The Funny Current

is actually a current controlling heart rate.

Month: October, 2012

3 Days of Counting Cavities

We spent Monday through Wednesday doing dental clinic. It consisted of driving out to southern Tucson schools (Summit View, Vail, and Three Points), varnishing preschooler’s teeth with fluoride, and giving very basic education on brushing everyday. I have no idea if that’s what tired me out for the rest of the week because I slept for the majority of today and I still feel like I’m jetlagged.

There’s a real art to dealing with kids. At this age, they’re not very resistant but there are a few who are terrified of the dentist (or maybe just white coats) and had to be held and comforted the entire time. That’s also an important note, always have the parent or the daycare adult hold a fussy child. It makes your life easier and I read somewhere that it’s just a bad idea in general for a doctor/nurse/ etc to try and restrain a kid. After all, you’re a stranger and you’ll need both hands to do whatever it is you’re there to do.

Going inside of one of the schools really brought me back to my elementary days–All the little desks and classroom animals.

Bets and I counted how many treated or untreated cavities there were, and if there were white spots, then we wiped saliva off the teeth (if we could) and brushed on the fluoride which solidifies on contact with water.

We sold the varnishing by saying they got to have bubblegum. Yeah, adults are all big fat liars. Interestingly, a few said the fluoride burned them, and I wonder if there was a correlation between those who had cavities and felt the unpleasant sensation. Since I only had 1 who said that, I couldn’t draw a conclusion.

Thank goodness we have baby teeth because some of these kids had a lot of cavities. It made me self-conscious about my own dental health, there are just nights when I just say “forget it” and I go to sleep.

Depending on the number of reapplications a child undergoes, the varnishing can be quite helpful, preventing from 50-75% of cavities in a 12 month period. Betty and Lorenia also mentioned similar numbers.

Sources

Fluoride Varnish Efficacy in Preventing Early Childhood Caries

Effect of Neglect

Talk about sexism when it comes to only females being seen as providers of love to children. That topic aside, I don’t think is new information, but visuals make it more effective.

“A shocking comparison of brain scans from two three-year-old children reveals new evidence of the remarkable impact a mother’s love has on a child’s brain development.

The chilling images reveal that the left brain, which belongs to a normal 3-year-old, is significantly larger and contains fewer spots and dark “fuzzy” areas than the right brain, which belongs to that of a 3-year-old who has suffered extreme neglect…”

http://www.medicaldaily.com/articles/12936/20121029/chilling-brain-scans-show-impact-mothers-love.htm

 

Mission San Xavier del Bac

We had a long break today and Lorenia took us to see our promotora’s house and San Xavier del Bac mission.

It’s a surprisingly large and ornate church for such an isolated area.The white building in the desert makes it look like a pristine and inviting place. The craftsmanship of the statues inside is amazing. There are painted angels and saints along the walls, and even the ceilings are painted. An interesting thing the tour guide pointed out was that there are Tohono O’odham symbols of the man in the maze allowed and even printed on the fabrics used in the church. Apparently, those beliefs don’t interfere with Catholic ones and so they coexist together.

They had a celebration last weekend for the first canonization of a Native American. There’s a photo of her in the gallery, Kateri Tekakwitha. I’ve never seen (for lack of a better term) such pagan statues in a Catholic church before, it was nice to see because for the first time, I see Catholicism as a more accepting religion.

I bought frybread right before we left, and I kept my mortified face inside as I watched the man dump a disk of dough into a pan filled with a lake of oil, then take it out and plop it on a paper plate for me. But I pretty much promised myself I have to try everything. As all fried things do, it tasted good even though it had no toppings. Never again though, never again.

 

 

Zombies at the Door

Kristen, Yaun, and I watched Resident Evil today to get Yaun prepared to go to a haunted house this evening. A few hours later, the doorbell rings and I see 2 mummies and a hippie outside. I did a double take because I’m pretty sure Halloween is a few days away. I was torn between heading to the door and just sitting inside, they asked to be let in and I was thinking, “this is exactly what happens in the movies. Some stupid girl opens the door to a murderer because they ask nicely”.

The landlord actually did know them, so we we introduced, but it was a freaky moment.

Rocks and Ropes

I found an indoor rock climbing gym and Kristen and I learned how to belay each other on a rock face.

Thumbs up, fetus! and a grab bag of other Ob topics

Last Wednesday was Ob clinic day. So far, one lesson is ingrained in my head. I’m seeing these women every other week, I should just say anything to them (within reasonable limits of course). Because it’s about building rapport, and I’m in a great position to have a good relationship with them. It would make taking a history easier and my Spanish better, because they wouldn’t feel like I’m the intermittent stranger who’s stumbling over words and won’t get their story straight.

So fun highlight of the day, the doctor and resident were going through their chart review and they were curious about one patient and the position of her fetus. The notes said that she was a possible breech and when they looked in the ultrasound notes, they found that fetal position was notated as “Great”.

That made for some laughs.

They were thinking that there was a typo or error in dictation. Dictation, as I later found out, is just an audio recording of a radiologist’s findings. I can’t imagine anyone would just put down “great” with no questions, so maybe there’s a machine that automatically transcribes the audio. That was an obvious item for the list of things we had to check out today.

We also told one patient that she had a horseshoe kidney. She had no idea. You normally have two kidneys, in this case, they’re fused in a vague horseshoe shape, usually connected at the lower poles, but they function just fine.

from the Department of Pathology in the Virginia Commonwealth University

I learned that sexual intercourse is the #1 reason for preterm labor. Is it improper to laugh a little? It certainly gives some credence to the myth that having sex with a pregnant woman could poke the baby.

