On our way to the Opera

While we were getting ready to head to the opera, my dad was approached by one of our fellow hostel mates.  He had been running up some concrete stairs in Odessa the previous nights and had slipped.  He cut his face badly in a few places, so he needed to have stitches.  After being turned away by one emergency doctor, he was finally seen and given the care he needed.  Our hostel friend wanted to get my dad's opinion on his injuries.  After examining him, my dad noticed that the stitches were way too tight so he decided to loosen them.  When stitches are too tight, they get engulfed by the surrounding skin and cause what is known as railroad tracks.  So, we went through my little black bag and got to work!  I sterilized a needle I had brought to sew clothing with a lighter and used the forceps I had brought.  

 My dad taught me that injuries swell, so stitches should be looser than expected to accommodate for such swelling.  He then showed me how to safely loosen stitches.  It was interesting to see him get to work in the most random of places.  Proving medicine does not have to be confined to a clinic! 

Forehead stitches

Loosening some more stitches

Only in Ukraine

After this impromptu post-surgical after care, we made our way to the opera.  We had purchased tickets to Tchaikovsky's Iolanta earlier that day, which was an adventure in and of itself.  The lady didn't speak any English, so when other tourists heard me speaking Russian they all crowded around me and asked me if I could help them.  I did all I could for them then we headed off to do more exploring around the city.  The opera was beautiful, but the opera house was stunning.  It was built by an architect from St. Petersburg in the neo-baroque (Vienna baroque) style in 1810.  It is guilded in gold, making it extra beautiful.

Admiring the opera house

Ready for the show

Beautiful mirror!

Papa

artistic shot

I am so glad I finally got to go to the opera in Odessa.  It was totally worth the $17 for two tickets!

Fire ants!

After returning from my Costa Rican tropical vacation, I was hit hard by some nasty virus.  I was coughing, sneezing, had mucus in my chest and had a head ache.  I missed out on a week of work, but still managed to made it to the first week of Microbiology.  I was sneezing ever 3 minutes, so I think that I got one of my classmates sick, because she got sick and did not show up to the next class.  I felt bad about that one.  I am feeling 100% recovered now, so I have been able to catch up with class, life and the tasks at hand.

As of last week, I booked my MD dad a flight to Ukraine and booked him a bed in the dorm room I am staying at!  I have a real live doctor coming to help me in Ukraine.  How cool is that?  I am thinking about all the amazing things we can do.  I have a feeling that microbiology will inspire me and teach me how to run tests that may come in handy out there.  Needless to say, I am excited that one of my key supporters in life will be coming with me.

Now, back to the medical photos you and I all love.  While we were on vacation, our apartment got infested by fire ants.  They swarmed my desk, occasionally made their way onto our couch and even found themselves in our shower.  Last week, I found a huge hole in our wall where they were coming in.  So, I decided to do my best to plug the hole up!  I frantically searched for the hot glue gun, because I thought that would be a good idea... but settled on blue putty that I use to hang photos.  I fought a losing battle as I sprayed them with water, circled them with chalk and saw them continue to pour out.  Without thinking, I started using my hands to plug the hole with the putty.  I managed to close the hole, but they got a few good retaliation strikes in.  The following photos are the aftermath.

5 minutes after

The next morning, I woke up at 4AM because my hand started throbbing.  I got up and grabbed and ice pack from the fridge, but my hand just kept getting more red and swollen.  I took a Benadryl at work that morning, even though I knew it would make me drowsy!  I was really starting to worry because it started oozing something fierce.  I used whatever I had lying around my apartment to treat myself.  I found old hydrocortisone cream that would help with the allergic reaction and itch, and I had a packet of antibiotic ointment that came in a first aid kit that Nat's mom gave us for Christmas.

18 hours

My hand got so swollen I had to take my engagement ring off, lest it get stuck there and need to be cut off.  Getting rings stuck on my hand is one of my top fears.  When I was doing my EMT clinical rotations, I watched the Emergency Department try unsuccessfully for 2.5 hours to get a titanium ring off a kid who had a smashed had.  The Fire Department had to come with bolt cutters the length of my arm to get that ring off.

48 hours

48 hours - post hydrocortisone

My dad wrote me a prescription to get some antibiotics, but by the time I was about to get it, the swelling was finally retreating.  I did not want to kill of my normal gut flora over this fire ant attack, so I waited it out.

72 hours

I am happy to report that a week later, beside a little round discolored scar on my pinkie, you can't even tell I got into a fire ant altercation.     

"It's just a flesh wound"

There are some perks to hanging around people who aren't studying exactly what you are studying.  In my case, whenever something goes medically wrong, or whenever something is bleeding, I get a call.  In my friend's case, when he split his finger open, he didn't have to go to the emergency room.

