A year long re-cap: Lots of babies!

Hellllloooo good people!  

It's been FOREVER!  Like, a full year kind of forever!  I didn't even realize so much time went by.  I had so many good intentions to update my blog but LIFE was happening at lightening speed and before I knew it, it's the END of 2021!

So lets catch up quickly...

After Residency Graduation in June 2020, my husband and I moved to Omaha, Nebraska for me to start my Fam Med OB Fellowship at Creighton University.  Before Fellowship started I had to take the Family Med Board Exam that was postponed due to COVID-19.  So much for a break between Residency & Fellowship.  The Creighton program has a surgical focus that had a goal of preparing me to perform Cesarean sections as well as manage moderately complicated patients.  We had A LOT of complicated patients.  Let me tell you...clearly, I didn't know what I was getting myself into.  My VERY FIRST NIGHT ON CALL a patient came in coding (cardiac arrest with active CPR in progress).  In the grand scheme of things,  as unfortunate as that is, it's not unheard of working in a hospital.  However, I was on the OB floor--not the ER.  This quickly became my problem when I found out the patient was pregnant! YIKES!  I didn't even know where the Emergency Room was or how to get there.  It was the middle of the night and I was the lone Physician covering OB in house at the time.  Talk about being thrown into the fire! It was a very emotional experience but one that let me know this place was going to keep me on my toes for the next year.  And that's exactly what happened....

Two weeks later to the day, another pregnant patient was brought to the hospital in cardiac arrest with active CPR in progress and I was on duty then as well.  I again asked, what did I get myself into?  Aside from these 2 patients and their unborn babies, I've dealt with lots and lots of COVID positive moms to be as well as other obstetric emergencies--placental abruptions, cord prolapses, postpartum hemorrhages, and crashing heart tones leading to emergency cesareans to name a few.  To say I learned a lot this past year would be an understatement.  It was a great experience and one that I'm glad I was able to undertake.  The OB's and other Family Med Physicians I worked with have all been amazing teachers.  I am lucky to have them as mentors, colleagues and now friends.  

I never expected to end up in Nebraska but we have been pleasantly surprised with Omaha.  When I applied for this program I actually had to pull up a map to see exactly where I was going, hahahaha.  We are right in the middle of the USA!  The city is large enough to have what we want/need but small enough that the people are still friendly and the traffic isn't terrible.  Cost of living is reasonable and it feels like we're getting a good bang for our buck.  If you've never been to Omaha, you should check it out; it's a hidden gem.  It's a city that will quickly suck you in and before you know it, you're agreeing to stay for a while.   

Along with working some crazy long hours I also managed to grow and birth my own human! I'm still not sure how I was able to work 300+ hours per month and carry around a growing life and not lose my mind or skip a beat.  Our bodies are amazing and resilient.  We do what we must.  My son was born in August and I am so thrilled to be his mom!  I delivered more than 200 babies over the past year but I must say he's definitely my biggest accomplishment and my favorite💙.

After 4 years of Undergrad studies, 3 years of grad studies, 4 years of Medical School (which included living in 4 different countries with a total of 20!, yes 20 different housemates), 3 years of Residency and 1 year of Fellowship...I'm FINALLY ready to practice Medicine on my own! 

What an experience this has been.  It took a long time but the journey was amazing.  I met my husband, crossed paths with some great people, made lifelong friends, been adopted into a few families, gained some wonderful mentors, traveled the world and learned SO MUCH!  My path to Medicine has not been traditional in the least but it was perfect for me.

If the last couple years has taught us anything: it showed how short, fleeting and unpredictable life can be.  Time will pass no matter what--so GO, CHASE YOUR DREAMS!  Because they really can come true!

Some of my awesome colleagues this year...the ones who had my back and kept me sane :)

Happy Holidays from our family to yours!

Class of 2020 in the midst of a Pandemic!

Graduation day was June 26th 2020!  I can’t believe the time has gone by so quickly.  I really thought it would take forever but it’s actually gone by in the blink of an eye.

There have been some really awesome moments over the past 3 years.  I’ve made lifelong friends, learned to be a doctor and grew a lot as a person. I got married.  Traveled. Had new family join the fold.  And lived thru a pandemic!  I can’t say thru yet because it’s not over but lived during is probably more accurate.  And was a doctor during a pandemic was even more insane.  

March 11, 2020 was the day that the World Health Organization declared COVID-19 a pandemic and nothing has been the same since.  Universal masking, social distancing and obsessive hand washing is now top of mind for many around the world.  There are still some people not taking this seriously and flouting all health experts advice...but that’s a story for another day.  With the pandemic declaration life as we all knew it changed dramatically.  Schools and businesses closed.  Millions of people lost jobs and the unemployment system was overwhelmed and left many people high and dry.  Elder Care and Assisted Living facilities were shuddered to visitors. Toilet paper, paper towels, Lysol wipes and meat flew off the shelves at record speed.  Many items still aren’t regularly back in stock or the cost is higher than pre-pandemic prices.  Gas prices plummeted due to excess supply and limited demand.  The airline and travel industries came to a grinding halt.  Grocery store clerks, transportation workers and housekeeping staff were recognized for the hard work they do every day.  Also, everyone FINALLY realized how critical teachers were—when parents were forced to “home school” their children!! Hopefully there will be some changes in recognition and compensation for these hard workers in the future. 

