Not Even Two Weeks, and I'm Sick

For the Medical Case Junkie:
CC: Vomiting, upset stomach, and fever Friday night

HPI: Patient is a __ year old Asian female who complained of vomiting, upset stomach, and fever.  Patient was exposed to more than a hundred sick children for the past three days in rural Sierra Leone for screening/treating malnourished children under five.  On her way back to Freetown (capital), she ate "meat on a stick" sandwich, which she had never had before.  But so did her coworker.  Later Friday, she cut up one of the slightly overripe 7 pineapples she bought for $2.50, and ate some while she cut them up.  Her coworker had only a few pieces.  She then had some late night oatmeal as her dinner.  She felt fine until later that night at around midnight, her stomach was bothering her.  She thought it might have been due to eating oatmeal too late at night or the unfamiliar damp smell of the bed sheets.  She woke up early Saturday morning and continued to vomit the contents of her stomach out, which included pineapple, oatmeal, and malaria medicine.  There was also slight abdominal cramping and diarrhea.  She slept for a 2 hours, and woke up with a slight fever of 99.5 degrees F and continued to have an upset stomach, but no vomiting.  She then slept for another 5 hours.  Her meals for Saturday consisted of Gatorade.  She does not have aching or headache.  In the past, aside from vomiting due to coughing too much, she has not vomited since she was a baby.  Symptoms subsided Saturday afternoon.

PMH: No surgeries or hospitalizations.  Shoulder hurts currently probably due to a strain.
Allergies: No medical allergies
Medications: Doxycycline for malaria, Peptobismol for vomiting, Ibuprofen for fever.

SH: Does not drink alcohol, smoke, or do recreational drugs.  Currently living in a beautiful house in Freetown Sierra Leone with coworkers, and some Ivory Coast people downstairs.  Medical student, but working with Project Peanut Butter until August 4th.  Used to exercise regularly, but right now, has not.  Tries to eat a balanced meal, but vegetables are relatively rare and the staple food is rice and sauce. 

FH: History of cardiovascular disease, high blood pressure, high cholesterol, and stroke (Ya...it sucks.)

PH: No abnormal findings.

Laka Beach! & When It Rains, It Pours!

Laka Beach:
Wow, you know it's been way too long since you've last been to a beach when you forget that waves can be pretty strong and you get completely knocked over and pulled under when trying to go swimming in the ocean. Yup, that's me. What do you expect, the clumsy gene is constitutively expressed. So everyone got a good laugh at it, and now whenever we see a stranger get knocked over/pulled under by a wave, the people I'm staying with call it "pulling a Yi." Perhaps a new discovery or surgical method, but THIS, this is NOT what I want named after me.

Pictured: Baracuda and Rice (yummmm) at Laka Beach post tidal beat-up


International Service at Mercy Ship (hospital on a ship that goes from port to port in Africa):
I remember sitting there and thinking, wow, this is just like a regular bible study in St. Louis where you sing songs and hear someone talk, yet I'm in a country thousands of miles away, surrounded by people I don't know who are from all over the world listening to this guy speaking in a funny accent. No, not in St. Louis anymore.

When it Rains, It Pours:
Holy cow, I've never seen so much rain in my life.  I knew it was rainy season, but I still couldn't believe it when the first storm came.  You remember that day when the tornado came to St. Louis and it rained like it was going to tear the building down? Well, every time it rains, that's what happens.  It's like the sky is a bucket of water and God accidentally tore out the whole bottom.  Sadly, it also means the roads become canyons.

Fooooooooooood!

6/5/10

Funny quote: “Car with lots of stuff on it, honking like crazy, and driving like a mad man – it means someone just got married” -MB

Had Hawaiian pizza yesterday - oh man was it expensive to get a pizza compared to local food here, but I felt bad because MB wanted pizza, and I didn’t want to say no. But maybe I made up that money by eating bread with eggs today – apparently it’s a common staple food here. I LOVE plantains!!! Perhaps that will become my staple .

The place I’m staying at is actually very nice! There’s electricity from 7-10 (or when we really need it), and there’s internet when we put in the little mobile modem. It’s so cool – almost like a little phone that has internet – whatever that’s called. But it’s super slow, so checking email takes forever.

