Cirugias y Más

I spend most of my time at the Fundación Cardiovascular either in the operating room or seeing patients in the clinic. So far, I have assisted in several vein strippings (safenovaricectomias) in the legs and retroperitoneal gonadal vein ligatures, as well as about five arterio-venous fistulas for dialysis patients and also one femoral-distal bypass. The team has taught me how to help close with several different types of sutures: subcutaneous and "colchonero", which is the mattress stitch. I have included a picture of me assisting Dr. Amarillo (the "yellow fellow") in a cephalo-brachial terminal lateral fistula.

Yesterday in the afternoon I had the opportunity to accompany Dr. Paille from the Fundación during his ER shift at the hospital across the street, Centro Medico Carlos Ardilla Lulle. While seeing a patient who was complaining of inguinal pain, I helped Dr. Paillie examine the abdomen and we discovered that the patient had a very obvious abdominal aortic aneurysm. The arteriography later on showed us that it was >5 cm, meaning it will be a surgical case. Not only did I actually get to touch an AAA, but I helped find it. It was one of the coolest things ever. Interestingly, it turns out that this man, who was a "campesino" or farmer, had never had a proper physical exam and he had absolutely no idea that he had a pulsatile mass in his abdomen.

xoxokr

La Casa de Pacho, Barichara, Colombia

Because today is the second Colombian Monday Holiday in a row (and once again, no one seems to be able to tell me what we are celebrating) there is no work for Colombians today. For the long weekend I was invited to a nearby colonial town called Barichara to stay at the house of Pacho Serrano, the owner of a Colombian grocery store chain called Distraves. I went with Silvia, Dr. Barrera's younger sister and her boyfriend Nelson on the two-hour, incredibly scenic drive through the jungle to San Gil and then Barichara. When we got there, I met Pacho and his youngest daughter Angela who came in from Bogota, as well as his son and his son's wife. Pacho's house may have taken up an entire block of Barichara, I think it might have had 15 rooms. Angela taught me how to make sushi (picture below)and we made about ten rolls for dinner for everyone in the large but very rustic kitchen of Pacho's block-house. I also found a picture of Pacho with Colombian President Uribe (also below).

Saturday we went very early on another scenic (and bumpy) drive to swim in the "quebrada" or creek on Pacho's finca. They neglected to tell me that I needed to bring my swimsuit for this little outing so I had to wear Pacho's sweet 80's Miami disco swim trunks and a Santos Presidential Candidate T-shirt (that Sofia and Juanita gave me earlier this week). I had to include a picture, I hope you think it is as funny as I felt. We spent the entire day driving around Pacho's finca, which I think was an entire mountain, looking at his cafe, cacao, and maize plants as well as checking up on the hundreds of goats, cows, búfalos, and chickens. I was literally in "la mitad de la Nada".

Barichara is a nice town with lots of little stores to shop in (yay!), and a pretty church (of course) but not much else. In the middle of the night I killed what may have been the biggest beetle I've ever seen, except for those in the Amazon (you know which ones I'm talking about, Juliana). I am now back in civilization and am returning to the Fundación tomorrow. It's hot and humid and this week we are going to a karaoke bar. xoxokr

Señora Santandereana

Today I went to a special lunch with a group of nurses and doctors from the vascular surgery service. When they asked me what kind of food I wanted to eat, I asked them to take me to a typical Santandereana restaurant (the region of Bucaramanga). They agreed to take me to the restaurant Señora Santandereana on one condition: that they order for me and that I at least try everything. I agreed. This is the plate that arrived. First: the beverage (which I thought was delicious) is Hipinto (Buca's version of Big Red) mixed with cerveza. The plate: on the right is actual goat vertebrae, the seemingly innocent rice is actually guts and rice cooked in blood, which the doctors informed me that they give to patients with anemia to raise their iron. To the left is some sort of fatty meat and in the middle is steak, I think. I tried everything and smiled the entire time. Bring on the Trichinosis!!!

Bucaramanga: Una Ciudad Santandereana

Thursday nights are "family nights" in the B family, and this week they gave me a grand tour of the highlights of the city. First we went to the Parque Garcia Rovira to see the Iglesia San Laureano, constructed in 1779, and the capitol building of Santander. On the way to the other side of town, we passed by the Museo Simon Bolivar, a large house where Bolivar lived for two months. Then we visited the famous Club Comercio de Bucaramanga, which is like a very old, ornate social club in the middle of the city. It used to be the place where people went to buy and sell goods. On the same block, in Parque Santander, is the Iglesia Sagrada Familia, (no not in Spain). I have included a photo of Sofi, me, Adriana, and Juanita standing in front of it. Afterwards, we went to the great "megamoll" which is a giant shopping center, where we ate dinner at Crepes and Waffles. Crepes and Waffles is a Colombian chain created by two graduating university student that only employs single moms. I had a "crepe de estilo hindú" and then we had ice cream.

Last night (Saturday) we went to the "Fiesta del Anniversario" of the country club. Everyone wore white and the food was delicious. After dinner was the dancing! Colombian parties are different from American parties in the EVERYONE dances. Nobody sits much, except to drink more whiskey, which is served alone with ice. I salsa-ed, cumbia-ed, rumba-ed , and I don't know what else to a Cuban band. Towards the end of the party, they serve a typical Colombian soup full of meat and potatoes and arepas, which are like corn biscuits, on the side. We did not get home until 4 am!

