Wednesday, May 29, 2013

El último día en Querétaro

Well, the time has come. Sadly, this will be my last post from Querétaro. To say that I've had an unforgettable, amazing, and fun time here would be an understatement. I truly loved every opportunity and experience that came my way over the last three weeks (yes, including the murder of the salamander and being eaten alive by mosquitos at night...because really, at least I'm in Mexico at all). If I had the chance to do it all over again, I'd snatch up the possibility in a hot second!  

In the morning, Jonathan was scheduled to meet with the Cultural Heritage class at Express Arte Caffe at 10:30am. Around 11:30am, the whole group was hoping to meet in one of the plazas that had giant "QUERÉTARO" letters on display and get a group picture around the letters. Afterward, the students were supposed to prepare a tour of the city to show Jonathan various places to which they've gone and learned about over the past few weeks. Following the tour, it was the Senior Seminar students' turn to meet with Jonathan for class discussion.  

Since Mary and I were not a part of the class meetings and therefore didn't have to be anywhere until 11:30am, we slept in and then went out to breakfast around 10am at the Breton bistro we went to with Barry the realtor. We both ordered our usual coffees (mocha for Mary, café latte with a hint of cinnamon for me) and Mary got an omelette while I enjoyed some quiche. While we ate, Mary worked on reviewing and accounting for the budget and I began re-reading the third book of The Hunger Games on my iPad. We were sitting right by the door with a cool breeze coming in as soothing music played softly overhead. It was SO relaxing to sit, sip, eat, and read in such a comfortable environment! By the time we had eaten our fill, it was about 11:30am so we headed to the plaza to meet the students and Jonathan. We ended up taking individual photos by each letter of the "Querétaro" sign (including Jonathan as the exclamation points!) and Jonathan is planning on using Photoshop to create a little montage of it all. The students and Jonathan then went on their way while Mary and I did some last minute browsing / shopping around downtown. She was so sweet and bought me and Husband some giant mugs to bring home - I'm very excited to use them for morning coffees in bed together this summer! We then went to the exchange place where I was able to "sell" my pesos for U.S. dollars and then we headed home. 

I started packing and started to get worried about bringing everything back home. On the way to Mexico, my suitcase clocked a nerve-wrackingly impressive 49.5 lbs - only a half of a pound away from being too heavy! I swore then and there that I would use up some of those liquids I had to haul (sunscreen, a full bottle of contact solution, shampoo, conditioner, etc.) and pare down on the weight. Unfortunately, while I've since used up nearly everything, I've also made some purchases and received gifts that may outweigh the difference. I think I'm going to have to stuff my backpack full of my pottery and hope for the best with the rest along with all my clothes and shoes in my suitcase. 

During my packing, I was hit with a huge wave of generalized weakness and dizziness. It reminded me of when I had mono back in 2008 during the spring semester of my sophomore year of college - it felt like a ton of bricks had hit me in the face and I couldn't move my body without it taking a physical toll on me. Luckily I had packed up most of my things so it was easy for me to stop and take a break. Mary suspected I was dehydrated and possibly experiencing a sugar crash at the same time, so I chugged a bottle of water and made myself some crackers and peanut butter in hopes of snapping me out of the fog. When I still didn't feel better 20 minutes or so later, she suggested I go upstairs and lie down, even if I couldn't fall asleep (since I told her I'm not a good day-sleeper / nap-taker). For the next two and a half hours or so, I lied in bed reading, only getting up at least 4-5 times to flush the water going through me out. I started to feel better, albeit still slightly dizzy and on the edge of developing a headache. 

It was good I was improving because Montse and Queta came over to our casa (with the children they babysit for, Cailen and Bastián) to say their final goodbyes. They came bearing presents, which was just too nice of them. Mary and I each received beautiful silver necklaces with unique stone pendants. Along with these necklaces, they also gave Jonathan, Mary and me each a bag filled with lots of sweets and candies unique to Querétaro. I was delighted to see more of the "Glorias" goat's milk caramel candy and am looking forward to the others that I didn't recognize. They stayed for just a bit since Montse had to work at 8pm but it was so good to see and talk to them one last time. As we were hugging, Queta told me that whenever I want to come back to Querétaro, I (and Husband!) always have a place to stay at their home - ella me dijo, "Mi casa es tu casa" (she said to me, "My house is your house"). Perhaps one day we can take her up on the offer :)

Jonathan, Mary, and I then headed downtown in search of a place to review and discuss how this May term went. Along the way, we of course had to stop at the panadería that she and I have been frequenting nearly daily to pick up our usual galletas (cookies). Jonathan had been teasing us about our daily stop, but really I had no shame! The woman who has rung us up every time was there tonight, so Mary and I explained this was our last visit and thanked her for helping us. She wished us a safe trip for tomorrow and bid us farewell for the last time. After picking up our sweets, at Mary's and my strong recommendation, we eventually decided to go to Di Vino to have dinner and this "meeting." It was cathartic and refreshing to hash out details and a review of our perceptions of this trip. Additionally, I was glad to be given the chance to voice my opinion and make suggestions for the next year. It was during this time that I could see just how much time and energy and thinking it takes to be a professor - Mary and Jonathan work SO hard to keep this trip running and I didn't even realize it until just tonight when we had this meeting. While I don't necessarily envy Mary's job right now because I see how much it requires of her, if I could have the opportunity to travel with students as a leader, I could see myself someday being a nurse educator. BUT that's a long long loooooong ways down the road...

After STUFFING ourselves yet again (Mary had a salad, Jonathan a chicken dish, and me spaghetti along with Mary and I splitting creme brûlée and Jonathan eating a chocolate lava cake on his own), we headed back to the house from downtown for the last time. I called Eduardo and arranged for him to pick up Jonathan in the morning and bring him to the airport since he's leaving on an earlier flight than us. He went to bed right after while Mary and I stayed up a while doing some more packing and getting the house ready to be left back in Gema's hands. Mary went to bed soon after but I decided I wanted to stay up and write this last blog post while in Mexico. Unfortunately, I don't think our internet is working so this post might not actually get posted until I've landed back in the U.S...

As for tomorrow's agenda, Jonathan will be flying out around 11am. Mary and I will be getting picked up by Hector from UAQ who will take us to UAQ to meet with the rest of the group. We will then pile on a bus that will take us about an hour away to the airport, from which we'll leave at about 1:30pm for Dallas / Ft. Worth, Texas. The flight will take about two and a half hours. Once in Texas, we must get through customs, but luckily we have a six hour layover so most likely we won't feel rushed. Our flight from Dallas back to our city in Michigan will take about another two and a half hours, making our landing time about 12:30am on Thursday "morning." Husband is planning on picking me up from the airport and I'm very much looking forward to being reunited with him! 

Here's to safe travels tomorrow :) 

Adiós, México!


Tuesday, May 28, 2013

Medicina tradicional y la cena final con las familias

Today was my last day with scheduled activities. I can't believe it was three weeks ago that all of us met back home for lunch and to buy gifts for our host families - time has really flown by! Since we didn't have to meet at the university until 10am, Mary and I took Jonathan to our trusty Express Arte Caffe for coffees and breakfast. I feel like I've been there nearly every other day to work on blog posts, eat lunch, have a coffee, etc. and the same server is there EVERY TIME so I really shouldn't have been surprised when he was there yet again this morning. I get kind of embarrassed each time I go there and he sees me - I've never been a regular at a coffee shop in my life and based on how I feel so silly here I don't think I will ever be one at home. Anyway, Mr. Usual waited on us, as usual, and, as usual, did a great job. Yikes, I just might have to go there tomorrow for one last café and bid him farewell...

We walked over to the university to meet all of our students, who were going to spend a few hours with Nanci learning about and making different traditional medicines. While the group got settled in a classroom for a lesson, Mary and I worked out and paid the transportation fees that we incurred during our time in Querétaro. At first it seemed like they were charging more than double what Mary paid last year so she had Antonio, the transportation director for the nursing school, confirm the amounts for each weekend trip. After a few phone calls, the total price was brought down to a more reasonable amount. Hector, one of the drivers, exchanged some dollars for pesos for us and drove us to the university cashier where we paid in full. We walked over to the little university store to browse for a bit and then went back to the nursing department and joined the group in the lab, where they were starting to make some of the medicines. I paired up with Ellie B. while Elli M. and Katie were together, Ryan and Heather paired up, and Hannah and Sarah became a team. We all started off by making some cough syrup out of eucalyptus, garlic, red onion, cinnamon, "bugambilia" flowers, rosemary, and a few other ingredients that I don't remember and soaked it all in water. We then strained the liquid out and added honey and sugar, bringing it to a boil for everything to dissolve together. Once it had cooled, we were each able to try a cup (the recommended amount for ingestion) and were all surprised by how sweet and tasty it was! Nanci gave us some empty bottles and we were also each able to fill them to bring home. 