Wow, it’s pretty cool to actually see the physical works of Dr. Manary and his Project Peanut Butter (PPB) pan out! Got to see the factory and the machine – can’t wait to see the clinics! Entering data is boring as usual, but it’s really cool to see the weights of the children increasing on those data cards! We also recently got an email from a physician working in another town saying that the UNICEF supply of Plumpy Nut failed to get to them, so they’re interested in getting it from PPB – kinda exciting that we’re needed!

Had oatmeal chocolate chip cookies today!!! Yes…it was from a bag from 2007, but it was delish!

Time Magazine Feature Amy Smith

Amy Smith was recently featured in Time Magazine among the world most influential innovators. Cool!! Read more: http://web.mit.edu/newsoffice/2010/time-smith.html

1st Day in Sierra Leone: Being Too Gullible and Taking Cold Showers

6/1/10: Pleasantly surprised with flight attendents' English accents.  I shoudl've lsitened extra well for Iris' sake.  Oddly enough, one of them kept on saying "Madame" and "excusez-moi" - I guess she was French.  I was almost going to reply with "de nada" when I realized that was totally not french.  Ack - getting languages mixed up and I don't even know that many.  Watched Temple Grandin - movie about autistic girl who got bachelors, masters, and doctorate - quite interesting. 

6/2/10:
I'm Too Gullible - what's new:
Off the plane and I get bombarded by people asking for help.  I refused everyone and decided to travel with some ppl I met on the flight.  They got delayed by lost baggage, and since I had to meet soemone, I decided to go on my own to find the water taxi.  But by then, everyone had left the building and I was left to the mercy of the vultures.  A guy just grabbed my bag and asked if I was going on a water taxi.  Though I knew ppl helped only to ask for money later, I saw he had a tag and thought he was an airport worker (somehow diff from other ppl there), so I let him help me get a ticket and call Mike.  Oops.  A Canadian from the flight tried to help me by saying he was with me, but I readily claimed I was on my own.  Oops again - thwarted the person's good intentions to help me.  SO I ended paying a little tip.  Anyhow, learned not to let epople help me - didn't learn from last time I came here, but I'll know from now on.  I'll think of it as a little donation.  "small small"  I guess what's important is I got picked up by Mike and I'm safely at the apartment - quite nice!

Cold Showers:
Yup, for the next 9 weeks - not sure if it's a good thing or a bad thing.

Where I'll be living:

/

As an aside, here's a little video about my last trip to SL: D-Lab Development

1st Year Done!

Officially 1/4 way done with med school!  And the next three years are supposed to be living hell.  Oh boy.  Oh well, can't think about that now!  Gotta enjoy my "freedom" while I can before I head off to Sierra Leone to work on Project Peanut Butter and malnutrition!

Sad News

My great aunt just passed away.  :(  God has given me a relatively grief-free life, so it's kind of a shock.  Granted she's had three strokes, completely bedridden, can't express herself, and wasn't expected to survive past 2009, it still brought about a couple of tear drops.  She and my grandmother took care of me from age 2 to 6, so she's essentially a grandmother to me.  I wish I had just spent more time with her, whether it meant singing, reading, or just talking to her.  I suppose there's always a time for people to move on with their lives - even if it means leaving it behind.  She never accepted Christ - so I really wonder what happens to her soul.  I suppose I'll be praying that she'll be in a better place now.

DeNovoMeter!

Teammate's status: CONGRATULATIONS team DeNovoMeter!!!! We won in the IDEAS competition ($3000)! Looking forward to building an affordable blood glucose monitoring device for diabetics in developing countries this coming year! Check us out at: http://beta-globalchallenge.mit.edu/teams/view/50

Avenue Q and Class Show

So who would've thought an innocuous musical featuring puppets could be so NOT innocuous and very much so raunchy and inappropriate for little children.  Little children't don't be fooled!  It may look like Sesame Street - but it's Sesame Street gone very, very, horribly wrong.  Here are some feature songs that might say what I'm saying...better:

• It Sucks to Be Me
• If You Were Gay
• Everyone's a Little Bit Racist
• The Internet is for Porn
• I'm Not Wearing Underwear Today
• You Can Be As Loud as the Hell You Want (When You're Makin' Love)
• My Girlfriend, Who Lives in Canada

And I will never look at teddy bears the same way again.  Sadness!  But overall, it was pretty funny.  