It’s been a number of months since the pandemic was declared and people were urged to stay home and things are opening up again.  Life is definitely not the same.  There have been more than 22M infections, 170,000+ lives have been lost in the USA alone and the worldwide death toll is approaching 800,000. It’s a very dark time especially for the families who have been touched personally by this.  The USA response to the pandemic has been chaotic, disjointed and politically charged.  

In the midst of the pandemic, George Floyd was murdered by Minneapolis Police Officers.  He was suffocated by a knee on his back and neck, for nearly NINE MINUTES...while in handcuffs, on video, while other officers stood by.  For years, members of the minority community have been trying to make others aware of the injustices committed against them overtly, systemically, and in the form of macro & microaggressions in the USA.  These cries have fallen on deaf ears for decades but after the death of Mr. Floyd, viewed millions of times--Americans and people around the world have taken notice.  This murder could not be ignored. It was so callous and shook many people to the core.  How could something so heinous occur in the USA in 2020 and we not do something about it?  Enough is enough.

It's an election year and I really-really-really hope the American people come out on the right side of history.  For now, we are all staying strong and doing our best.  We will get through this with hopefully more compassion, appreciation, kindness and love for one another.  

                                Protests in the midst of a Pandemic

                     

                     

                    

The Class of 2020 has shown their resiliency through all that's going on. Elementary, Middle, High School, College, Technical and Professional/Terminal degree recipients have been innovative with how they chose to celebrate their success.  People have held caravan parades, Zoom/Skype/Facebook Live parties, individual family celebrations and size restricted gatherings.

As part of the Class of 2020, it's definitely been bittersweet.  While preparing to be a better doctor I was also working on being a better human.  I’ve built a new network of colleagues that I'll be able to call on as we move forward in our careers.  I added yet ANOTHER city to the list of places I've lived.  And was adopted into the families of my coworkers...I'll be looking forward to the next Family Reunion! 

As one chapter closes and a new one begins, here’s a little walk down memory lane with my co-residents. 

     This says it all...I don’t know how Bryan put up with all of us but he knows he’s  

                                        stuck with us forever!!!! 😂😂😂

                    

            

                

Time to celebrate!!

                  

        

                      

The "Don't Rush" Challenge gave people a bit of excitement and a reason to get dressed up (still at home) to highlight various occupations, organizations, friend groups, etc.  The Class of 2020 decided to join in on the fun!

                      Cheers to the All Saints Family Medicine Residency Class of 2020!

I’ll miss you guys!!!! Until next time...

Back to Nakaseke 10/2019

Confession: I can really be a slacker sometimes!  But when things really need to get done, I’m your girl.  I’ve been living life, finishing residency and trying to figure out my next moves in life.  This blog post has been written forever but somehow I never actually posted it.  

So today, I’m copying and pasting it for those that have kept up with my musings and for me when I want to go back and reminisce and reflect on times gone by....

November 2019:  

Being back in Nakaseke, Uganda was like I was just there although it’s been exactly 3 years. When I arrived, I was welcomed with open arms by Winnie, Ronald & “Driver” Salongo—Deo. We stopped in Kampala to see my girl Roona who didn’t remember me bc she was so young last time I was here...then on to the village. There have been so many positive changes & some things that were nice and familiar including some of the staff on campus (including Masereka who happened to stop by) and at the hospital.  They’ve not only built a hospital on the ACCESS campus but guest housing now includes hot showers, a microwave, and internet!!  

My first day at Nakaseke Hospital I assisted in a C-Section and hernia repair and then was given the scalpel to be the primary surgeon for a C-Section of a twin delivery. Pretty crazy and pretty awesome at the same time!!!

The first time I was in Uganda was Sept-Oct 2016 as a 4th year Medical Student. After living in St. Maarten, the UK and traveling the world since I was a child, I was no stranger to experiencing different cultures; in fact, I welcomed it. Visiting Uganda for 6 weeks during my Med School rotation was definitely an eye opening experience. I talked about it extensively and chronicled my experience during that time on my blog. Seeing how the people lived in both Kampala and Nakaseke was something I would never forget. Spending time with the staff at ACCESS and Nakaseke Hospital gave me a new appreciation for “working with what you have.”  This area is resource limited compared to the USA when it comes to healthcare spending allocation and per capita income. Many families in Nakaseke are surviving on less than $1 per day. These are families of 4-10+ people. The hospital is run mostly with government funding and they don’t have half of the bells and whistles compared to what many Westernized Countries are used to however they have the necessities and they make it work. 