Last semester, I got a call at about 1PM on a Friday.  It went something like this:

Friend: "Hey, Erika... um... I cut my finger with a kitchen knife and I don't know if I should go to the ER."

Erika: "Oh no, how long has it been bleeding?"

Friend: "About half an hour..."

Erika: "I'll be right over."

I grabbed what was left of my EMT supplies and rushed over.  When I arrive, he explained that his room mate, also a law student, was too disturbed with the sight of blood to help him.  

Minor Finger Laceration

Upon examination, I realize that it was "just a flesh wound" and stitches would not be warranted.  I had learned at an early age when a cut or scrap was serious from my MD father.  I would often run to him crying when I had cut my toe running on asphalt.  He would look at it, give me a hug, and tell me it's just a flesh wound.  "Band-aids won't help," he'd explain, "We will just put some hydrogen peroxide and alcohol on it and it will heal up just fine."  I could see that the superficial skin layer, the epidermis, had been damaged, but the deeper layer of the dermis was not.  So, I told my friend it was just a flesh wound and gave him roughly the same treatment my dad would have given me.  I cleaned his injury with alcohol, hydrogen peroxide and some Neosporin.  Although, unlike my dad, I believe in the powers of band-aids, especially when flaps of skin are involved.  So, I tightly wrapped a band-aid around his finger to make sure the skin flap healed properly.  

This was early in my career as a personal on-call EMT, so unfortunately I didn't have the proper personal protective equipment (PPE) at the time.  I washed my hands thoroughly with soap and water both before and after treating the site.  Since then, I have increased my stock of medical supplies and am proud to say I now stash a box of gloves in my apartment.  Just in case my medical services are ever unexpectedly needed again!

Healed Finger

This is a picture taken months after the incident.  Glad to know he didn't have to waste his time at the emergency department over such a minor laceration. 

O time, thou must untangle this, not I...

“O time, thou must untangle this, not I...It is too hard a knot for me t’untie" 

(II.ii.38–39) Twelfth Night by William Shakespeare

I learned this quote in high school when my love affair with Billie Shakespeare began.  Although this quote has more to do with forlorn cross-dressing lovers than with anything I am currently experiencing, I still find comfort in its call for fate's intervention.  There are just too many questions lingering to really determine what will be happening with my academic future: will I apply this year, will I return to California or stay in Texas, will I have to take Organic Chemistry, will I need to spend more time working to accumulate clinical experience?  It all got too stressful to think about, so for now I am going to kick back and just let fate do some of the work.


Over the weekend, I paid a visit to my home state of California.  My main motivator was an open house held at Western University of Health Sciences.  I had been in contact with the university for some time now, and we eager to see the program and learn about all the school had to offer.  Their motto, "The disciple of learning, the art of caring," really embodies what I hope to get out of my experience as a future Physician Assistant.  I left the open house excited to write my personal statement and turn in my application!  


I also had the pleasure of attending an event held by The University of Southern California, where my father went to medical school.  Hearing the dean talk about the future of the Keck School of Medicine was awe-inspiring to say the least.  I would be honored to continue the family tradition and attend the Keck School of Medicine as a Physician Assistant, although, as an alumni from the University of California, at Berkeley I would be a Bear in wolf's clothing! 


With all that official business out of the way, I also got a chance to catch up with my best friends from high school, eat delicious Indian and Thai food that is just infinitely better than anything in Texas, and even go on hospital rounds with my dad!  Going into the family business is handy, especially when you want to gain real work experience.  Even though I felt like a little kid, stumbling in high heels, trying to keep up with my dad as he flew from room to room in the hospital and his clinic, I was able to get some great exposure to some interesting cases.


Our first visit was to a patient who had been suffering from pitting edema, a condition characterized by fluids exiting the capillaries and vessels which leads to swelling.  When we visited this patient, instead of seeing the swelling that persisted, the patient's legs were a dark purple/black color.  This was because the hematocrit in the blood had leaked out of the capillaries when the patient first started experiencing the edema.  When blood oxidizes, it turns a dark purple/black color.  My dad assured me that, although his patient's legs looked grave, he was in fact healing nicely.


While at the clinic, I got to palpate a rebounding and painful abdominal Right Upper Quadrant, indicative of an inflammation of the gallbladder; examine the smallest bone in the body, the stapes, while using an otoscope (instrument with a flashlight built into it that is used to look into ears, nose and throats); and even watch my dad remove a foreign body from an inverted eye lid!  All that in just one morning.  I can't wait until I can be at the clinic every day shadowing my dad and our PA.  For now, it's back to the books!  One more test in Anatomy and Biology.  Then, I get to take the dreaded standardized test for big kids, the GRE.