Moving on, we made tinctures for weight loss, calming the nerves, and lowering blood pressure. This was different in that water was put in a giant glass jar and the ingredients were added until it was all filled up. The bottle was then shaken and placed on the counter to sit for 20 days. Once this time had passed, the liquid could be placed in eyedrop-like bottles and patients are instructed to add 20 drops to cold water and drink in the morning before eating. Additionally, we made "magic ointment" designed for treating burns, bruises, etc. We started by taking globs of vaseline, plopping it into a large pot, and making a water bath over the stove to melt it. Once it became liquid, plants and other ingredients were added to the pot. After mixing thoroughly, the pot was taken off the heat and set on the counter, where like the tinctures it would sit for 20 days. Unfortunately, since these all required sitting before bottling and we're leaving in a couple of days, we were unable to take what we created home. However, Nanci brought out bottles of these medicines that had been prepared earlier for us to take home and try. I'm looking forward to getting a cold and trying out my cough syrup and trying out the tincture before one of my exams, since I grabbed the one for calming nerves and let's face it - I need all the help I can get to control my anxiety before I take tests!

It was such a fun afternoon working in the lab and creating these medicines. It is crazy yet really cool to think that these nursing students take a class on creating traditional medicines for a whole year. Back home at our nursing school, we talk and write a research paper about complementary and alternative medicine (CAM) twice - once in pharmacology and a second time in special topics. Mostly we just discuss the basics of various CAMs to make ourselves aware of the practices. However, we do not learn about incorporating them into patient care, let alone take a lab course to actually create different CAM medications! It was so interesting to read about how each plant helps which part of the body and I'm really looking forward to trying them out once I need them :) 

A few of us walked downtown after we got done with the medicine class and I took them to the candy shop, a little chain called Dulces Bernal, where I bought the "Glorias" dulce de leche de cabra (goat's milk caramel) candy. After buying one to try and giving each of them a sample, several of the students promptly bought some to bring back home as gifts.  After that, I took Ryan to La Mariposa just down the street so he could experience one of the delicious malteadas (milkshakes). When he realized he didn't have enough money, though, I then took him to the bank downtown to get money from the ATM. We returned to La Mariposa and he ordered a malteada de vainilla, which he let me take a sip of and was SO satisfyingly tasty! We walked really far up and down the street in search of this wooden figurine shop where I wanted to buy Mary a present. She and I had run into it on one of our first days in Querétaro exploring the area and there was this cute little nurse wooden figure that she liked. I made a mental note to go back to it but forgot about it until today. It was siesta time (about 2:30pm), though, so a lot of the shops were closed and I couldn't find it. I decided to give up and just go home, shower, and get ready for the final dinner we had tonight at the restaurant El Fin de Siglo. 

I decided to leave early to try to search once again for the shop. It was after nearly an hour walking up and down several streets that I began to get frustrated with the lack of signage for Mexican shop names and their hours. Often stores close between 2-5pm for comida (lunch) and siesta time, closing and locking up doors and windows and not leaving any trace that they exist - no sign above the door, no store hours posted in the window...nada. I really did give up after walking down the same street for several blocks three separate times just to make sure I hadn't missed any clue where the store was located. Sadly, empty handed, I walked to the restaurant to meet up with Mary and Jonathan at 6:30pm to verify everything about the reservation was in order - which it was! Five tables of 8 seats in the large dining room, separate tables for the desserts and drinks, salads, and buffet of entrées...everything was all in order and it was only 6:35pm. 

Mary had a seating plan all figured out based on the number of family members students had reported would come to the dinner. However, she quickly had to throw that out as people arrived, starting around 7:10pm. As they trickled in, I took photos of each family and Mary moved around where everyone would sit. Some had reported fewer than the number that showed up while others said someone in their family couldn't come after all as soon as they walked in the door. I ended up sitting with Montse, Queta, Angel, Ruth, Mary, and Jonathan. Once everyone had arrived, Mary thanked everyone for coming and opened up with a word of prayer (in Spanish! she did a great job). Then the eating began - I was so hungry since I hadn't eaten much of anything since breakfast at Express Arte Caffe that morning it was GREAT the whole thing was a buffet. There was poblano cream soup, spaghetti alfredo, frijoles con arroz, pollo en mole, a huge variety of salads, and much more. I ate two helpings of food along with two pieces of a yummy and refreshing gelatina dessert. The group of students and I surprised Mary with a frame we'd (Ryan) bought and a picture that we'd (Elli M.) printed of us on the day we all took a tour of Hospital General and were wearing our white scrubs for the first time of the trip. The students also handed out gifts to their host students and Mary presented Nanci with a gift. I gave Montse and Nanci each a personal gift, Mary also gave Ruth and Angel personal gifts, and there was just a LOT of gift giving going on all around! Once everyone had finished eating, everyone went outside so we could get a group picture with EVERYONE in it. The poor hostess girl juggled about five or six different cameras and struggled to take a couple of photos on each while we moaned to get it over with. The families slowly trickled off, and before we knew it, Mary and I found ourselves in almost the same position as our first night - sitting inside the restaurant with Ruth and Angel (and Jonathan, this time), chatting about and reflecting on our time in Mexico. Like I said before, I can't believe three weeks have gone by already! It feels like just the other night we were sitting together in Las Monjas discussing our goals and objectives for the month... 

All in all, the whole trip has been absolutely amazing and I cannot believe I was so lucky to have been able to experience it. I'm so grateful I was given the chance to travel to Querétaro and learn about their culture, the health care system, and make lots of friends (both American and Mexican) along the way. It's hard to believe that tomorrow (today? It's already 12:30am!) is our last full day here and then we leave the next morning to head back home. I'm really glad I decided to blog about each day so I can look back on my time spent here. I will forever cherish the memories from these past three weeks! Tomorrow the students will be meeting with Jonathan for both a short class and lead him on a tour of city highlights. Mary and I, on the other hand, will be packing and tying up loose ends before we head off so we'll have to see how interesting (or not) my post is tomorrow (and if the wifi works in the casa!). 

Hasta mañana :) 

Sunday, May 26, 2013

The longest post EVER - el último viernes, sábado, y domingo

This blog post is coming a bit late due to a combination of spotty internet along with a busy schedule that doesn't leave too much time for writing. But I am determined to keep up with daily documentation! I've come this far so I have to keep up! Thus, this will also be the LONGEST post ever...just a fair warning!

Friday was our second day at Hospital General and our final day in the hospitals here. Mary actually went with Ryan to CRIQ (another physical therapy campus through the university) and Nanci couldn't stay with us for the day because she had to go to the Corregidora campus for other classwork so I was flying sola with the nursing students. Nanci stayed long enough to get the students situated on their floors and with their nurses and then she had to take off. At first, I wasn't sure what I was supposed to do - I've never been in the "clinical professor" role! I sat down and realized I didn't have my book with me to pass the time so I played some Fun Run on my phone (practice mode only since there wasn't any internet access) then headed to the emergency department to observe. I saw Marcos from the previous day but he was busy with documentation so I didn't bother him. I was shocked to see some of the same patients still there from Thursday, but I guess with a hospital at full capacity there isn't anywhere else to have those in critical condition stay. Mary later reported this even happens in the U.S., though, so perhaps my shock was unwarranted - goes to show how I need more clinical experience still. After spending some time circling the unit and scanning some charting (so amazing how I can just pick up any and every patient chart here), I made rounds on the floors to check on the students.

Heather and Sarah went off their unit for a break and I joined them. We sat outside eating our granola bars and talking about how their day has gone so far. When I told them I was able to observe in the emergency department for a while, they asked if they could just do a walk-through to see what it's like. When I agreed to take them there, I was NOT expecting a paparazzi / celebrity-like, response from the staff! We had only made it about halfway around the unit when we got pulled into the middle of the pathway by Marcos and another nurse asking to take our picture. There were patients all around us, just staring as they were lying in their beds, so I said okay while crossing my fingers it would only take a second. However, what followed was a steady stream of various nurses and doctors jumping in and handing people their phones or cameras to snap a shot with the gringa enfermeras (us). There we were, just standing in the middle of the emergency room with patients all around us, with staff taking 10 minutes to get at least 50 photos with us. While we were flattered, it was also somewhat embarrassing. After thanking us, one of the physicians told us the department chief wanted to meet us so we shook hands with him and explained what we were doing for our May term in Querétaro. I'm almost positive the reason we got so much attention was because Heather and Sarah are super cute blonde-haired, blue-eyed girls :)

I brought them back to the unit and made some more rounds with the other floors. Hannah and Ellie B. were sitting at the desk with their nurses and Elli M. and Katie had paired up together with one nurse to help care for a very critical patient. When I went back to Sarah and Heather, one of the nurses gave them supplies to do a curación (cleaning) for a recent double-amputee post-op patient on one of his incision site so I stayed to assist them. We ended up not only cleaning his surgical site but we also changed his dressing, gown, and bed linens. I loved being able to converse with the patient in Spanish (even though he was slightly sedated) and provide direct patient care. When we finished, the patient's son thanked us for helping his father, which felt so rewarding. After we washing our hands, it was time to leave so the group gathered back together and caught the UAQ van that took us back to campus.

