Full Circle

Today was my last day of work, and the time in Kijabe has gone so fast. This was a week full of parties. Wednesday, we had the interns over for taco night. They had no idea what tacos were, and Karen got confused and asked if we were going to eat tequila. There is no alcohol in Kijabe, so I was thrown off by her asking. It took me a minute to figure out she really meant tacos. We served soft and hard shell tacos, guacamole, beans, rice, and no bake cookies. The singing started at the stroke of midnight, Aurelie’s 31st birthday. They sang an awesome version of happy birthday, and they sounded amazing! I taped it on my camera and hope to post it on the blog when I get back. The interns stayed until almost 1 am, much to the dismay of the couple living beneath us.

Thursday we celebrated Aurelie’s birthday some more with homemade pizza and chocolate cake. I had to improvise the red plate, but I think she had a memorable 31st.

Friday night, the interns had us all over for a Kenyan feast. Pulei (an intern) made ugale (typical Kenyan bread-like fluffy substance), sucuma wiki (spinach and kale), chapati, chicken, pilau, and chai. It was delish. Dinner was followed by a dance party where we watched African music videos and tried to copy their moves. Charles, one of the interns, played DJ, and we danced to a very eclectic set, including “Breathless” by Faith Hill, “18 til I die” by Bryan Adams (shout out to my mom – It’s her favorite song!), Elvis, and Rhianna. The interns are super fun, and I will really miss them. It has been fun to bond with them in their first month in Kijabe.

I feel like I have come full circle with a few patients in Kijabe. I admitted a preeclamptic woman name Jane on of my first days in clinic. We have been observing her over the last 3 weeks for signs of worsening preeclampsia, and last Wednesday her blood pressure shot up to 200/130. Her gestational age was 30 weeks, 4 days, which isn’t terrible for Kijabe, although we had hoped for 32 weeks. We tried to induce Jane’s labor, but I got a call Thursday night that she was having brisk vaginal bleeding. My attending and I took her to the theatre for a crash c-section. Her baby was vigorous and is just using CPAP…I really hope she will make it. I have really enjoyed taking care of Jane over the last 3 weeks, and I feel good about seeing her pregnancy to the end. Pray for baby Mercy!

Another patient, Gladys, came in last week preterm premature rupture of membranes at 20 weeks gestation. She had no amniotic fluid on ultrasound, and we counseled her that the baby would not live. She was discharged, but returned today with pain and bleeding. She was able to deliver the fetus, who had died in utero, but was having pretty significant bleeding. Her placenta had sheared off the amniotic membranes due to infection and there was a lot of material in the uterus. Tembu and I took her to theatre for a d and c. I think she will be ok despite hemorrhage and infection. Matt and Ben donated some blood last week so maybe it will go to Gladys. I’m hoping to donate after we climb Mt. Longonot tomorrow. I’ll save my red blood cells until then.

After rounds today, Matt, Aurelie, Ben and I went to the, as it turns out, aptly named Hell’s Gate National Park. The park has huge rock towers and canyons. We rented mountain bikes and took the 9 km road to the gorge and the Central Tower. We set out at the hottest time of the time of the day, so most of the animals were hiding in the shade while we pedaled to the gorge. It turns out that I really don’t like mountain biking and particularly riding through sand-like dirt. I was happy to be off the bike when we finally got to the gorge. A Maasai guide then led us on a hike through the gorge. It was nice enough until we started hiking through a canyon to get to a cave. At one point early in the hike, the canyon was blocked off with water. The guide suggested we take off our shoes and walk through the water. He left his shoes on the bank and continued walking through the canyon barefoot. I’m not sure if it was because his English was limited or if we are just completely idiotic, but we left our shoes too, thinking we didn’t have much further to walk. However, we walked for about 30 more minutes barefoot over dagger-like pebbles, obsidian chips, and dirt. I had the misfortune of stepping on a thorn, which was imbedded into the ball of my foot. (Thankfully, I got my Tdap vaccine a few months ago. Matt and Ben got tetantus boosters at the hospital last week ---only 80 cents each). I couldn’t believe we were doing actually walking barefoot, yet we still continued scrambling through the canyon. I guess our guide missed the powerpoint slide about delicate Wazungu feet in his new guide orientation. When we were well past our breaking point, our guide told us there was 1 more minute until the cave, so we pressed on. The “cave” turned out to be pretty much a dead end in the canyon, so we took a picture and made the painful journey back to our shoes. We ditched the bikes and took a taxi from the gorge to the main gate. Through the tinted taxi window, we saw zebra, buffalo, and giraffe grazing, so it might actually have been nice to bike out, despite my dislike for mountain biking. Tonight’s evening activity is scouring the tropical medicine book for all of the diseases we might have contracted through the soil and water. Tomorrow’s activities include consulting with our infectious disease specialist neighbor and buying some antihelminthics from hospital pharmacy. I hope I can ascend Mt. Longonot despite my sore puncture wound!