On a more serious note, we had someone else who had a “possible history of HSV (aka herpes)”. What a strange note. I thought we would send for titers even though on questioning, they didn’t recall anything related to an outbreak. But there’s also the problem of no/little insurance, and this isn’t a test included in the prenatal package. I was a little on the fence, maybe because I’m used to double-checking things and having insurance. But with no supporting history except for the mysterious note, it was thought best to just treat it as a mistake.

Afterwards, Lorenia, the MA, took me out to a carretera (the Mexican version of the Korean 포장마차) to eat some Sonoran hotdogs. It’s a food cart, sometimes with tarps, in a parking lot.

She thought it was hilarious that I said “I need to try Sonoran hotdogs” versus “those sound good”– some of my type A New Yorker tourist personality leaking through. I should have taken a picture of them, but I was so hungry I just swallowed them whole. They’re hotdogs loaded with all kinds of Mexican toppings like salsa, cheese, and jalapenos. I feel like an old man saying this, but the first one did a number on my stomach and as much as I wanted to put some more hot stuff on, I had to stop myself. Lorenia also got some horchata, which can be a variation of a rinsed rice or nut-water drink with cinnamon. It was pretty good, and a great spice-tamer. Next time, I’m going to order some of that.

Lorenia has actually been amazing to me. She’s given me rides to the clinic and back everyday without any kind of complaints, she’s really friendly, and is extremely organized. Things I can be in deficit of. She even paid for my lunch! I wanted to bring some baked goods to thank her. The 2 things stopping me are my catastrophic cinnamon failure and thinking about how this is going to support diabetes.

Mancala Redux

I got up early this morning to go to the supermarket so that I could do something this afternoon. Turns out I went in the completely opposite direction so I spent twice as long as I should have getting there and my hands were freeze-chapped because it’s freakishly cold in the mornings.

A long time ago when I was in elementary, my favorite game was Mancala. You use a wooden board with pockets carved out and drop glass beads as you move around the board. The board was much longer than my bag so I shoved in as much as I could and started walking to school. Along the way, I notice my mom’s not with me anymore. She’s like 30 feet behind of me, holding up the board which fell out and I never noticed. This story has been something my mom brings up every time I do something idiotic.

I basically had the same episode today. I had groceries piling out of my bookbag, I even had a bag of spinach strapped to the outside. So there were mushrooms and eggs at the very top with the zipper closed around them. People on the road must have been laughing their butts off as they saw me huffing on the bike lane with mushrooms and eggs flying out. My bag was half open by the time I noticed.

Agh….

Luckily, things fell out mostly towards the end, so I salvaged the broken eggs for breakfast. My pride? Another thing entirely.

U of A- Museum of Art

The university has their own little art museum. They had a few pieces of Georgia O’Keefe, Picasso, and Matisse…I wonder if students were tempted to pull a heist for them.

Serious Business

As promised, Dr. Hadley brought me to a meeting with a few residents who were creating a proposal to start a Coumadin clinic with Mobile Health.

Coumadin aka Warfarin is a blood thinner. Used in cases of certain arrythmias liek atrial fibrillation, and people at risk for altered blood dynamics causing often fatal conditions like deep vein thrombosis and pulmonary embolism. In short, it prevents blood clots. The major drawback is that it has to be closely monitored, people have to come in every couple weeks to make sure they’re getting a good dosage.

Let me just say that watching residents is like a breath of fresh air. There’s no sense of stress about them, they laugh a lot and seem to have fun. Medical students on the other hand are really uptight, competitive, and sometimes just evil. I’m blaming the Match for this discrepancy. Once people are set, I guess they’re just happy.

Things learned: Print out meeting outlines for everyone + 1 extra. Also, freely delegate tasks.

It seems like a really ambition project. About $10,000 to get all the equipment needed to check people’s INR and support a population with little to no insurance. I’m not sure how it will play out because so far, I don’ think I’ve seen anyone on coumadin come to the clinic, but there’s always a need, it’s just not always obvious.

I do love how I know what the IRB is and the basic guidelines for human research. It made me competent in that meeting. Thank you Downstate, for making me take that ridiculous online course on it.

Quisiera Tratar las Agujas?

Susan is a quirky lady. About 5 foot 2, she has close cropped greying hair and sported a robin’s egg blue medical coat. She had a warm and friendly demeanor, putting the patients at ease and inviting them to tell her all their problems, starting with their chief complaints and moving onto the daily stresses of life.

Aside from the usual nurse’s equipment, she also carried with her a box of needles and a sharps container. At the end of each visit, she offered “agujas” or “needles”, meaning acupuncture to each patient. People are rather perplexed, and I think she relishes the opportunity to give a great demonstration, smiling as she sticks herself with a needle right on the top of her head.

“Want to try?” she asks, and people mostly respond with a variant of why not.

One man with high blood pressure sat with a delighted grin and a needle poking out from his head. Manipulation of that point was supposed to help bring his blood pressure down.

“I don’t feel anything,” he said to us in Spanish.

The day continued with Susan offering to walk a mother and daughter through relaxation and breathing techniques. It’s common knowledge that stress affects you physically, but most people are fixated on only one aspect of the relationship, that stress makes you sick. This is a two-way street and we should really be advocating that de-stressing yourself can lead to better health.