That afternoon Elli M., Ryan, and Katie came back with Mary and me. While they only intended on staying long enough to change their clothes and head downtown, they ended up staying for lunch and then we all played Euchre for hours. They helped us plow through some of the dinner leftovers and once everyone was full, we sat down on the patio upstairs outside and Mary brought out the cards. I hadn't played Euchre since high school so I was more than just a little rusty (along with Ryan) and the others had to walk me through the rules and strategies. It took a few rounds but eventually I got back into the groove and partnered with Mary against Katie and Elli M. They won the first game but Mary and I beat them in the second one. We'll have to go for the best two out of three in the airport or something on our way home!

Bob and Maria are the people who own the house and apartment that Mary has rented and stayed in the past two years for this May term. However, they have since stopped doing long-term rentals for their properties because Maria was diagnosed with cancer and has been undergoing treatment. Due to the extensive work that goes into short-term rentals, they switched to long-term and were unable to have a place for us to rent this year. However, Mary has developed a close relationship with them over the years. They invited us over to their house (as they do for Mary each year) so Friday evening went over to their casa for drinks and appetizers. It was only a few minutes from downtown and our casa so we walked on over. Their home is gorgeous! When they let us inside we stepped into their large and open entryway that led straight into the courtyard, where there was a table set up with lots of food. Maria said Bob makes a mean margartita, and with that description how could I not accept one? (She was right, by the way.) We sat and chatted about our time in Mexico, how Bob and Maria have sold their home in West Virginia and settled in Querétaro completely, a little about myself, how Mary and her husband have been doing, etc. It was so peaceful to relax and sit around the table, casually talking while the sun began to set and with a wonderfully cool breeze. Maria gave me a tour of the house, which they had renovated and re-designed when they bought it years ago. It was absolutely beautiful with original stone walls (it used to be a convent), a very Mexican / Spanish-inspired kitchen with lots of colors and tiling, high ceilings, and just lots of open space. Mary and I had such a great time catching up with them and I'm so happy they invited me to come along with Mary for the visit.

Later that night I met up with some students and their host siblings in La Plaza de Armas. First we headed to a bar and had some beers to commemorate our last Friday night here in Mexico. Afterward, Elli M. and Sarah headed home for the night while Katie, Hannah, Ryan, his host brother Alex, and I went to La Mulata for some dancing. While we ladies were surprisingly let in for free, the boys were charged 120 pesos each! If we had known they'd have to pay so much we wouldn't have gone in, but they have separate entrances for males and females so we didn't even see each other and find out they paid so much until we were already inside. Unfortunately, the music for the night wasn't very interesting and there were tables spread across the dance floor with people sitting. We stayed until about 2am and were kind of disappointed with how the night turned out. We officially decided last week at Barra Habana where we went salsa dancing was the highlight of our time experiencing night life here in Querétaro.


Saturday was a very long but very fun day. We started off by meeting at the university at 8am and were happily greeted by a giant luxury bus. Mary had been fighting all week for us to get a larger bus for today since our trip would require lots of time in it (nearly four hours each way) so we didn't want to get stuck with the small minivans and economy vans we've been regularly getting here. Her advocacy definitely paid off and we all gladly settled in the big, comfy, plush seats in preparation for the ride. The Mexican students that came with our group included Sindy (with Heather), Alex (with Ryan), Eduardo (with Hannah and Katie), Mini (with Elli M.), Esme and her family - husband Hugo, daughters Pili and Carol (with Sarah and Ellie B.), Nanci, and Nanci's friend Sandy. It was a big group!  In preparation for the long, winding drive through the mountains, I took TWO Dramamine tabs as prophylaxis for my motion sickness before we drove off.

Our first stop was about two and a half hours away, into the Sierra Gorda to see las grutas de Los Herrera (the Herrera caves). There was a huge parking lot with a small cafetería that held baños (at a cost of 5 pesos to use...) as well as a bunch of swings and little huts with grills for picnics along the hillside. On the other side of a metal bridge that crossed over the entrance into the caves, there was also a small playground. Mary bought the tickets and everyone enjoyed the (cold!) hour-long tour through the caves, where we walked through 7 different "rooms" and our tour guide pointed out fun figures that the rocks have formed that give each room a different name. Despite people all around me talking, I loved listening to the quiet of being underground - it was very peaceful. After we finished our tour and took a serious amount of group photos, we hung around the area a bit and played on swings, walked around the hillside, and just enjoyed being outside and looking around at all the surrounding mountains.The weather was wonderfully cool with clouds blocking the scorching sun and a constant breeze that even prompted me to keep my long-sleeve zipup jacket on. Such a difference from the city where I'm always sweating! I was very content with the change :)

We drove a few minutes down the road to the extremely hilly town of San Joaquín for lunch. Mary intended on having us eat at a restaurant they went to last year called El Burrito but it was closed when we arrived and we couldn't figure out when (or if) it would open later that day. We walked back down and up some hills in search of a restaurant to have lunch, which turned out to be way more of a challenge than we anticipated, considering everywhere we looked either only served breakfast (no thanks) or wasn't open at all. Finally, some of the students went on a search and discovered a great restaurant called El Torito that had well-priced food. I'd been craving some good old American food lately so I ordered a hamburger and French fries and was SOOOO glad I did because it was DELICIOUS (and cheap at only 30 pesos = approximately $3 USD). I wasn't even the least bit ashamed to eat the whole thing!

It was a good thing we ate to our fill because our next destination required lots of energy for hiking. We had been planning on going to see some nearby waterfalls called Cascadas Maravillas about a half hour's drive away. However, we ran into a bit of a problem when we found out our large and luxurious bus wouldn't be able to make it through the winding roads to the town we needed to go to. After Nanci did some talking to locals, Mary decided to have us take two pickup trucks to the town - with us riding in the back! It wasn't like we were just sitting in the back cross-legged and hanging on for dear life, though. The trucks were obviously meant to hold people since they had benches on each side and railings to hold onto during the ride. I think this made us all feel a little better and more confident jumping in the back...a little. The ride to the town turned out to be awesome, though! It was actually COLD for us to ride in back (again, a nice and welcome change in my opinion) and we were able to see the most gorgeous views of the mountains and clouds. I didn't feel unsafe at any point of the ride :)

We ran into another small hitch when we got to the town, though. There was a rope strung across the street and people at a hut demanding money for entrance. We hadn't been told about this so we were all a little wary and thought back to when some random person charged us 3 pesos each at Bernal to use the bathroom - I had later gone back and nobody tried to get me to pay, pretty much confirming our suspicion that the bathroom was actually public for anyone's free use. Anyway, Mary paid for everyone nonetheless and we actually received very official looking tickets so this was probably a different situation. Probably. The drivers made a stop at the top of a hill which turned out to be the beginning of a very long 2-km walk down to the falls. Luckily the clouds kept things cool, but my quads were screaming after 20 minutes of constant contraction as I walked downhill. The signs said it would only take a half hour, and I didn't time it, but I'm almost positive it took longer (45 minutes? An hour?) than that to make it to the waterfalls. Once we reached them, though, it was well worth it - it was so pretty! The water was crystal clear and Hugo and Esme said it was super clean because it came from so far up the mountain. Some people walked down further where there was a manmade pool with filled with water from the falls and jumped in (I didn't join them). They said that while it was freezing cold, it was also very refreshing and clean. We spent a good chunk of time enjoying the falls, dipping our toes or fingers in the water, and taking photos in effort to capture the beautiful scenery. The walk back up was PAINFUL (more so than the walk down) and I'm just grateful my calves didn't cramp up at any time during the hour-long trek back up to the top. Heather, Ellie B., Hannah and I had left a little before the others because we knew it'd be quite the hike and wanted to take it slowly with plenty of breaks along the way. The clouds kept us nicely covered and shaded even though we were dripping sweat anyway. I can't imagine what it would be like to try to hike down and up underneath a scorching sun! I'm so glad we didn't have to find out. We made it up before the rest of the group with little Pili, Eduardo, and Nanci quickly following. As the rest of the group trekked up the last upward stretch of hill, Pili began shouting the encouraging words, "Sí, se puede!" which means "Yes, you can!" It was so cute and I think everyone brightened up a little with that!