The Physicians are extremely well trained and their clinical skills are outstanding. They have to be when the hospital doesn’t have the same diagnostic equipment or lab tests available that many who adopted Western medicine rely so heavily upon. Not only does the hospital not have expensive equipment like CT scanners or MRI, the entire country only has a few CT scanners. Even when the tests and technology are available, they are so cost prohibitive that the patients that need them most likely can’t afford them. And when I talk about cost, I’m talking about $10-100, for potentially life saving evaluations. So what do we do here? The physicians rely almost exclusively on their history taking, clinical exam & prevalence of diseases in the area to determine what illness  their patients are most likely suffering with and then they treat accordingly.  

As a Medical Student, our focus was tropical medicine and getting a broad overview of culture & medicine here in Uganda.  This second time around as a 3rd Year Family Medicine Resident interested in Women’s Health and Obstetrics, I elected to predominately focus on these two areas. 

ACCESS spearheaded a huge program targeting Family Planning in Nakaseke which has grown even bigger since my last visit.  Many families have a lot of children and women often have short inter-pregnancy intervals which isn’t as healthy for moms.  Having children in a short space of time can also put a big financial strain on families. Supporting a large family is the primary issue but a secondary issue is if a woman starts having children very young, she’s less likely to complete schooling or pursue higher education.  This further reduces a woman’s ability to be more self sufficient and contribute financially to the household.  

During my first week, a woman delivered her fourth or fifth child. This isn’t unusual in an of itself.  The day after the delivery, mom was not producing any milk which is a major problem for the baby since the primary means of infant nutrition is breast feeding. I didn’t see anyone using a bottle the entire time I was in Uganda. After discussing what the problem was and what should be done, the Medical Officer stated the reason she wasn’t lactating was because of inadequate nutrition in mom.  She hadn’t had anything to eat in 2 days. Her husband was responsible for providing food and drink as well as paying her hospital bill. Dad was there for a short period of time and left but never returned with food. The next day, he came again without food and in fact brought raw milk (which hadn’t yet been boiled to kill any bacteria)—mom definitely couldn’t drink this. This woman was at the mercy of her husband who smelled of alcohol and didn’t bring food for his wife who just delivered their latest child.  I had plenty of food prepared for me so I shared with the young mother.  She started producing milk and she was able to feed her new baby which no longer required IV fluids.  She was later discharged home and her baby was feeding well. 

I couldn’t imagine being in that situation with no one to help. Being a Physician isn’t always about knowing every disease process, medication or treatment option, it’s recognizing all of the abilities you have and choosing to use them for the good of humankind. 

Overall, my return trip to Uganda was wonderful.  Most days were spent in the hospital doing C-Sections and other surgeries with the Nakaseke Doctors.  Other time was spent involved with one of the many ACCESS Programs: at the clinic placing IUD’s, birth control implants, administering childhood vaccines, and seeing other ill patients with the Medical Officers; meeting with participants of the Dream Girls Program which provides vocational skills training (tailoring and hair dressing) to young girls who have left school due to various circumstances; spent time with the crew at ACCESS and one weekend we celebrated Dr. Robert’s son’s birthday at their home in Kampala.  There was even time to re-connect with Dr. Henry Sembatiya!  He taught me so much the first go around and had so much confidence in my abilities.  We had a great reunion at Cafe’ Java’s, one my & Kendal’s favorite places during our first visit.  The pizza there is reaaaally good.  

Quite a bit was squeezed into my 2.5 week trip and I’m very thankful that my Residency program supported my dream to continue to pursue Global Health experiences!  Note to my future employers: continuing these types of opportunities are paramount and will be near the top of my request list please & thank you 😁😁!!!

This is what the ACCESS campus looks like now!  That's the new hospital on the left and the clinic annex on the right.

New Women's Hospital

The Guest House is a wonderful addition since my last visit.  It's huge with plenty of space for multiple visitors at once with all the comforts of home.

Images from the OR

The NICU at Nakaseke Hospital.  If you look closely, you can see two babies  sharing the isolette. The fact that this equipment is available in the village gives more babies increased change of survival if they needed a little more support. 

Discussing birth control options with mothers and then placing LARC's (Long Acting Reversible Contraception).  Helping to increase the time period between pregnancies.  Options available at ACCESS are: Depo, Mirena IUD, Paraguard IUD and Implanon.

Mom's preparing to have their babies immunized

Dream Girls Project Sites: Tailor Shop & Hair Dressing Shop

Irene teaching me to make chapati...one of my favorite things to eat there.

Pilau rice and beef stew, with vegetables ( beans, peas and pumpkin).  I could eat this every day.

Friends...

                                            

Holding all these Shillings made me look wealthy, but the experiences gained and lifelong connections I've made is what actually make me rich!

ACCESS is making a huge impact in Nakaseke with a variety of health, education and social support programs.  If you are inclined to support any of the wonderful programs, here’s a link to their website to make a donation: ACCESS Uganda.  

Until next time...