Slept in until almost 7:30. Caught up on my blog (internet superstar here!) and finished reading the WHO guidelines on cervical cancer. Then went for a long walk. I walked quite a ways past beautiful beach homes and magnificent resorts. Especially the further east I walked. I would have kept going but a strong wind came up and the weather it looked to be blowing in was a bit ominous. Never ended up rolling in.
I took a swim off Peggy’s dock. It’s delightfully windy at the end of the dock, so I stayed out there and worked on my pap smear protocol, thinking of all the different questions I needed answered and different options for how to streamline the process. This was a good thing because when I got to the clinic, I caught Berta before she left and she showed me the log that she keeps of all citologias completed. It’s a handwritten notebook with lots of gaps in the info. And there’s no indication of whether the clinic received the report, contacted the patient, or gave the patient the original. And no way to tell (once the report leaves the building) whether the exam was positive or negative. All in all, it’s a mess and I’m going to fix it.
Seeing Berta’s book, however, it dawned on me to use a spreadsheet approach. Berta confirmed that she uses the computer during the visit anyway, to chart the procedure… so helloooo spreadsheet system! I borrowed her book and created a spreadsheet with all the necessary procedural and follow-up information. (I even made it pretty and colorful). I started to enter in the past entries from the book. It’s going to take a long while, but I think it will be good to have record of the women who received a pap smear, even if we don’t have the results anymore. Tomorrow, I will be going over the spreadsheet with Berta and figuring out what to do with the results stuffed in the drawer.
I worked with Dr. Molina again. I was quite tired today which was a detriment to my already minimal ability to follow along in a patient encounter. One interesting case was a women who had cervical cancer and was treated with chemo and radiation. The radiation damaged her nerves so bad she couldn’t walk and had to crawl. She’s been doing PT and is now walking with a single crutch. There were 2 OB patients, a man with hypertension, a woman with menopause concerns, a gringo with an eye infection, and a few others in there as well.
Oh before I forget, a quick note on mangos. If you recall, they’re the ones that smashed all over the back roads and are quite slippery. Well, I ate my first Honduran mango at the soccer watching party. They just handed me the whole thing and after watching a few others, I just bit in and started peeling the skin away with my teeth. It was so sweet and quite delicious.
I left the clinic with Lena, who is a wonderful help to us volunteers, and I walked back to the hostel to change. I then walked down by the beach to see what was going on and saw some people out on the dock. The guy volunteers were all preparing to go night snorkeling. It quickly grew dark and as they were preparing to head off, I was so jealous I didn’t have my gear. They were going on a clandestine fishing mission. I guess it was clandestine because you’re not supposed to fish at night in our area, but they all had cool little spears and were going to break up into groups so not to draw attention to themselves.
On the way back up the hill, I stopped at one of the little stores to purchase some eggs, tortillas and an avocado. As I walked back to my hostel, I thought what a yummy supper I was going to prepare. Darren and 3 other Irish folk (who arrived a couple days ago) were on the porch. One of them was cooking in the kitchen where I joined her. First, I cut a slice out of the avocado to realize it was horribly not ripe and it left a terrible taste in my mouth. I started to open a can only to realize it wasn’t beans I was trying to open, but a can of beets. So I went ahead and cracked the eggs, pulled out the shards of shell, whipped it up and poured it on the hot skillet that the Irish gal just finished soft boiling eggs in. I didn’t have any oil so I just poured the eggs on there. It’s a tiny little thing with no handle so you have to use a wet rag to touch it. I put the eggs on a tortilla and that was the meal. No seasoning or sauce or any accouterment. I then ate half the can of beets (which was a beast to open), a couple naked tortillas, and finished my bag of trail mix. I did my dishes and retired to my little room to touch base with the home front and hopefully hit the hay early.