After everyone made it back up (some of the Mexicans even did so in their jeans, sweaters, and layers of clothing = impressive) and our legs were officially shaking and / or like Jello, we piled back in the pickups for the ride back. It was a good thing we were in the back of those trucks because we all needed to cool off AND air out (we all completely sweated through our clothes) before getting back on the bus for the three-hour drive back to Querétaro. I'm almost certain everyone fell asleep at once and stayed that way for the remainder of the ride (I know I did). My legs were so stiff after sitting and lying in the same position sleeping for three hours that I'm really surprised I made it off the bus at all.

Mary and I walked back to our house and concluded that we were both starving since we hadn't eaten since our lunch in San Joaquín, before we had burned off all our lunch calories and then some hiking to and from the waterfalls. Without even bothering to shower or change clothes (at least for me, since Mary ended up putting on a different shirt), we walked downtown to a nice Italian restaurant called Di Vino that she had gone to last year and raved about. We each ordered a well-deserved glass of wine, a pasta entreé (gnocchi for me and ravioli for Mary), and crème brûlée with fresh fruit. It was hands down the BEST meal I've had thus far, though this could be somewhat skewed since I was famished from our long day of travel and the strenuous hike from earlier that day... We walked home completely stuffed (we joked about having to be "rolled outta the restaurant" from ingesting so much food), each took showers, and then crashed into our beds for the night.

All in all, well-enjoyed day :)


Today (Sunday) was a VERY welcomed day of sleeping, after our busy and energy-filled Saturday. I didn't wake up once during the night and slept until 9:30am - a full nine and a half hours of solid sleep! Montse and I had made plans to go to San Vicente, a nearby town about 30 minutes away that specialized in leather goods, to do some shopping. She had said she'd pick me up around 11am but called me in the morning to switch it to 1:30p. I later found out that she switched the time because she went out to breakfast with her boyfriend, another nurse, when he got off work :) Mary originally wasn't planning on going with us, but when the time switched, she (and Jonathon, the other professor from school, who flew in just this morning) decided to come along. Montse picked us all up and we drove to her house, where we met up with her sister, Abby, and Abby's boyfriend, Alan. We then piled into Alan's car (Montse, Mary, Jonathon and I squished in the back) and made the drive to San Joaquín. We stayed for a couple of hours, browsing the shops filled to the brim with purses, boots, jackets, wallets, and other items made from leather. Mary bought a pair of soft leather gloves for only 12 pesos but eventually decided against some of the beautiful jackets she tried on. I found a bag that I liked but couldn't justify the price (or suitcase space!) so I left empty handed. Jonathon, Mary, and I did try some homemade ice cream from a street cart with the flavor piñón (pine nut), which sounds kind of gross but was actually REALLY good. Montse enjoyed an elote with chili powder and cheese on it, which I tried and found tasty.

Alan dropped Jonathon, Mary, and me off in the downtown area so we could confirm our reservation for our final group dinner tomorrow at the Fin de Siglo restaurant. We then went across the street and I bought a bag of Mexican "Gloria" caramel candies to that I'd tried at Bob and Maria's to bring home. Afterward, we decided to eat dinner at the American time of 6pm and went to San Miguelito (the third time going there for me...). We walked around after we finished eating in search of a Día de Los Muertos figurine for Mary but to no avail. We also were disappointed on our walk back home when we wanted to take Jonathon to our favorite panadería for some daily galletas (cookies) and found it closed for the day :(

The rest of the evening was spent writing this WHOLE blog post on the patio, doing some laundry, and basically taking things nice and easy on this relaxed, last Sunday here in Mexico. Tomorrow Nanci is going to teach us how to make traditional Mexican medicines during the morning / afternoon and then we are having our final dinner with the students and their host families along with Bob and Maria, Montse and Keta, and Ruth and Angel. I can't believe we are really in our last days - it feels like we JUST got here! While I'm sad to leave and am going to have a difficult time saying goodbye in a few days, I must say that I am looking forward to going back home to Husband and enjoying a beautiful Michigan summer filled with beach days, settling in our new rental home, running, catching up with friends, and starting up my job doing nursing research at school. Let's just hope summer doesn't go by too fast!

Thanks for staying with me during that doozy of a post. I'm hoping my next one won't include a summary of more than one day and be so extensive!

Hasta luego :)

Friday, May 24, 2013

Hospital General y una salamandra en la casa

Spotty internet - hence this post is from yesterday (Thursday):

Today we headed to Hospital General bright and early in the morning. Mary decided we needed the exercise from the 20-30 minute walk so we made the trek over from the university to the hospital by foot instead of our usual van ride. At one point we had to use a bridge to cross over the busy highway. According to everyone else, the bridge wasn't that high up. To me, on the other hand, thanks to my fear of heights, it felt like I was a mile off the ground. I gripped Hannah's hand the whole time and tried to focus on looking up instead of down. Everyone else was taking their time snapping pictures of the view and I just sped along. Luckily Hannah (who is also my motion sickness buddy) just charged ahead with me. 

The group split up in pairs among three different floors - post-op, internal medicine, and intensive care. I honestly can't remember who was where but the pairs were Heather and Sarah, Elli M. and Katie, and Hannah and Ellie B and each were subsequently paired with a nurse on the floor. Once we got the them settled, Mary, Nanci and I headed down to the Urgencias unit. Mary was especially curious to observe this area because she is an emergency nurse back home in the U.S. and has been for over 30 years. Nanci also said that she is interested in possibly pursuing a job in emergency nursing so she was eager to see this unit as well. 

When we first arrived, there were already some beds lined up against the wall since the rooms were all occupied. The heat and mixture of odors was present but not completely overpowering, though it still made me feel a little dizzy - I made sure to drink plenty of water. We met one nurse in particular, Marcos, who spoke English because he lived in Georgia for a few years. He let us follow him around for a while and we were able to visit with a patient who had suffered complications from a brain surgery that left him handicapped. It was so sad to hear the story of how the surgeon had made a mistake that resulted in brain damage and subsequent neurological problems. When I asked Nanci if legal cases were often filed in Mexico and she said that although they are, it is always a long process that takes a lot of time and effort and energy to work out. From what I have gathered, it appears that there is not the same sense of "entitlement" and frequent blaming of health care workers for deaths or medical complications like there is in the U.S. When we were in the clinics, Nanci had explained to me that Mexicans more or less accept these things as being inevitable given the situation and there wasn't anything that could be done by the health care team to prevent them from happening. When we later returned after taking a break, the floor was even busier and people were seated in chairs along the wall waiting for beds with their IVs already started. I was allowed to start an IV on an elderly patient and he had such a good vein that I got flashback right away! The nurse stepped in to collect blood samples and then I helped her hook up and start the normal saline solution. After all this great practice with IV starts, I'm hoping that I will feel very confident in completing this skill on patients once I get back to the U.S. and start my Adult clinical and internship in the fall. 

We then went to check on the pairs on each floor and spent some time in patient rooms with them. At one point, we were on the intensive care unit and were able to visit with the family of a burn patient. He had suffered third degree burns after an electrical accident at work. Mary, Nanci, Elli M., and I were given disposable gowns (which we later found out we were supposed to share and use to go in the room in pairs rather than all four at once...the nurse manager was not happy with us for using them all at once...) and masks to wear. When we entered the room, I was immediately hit with the smell of burned flesh. This paired with the fact that the room was at least 10 degrees hotter than the already-warm floor hallway and the fact I was feeling funny in the emergency unit made my head spin a little. I tried my best to listen to the conversation Nanci was having with the family member but I was just trying to concentrate on not locking my knees and keeping my breathing even. Mary explained the differences between the treatments in the U.S. compared to Mexico for burn patients. For example, the patient's skin was open to air whereas in the U.S. there is a certain covering they use to put over the body. Subsequently, the open air dries the skin and they use heparinized solution (a blood thinner) to break up the dried blood for debridement and cleaning. The covering used in the U.S. contains a solution that keeps the blood from drying. Later, once we had thanked the patient's family for taking the time to talk with us, Nanci said that there was a great need for nurses to work in the burn hospitals (which is where this patient was being transferred later). Apparently there is a shortage because hardly anyone wants to work in these facilities. Nanci said that because of this need, she would be willing to work in one of these hospitals to do her part in helping these people. It was inspiring to hear about her great desire to help others, especially those who are underserved. 

