Updates
It's been a while since I last posted...sorry about that.
I have collected a smattering of pictures since the last post, that will serve well as a brief visual update:)
Friday November 8:
After our morning rounds while preparing all the discharges for the day, this lovely green beetle came for a visit
Pharmacist Touch (left) and Dr. Chang Noi enjoying another delicious lunch prepared by Phi Pon.
Saturday November 9:
Jen evaluating little Jack, a little boy who just underwent multiple urologic procedures with the urology team from Singapore to repair hypospadias amongst other urethral anomalies that he has been struggling with since birth. He had a suprapubic catheter placed after the procedure to allow his urethra to heal. Here Jen is trying to figure out how to effectively secure the foley bag to this active little boy so that he can go home and it doesn't fall out--for me to deal with his acute urinary retention on his emergent return. I think we can came up with an effective solution (AND he was able to urinate out of his urethra before discharge), so fingers crossed I won't have to replace his suprapubic cath emergently...
Sunday November 10:
Skiddish cat that lives outside of the hospital...
Our favorite new VEGETARIAN restaurant that supports a local orphanage Baan Unruk. Chris and Chang Noi enjoyed their veggie burgers AND pizza! We have been trying to visit the bakery every weekend and have befriended one of the current volunteers, Laura. She is from Ireland and has been baking up some tasty treats, like homemade granola :) We always leave with far too many slices of cake than needed...
(check out their site!: https://www.baanunrak.org/)
That same night we had the privilege of meeting Dr. Sakda (around the 10 o'clock position), a local Thai physician who has dedicated his life to caring for the local people of this community. He is a general surgeon with a very busy practice on the Thai Burmese border about an hour from KRCH. Rohith connected us, along with his wife (bottom left) and a mutual friend (and previous KRCH translator) Ajjima (to the right of Sakda). Sriwilai, one of our amazing support people her in Huay Malai and Lit also joined (seen at the head of the table). We had an amazing dinner right on the water in Sangkhla Buri. The food (and beer!) didn't stop, and we could barely walk out of there... we look forward to our next visit with them and I'm really glad to have met Sakda as he will be a vital resource during Jen's absence.
Chris and Ying, who was instrumental in ordering the pizzas and having her boyfriend get us cake!
Tzadi (one of Dr. Jen's daughters) as a human pretzel.
newborn exam
HUGE flying insect pulled out of a woman's ear...
Some of our furry friends that live around the hospital. The dog is laying in front of the hospital, and in the background you can see the small "restaurant" where we all eat lunch.
Yesterday Jen's wife Liz brought us to a noodle restaurant in Sangkhla Buri that was delicious. We enjoyed a lovely meal with her and her twins, Tzadi and Dalet.
ATTENTION SMART FRIENDS:
The patient below is a ~60 year old male with this chronic rash x 7 years. He came in today with ongoing pruritus. This is in the setting of having run out of his antihistamines, methotrexate (which he takes chronically for this), and triamcinolone cream one week ago. The rash waxes and wanes, but never goes away. As you can see, it is located over the extensor surfaces of his forearms/wrists and anterior shins. He has had biopsies in the past that were negative or psoriasis and just suggested "chronic dermatitis". WHAT IS THIS?? I did a quick google search and found dermatitis herpetiformis, which is seen in celiac disease. I recommended that he cut out gluten for 2 weeks, continue the above meds, and we'll see what happens. Thoughts?? As you can imagine, this is not something I see often in the emergency department...
I have collected a smattering of pictures since the last post, that will serve well as a brief visual update:)
Friday November 8:
After our morning rounds while preparing all the discharges for the day, this lovely green beetle came for a visit
Saturday November 9:
Jen evaluating little Jack, a little boy who just underwent multiple urologic procedures with the urology team from Singapore to repair hypospadias amongst other urethral anomalies that he has been struggling with since birth. He had a suprapubic catheter placed after the procedure to allow his urethra to heal. Here Jen is trying to figure out how to effectively secure the foley bag to this active little boy so that he can go home and it doesn't fall out--for me to deal with his acute urinary retention on his emergent return. I think we can came up with an effective solution (AND he was able to urinate out of his urethra before discharge), so fingers crossed I won't have to replace his suprapubic cath emergently...
Sunday November 10:
Skiddish cat that lives outside of the hospital...
Our favorite new VEGETARIAN restaurant that supports a local orphanage Baan Unruk. Chris and Chang Noi enjoyed their veggie burgers AND pizza! We have been trying to visit the bakery every weekend and have befriended one of the current volunteers, Laura. She is from Ireland and has been baking up some tasty treats, like homemade granola :) We always leave with far too many slices of cake than needed...
(check out their site!: https://www.baanunrak.org/)
That same night we had the privilege of meeting Dr. Sakda (around the 10 o'clock position), a local Thai physician who has dedicated his life to caring for the local people of this community. He is a general surgeon with a very busy practice on the Thai Burmese border about an hour from KRCH. Rohith connected us, along with his wife (bottom left) and a mutual friend (and previous KRCH translator) Ajjima (to the right of Sakda). Sriwilai, one of our amazing support people her in Huay Malai and Lit also joined (seen at the head of the table). We had an amazing dinner right on the water in Sangkhla Buri. The food (and beer!) didn't stop, and we could barely walk out of there... we look forward to our next visit with them and I'm really glad to have met Sakda as he will be a vital resource during Jen's absence.
SIDE NOTE:
Oh yeah, I forgot to already mention, that on 11/14 Jen had to go back to Singapore for 2 months. He'll be back January 6...and until then it's me, Chang Noi, and young doctor Thew. And Thew just got back today, so really it's just been me and Chang Noi holding down the fort. And in an effort to stay positive and friends with everyone, I will not go into too many details, but let's just say that having Jen here is an entirely different situation from that which I am in currently. Jen can handle anything that comes through the door, whether it's an obstetrical emergency, surgical emergency, whatever. I can handle most things, but not having surgical experience, there are some things that I am simply not comfortable doing. And through January 6, we do not have access to those skills on an emergent basis. So yeah, it's nerve wracking....
November 12: Chris turned 28! Through the help of several friends here we were able to surprise him with a pizza party! The pizza was actually delicious, and the chocolate cake was too!
The days Chang Noi and I have been running things on our own...
newborn exam
HUGE flying insect pulled out of a woman's ear...Some of our furry friends that live around the hospital. The dog is laying in front of the hospital, and in the background you can see the small "restaurant" where we all eat lunch.
Yesterday Jen's wife Liz brought us to a noodle restaurant in Sangkhla Buri that was delicious. We enjoyed a lovely meal with her and her twins, Tzadi and Dalet.
The patient below is a ~60 year old male with this chronic rash x 7 years. He came in today with ongoing pruritus. This is in the setting of having run out of his antihistamines, methotrexate (which he takes chronically for this), and triamcinolone cream one week ago. The rash waxes and wanes, but never goes away. As you can see, it is located over the extensor surfaces of his forearms/wrists and anterior shins. He has had biopsies in the past that were negative or psoriasis and just suggested "chronic dermatitis". WHAT IS THIS?? I did a quick google search and found dermatitis herpetiformis, which is seen in celiac disease. I recommended that he cut out gluten for 2 weeks, continue the above meds, and we'll see what happens. Thoughts?? As you can imagine, this is not something I see often in the emergency department...
Comments
Post a Comment