The (salty) taste of Bolivia

Hello from La Paz!

I am trying to upload just ONE picture from Mindy and my spectacular trip through the Salar of Uyuni (the world´s largest salt flat) to give you a taste of our latest Bolivian adventure, but I (quite technologically-challenged at times) cannot seem to get my memory card reader to work from our hostel in La Paz. Bummer! There was some more serious hiking, we met some hilarious people along the way, the sights were surreal, and I can´t wait to share pictures. However, it will have to wait until either from Lima (where we return tomorrow), or Sacramento, where I will return on Sunday. Can´t believe it´s back to the grind on Monday.

It has been an unbelievable trip, with too many laughs and memories to count.
Besos y abrazos!!!

Andean Adventures: Peru, Part 2

Hello from Bolivia! I have a rather slow internet connection, but am doing my best to upload some photos from the past week.


It has been a phenomenal vacation so far!



After my week in Pampas-Huaraz, Mindy (college roommate), Kelvin (residency friend), and Chamreun (Kelvin´s friend from jr high), met me in Lima for the next part of our adventure in Peru.



Quick pics from my wandering around Lima, where I visited the San Francisco Monastery, Inquisition Museum, and China town!



I love how everything in Peru has the -ito suffix!





We headed south on a bus to Nazca, which is famous for the Nazca Lines, mysterious sand art drawings made in the desert sand, which are quite impressive when viewed from the overflight. They were likely made between 900 BC and 600 AD, but no one knows the significance!


Mindy and me before the flight


"The astronaut" (looks like ET!)

Unfortunately, the overflight, complete with "now left, now right," left most of us very nauseated and some of us (i.e. me) with the experience of losing breakfast....

here is me with my barf bag...

Despite vomiting, we had great food in Nazca, including ceviche, which I could easliy eat, and love, for every meal...




We spent the afternoon in Nazca being quite adventurous and hiking up to the Cerro Blanco, supposedly the world´s highest sand dune. Although we got started late in the day, making our guide, David, nervous we (girls) wouldn´t hike fast enough, we made it in time to do-try some sandboarding, which quickly became sand-sledding. Although our hike back was entirely in the dark, and our shoes, clothes, ears, and mouths were filled with sand, it was an awesome experience! Even Mindy, who was not super thrilled about the idea to start with (her quote was, and which shows how good a friend she is, was "I am 0% interested in that, but I will 110% go with you!") had a good time :)


Kelvin-Chamreun

stone towers at the top

We then overnight-bussed it to Cusco for time to start our 4d trek in the Lares Valley. We were with a company called Chaska, and I cannot say enough great things about them. We four were paired with two Australians, Daniela and Lily, who were so fun, and the whole staff, including Susana and Huber, our guide, were outstanding. The food was amazing, the scenery spectacular, and the company just as great. Although Chamreun got pretty altitude sick, and the hiking (combined with rainy-haily-cold weather) was certainly not easy, we all made it up and down the mountains, which included 2 passes of 4450 and 4900 meters (just over 16,000 feet, which is the highest I´ve ever been!) . Although she totally schooled us, even Mindy, who has summited 34 of Colorado´s "fourteeners" (14,000 ft peaks) and Mt. Kilimanjaro, was challenged at times.



Our group (Daniela, Mindy, me, Kelvin, Chamreun, Lily)



with Kelvin

Huber and me



Llamas!

Clothing discrepancy!

Al fin

The Valley (Daniela likes taking diagonal pics!)

After the three days of hiking, we spent the fourth day visiting Machu Picchu, the Lost Incan city.


Enjoying mojitos in Aguas Calientes





Although I had been there in 2005, Machu Picchu is one of the most spectacular sights I have seen in the world, and certainly not overrated. We hiked Wayna Picchu and got great info from our wonderful guide, Huber.











Sudoko on the train back to Poroy.




Today, Mindy and I made our way to Puno and then to Copacaobana, Bolivia, where we will visit la Isla del Sol tomorrow and then continue on southbound (the boys are headed to Argentina).