After checking on all the floors, the three of us (Mary, Nanci, and I) wandered into the peritoneal dialysis area and were surprised to find a young teenage patient who appeared to belong in the intensive care unit with dozens of medications and tubes. As we were looking over the patient's chart to review the reason for hospitalization, diagnosis, and symptoms, I could hear and see a family member carefully and gently providing care. He had brushed her hair so it was shiny and laid flat on the pillow and was singing softly as he massaged her feet and calves. When we walked in to talk to him about exactly what happened, I could clearly see the pained look in his eyes while he explained how his daughter had gotten there yet also the tenderness he showed as he rubbed her feet and held her hand. I don't know what came over me but I suddenly felt tears sting my eyes and threaten to cascade down my cheeks. I excused myself from the room and let them fall down my face. I couldn't believe this young patient's grave prognosis and my heart broke for her father who so obviously adored her. I hope and pray for them and the rest of their family as they work through this difficult time, that God watches over them and brings them comfort. 

Hospital General was definitely busier than the other clinics and hospitals we've visited thus far. Not only were people lined up in the emergency unit, but rooms on the floors often held 2-4 patients, and all the rooms were at full capacity. It amazes me that on average, the nurses who work on the general floors have at least six patients each and those in the intensive care unit have at least three critical patients at a time. It is for this reason that often family members are very involved in patient care, providing baths, helping with feeding, assisting in the bathroom, and changing clothes. Without the assistance of unit techs, I am sure the nurses are grateful to have the help of willing family members. 

When we got back to the university in the afternoon, Mary and I headed home to eat before going downtown to run some errands. We exchanged dollars for pesos, retrieved some money from the ATM (with a bank withdrawal fee of $69.50 pesos! eek), and were sorely disappointed when we found out from the department store that they didn't carry small fans, or any fans less than $299 pesos (about $25 USD) for that matter. It's been so hot and mosquito-y in our rooms that we were really looking forward to picking up some cheap fans for the remainder of our time here. However, we left the store empty-handed and refused to take the long ride to Walmart (suggested by the Del Sol department store employee) in search of small fans. To drown our sorrows, on our walk back home, we got iced coffees from Express Arte Caffe  to go and also picked up some freshly baked cookies and cheese bread from our favorite panadería down the street from our house. Once we got back, we settled onto the patio and read while sipping our drinks and taking bites of our baked goods. 

We did this until 7:30pm rolled around, when Melisa picked us up. We went downtown to San Miguelito (the restaurant with the fabulous margaritas) and met her 31-year-old student, Juan, who meets with her twice weekly for private English classes. Melisa had decided him meeting me and Mary would make for great practice since we are native English speakers. We spent two and a half hours drinking margaritas, eating some totopos (tortilla chips) and guacamole, and having some good conversation. We found out that Juan is planning on traveling to New York City in June and will be staying there for two months to attend English language school. Although he is a lawyer who works as a public notary in Mexico, he wants to improve his English and was granted time off to go to this school. Melisa had him practice asking questions so he also was able to learn about me and Mary and the U.S. It was fun having things flipped for once here where we were the ones being asked to speak more slowly and repeat things! 

Melisa drove Mary and I home and we had our final goodbyes since we will not see her again before we leave next week. When we walked into our house, we were "greeted" with a nasty surprise - a salamander hanging out in our entryway! It was actually really gross - almost translucent with beady eyes and about six inches long including its tail. Mary screamed right away when she saw it and I ran upstairs to grab my camera! She got the broom out from the cleaning closet and attempted to get it to run towards the front door and outside. However, it kept circling around one of the pillars and out of her reach. Mary was screaming the whole time for it to just get outside and I had this mixture of laughing, snorting, and screaming coming out of my mouth at the same time. We must have been quite a sight, two American women jumping up and down and yelling at a tiny lizard, one trying to bat it away with a broom and the other just taking pictures the whole time. One of the neighbors who was walking outside with her son asked if we needed help and without hesitation we unlocked the door. Her son walked in, grabbed the broom that Mary had abandoned on the wall when the thing wouldn't move, and proceeded to shoo it away from the pillar and stomp on it when it tried to escape, all the while we are still freaking out and jumping up and down. He managed to beat it to a pulp and sweep it out to the street, but we didn't realize until after we thanked him and shut the door that THE TAIL HAD BEEN LEFT BEHIND AND WAS NOW TWITCHING ON ITS OWN (I kid you not). I went back to screaming while Mary had no idea what was going on and just followed me into the living room as I jumped up on the couch. She then went to look to find it and when she did, resumed the screaming right alongside me. Since our neighbor boy was long gone by this point, having already gotten rid of the salamander's body, it was up to us to get the (thankfully-no-longer-twitching) tail outside to join it. It took about 15 minutes of screeching and maneuvering the tail over our stony entryway before we could sweep it out. 

All in all, the whole process probably took about a half hour to 45 minutes. People were definitely outside on the street either watching us, laughing at us, or both as Mary and I couldn't help ourselves but absolutely freak out about the incident. It seems like everything is starting to creep out in this house now - the salamander, the mosquitos and we've found four cockroaches (one in the fountain in the entryway, another in one of the bedroom doorways, and the other two outside by the washing machine). If there is anything that is making me look forward to going home, it's the lack of these things in my home! Though, I can't speak too soon, since Husband sent me a picture of a huge spider in our bedroom...I'm going to try to ignore that for now, though...

Ay caray. 
Let's hope and pray and hope and pray again that we don't have to deal with THAT again. 

Hasta luego :)

Thursday, May 23, 2013

Día libre y una cena en nuestra casa

For the first week in Mexico, despite the heat in my room, I fell asleep quickly and slept soundly throughout the night for at least 8 hours. However, as the heat has built up and the rain has brought mosquitos, my sleep quality and quantity has greatly diminished to about 5-6 hours per night. For the past three nights, as I've started to fall asleep, a mosquito or two has buzzed in my ear and woken me up in a hot second. Each time I've quickly turned on the light with hopes of seeing them with intention to kill, but sadly I always miss it. I've taken to burrowing underneath the sheet in spite of how much it makes me sweat because I refuse to offer up my body as a blood buffet for the evil insects. You see, I'm slightly traumatized by a past experience from high school when I woke up with bites on my face for a whole week. I went on a weeklong bike trip with my church's youth group from our town all the way up north to Mackinaw City. We slept in tents on campgrounds each night and I ended up with a tent that had more than few holes. Each night, mosquitos would find their way in and feast on our bodies, particularly our faces. My tentmates and I would awaken to unconscious scratching that refused to subside as the day progressed. Imagine trying to scratch your face while attempting to ride a bike for 60-80 miles each day - not fun. Thus, I despise mosquitos when I'm sleeping and slightly freak out when I hear their buzzing as I fall asleep.

**Update at midnight: I've been trying to fall asleep for the past half hour and so far I've killed two mosquitos. Despite dousing myself and my entire bed in bug spray, one managed to land right on my neck and another followed on my arm. Needless to say I fought all instinct to immediately swat them away and rather let the buzzing continue until they landed on me before violently smooshing them to their death. Let's hope the rest learn from their counterparts and stay the heck away from me for the remainder of the night.**

Luckily today I was able to get a little more sleep since it's our day off. Though I sweated throughout the night underneath the sheet because mosquitos woke me up three separate times as I tried to sleep over the span of two hours, I was able to sleep in this morning. Mary and I headed out to meet one of the former UAQ host students, Nayelli, for breakfast. We met at El Arcangel downtown, where Mary and I went once before during the first week. Nayelli, now graduated and working as a nurse in a facility for older adults, updated Mary on her life. We also talked about the different hospitals and clinics our group has been to and the differences between them and those in the U.S. About two years ago, Nayelli and Montse were chosen by UAQ to visit our school and local hospitals, just like what the U.S. students from our group are doing now in Querétaro. They were able to see the similarities and differences between the health care facilities - technology, responsibilities of the nurse, medical resources, etc. It was interesting to hear her perspective and thoughts on these topics. 

After heading back to the house to let Galdina, our chef for tonight, in the house and to greet Brenda, the girl who comes to clean weekly, Mary and I headed to the university computer lab (for her to get some actual work done and for me to catch up on Facebook, blogging...the essentials, you know). It was so funny to sit and eavesdrop on some of the nursing students' conversations because it is obvious that whether in Michigan or Mexico, nursing students work hard and sometimes just need to laugh about how ridiculous school is sometimes. Their professor was late for class in the lab so they ALL took the opportunity to jump on the computers and take a break. The girls behind me giggled over Facebook photos and posts and I could see the guys in front of me on YouTube and having at least five different Facebook conversation chats going on. Some worked on PowerPoint presentations, but the vast majority chose to engage in some social networking instead. Save for the Spanish, it felt like I was sitting in our nursing resource room or in class with my fellow nursing classmates. I liked being able to just be like a bug on the wall observing the surroundings and interactions and relate them to experiences back home at school. I love how being a nursing student transcends languages and locations :) 

We headed back home to find Galdina working hard in the kitchen. Mary and I set up seating and plates and utensils in preparation for the evening's activities. I enjoyed a conversation completely in Spanish with Galdina, learning about her family (she has six grown children) and how she came to learn to cook so well (she worked in a factory cafeteria where she cooked for a thousand employees every day). I was so excited to see her making tamales and rajas con crema, the latter of which is what Ryan's host mom made for me when I went there for lunch. Galdina even made me a chicken tamale to try before the group arrived and I was in heaven! 

