of TB). I also saw two X-rays of very dilated loops of bowel..so we were able to go through the case – the patients history (in both cases these were newborn babies) and their physical exams and their imaging to come up with a differential and decide what was the most likely diagnosis. One case was ileal atresia (the ileum is part of the small intestine and basically the intestine just stopped there!) and one case of an imperforate anus (no opening where the anus is). I actually loved this radiology session! I learned a lot in that one hour and got to see some very interesting cases!!

I went to the botanical garden one day after work to read and explore. It was really wonderful! I stayed until the sun set below the mountain – which was like only 6 PM.

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On Wednesday I saw a gigantic “pseudocyst” taken out of the abdomen of an 11 year old.  Pseudocyst basically means a fluid-filled sac that looks like a cyst but maybe isn’t. This definitely was NOT a cyst. This was a very large mass. When you looked at the child’s belly, you could see the mass protruding out. In the states, this would warrant a biopsy, but here they use less testing/imaging. Due to its size, they just decide to take it out. We are waiting on pathology results to see what it actually is. The surgery took about four hours because the mass was adherent to the back of the abdominal wall and to the kidney. It ended up weighing 3 kg (approx 6-7 lbs). It was unreal.

I went to a free concert on Wednesday night with two of my program directors! It was so much fun! The music was awesome and everyone was just having such an amazing time! The Annual International Jazz Fest is this weekend and it is a huge event! So this is a small preview of what the concert will be like. It was a really fun night and we went out on Long Street afterwards which was cool to see what the nightlife is like!


Friday was a wild goose chase to fill out my residency contract. It was nuts. I felt like I went to one million places to get everything that I needed together. It’s tough without a car. You’re definitely not meant to do this in another country lol. But I finished it! And met a med student from Austria that day so we chilled at the waterfront to get some food and then went into the city! It was super cool to hear about their healthcare system and how their med school is in Austria. One of the coolest things she told me was that they are given sterile shoes to wear in the OR. You don’t wear your own shoes with booties like in the US!

A waffle from the waterfront!

The new American students come this weekend! Im pretty excited to have more friends here to hangout with! 🙂 No more selfies with ghost friends! Im still just so incredibly grateful to be here!

No yelling on the bus!!!


^^ my ride for the weekend. Ok, before you judge me for being theeee ultimate tourist, you have to hear me out. I’m alone for the next week and I would still like to explore the city! It’s not really safe to go places alone and Public transportation here isn’t great. They have taxis and buses, but I wouldn’t want to do that alone. We use Uber a lot and it is excellent! It is very safe and reliable here! But to Uber everywhere in the city is costly. So I needed a safe affordable way to explore! And soo… The big red double decker bus!

Basically it picks you up and takes you all around the city, to the beach, along the coast, into district 6, to constantia wineries, to haut bay…seriously I was sooo impressed! AND while you’re on the bus, you can sit on the top – in the sun! – and listen to the history of each place you go!! Honestly it was great! So early Saturday morning I hopped on the bus and took it from Long St., which is like the popular going out area as well as where a lot of markets are, to table mountain and then all along the coast!


So I got to see all of the beautiful beaches and a description of every city I went through!


Then I ended up at the waterfront which is already one of my favorite stops because it has a good market and it is amazing!!! 🙂 so I got a little quiche and a coffee while listening to live music by the water!



I got back on the bus and went to the wineries! Constantia is the oldest wine region in SA! It’s not the most popular – like Stellenbosh – but for me it’s a must-do! And it was so beautiful!!! The wine was very good as well! Although I think the scenery tops the wine!


Then I had to head back because I was going out with Justin, my homestay brother, for his cricket team! It was really cool to see one of their “dive” bars and just have a good time with good people! 🙂
Then Sunday I went back on the bus!! I wanted to go to St George’s Cathedral for church. It was one of the only churches during Apartheid that welcomed people of all color.


Then got back on the bus to go to District 6 which was one of the largest removals of people during Apartheid. 60,000 people were removed from their homes. Side note – my drivers in the program are the most wonderful elderly couple – who love telling stories and they have told me how great it was in district 6 before their families were removed! How everyone got along no matter race/color/religion.


Gangs all here!!😂

Then I went along the coast again! I had to wear a sweater today though bc I got very burnt yesterday! The beaches are so beautiful here!


Then back to the waterfront! This time I got kombucha 😍 and the most delicious chicken curry wrap!! And just enjoyed the water with music again…with my friends. 😂

Then I headed home 🙂 it’s wonderful here! A full hospital week this week! I’m excited for what I will experience this week!

City adventures!

Friday we were supposed to go skydiving but it got cancelled due to high wind :/ so we decided to go into the city! It was Jen’s last day and then I’m alone for a week before the other students come! It’s not super safe to do things alone here so I’ll just have to plan accordingly.


First we went to the Pan African Market! It was really cool to walk around and see the different art, paintings, and sculptures. The paintings were my favorite part and the artists were creating them right then and there.


Then we walked to Green Market Square! A ton of outdoor stands selling African crafts and clothing, etc.


After this we got lost and ended up in Bo-Kaap! Not a bad place to end up! The colors are beautiful!!


Then we went to Truth Coffee for lunch! It’s supposed to be the best coffee and ambiance in SA! It was actually such a cool place. It’s described as “steampunk”. Super cool place. Would definitely recommend to anyone visiting here. 🙂

Then we were so full and walked over to the Company Garden which is the oldest garden in South Africa!


That last picture is in front of the art museum. It’s a war tank (obviously) but it’s actually covered with beads!! It’s so amazing!!

Then we had to get back home so Jen could pack and leave! It was so wonderful to have made a good friend here especially to show me the ropes and plan fun things! It’s going to be different this week when I’m alone, but I’m super grateful that Jen was here my first week!

Pediatric surgery!

I write most of these posts on the way to the hospital. It takes us a good hour to get there, not because of the distance but because of the traffic! The roads here are mainly just two lanes and not very well structured! The drivers are very aggressive as well.


Why a picture of coffee? Because it’s rare for me to have a “real” coffee..usually it’s just the instant kind! I’m always very grateful for coffee in the States – but I was super grateful for this one today!! The hospital has a little cafe that sells coffee and I’m loving it.


View from the docs lounge! It’s a bit cloudy but it clears up around midday 🙂

The hospital has been awesome! I’m on Peds Surgery which I’ve never gotten to experience before and it’s so so cool! I got to see a Tetrology of Fallot Repair in a 21 month old child. Tetrology of Fallot is a heart defect. It is truly unbelievable to watch the heart beat in a child’s chest.

I also got to see a mitral valve (heart valve) replacement. This was due to acute rheumatic fever and they wanted to wait for the rheumatic fever to settle down, but the child couldn’t come off of a ventilator so they went into the surgery with the intention of saving the valve but it ended up needing to be completely replaced. This was in a 6 year old child who was lost to follow-up after initial diagnosis.

The OTs (operating theaters) are really nice here and remind me of the states. They do things very similarly including time outs, scrubbing, sterile procedures. Their sterile equipment is draped in green instead of blue. They are less “intense” about the sterile field. There are some great teachers here! The residents are called “registrars” and their med school starts right out of high school and lasts 6 years.

Here’s a picture of the beach from this weekend 🙂 I can’t believe I get to experience this amazing place!