Lake Titicaca sunset



Back to the states on 11-1-09. We are getting kicked out of internet!
Miss you all!
Love from Bolivia!!

Peru: Parte uno

Wow! It´s hard to believe that one week (of my three weeks) in Peru has passed. It feels like ages since I´ve been in the states! I am blogging from the guesthouse in Lima, with a foreign keyboard, so I apologize in advance for all the crazy punctuation typos which I will probably let slide :)

It has been a fantastic trip so far! I left Sacramento last Saturday and made it to Lima late, late in the evening after basically sleeping away all 12hrs of flights or so :) Although I certainly was sleep deprived, coming off OB nights with subsequent clinic, packing, and Friday night partying at Rocky´s, I keep my not-being-able-to-stay-awake-on-a-plane streak alive :) Dr. Mayes and the group of 15 Univ. of Richmond sophomores (part of this SSIR, or sophomore scholars in residence program) participating in his Global Health seminar, arrived and met me about 5 hours later in the Lima airport. After a sendoff breakfast at the home of the Espinozas (who started the nonprofit organization Pan Peru which serves the town, Pampas Grande, where we stayed), we drove the 8 hrs to the mountain town of Huaraz.

Huaraz

(I could live with waking up with this view every day! I think itçs the peak Huascaran, but I am not totally sure)

Students in el mercado

The next day, we drove another 5 hrs or so to the tiny pueblito of Pampas Grande, which lies at around 12,500 feet or so amidst the breathtaking Cordillera Blanca mountains of the Andes.

Pampas Grande, or "Pampas" as we called it

We were welcomed with a (much appreciated) meal of traditional cuy (roasted guinea pig) which I´m proud that the students tried! I´m glad the head was left off (when I was in Peru in 2005, I definitely got some cuy con cabeza!)

Here is Becky (another UR alum, and fellow adulto on the trip whose company I much enjoyed!) with her cuy!

We tried to acclimatize to both the weather (cold, cloudy) and altitude by going on a walk with the kids. Some photos of la gente

Leni and me

Las niñas loved playing with Kaitlin´s hair!

Ovejas

Welcome dinner, con mucho bailando

We spent the next 2 days participating in various activities regarding health promotion in the town. The Richmond students led workshops on toothbrushing, sex education, talks on first aid, child abuse, and domestic violence prevention.

Here is a picture of Becky and me in our Pan Peru vests, ready to start the day. 7 am was about the peak of warmth in Pampas when the sun was out



Me with "joven Jack," as he came to be known

I spent the days in the medical clinic just seeing patients who walked in for free services. They do have this small clinic there all the time, with an "intern" doctor doing his year of service in Pampas ¿all Peruvian medical grads spend one year serving a rural or underserved area before starting residency?... Unfortunately, I didn÷t take that many pictures. I also didnçt see as outrageous things that I did my last time in Peru, in 2005 with Amazon Promise in the jungles around Iquitos, but lots of abdominal pain, gastritis, parasites, and arthritis from hard work in the fields. Somehow, after disclosing the nature of my residency training program, I got labeled a "gynecologist" and ended up seeing lots of people in "consultation" for female problems... interesting. We brought lots of basic medicine to give out including antibiotics, acid blockers, pain medications, cough syrups, etc., along with vitamins, which were appreciated. While I felt that what I was doing did make a small difference, I still felt somewhat empty in thinking that, after weçre gone, I donçt know what would happen to patients that need continued care. There was really no place for things like antihypertensives for chronic high blood pressure, and I only wonder how many undiagnosed diabetics I saw. The work felt a bit limited, and very temporary, without a larger system in place to continue to deliver health care there. However, Pan Peru plans to continue to work to encourage trips like this one which gives us hope.

Here is a posted price list for regular clinic business. To give you an idea, one US dollar equals about 3 soles

Una paciente con su bebe

Las dentistas, who really were hard at work


Pampas at sunset

We spent two more days traveling back to Lima, where the Mayes group left me yesterday.

I have so many thoughts in my head, and while I have tried to convey some of it here, I feel like this blog entry has ended up too objective.