Quite a crowd showed up for dinner and it was so much fun to have everyone over. Along with Mary and me, there was Galdina, Heather, Katie, Elli M., Ellie B., Sarah, Hannah, Ryan, Eduardo, Mini, Alex, Sindy, Montse and Keta (who also brought Cailen and Bastián for a while) and Hugo, Esme, and their two daughters (Ellie and Sarah's host family). It was a full crowd! Galdina made a feast of steamed vegetables, guacamole, tortilla chips, quesadillas, fruit salad, tamales (vegetable AND chicken), rajas con crema, and a sweetened pineapple water to drink. For dessert, Mary and I had bought a large fruit tart and tres leches chocolate cake from the mercado the night before and both were nearly gone by the end of the night. Before we dug in, Elli M. suggested we say grace so we all joined hands in a big circle and Mary said a wonderful prayer (in English), giving thanks to God for the delicious food and for the opportunity to gather together. I loved being able to speak both in English and Spanish and help with some interpretation for those who couldn't speak one or the other very well. Despite some of these language barriers and challenges, everyone made efforts to communicate with and among each other. 

Sadly, the night had to come to an end, as we all have to be up tomorrow early for our first day at our last hospital here in Querétaro. Tomorrow we head to Hospital General, the public hospital where those who cannot pay (and the majority of which are from surrounding rural areas and of lower socioeconomic status) go for medical care. Many of the UAQ students have talked about how much more hectic this hospital is in comparison to the clinics and other facilities we've visited thus far so it will be very interesting to observe and  work there for the next two days. I just cannot believe we're in the final days of this May term! Time has definitely flown by and I'm still not ready to head back to the U.S. just yet. While I'm looking forward to going back to Husband, flushing toilet paper instead of throwing it in a trash can, getting my drinking water from the faucet instead of hauling large garrafones from stores and putting them on the dispenser, and having air conditioning in hot weather, I've truly enjoyed and am so grateful to have had the opportunity to experience all that has happened over the past two weeks. I know that I will look back on these posts with so much fondness and reminiscence and I'm really glad I've been able to stick to writing nearly daily. Let's hope that doesn't falter during this last week! 

Adiós :)  

Wednesday, May 22, 2013

Segundo día en HENM y caminando el centro por la noche

I had wanted to post this yesterday but we were without internet again. I'm now at the UAQ computer lab with wifi so here is a recap of Tuesday:

Today we went back to Hospital de Especialidades del Niño y la Mujer (HENM) for our second day in the NICU and on the L&D floor. At first, I thought I would be going to the NICU with the group who was on L&D yesterday with me. However, after thinking about the rare opportunity to see so many deliveries in a short amount of time, I asked Mary if she would mind if I went back to L&D with Hannah and Ellie B. She graciously let me go with them along with Marlen (the UAQ student substituting for Nanci again today) and Ryan, who joined us today in order to see a live birth and observe a PT working in the hospital. 

We met at 8:15am and piled in one of the UAQ vans as usual. However, this van had some strange seating going on that resulted in me not being able to see out the windshield despite sitting in the first row. This coupled with the fact that our driver was very stop-and-go left me with the worst headache and a slight bout of nausea. Luckily these subsided as soon as we arrived at HENM and my feet were able to touch solid ground. We dropped our bags off in a conference room, shoved our snacks in pockets for later, retrieved our protective wear, and split up into separate groups. 

Mary had been telling Ryan (who had never seen a birth) before we even left for Mexico that if he observed a delivery, he was NOT allowed to faint by any means. This morning she reiterated this, along with the fact that he MUST IMMEDIATELY leave the room / delivery area and sit down if he felt at all faint or dizzy or ANYTHING out of the ordinary. I added to this sentiment by telling him that if he did in fact faint, I would by no means attempt to break his fall, as he's well over 6 ft tall and probably 200 lbs and I am a dwarf next to him. It's not like I really doubted his ability to handle the delivery, but considering yesterday the air conditioning was broken and there was so much movement in and out of the room that even experienced nursing students who had seen births had to leave the room as a result made me wary. In fact, the other girls with me (Hannah and Ellie B.) had also not yet seen a birth since they haven't had their OB clinical yet, so it was also pressed upon them to remove themselves from the area if they felt uneasy. 

Thankfully, the air conditioning was working just fine right from the time we got there and there also seemed to be a lull in deliveries. I showed them the two laboring rooms, the postpartum area in the back, two c-section rooms, two urgent delivery and general gynecological procedure rooms, and the room designated for spontaneous and elective abortions. I encouraged the nursing students to seek out opportunities to get involved with patient care. We met the charge nurse for the day and were then informed of a c-section that was getting started in one of the rooms. I was so relieved when all the students handled it well! Nobody felt faint or had to leave the room and were able to see the whole process. When the baby was lifted out of the uterus by the doctor, I heard Ryan behind me saying, "Oh, there it is! There's the baby!" almost in awe. It was too precious (both the infant and Ryan's reaction). Not too long after the c-section we were all able to observe a vaginal delivery, which the students handled well, too. Ryan left soon after to follow the hospital PT around while Hannah, Ellie and I stayed behind. 

It was during the vaginal delivery that I introduced myself to the pediatrician, Dr. Perez, who was standing by. He asked where we were from and what we were studying and I told him him that me, Hannah, and Ellie were nursing students from the U.S. Once he learned that I was a senior student and the other two were still early on in their nursing education, he made it a point throughout the day to get us involved in different deliveries to see and learn as much as we could about the role of the OB nurses at the hospital. He also had us assist every now and then throughout the day, such as having Hannah tie his surgical attire before he assisted in a c-section and hold oxygen for a newborn delivered via emergency c-section due to meconium. 

As we watched three more vaginal deliveries, two more c-sections, a dilation and curettage (D&C) for a miscarriage, and postpartum mother / baby care, it was interesting to see how the nurse acted in so many different roles for each situation. With so many responsibilities, it's no wonder the nurses are all over the place and running back and forth between patients and rooms. Today I got to see some of the nurses act as encouragers for laboring women, which answered my question from yesterday about it possibly being culturally driven. This encouragement was slightly different from that in the U.S., though. It seemed to be more of a "tough love," with nurses and doctors encouraging the mother to stop crying or yelling out and to instead put her energy into pushing. However, they used terms of endearment such as "mija" (mi hija = my dear) and it was evident that they were trying to be supportive and empower the women in having the ability to get through the hardship that is birth. Another thing that I saw today that I didn't observe yesterday was presenting the mother with the baby after completing the newborn assessment and medication administration. The nurse (or the pediatrician, in the case of emergencies) completes a full newborn assessment, checking APGAR scores, vital signs, reflexes, etc. as well as administering prophylaxis eye drops and vitamin K injection. After wiping the infant off and swaddling, the nurse or pediatrician then brings the baby to the mother's side to "introduce" them and have the mother give the baby a "besito" (little kiss). It was so beautiful to see the instant connection between mom and baby each time. 

At one point, a nurse who was teaching some Mexican nursing students allowed us to be part of one of her lessons. We used a Pinard horn (which is like an ear trumpet) to listen to fetal heart rate on a couple of laboring women. It was fascinating to learn how to use this instrument, since I had only learned about electronic fetal heart rate monitoring during my OB clinical back home. My OB professor had mentioned the Pinard horns at one point, but we didn't go in depth about them since we are not likely to come in contact with them working in the U.S. However, I'm so glad I had the opportunity to learn about it here in Mexico. When I saw the nurse using it and teaching her students, I pushed Hannah and Ellie to politely ask questions and if they could try it since they most likely wouldn't get the chance otherwise. 

By the end of the day, we were exhausted from the constant movement and hustle and bustle of the unit. It was an awesome experience and I'm so grateful to have had the opportunity to be on the L&D floor twice. While I intended to observe in the NICU today, I may try to get that unit back home for my internship this fall so I can get some experience that way. I am really happy Mary let me stick around the L&D unit to experience more births. While it was very sad and difficult to watch, I am also grateful for the chance to stand in on a D&C and see how that process is carried out. The past two days have been an amazing learning experience and I can't believe I had all of these opportunities to observe. 

