An unexpected stay at the beach

I was recruited to go to our summer camp and was not sure what to expect.  I was told to bring a swimsuit, shorts and sunscreen – but for some reason I didn’t really realize I would be staying in a Soviet era sanitarium on a beach, somewhere in Ukraine.  I have very limited internet here, so I am not even sure where I actually am.  All I know is it is beautiful.  This definitely feels more like a vacation than volunteer work.  The children are all very sweet, though sometimes I wish they didn’t talk so fast!  They are really patient with me though, so I appreciate them even trying to converse with me.

The grounds

The grounds entrance from the beach

Today we went to the beach, which is literally across the street.  The sand, little swimming shrimp and jellyfish fascinated me.  When we first arrived to the beach, the children instantly ran up to the jellyfish and started picking them up.  I was alarmed by their actions, and told them that they are dangerous, but they just looked at me like I was crazy.  They told me they weren’t dangerous at all, as they held them up for me to see up close.  Maybe they were too small to be problematic.  Then we jumped into the water and splashed around.  One six-year old little girl immediately became my friend and her smile and laughter nearly brought tears to my eyes.  This is a very special vacation for all these children who the rest of the year living in poverty, children’s homes throughout Odessa, or worse.

Huge jellyfish!

My new best friend holding a jellyfish

Catching shrimp in the rocks

 I love being tan, yes, but there comes a point where enough is enough.  With my wedding around the corner, skin cancer on the rise, and just being too tan, I decided I would start trying to limit my exposure to the sun.  This proved very difficult because we go to the beach at least once a day, if not twice a day!  I think I went to the beach more this week than I have in a year, which is huge since for the summer, I lived in Orange County.  The kids would see me applying sunscreen and ask me what it was.  I would tell them it is sunscreen and they would look at me confused and ask why I would  want to put it on.  One Ukrainian woman stopped me on the stairs and asked me if I use sunscreen, so I showed her my little bottle I carry in my purse.  She said I had a beautiful color, and told me I was a very beautiful girl.  This was a huge surprise, since I was certain Ukrainians preferred fair skinned people, like their Russian counterparts.  I suppose when you have a fantastic beach on your border, unlike Russia, you value tanned skin as being a sign of leisure and vacationing!

The kids loved my dress, and were confused by my desire to stay out of the sun

We are having Ukrainian borsht for lunch today.  I will be helping in the kitchen, so I will take note of exactly how it is done. My attempts at home have been good, yet not authentic.  Well, time to hit those communal showers (which by the way only produce frigid water).   Don’t worry, I lock the door and make sure I am the only one in there! 

Update:

I later found out that if I use the shower to the left, it has hot water.  Sure it’s not a steady stream, and it gets super hot or cold for no reason, but it works great!

I also discovered that those shrimp people were catching were for eating.  I can’t imagine catching something by hand in a bottle, cooking it then eating it.  I am thinking about the time my sisters and I caught a bunch of crawfish in a local park in the river by our house.  They were alive, yet filled with worms… yuck…

While one of our girls cooked the borsht, I paid diligent attention and wrote down the recipe.  Goodness, it was delicious!!  I cannot wait to cook it when I get back.  It’s way better than anything I made while in the US.  Yummm!

Ukrainian Borsht

Summer Camp

I don't have much time, but I wanted to let you know that I am heading to The Way Home's summer camp.  Most of the kids are out there, so they need help.  I was told that the nurse out there broke her arm, so I packed my medical supplies!  Maybe I can give her a hand while I am there.  I am not sure how long I will be gone, but it may be up to a week.  Don't worry, Papa.  I will be back to pick you up from the aiport!

If the internet works out down there, I will be posting and checking email.  If not, I will just have a lot of updates when I get back!

Odessa Mama

I made it safe and sound, y’all!  In Munich, I found out my carry on roller bag was too big so they checked it for me, but luckily it actually made its way all the way to Ukraine.  Turns out those last two flights were super short.  Frankfurt to Munich was 30 minutes and Munich to Odessa was only 2 hours.  I even managed to sleep! 

It looks like Odessa has seen a lot of rain lately, because the shuttle bus we took from the plane to the airport almost flooded when it drove into a mini river.  I wasn’t really counting on rain, but it is really hot here!  They told me it has been about 86 F, but Texas still wins.

They told me not to take photos

I am got to my apartment with some cab negotiating – they wanted to charge me 20 Euros, which is close to 26 US dollars, but I managed to get a ride for 150 Ukrainian Hryvnia which is about $18.  I still that that is too expensive, but I had a lot of luggage and I didn’t really want to have to venture into the street to find a black cab.  My cab driver was a nice young man who spoke to me in Russian, which I appreciated.  I was so proud of the conversation we had!  I know it has been three years, but for the most part, I was able to keep up.