Not apparent in this post is the warmth of the people of Pampas, who welcomed us "gringitos" with such open arms. We were greeted by the schoolchildren of the town, with bouquets of flowers, and who shed tears on our departure, not knowing when they might again see a group of outsiders return to their isolated town. We were served 3 hot meals a day by Lucia and Pedro, which, for 19 people, was no small feat. We were given beds to sleep in and transportation and were cared for immensely. As we were there so briefly, I do wonder whether what we brought to the citizens of Pampas was any more valuable than what we received, in love, education, and experience, which I am certain none of us will forget.

Memories which I am noting for the sake of my own journaling...

= the children of Pampas playing futbol with such passion, and watching them light up at their first sight of a frisbee

= watching "Joven Jack" and his dance moves with the teenage ladies of the town

= how everything in Peru seems to get labeled =ito, which is a sign of affection

= the vast quantity of sopa and te we consumed in the course of the week

= what a tasty lifesaver Sublime chocolate is

= the bitter cold of Pampas and altitude headaches

= how a 50 foot hike up a hill at that elevation made me feel as if I had never worked out in my life

= how 3 days without a shower doesnçt seem that bad...

= the bucket seat and perhaps the most uncomfortable van ride of my life

= a van of college students singing Replay, over and over and over again

There are so many more things to say but not enough words to say them. The trip made me extremely nostalgic for college, as I remembered those days without worries about future jobs or responsibilities. I did kind of feel old ¿Becky and I, with Diana, joked about being the "adultos" that had to go to bed early, as a lot has changed at UR since I graduated in 2003. While, when I was there, there was a Girls" side and Boys" side to Westhampton lake, now the dorms are even co=edª Gottwald ¿the science building? is totally redone. I am wondering when I can next go back to visit.

I am so thankful to Dr. Mayes for inviting me on this trip. What a great and motivating start to another 2 weeks in South America. While I was a bit lonely today, riding public buses and braving the streets of central Lima, which Lonely Planet, on every page, notes is quite "dangerous," I have company joining me later. Mindy, Kelvin, and his friend arrive tonight and we set off for Nazca tomorrow. The plan is to visit the Nazca Lines, then make our way to Cusco, hiking, visiting Machu Picchu, and then Lake Titicaca and Bolivia.

Espero un buen viaje. Hasta luego for now...

Counting down...

So I apologize for my lack-of-blogging recently. Usually that means one thing: a busy schedule with not much (other than work) to discuss. I've been back on OB for the past 2.5 weeks.

I have no cool pictures to post, despite recent outings to the Lodi Grape Fest (beats the Pear fest! :)), Apple Hill (a collection of many orchards about 40 minutes east of here, which was gorgeous and where we got awesome donuts!), and the Dixon (world's largest!) Corn Maze. Last week was my last frisbee outing for a while.

Despite long hours on L and D, it's actually been a good time. Despite a week of antepartum, which is quite painful, I was the "day" resident for one week and got a lot of c-sections. I've had some calls busy with deliveries, which has been fun, and I also got to deliver one of my continuity OB patients last week. I've worked with fun residents and attendings. Now I am on nights, and it hasn't been too bad because I haven't had to spend much time in the ER. The quality of nights/call on OB (for me) is based almost entirely on whether or not I have to go to the ER for a consult on vaginal bleeder, rule out ectopic, or pelvic pain patient. I hate, hate, hate it. I just want to hang out upstairs watching and helping babies be born :) I even got to sleep last night! As an intern, I don't think I even knew there was an OB call room. And I think I only got to sleep once as a 2nd year.

I had a scheduled Saturday 24h call into nights this past weekend which would have been pretty horrible, but Joe kindly came in to relieve me, which gave me a few more hours to sleep and catch up on some "life" stuff, including getting to see Aline (last year's FP/OB grad, now working in Colorado and potentially saving me a spot to practice ;)) who was in town for the ALSO (Advanced Life Support in Obstetrics) course, and getting to celebrate Kyla's birthday (with amazing desserts from Rick's Dessert Diner). We celebrated Jeremy's birthday with Karaoke and Italian food on Friday.