After removing and throwing away our disposable scrubs, we met back up with the Mary and the other students. We headed back to UAQ on the dreaded van with all the stop-and-go driving and I felt even worse than this morning when I was able to jump out. Mary wasn't feeling well either (but due to dehydration) so we quickly walked home. She decided to take a nap while I changed and headed downtown back to Express Arte Caffe for a light lunch and iced coffee and to start writing this blog post. It was such a relaxing and refreshing afternoon sitting in the cafe with the doors open and breeze going in and out. I stayed for two and a half hours, taking my time eating, sipping, and writing. I decided to wander around the area for a while before heading home, walking through bookshops and other little stores as I zigzagged through the streets. As I made my way back to the casa, I stopped at a little panadería along the way that Mary and I have gone to countless times since arriving in Mexico. We've always gotten a variety of sweets each time and I've come to love these cookies called "orejas" (ears). They're made to look like elephant ears and are very crisp and taste like sugar cookies but lighter and more buttery. They're fantastic :) 

After I got back home, Mary and I had to go to the Mega mercado (grocery store) to pick up some more items for the dinner we are having at our house tomorrow. Ryan and his host brother, Alex, had hoped to have the group meet up for some drinks and catching up but nobody in the group felt up for the trek to the bar they had chosen. After some texting, I said I would be interested in hanging out with them in the downtown area since it was within walking distance and then I wouldn't have to take a bus or taxi alone. So they swung by our casa to pick me up and the three of us walked downtown. We went to a "tranquilo" (calm) bar, had some cervezas Mexicanas (Mexican beers), and had some great conversation. Alex and I spoke a lot in Spanish while Ryan tried to follow, and then I talked with Ryan in English and Alex attempted to follow the conversation. We talked about each others' lives, the differences in nursing and nursing school between Mexico and the U.S., and we joked about how Ryan is "un niño consentido" (a spoiled child) in Mexico because his host mom loves him so much and does so much more for him (cooks him his favorite foods, washes all of his clothes, picks up his room, etc.) than she does for her own son, Alex. After finishing up our drinks, we decided to just walk around between different plazas. Along the way, I learned so much cultural stuff from Alex! For example, he told me that Querétaro is so clean because the government pays workers to wash the plazas, sidewalks, and streets every night. They drive around with large water tanks and hoses and spray down each plaza and along the road. They also pay workers to sweep all of the sidewalks and storeowners also regularly wash these with soap and water. Additionally, he explained to me the difference between "mudarse" (to change positions) and "moverse" (to move places) and taught me cultural phrases, vocab words, and social norms (such as calling a person "naco" who is of lower socioeconomic status - saying this to someone's face is acceptable and taken as a joke between friends but is very offensive with strangers). He also told me that it is safer for me at night to walk in the middle of the street rather than the sidewalk because there are so many places people can lurk and hide for snatching. The middle of the street is out in the open and more well-lit and thus safer for walking at night when alone. To be noted, he DID say that this is NOT common in Mexico (the lurking and subsequent snatching, that is) but sometimes it happens and it is better to just stay on the safe side. I was also able to learn about both Alex's and Ryan's aspirations and goals in life and just get to know them better. It was both fun and relaxing to hang out with them and I'm so glad they decided to come to the centro (downtown) area so we could all go out together. 

Tomorrow is our last free Wednesday and I can't believe that we leave to go back home in exactly one week - where did the time go? It has FLOWN by and I've truly loved every minute of it. It has been wonderful learning about the Mexican culture, specifically their health care system and the many roles of nurses in this country. I've even enjoyed the challenge of sharpening my Spanish speaking skills, since the practice was lacking the past four years since graduating from Hope with that degree. As we head into our last week here I hope to enjoy and really soak everything up :)

Hasta la próxima vez!

Monday, May 20, 2013

Hospital de Especialidades del Niño y la Mujer y comiendo leches malteadas en La Mariposa

Today we were back in the clinical setting at Hospital de Especialidades del Niño y la Mujer (HENM). This is a public hospital that specializes in pediatrics, gynecology, and obstetrics. Patients who come here have insurance and therefore do not pay for the services. For patients who can afford to pay more, they go to private hospitals, such as Médica Tec100 which I wrote about visiting last week Friday. I have REALLY been looking forward to today and tomorrow since labor and delivery (L&D) is my favorite unit and I hope to one day work on an L&D unit or in a neonatal intensive care unit (NICU). I've been so excited to see some births and hold some babies since coming to Mexico and finding out that we'd be going to this hospital! 

We met at the university at 8am. Since Nanci has to be in Mexico City for today and tomorrow to get her visa approved for travel to the U.S., Ruth had another student join us named Marlen. We all piled into a UAQ van and headed over to HENM. Once we arrived, we were given a tour of the entire hospital, which had two buildings. In the first building, we went to Urgencias Pediátricas on the main level, which was an emergency unit only for pediatrics. We then headed up to the next level where on one side there was the NICU and intermediate / stepdown NICU. The other side of this floor had a mix of pediatric units, which included respiratory illnesses, oncology, dialysis, and internal medicine. On the third level, there was one side that had inpatient postpartum women who were accompanied by their babies if they were healthy.  On the other side this floor, there were patients with various gynecological issues such as cancer, infection, etc. We then walked over to the other building that had a separate emergency area for laboring women. Further inside we were able to see the entrance to the L&D unit, in which both vaginal and Caesarean section births take place. In this area there was also a short-term postpartum area for women who were able to go home within hours of giving birth. 

We split up into two groups, one going to the stepdown NICU unit and the other in the L&D unit. Mary went with the NICU group (Ellie B. and Hannah) while I went to L&D with Heather, Sarah, Katie, and Elli M. We got personal protective wear that included a disposable top and pants along with a mask, head covering, and shoe booties. It's interesting because here they have a step that goes from the changing room up into the unit so you can't forget to put on your shoe booties. You lift one foot up, put on the bootie, set that foot down on the other side of the step, and then put the other bootie on the other foot and cross completely through the doorway. It's a good way to ensure you have all the right stuff on because it makes you stop and think to consider what you're wearing! 

When we were all dressed correctly and on the other side of the doorway with our protective wear, we were shown around the unit by the nurse manager, Gabriela. She showed us the rooms reserved for C-sections, general vaginal delivery, and abortions/miscarriages as well as the two labor areas and the one postpartum area for mothers and babies. It was interesting to note the differences between the OB units I've seen and had clinicals in in the U.S. compared to this unit. Family members are not allowed back in this unit and women are lined up right in a row to labor. Sometimes they also give birth right next to someone else, often without a curtain to separate the space they share. At one point, there was a woman giving birth crying out in pain and her "roommate" who was still laboring looked very nervous. In that instance and in several other situations I wanted to hold the woman's hand or offer encouragement as she gave birth, but I wasn't sure if that would be culturally appropriate in these situations. I'm still not sure if that would be welcomed by staff or patients and I wonder if social support during birthing is something that is culturally driven. 

It was sweltering hot for the first hour or so being in that unit and I would guess that the temperature was somewhere in the 80s. I was sweating profusely and at one point while observing a C-section, two girls had to step out of the room and sit down. I don't think it was so much the actual surgery itself that put them over the edge, but the mixture of the heat, the overwhelming number of people moving around and in and out of the room, and wearing a stifling mask that was difficult to breathe through that made it easy to feel slightly faint. I realized how we take having air conditioning in a hospital for granted, seeing as how all the public hospitals and clinics we've observed in while here in Mexico don't have it. I can't imagine giving birth, something so strenuous and requiring so much energy, without at least a fan. We are fortunate to have such resources and I give so much credit to these hospitals' patients AND staff who stay and work in these facilities. Additionally, I noticed paper charting and typewriters all over the tables on the floor. I actually recorded four people (med students? nurses? doctors? a mix I think) at one table just typing away at their notes. All over the unit the sound of typing on the typewriters echoed. Again, I give the staff credit for their organization and skills in keeping track of and completing all their documentation without computers like we have in the U.S. I peeked at one of the charts and was so impressed to see the great detail documented through handwriting and typing by the hospital staff - SO much work with such little time since they juggle several patients at a time. 

In all we saw about four C-sections and four vaginal deliveries - WAY more than what I saw during my half-semester OB clinical back home! It was very fast paced and women were just laboring and giving birth left and right! I loved watching the women get moved to the postpartum area and spend time with their tiny little newborns. After working so hard and going through so much pain (only C-sections got epidurals, from what I could see), it was great to see the moms bond with and love on their babies. However, I must admit, just like how I felt after my OB clinical back home, watching all that laboring and delivering made me cringe at the thought of myself going through that process. It's true that they say nurses / any health care worker make the worst patients because it will sure be awful to know exactly what's happening, what could happen, and what to expect when/if I find myself in a L&D unit as a patient! 