Today (Sunday) we are resting, and I am helping Dr. B with a presentation that he is giving in Boston this week about the paper that we are writing. It is a clinical study demonstrating the benefits of performing synchronous carotid artery stenting (CAS) and coronary artery bypass graft (CABG). My "mission" while I'm here (besides learning as much as I can about vascular surgery, the Colombian health system, and Spanish) is to help them translate the research in Spanish into a paper in English, to be submitted to a journal to be published. It is apparently a very controversial topic whether to perform these procedures together or on separate occasions. When it is published, my name will be included in the list of authors!

Until later this week,

xoxokr

La Fundación Cardiovascular

Today was my third day working at the Fundación Cardiovascular with Drs. B. Monday and Tuesday Dr. B and I, along with the other vascular surgeons on our team, spent most of the day in clinic visiting with patients and doing Duplex studies, which is essentially ultrasound of the different vessels, depending on the case. I saw patients with vasculitis, carotid disease, stenosis, calcifications of vessels, and many different forms of peripheral diabetic vascular pathology. The surgeons showed me CT scans and MRIs of several recent patients with different kinds of aneurisms.

While passing through the pediatric ward with Dr. B, we saw an entire family with an acute case of Chagas, which is an infection from a parasite that sometimes causes cardiac failure and even the need for a heart transplant. The family had brought one of the bugs bit them, called the "pito", which is a "phlebótomo", or blood-sucker.

Today was my first day in surgery. While scrubbed in with one of the fellows, I assisted in a vein stripping of a woman's leg who had "várices", and while exiting the operating room, we found Dr. B operating on an amputee patient who had ruptured her axillary-femoral bypass bedside. When they arrived in the OR, all of the rooms were taken and the rupture repair was being done in the hallway of the OR floor.

I also get to accompany Dr. B to the morning meetings where we discuss different patients with the other surgeons and decide the best treatment for them. I am learning so much about vascular surgery, but also improving my Spanish because I do not speak English all day long. Even writing this blog is difficult for me today because I am starting to think in Spanish grammar!

After I got home from the hospital, I went with Sofia to the mall where we looked for white sandals for me to wear with my white dress to the party at the "club campestre" this Saturday (the dress code is all white), but none of the shoe stores had my size! I guess women with skis for feet are not so common here... Eventually we found some, and the price translated to 10$. Then we had manicures at the country club for the party this weekend, and they were 3.50$. I think me and Colombia are getting along just fine...

Above I have included a picture of me watching the surgeons search for a popliteal pulse in the only remaining leg of the patient that had been operated on after rupturing her bypass. As you can see, we are in the hallway. I also included a picture of me and Dr. and Dra. B in our office, where I study vascular surgery journals and patient reports in Spanish in between clinic and surgical cases.

xoxokr

Bucaramanga, Day 1

Today I arrived in the Bucaramanga Airport Palo Negro where my new Colombian family picked me up. They are very excited to have me and gave me a grand tour of the city today. Their home is in a gated neighborhood that is walking distance from their "club campestre", or country club, which looks more like a Miami art deco hotel than the typical country clubs that I know. Sofia and Juanita have offered to give me golf and tennis lessons in exchange for time where we speak English together so that they can practice. They are learning English in their bilingual school, which is also in the neighborhood. When I arrived at their home, they had made me a welcome sign in English on put it on the front door. I am so lucky to be staying with such a nice family.

After dropping off my bags, we went to the "finca" or farm of Dr. B's family where we visited with the horses, cows, dogs, and even baby goats. Dr. B was very eager to explain to me how their Colombian breed of horses is better than any other. They have a much larger farm outside the city that also includes roosters which I was told we will be staying at the weekend after next.

After that, we went to vote! Today was the presidential election day, and I watched the girls as Drs. B voted inside a nearby school. The entire compound had very strict military security and I was only allowed in if I kept my mouth shut and did not speak with my gringa accent, according to Sofia. It was very interesting watching the Colombian citizens (80% of the nation comes out to vote) fill out their paper ballots in cardboard partitions and place them into boxes.

Afterwards, we went to the house of the Dr. B's mother, who had prepared turkey and many desserts for an election day party, where we watched the results of the vote this evening.

Tomorrow is my first day of work with the Drs. B, we will be going to the Fundacion Cardiovascular that is close by to work in the clinics and grand rounds with the other surgeons.

xoxokr

IAH

Hello my friends and family,

I've decided to try my hand at this blog business instead of sporadic update emails in order to share the details of my travel experience with my peeps. I am about to embark on a five week visit to Bucaramanga, Colombia, where I will be working with vascular surgeon Dr. B, helping him with his research, working in the Colombian medical setting while improving my Spanish. I'll be staying with gracious hosts the B family in their home in Bucaramanga.

I'm currently sitting in IAH waiting for my flight to Bogota, I'll be sure and upload pics upon my arrival!

I hope you enjoy reading the chronicles of my trip, the trials and tribulations, the excitement, the happiness, the heartache, the adventure...

xokr