Street Kitties!

When I arrived to my hostel, I was happy to see some cute street kitties that will fend off the homesickness.  I was supposed to be staying in a room with 3 other people, but when I got here, it turns out I am in a room all to myself!  Any best of all, they said my dad is getting his own room too!  This is huge, because single rooms are always more expensive.  I will be here for 28 nights, so I am glad to have a place to call my own.  Last time I stayed in a room with 12 beds, and the lack of privacy gets annoying.

My new home

Apartment

I have already made a friend here, a young Bulgarian guy who lives in the hostel.  It is nice to have someone I can ask questions about where to find supplies in the city.  Tomorrow I am walking to the center where I will hopefully still be meeting someone from the NGO.  I wrote to him on Facebook, so wish me luck!

I suppose I should venture into the city in search of water and basic food supplies.  I only ate one real meal today – breakfast on my overnight flight.  I am starting to feel the hunger pains, but maybe I should just stick it out until tomorrow.  Get a jump start on this wedding diet that I keep slacking on.        

Show me your Frankfurt

Well, here I am - writing after a long hiatus.  So it turns out planning a wedding, applying to graduate school and planning this trip to Ukraine is a lot of work.  But now that I am on my way to Ukraine, I will have much more time to sit alone and type.  Friends, I will miss telling you these stories in person, but take this blog as a suitable replacement while I am away.

I am currently at the airport in Frankfurt, Germany.  This airport is interesting.  It resembles IKEA in its colors, décor and furniture.  I also think it's pretty cool that the airport has free coffee and other beverages I plan on raiding after I finish writing this post.  It is a little ridiculous I have to fly to Munich before heading to Odessa, but at least I have a little layover to wash my face, eat something and change into jeans.  I figured once I get off the plane in Odessa, I will be fresh meat for the taxi drivers so I need to do my best not to look like a complete foreigner who has been in transit for 20 hours.

Funny stories about getting through German customs:

First off, I had to send my stuff through the X-ray machine again.  After I walked through the metal detector, a nice German lady told me to walk into the little cubicle, take off my boots and take a seat.  She put my boots into the X-ray machine and returned.  She then told me to stand up and gave me a full on thorough pat down, no apologies given.  Not that I need any; I don’t mind getting patted down from time to time, but it was just funny to see the difference in airport protocols.  Pretty sure her conduct would have landed her a lawsuit in the US.

Next, my suitcase got flagged.  The German security agent asked me to open my luggage, and proceeded to riffle around. My stuff just kind of poured out, since I had to pack everything super tight, so he asked me to show him the metal object about this (hand gesture) long that was in my suitcase.  I figured he was interested in one of my medical instruments so we played a little game. 

Erika starts fishing through her little black bag...

Erika - “Is it, a TUNING FORK??” 

Security agent – ::shakes head::

Erika does so more fishing...

Erika – “Is it, an OTOLARYNGOSCOPE??”

Security agent - ::laughs and nods::

I was free to go.  I find pride in having made the German security agent laugh.  Also, I am so glad I did not pack a suitcase of donated needles.

Off to raid that beverage dispenser!

Ring-ectomy

Today was a fantastic day for me.  I got to do some serious hands on clinical work at work today and loved every minute of it!  It all started when I noticed something a little funny about one of my patient's fingers...

There I was, sitting at the nurse's station surveying the scene.  I was feeling a little uneasy about how my day was going to turn out, since earlier a patient had flipped out on me and yelled at me because I kindly asked him not to sit on our desk.  He said I was disrespecting me and asked me if I thought I was the president or his mom.  Clearly not, or he would have been speaking to me with a much better tone.  Anyways, at about 1PM one of our out patient's came up to me and asked me if he could have a cigarette.  It was then that I noticed something funny about his finger.  I asked him if I could take a look at it, but at first he adamantly refused.  He stating he was treating it with medicine, as he furiously doused his hands with hand sanitizer and rubbed it all over.  He finally relented, and what I saw shocked me.  His hand was so swollen that his ring was cutting off some circulation to his fingers.  This is not even the worse part!  His fleshy tissue was actually bulging out of the grooves in his ring, and cutting into the dermis at the both ends of the ring.

You may have heard the story about the patient I worked with while I was doing my clinical rotations at the emergency department.  Well, his hand got smashed in an accident, and his ring was also cutting of his circulation, but at a much faster rate.  We struggled for 3 hours trying to get it off, when finally someone took my advice and called in the big guns: the fire department.  They came with bolt cutters so large, they would make you cringe.

