Shilpa’s Blog

patients + Pondicherry :)

i knew i would be bad at this blogging thing….

back to where i left off…..protein  energy malnutrition (PEM) is so prevalent here. One of the many children i have seen was 15 months old and about a little over 5 kilograms. The baby couldn’t walk and  because of severe muscle wasting and was being carried by his mother who had no idea of the consequences of her child’s status. She was uneducated and living in poverty which compounded the situation… she had been breast feeding this child since birth… with no additional supplements/food. Breast milk for 15 months….

PEM in this child and many others is what inspired me to choose my presentation topic : Vitamin A Deficiency in children. It is the leading cause of blindness in children and is extremely prevalent in developing countries where resources may not be available (food and money), infection rate is high (i.e. measles and dysentery), maternal malnutrition is present, and there is lack of education. Vitamin A deficiency is seen in the same population as children suffering from PEM and if caught early can be treated and prevent irreversible eye changes.

My first week has been great. So many interesting cases :

The cutest baby boy ….about 8 weeks old whose parents died and the baby is adopted and was admitted for respiratory distress and through different tests we came to find a lot of cardiac issues are causing his breathing difficulties. An ECHO was done which showed a 1 chamber heart (1 ventricle), pulmonic stenosis, tricuspid valve atresia, osteum secundum, and other complicated malformations in his heart which basically meant that without a heart transplant this baby is going to die. Which, unfortunately is ultimately what is most likely going to happen….

Another case was of SLE in a young girl with a massive pleural effusion that drained 500 mL of fluid.  I have never seen SLE in a patient so young… 11 years old.

And I cant forget about DENGUE! Never that I would be so excited to see something I read about in a text book. Dengue is endemic to this area I am in and I have seen so many now! Most cases are admitted and treated symptomatically and with supportive care and the kids will recover spontaneously within a few days before ever progressing to hemorrhagic shock. But their bones do hurt and they have platelets as low as 16,000!

This past weekend a group of 9 of us went to Pondicherry! What great weekend advetnure! J  Pondi is a French city about 3.5 hrs from Vellore. Got to enjoy the beach and eat at lovely French places. Yum. Banana Chocolate Chip Pancake… french style…which is very completely different than American! Lots of cute shops and restaurants! It was even hotter than Vellore though!

Week 2 has started! Crazy how time has passes so quickly! Some days I miss home more than others and then other days I completely forget that I have another life outside of my temporary one here!

I have started running in the mornings here! Its so lovely  early around 6 am before it gets hot. The campus is a perfect setup for jogging!

I do miss black coffee though… although I have replaced it with fresh fruit juices…Papaya, watermelon, pineapple… mmm

a really long post… for a really long few days…

I just now got access to the internet! So some of the things I will blog about happened a day or 2 ago… but regardless I finally arrived in India! I arrived on Saturday at close to 1 am at the Bangalore airport, welcomed by my grandparents! … after sleeping for a few hours I was reminded that today was a big day for India…World Cup Cricket Finals in Mumbai (Bombay)! The match against Sri Lanka lasted for about 7 hours but finally around 10:30 pm India WON! Fireworks went off in the streets and you could hear everyone going crazy!

Sunday morning I left for Vellore (in Tamil Nadu) which was about 4 hours by car. Upon arriving here, I went to the Christian Medical College (CMC) campus in a place called ‘Bagayam.’ The hospital is about a 20 minute bus ride from Bagayam. I received the keys to my room at the Modale International Student Hostel and started unpacking!

 Bagayam Campus is huge and has multiple hostels for the medical students at CMC as well as international students. Many of the doctors who work at CMC hospital also reside here. The place is really beautiful and well maintained. Despite the heat, the landscape is nice in that there are many trees and greenery to create some shade. It’s quite a distance away from the main city and basically it is its own little abode. You would really never need to leave the campus for anything because there is a college canteen which is centrally located and is where the college bus picks up and drops off the students and doctors everyday; there is a mini-store which sells everything from corn flakes to laundry detergent and a tailor that sells ready-made clothes as well as material if one wanted to get an outfit stitched. It’s great! Lots of friendly faces and people walking, riding bikes, etc. throughout the day and evening!  

My roommate is Alicia who is from Bristol. She has a wicked English accent that I am particularly jealous of! She is studying medicine at Chafield (sp?) in the UK.  Alicia is extremely friendly and sweet and was kind enough to give me a mini-overview of what things are like and what to expect because she has already been here for 3 weeks!  

Monday was my first day – also the Indian New Year (Ugadi) – and by the end of it I was way too exhausted to blog, despite having internet access! Lol. I met with Miss Sheila to get my posting for the next 4 weeks: Child health, Neonatology, and CHAD (community health and development).

CMC Hospital is massive!! It’s a tertiary care center in India that was founded by Dr.Ida Sophia Scudder in 1900. In 1900 the life expectancy in India was 24 years old. Yea… I would have about 1.5 years left! Dr.Scudder’s mission began with women and children. She began “roadside clinics” that took medical services to villages in Vellore. She started training local women to help her as nurses and then opened  a medical school for women which opened in 1918. With the help of many devoted people and physicians the medical school continued to expand and by 1947 was a medical college for men and women students.  Now CMC has about 2,500 beds and rated as one of India’s finest institutions.

I read a lot about the history and background of CMC before arriving and knew it was regarded as one of the best places for care in India. Despite it being an old building that is non-air conditioned except for specific room with expensive machines, the care provided inside is unmatched. The hospital has many buildings that are all somehow connected via a walkway and some parts are open to the outside air. There were people literally everywhere….in the chapel, at the canteen, standing in line for a clinic, in line at the pharmacy, at the “casualty/emergency” department getting triaged, or lost like me and trying to find their way!

 Finally I made it to the Child Health Unit and joined the discussion on Protein Energy Malnutrition… which I will continue talking about tomorrow. The case was ridiculously interesting… and horribly sad…

At KCI…

I’ve never blogged before….So here it goes!

(I typed this a few days back but didnt get internet till now…)

After a crazy week prior to my departure…I can honestly say I am finally relaxed! Got everything on my checklist checked off and now can finally look forward to this month! JI wish I could say I packed lightly…. but that was definitely not the case….I arrived at KCI this morning with one bag to check in (the newer rule is one bag with a max of 50 lbs). The man took my bag and kindly reported to me that it was 59 lbs. Yea… my scale at home last night definitely said 49… oops! An oversized bag is an extra $200. To my surprise, he said his computer was showing that I could check in 2 bags for no extra charge… I was pretty confused considering since the time I booked the flight till now I have received millions of notifications for ONE BAG-50 lbs MAX! I voiced this to him, but he suggested I just go but a duffle bag and transfer a few items into it. So first purchase of this trip: blue duffle bag from KCI airport. On my first attempt, I purchased a bag with a broken zipper. Classic airport luggage. Then finally after exchanging it for a functional one, I returned to the check-in counter ready to transfer my items! I sensed some trouble…The man came up to me and said…”so when I went back and looked in the computer, you were right, only one bag can be checked in without additional costs…” There was no way I was paying $200! Call it good luck or God’s grace (I think it was a combo of both)…he then continued and said, “….but since I am the one who told you that you could check in 2 and suggested you buy a bag…I just waived the fee for you.” So when all was said and done, all 59 pounds of my things are officially checked in all the way to Bangalore! No extra charges!

Lessons learned:

 1) Get to the airport early… the people are nicer before all the other passengers get there!2) My scale at home has been lying to me all this time and telling me I am 10 pounds lighter than I actually am…. Damn!