Currently, in my "time off" between around 8:30 am and 6:30 pm, I am working on finalizing/organizing details for PERU!!! I end my week of nights on Friday morning, with post-nights Friday AM "torture" clinic and a circumcision to follow, and leave Saturday morning for Lima. I am excited, although I'm not sure it has hit me yet that I will be out of the country for three weeks! This is, by far (and sadly), my longest (and farthest) trip in residency!

The first week will be spent with Dr. Mayes and a group of University of Richmond sophomores working with a Peruvian organization Pan Peru in Pampas Grande, working in the Andean village's clinic and schools doing health care and health education. Then Mindy, Kelvin, and his friend meet me in Lima to travel around for the remaining 2 weeks. We're planning to visit Nazca and see the lines (mystical sand art), then hike a 4-day trek around and visit Macchu Picchu. Mindy and I will head to Bolivia while I think Kelvin and his friend are going to visit Argentina before meeting back up in Lima at the end to fly back to the states on November 1st. While I will miss many local "fall" activities, including more trips to Apple Hill, Oktoberfests, Halloween parties (I actually don't really like Halloween), and weather which is just perfect (I LOVE fall; and, Hans and Rachel, I bet my "fall" is appreciably warmer than your "fall" :)), I am looking forward to some much needed R and R (my last vacation was in March). It should be a great time!

And while I am not sure I will be a better blogger from South America, I may drop an update once in a while. I will make up for my current lack-of-pictures with pictures on my return. Adios for now...

Lassen

So despite visiting San Diego last weekend (and just an update: the delivery I was so awaiting happened on Tuesday [and went very smoothly, I must and very happily say!]), I still had the travel itch. I have wanted for ages to go visit Lassen Volcanic National Park, which is approximately 180 miles Northeast of Sacramento by Redding. Although the park is open year-round, the main road closes in winter (as early as October, reopening sometimes as late as July) to through-traffic. Due to my current rotation, derm-a-holiday, soon being over (being replaced in a week labor and delivery), this was probably my last chance to visit most of Lassen this season and so, a bit impulsively (and aided by some early morning insomnia), I decided to drive up for a day trip yesterday.

Lassen Peak, which erupted last in 1915, is still considered an active volcano and is part of the Pacific Ring of Fire. The park had beautiful mountain (volcanic) views from the road, as well as cool thermal features (which reminded me a lot of Yellowstone!), pretty lakes, and hundreds of miles of hiking trails. Although my time there was limited, I felt like I got a good taste of a park I'll certainly have to revisit another time! Thanks to Sarah for suggesting the highlights!

Views from the road










Thermal area of Bumpass Hell (kind of a an interesting name... but less offensive when I learned it was named after Kendall Bumpass, a guide who dropped into a boiling pit and lost his leg)

Sulphur Works (and you could definitely smell it!)

Although I got a bit lost, I did go on a moderate-length hike up towards Echo Lake

Nice views of Mt. Lassen

Summit Lake

Guesses... tourist- or self-timer- taken? :)

(Echo Lake)

The drive back from Lassen was just as beautiful as the park! I drove back (a different way than I'd driven there), along Lake Almanor, past little mountain towns like Chester and Greenville, through a deep canyon, and enjoyed watching the sun set over the pine forests.

Railroad, still in use

... which brings me to a random thought.

Although I got great gas mileage on the roads back, I did have to stop once to fuel up. Much like my weakness with gumball machines (I have an absolute inability to walk by one without dropping a quarter to watch a ball roll down the spiral-y chute), I have certain indulgences that I love from gas stations but which, honestly, I never get anywhere else or at other times:

1. Gas station coffee (the stuff like vanilla-mocha-cappucino that comes out of the machine-where-you-push-a-button)

2. Slim jims, or the long-stick-of-meat equivalent

These items made the trip back (a bit longer, closer to 3.5 hours since it was the "scenic route") much more enjoyable!

I'd be curious what strange things other people must have from gas stations!

Counting down:

- 1 week until (as I mentioned above) I head back to L and D

- 4 weeks until my next trip: Peru!