We met back up with Mary, Ellie B. and Hannah and headed back to UAQ. Some of the girls went out to lunch at VIPS downtown for some American-type food while Sarah and I went to Express Arte Caffe to eat and have internet access at the same time. We enjoyed eating at a table just by the doors that offered a nice breeze that accompanied by the soft music made for a perfect afternoon. We had some great conversation while eating and then I worked on this blog post and she did some homework. It was soooo relaxing and perfect after constantly moving all morning / early afternoon in the L&D unit. 

Elli M., Katie, and Heather met up with us at the cafe and I took them to a place downtown where that I had found that was really cool where I thought I would buy Husband a gift (note my extreme vagueness here since I don't want to ruin the surprise of what I got). They all thought the place was great, too, and proceeded to buy the same gift for their families back home. After I walked back to the house and got ready to go out with Mary and her friend Melissa, who she met during her first year in Querétaro. 

Melissa picked us up around 7:45pm and took us to La Mariposa (The Butterfly), which is a cute little ice cream shop and restaurant with a 50s vibe. Mary had taken me there on Sunday night when we got some leches malteadas (milkshakes) and we ended up ordering the exact same thing this time around! Once again, it was so delicious and refreshing. The place was also air conditioned so I even got cold after drinking the my chocolate shake! We talked for a long time about what Melissa has been up to (she's an English teacher at a bilingual school here, she also teaches private English lessons to adults, she has recently bought a new car and started living on her own, her little sister's quinceñera that happened in February, etc.), what Mary's been up to, and introducing me and my life. Naturally, since she's an English speaker, the whole conversation was in English and I was super impressed with her. Apparently she studied in the U.S. for a year during high school as part of an exchange program and that sparked an interest and propelled her toward her current career teaching English at the elementary, middle, and high school level for Mexican students. She was a blast to talk to and get to know! Mary had told me that she had a lot of energy and she was definitely right! Melissa also brought Mary some gifts of traditional Mexican items and candies and even brought me some, too - too sweet of her :) We headed home, bid farewell to Melissa, and are now about to go to bed, considering we have another early morning and long day tomorrow again.

Hasta luego!

Visitando Tequisquiapan

Seeing as how I am without internet signal in the casa (for the third or fourth time so far), this post will most not likely get put on the blog until tomorrow. It's such a bummer that the internet can be so spotty, but I'm at least grateful for any access at all in the house. I think back to my summer in 2007, right after I finished up my freshman year of college and I worked for Merge Ministries in Guatemala, Dominican Republic, and Mexico, when I had to go to an internet cafe in order to get access (which was probably close to once every two weeks or so). Hardly anyone even really had smart phones back then. I most certainly didn't, let alone have any electronic gadget with me for those two and a half months save for my free-with-plan flip cell phone and a travel alarm clock. Fast forward six years and here I sit, back in Mexico but for a totally different reason, with (albeit spotty) internet in my house and an iPad to document each day. Gratefulness abounds. 

Moving onward...

Today (Sunday) was a more-than-welcomed free day for me. I was so exhausted last night that I yawned at least ten times throughout my attempted FaceTime with Husband (which, by the way, ultimately failed, thanks to the spotty internet and its tricky signal that kept going in and out). I slept in until I could no longer ignore the various noises that daily make their way into my bedroom (it has a window that faces the street), which was at 9:30am. This left me with nine hours of sleep and still wanting for more. But as the heat started to set in in the bedroom, I got myself up and ready for the day. 

Mary and I decided to go to a little town called Tequisquiapan for our day off. I called Eduardo, a taxi driver who our program was recommended years ago by UAQ students and staff as a reliable and safe driver and Mary has used every year, to pick us up and take us to the bus station. He came only 15 minutes later and dropped us off at the terminal. In no time we paid our 45 pesos each for tickets, boarded the bus, and were on our way. The nine hours of sleep I had gotten the night before apparently wasn't enough, seeing as how I immediately fell asleep and dozed for the whole hour-long ride. 

We arrived in Tequisquiapan and attempted to get information on how to return to Querétaro. That turned out to be way more confusing than it probably should have been! First, I went inside the station and asked a man at the desk where I could buy return tickets to Querétaro. He replied saying that he doesn't sell those tickets and that I had to go back outside where the buses were. When I asked where exactly I needed to buy them, he just said to go outside and there would be someone. So, when I went back to where the bus dropped us off, I approached the guy with a fanny pack full of money and tickets, calling out announcements for travel to Mexico City. When I asked him if he sold tickets for Querétaro, all he replied with was no, and then was back to calling out. When I asked WHERE I could get tickets, he just said to ask someone else. I was stumped. Mary suggested we go back to the bus driver who dropped us off to inquire so we headed over. Thankfully he was very patient and explained that we would simply come back to the station before the last bus left at 8:10pm and could buy our tickets right before boarding the bus. I had him confirm at least twice more that we did not have to buy tickets in advance and that we could just buy them right before getting on the bus. He agreed both times, only emphasizing that we should probably at least be there 10 minutes before the last scheduled time at 8:10pm. After thanking him profusely for clearing up the confusion, we hailed a taxi to take us into the main downtown area. 

The taxi driver dropped us off at the main plaza, which had a gazebo in the middle, a large church with a towering steeple toward the side, restaurants and shops beneath a line of arches surrounding the plaza's entirety, and groups and crowds of people throughout. We went to Kpuchino, where we sat outside underneath an umbrellaed table and ordered some coffee (hot mocha for Mary and a cold frappe for me) and a corn dulce de leche piece of cake to split. It was so relaxing to sip our drinks, slowly nibble on the cake, watch passersby, read a bit from our books, and just take it all in without any rush or hurry to get anywhere. 

We then decided to browse the markets nearby the downtown area. There were two artisan markets with lots of basketry, pottery, wooden toys, and other items. At the first market, Mary bought some custom-made calves' fur slippers which, despite my initial indifference to the fact that baby cows had died for them, were incredibly soft and I could tell would be perfect for Michigan winters. We also walked through a more general market that had items I think locals would shop for - shoes, everyday clothes, produce, watches, socks, belts, etc. The last market we browsed was an outdoor lineup of booths with pretty table linens, jewelry, and other handmade things. After going through all of them, we decided to go back to the first market to retrieve a few things we'd had our eyes on but wanted to see other options before biting the bullet. Mary bought a beautiful handpainted ceramic planter and I got some pretty pottery in a pattern I've been swooning over ever since I laid eyes on it when I first arrived in Mexico. I picked out a pretty bowl with a scallop-like edge and a butter keeper. The pattern is a mix of blue, yellow, white, and sometimes orange and/or red with dots and lines and flowers throughout. It's difficult to explain but I've seen it at a bunch of shops throughout the cities we've visited and I LOVE it. In Bernal I also bought a small pot in this pattern and hopefully now I'm all set! I'm looking forward to figuring out how to decorate with it around the house. 

We walked through some more shops and took a look inside the church in the plaza before deciding to go eat some "lunch" (at 4pm). I was slightly embarrassed when we went back to Kpuchino, but that quickly dissipated once I realized how wonderful the food appeared. I ordered chicken flautas (my favorite) while Mary got a tuna fillet and berry salad. We were both stuffed and full with food babies from the large portions and decided to head back to Querétaro when we finished our meal at 5:30pm. We grabbed a taxi by one of the markets and headed back to the bus station.

Just as the driver had said, we were able to buy tickets right before boarding the bus and leaving Tequisquiapan. Apparently we had gotten to the station just in time because it left within minutes of us getting on, at 6pm. Although I slept for about half the trip, I was soon woken up by someone asking me to move over so they could take the seat next to me. The bus was PACKED and even one person had to stand up. It was only about 20-30 minutes longer before we were back in Querétaro and dropped off. Initially there was some confusion when we went to get a taxi, since there was a line of people waiting by a sign that said "Línea Para Taxis" (Line For Taxis) with each person holding what looked like tickets in their hand. It turned out that we had to go to a booth inside the station, indicate what neighborhood and street we were heading to, pay, and get a ticket in order to get a cab. We followed the steps, were directed to a taxi once the line moved through, and were brought back to the house. 

The rest of the night consisted of finishing up the book I've been reading, attempting to access the internet, eating my two leftover flautas from lunch for dinner, and writing this post. Tomorrow is the start of our second (and last) full week in Mexico and I can't believe how much time is flying here! We are in for another full schedule of hospitals, this time to the mother/infant/child hospital to see lots of deliveries and to the general hospital for experience in a variety of floors. While we will still have our free day on Wednesday, Mary and I will be busy getting the house ready for a group dinner. Galdina, another person who Mary has developed a friendship with, will be cooking a traditional Mexican dinner for the group and their host students that night. Apparently this is something she's done each year and I'm looking forward to trying some new things. 

Hasta mañana!
(See you tomorrow!...or at least I hope so, since the internet might be out again...crossing fingers that this won't be the case...)