Short synopsis: Boy out of college finding his purpose in life.

Our Class Show was Baller
Totally showed the 2nd years!  (Class show is tradition where we make fun of all things related to med school).  Sample of our show: Real First Years of Genius

B-day Farmhouse

hahaha...made funny cake for friend's b-day to make fun of his farm-like ways:

The best part was we all went to fro-yo dressed up in farm clothing (yes....straw hats, rolled up jeans, plaid-shirts, boots, etc...)

Grounding?

Hahaha...friend's (SD) random status message:


Question: Did you ever get grounded as a kid? 
Answers: "no, my parents didn't know about grounding"; "no, my parents don't even know what grounded means"; "nope, I got beat"; "lol, it's called getting a beating. means no grounding"; "haha, I got smacked"; "my mom would just make me do chores" ... sighh 

Tornado!!!

OMG! Tornado!!!
http://www.kmox.com/NEW-VIDEO--Tornado-touches-down/6881801

My Friend Is Getting Married In...

Disney World!!!  (Epcot to be exact!)

Once Upon a Mattress

At the prime age of nine, YW had to make the most important decision of her life.  Although she already had a well-paid job as the baby boy mouse in the Nutcracker, she risked it all to be a pro-tennis player.  Like most decisions she make, it was the wrong one, and she has since then failed to win the U.S. Open.  Reminiscent of being a ballerina and her good old days in elementary school as the pink fairy in A Midsummer Night’s Dream, YW decided to take a break from chasing after fuzzy green balls and be a lady – a lady who screeches, spins in the wrong direction, and looks utterly confused...

...And that's how I landed the role of a random lady in Once Upon a Mattress.  Yup - rehearsal every Saturday since the beginning of the school year, and 4-5 hr practices the week before the shows - and i don't even have a speaking role! (I "sing" and "dance" in the chorus.)  Wow, now I have A LOT of appreciation for those in the arts.  Man, people are so talented!  Their voices that go so many notes higher than mine, and their priceless facial expressions!  It was definitely a lot of fun!  

Immunology Exam Fun (ya, i know, exam and fun in the same title O_o)

This was one of the exam questions (scroll down for funny responses):
7. If you could “redesign” one component of the immune system to make it more effective/efficient, which component would it be and why? (4 points)

The most common responses:
(1st number is # of students; 2nd is % of class)

improve IgE responses to eliminate allergy: 27, 22.0

make vdj recombination more efficient: 12, 9.8

simplify/alter complement: 12, 9.8

suppress autoimmunity somehow: 11, 8.9

improve response to HIV/viruses: 8, 6.5

speed up adaptive response: 5, 4.1

T cell selection/development: 5, 4.1

allow MHC to bind polysaccharides: 5, 4.1

be better able to clear immune complexes: 4, 3.3

change class switching: 4, 3.3

improve response to tumours: 4, 3.3

more redundancy in cytokine receptors: 3, 2.4

have a new type of T cell: 3, 2.4

enhance NK cells: 2, 1.6

remove barriers to immunopriv sites: 2, 1.6

no response! Loss of 4 points right there: 2, 1.6

_________________________________________________________
And some of my(TA's) favourite excerpts:

… What we need is better innate immunity based on better barriers - a more acidic mouth, maybe, or scales that mosquitoes and tsetse flies can't penetrate with their little teeth

… get rid of c2 and c4 for pete's sake!

… Ah, my world would be such a better place without my mast cells degranulating to dust, pollen,…

… And we all know that he who has the ATP makes the rules. I think that's a quote from Aladdin.

… Also harsher punishment for negative selection violators… and world peace.

… [in regards to complement] It would also make for happier medical students because they don't need to memorize as much

… Also, I would eliminate Factor H. Honestly, who invited that guy?

… Then, when [the NK cells] migrate to a site of inflammation, they'd be all like "ZOMG OM NOM" to more viral infected cells…"

… It wouldn't be easy, but sometimes the hardest thing and the right thing are the same.

… I would also give our CD8+ cells laser pistols and sunglasses [picture included, with a granzyme grenade]

… The thought of "design" and the immune system contradicts mountains of scientific evidence and vertebrate evolutionary history, but for four points I will "intelligently re-design" a component of a system that natural selection has been acting on for millions of years.