Luckily, this "ring-ectomy" was much easier.  I helped stabilize while my coworker used the bolt cutters I found in the back of our hand guy's truck.  I did wash them with hot soap and water, and flamed them before use in attempt to sterilize.  When working psych, I have learned that improvisation and creativity is key.

Removed ring

We had to cut the ring in about 4 different pieces so we could pull it off without hurting our patient's delicate skin.  He kept insisting it felt fine and that it didn't hurt.  He was sad to see his $3 ring get cut off, but he understood that it needed to be done.  He kept trying to take the ring off himself, but we had to tell him to let us do it ourselves.  It's a good thing he did not try to muscle it off since it would have definitely torn a piece of flesh off.

Next we cleaned the finger with an antiseptic towelette.  We debated how to further clean it, and decided iodine would be the best route to take.  I did not realize that hydrogen peroxide is now contraindicated unless you are trying to do some serious microbe or dirt removal from a wound. This is because it actually kills skin cells and causes the healing process to take longer.  Supposedly lots has changed since my days of getting scrapped knees as a kid.  We were also aware that alcohol would hurt  way too much.  So we settled with iodine.  Iodine is commonly used to antiseptically clean areas before surgery. According to my microbiology class, iodine will disrupt bacteria's protein synthesis and plasma membranes, thus preventing them from carrying out normal functions such as replication. 

After we cleaned up, we wrapped him up with a loose gauze.  We wanted to keep the pathogens and dirt out, but also allow the wound to breath and heal.  I explained to him the importance of keeping the site clean.  "Use warm water and soap when washing your hands, and avoid getting your hands dirty," was my initial advice.  I also had to look him straight in the eyes and tell him the importance of calling us or seeing a doctor if his finger started to change colors, smell, feel tingly or anything unusual.  Although, for a schizophrenic, reality is often unusual.  Many schizophrenics are disorganized and struggle with personal hygienic practices.  I am a little worried that he will not properly care for his wound, so I will ask his study coordinator to call him next week to follow up and ask him how it's healing.

post ring-ectomy ring piece

I am so proud of myself for noticing such a serious, yet small and easily overlooked, condition.  His finger definitely had already started to smell a little bit, but if he had gone a little longer, he could have gotten an even more serious infection.  He could have gotten infected by Clostridium perfringens, or Staphylococcus aureus causing him to get gangrene or necrotizing fasciitis respectively.  He could have lost his finger, or worse.  We also noticed a ring on his other hand was causing a similar swelling to take place so we cut it off before it also got infected and cut into his flesh.

It's times like this that I really wonder about the marketing of "unbreakable" rings.  Serious, why would you want a ring that couldn't be come off?  One last random note to make about rings - I learned in my EMT class, if you ever come across a burn victim, the first thing you do after your quick initial exam is to take all rings and jewelry off the patient.  Hands will literally swell around rings and will cause circulation to be cut off.    

Where'd you go?

I've been working as much as possible in order to rack up those clinical hours for PA school applications, and of course studying Microbiology.  Sometimes I go to work from 7-3PM, then head almost immediately to my class from 4-7:30PM, work for my parents online and go to bed exhausted.  I have been keeping up and excelling in my class, so all in all life is good.

Big news - a coworker at my psych clinic told me that her woman's groups wants to support my efforts in Ukraine!  I was very touched by her offer, so I have a renewed vigor to sort out the nitty gritty details.  I have about 5 large boxes full of needles, vacutainers, and blood draw tubes - still not sure what to do about getting them to Ukraine.  I did call a contact today who I believe used to work at the Ukrainian embassy, so maybe he can shed some light onto the situation.  I contacted a few local nonprofits to see if they would take the donation, if I cannot feasibly take them to Ukraine.  

I am also somewhat in contact with someone at The Way Home - we have been been communicating via Facebook in Russian.  I love how my computer has an easy way to switch to international keyboards!  I definitely have some brushing up to do.

I found out today that the physician assistant application portal will be available April 17th, so I am excited to get all my information into the system and apply this summer!

I am currently working an overnight shift at my psych clinic.  Besides driving home at 7AM in a daze and trying to fall asleep when the sun is up, it's not bad.  I mean, I have done a lot of homework, wedding research and plan on spending about an hour or so reading up on fun places to visit while in Hong Kong.  Oh yea, and I am going to Hong Kong this Thursday with my fiance to visit my sister, her husband, and one of my best friends from college.  I cannot wait for that!

Here are a few photos I have compiled over the past month.

Just a small example of what I have lying around my apartment

Gram-positive streptococcus bacteria found after preparing a slide with cultures from my mouth in Micro lab

Trash and Cash - a gift from one of my psych patients

Sand volley ball did not end well for this friend's toenail

It will probably just fall off and grow back.  Not much I could have done besides suggest cleaning it and applying a bandaid to protect it from infection

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.