Two Months Down

Well I'm now two months into my anesthesiology residency. It is a ton of work, but I really enjoy it. Two months down and only 34 more to go, but whoose counting :)

If you enjoy my blog, please check out my new site emailtheMD.com I decided to try out a free website designed to help people from all over the world figure out what to expect before they go to see their doctor. My MEDCAP missions helped inspire this idea. Thanks!

I'm Back

Well I'm back! Actually I have been back for over 9 months now. I thought I would countinue to update my blog as I enter my next journey in life, Anethesiology Residency. Wish me luck as I plunge into this one for 3 years. Transitioning from flight surgeon to resident will be tough. If you have any questions on MEDCAPs feel free to contact me. It seems like our Military is doing more and more of these missions which is great!

All the way from the Marshall Islands

Here I am all the way in the Marshall Islands. I am actually on an Army base out here called Kwaljalein and staying at a BOQ. I didn't even know we had a base out here! This is the place they do a lot of missile testing as part of the Reagan Ballistic Missile Program. Here is a picture of sunrise here:

We have been extremely busy here. We flew in here on another C40 and we have done 5 medcaps since we have been here. My first madcap we took a small boat out to a remote Island where only 30 people live. Needless to say, we were likely the most exciting thing coming to the Island for the day, if not the month so everyone on the Island showed up. They were very appreciative of our service and sang to us at the end.

I saw some really interesting cases here on Ebeye Island. Here is a picture of a man’s hands with nodules all over them. This is Gout with tophi nodules which are extremely painful. I have never seen a case this bad before. I referred him off the island to see a rheumatologist.

This woman had a strange growth on her nose that was getting progressively worse over the past 5 years. We had no clue what it could be. I thought maybe Leprosy or a bad case of rosacea, but neither fit very well. I’ll show it to our Dermatologist when I get back to the ship.


The kids here are like the kids everywhere else; friendly, curious, and always smiling.

Well we are wrapping up our medical missions altogether. We have 2 more to do and then we are all done with medcaps. I will be able to help out with a few surgeries back on the ship. Once

back on the ship, we will have about a week or so before we pull back into Hawaii. I'll be flying home from Hawaii after a being away for 3.5 months. This trip has been a blast and thanks for everyone's support while I was gone. I'll try to update another blog once I get back on the ship in a few days!

The Sleeping Lady from Kosrae

Well we traveled to the small island of Kosrae in the Federated States of Micronesia. It is a small island with about 6-7 thousand people on the island. They are very simple people and are extremely friendly.

We arrived on a C40 which was really comfortable with extended legroom. It was basically a 737 with the military running it.

We did 4 medcap missions here and at every medcap they brought us local fruits and baskets. Here is a picture of one of the kids that I saw that had Impetigo, a skin infection on the face.

Here is a picture of how we were welcomed to Kosrae. They made flower hats for each of us

The mountains behind me are called the Sleeping Lady Mountains. I guess it looks like a woman laying down. It looks like it could be Madonna :)

Overall we had a good time here, but I was having cabin fever on the island since there isn't much to do. I went snorkeling once which was fun. The hotel that we stayed at had good food and beer which was welcomed after a medcap. We traveled to the Marshall Islands a few days ago and things are sweet here. We are actually staying on an Army base here that is top secret. More to come soon about the Marshall Island medcaps!

What did I get myself into?

Well I did have to tell this story since it was a pretty amazing story. On the 14th, I was the officer in charge of a medcap at the Ileg medical clinic in PNG. We took a 15 minute flight in by helo from the ship. We landed and set up shop and started cranking through patients. Things went fairly smooth with the only exception being our immunization area. We had way too many people show up and most on them were children. I had to basically stop immunizing adults and only immunize children. We ended up seeing over 675 patients and giving out thousands on immunizations. The clinic director and the people were extremely grateful. We even transported 15 patients by helo back to the ship for surgical screening and 7 of them had surgeries done for inguinal/umbilical repairs and lipoma removals.

Here is the amazing story though from yesterday’s medcap. Around 1100am I was asked if someone could go over to the next village to see 2 patents. One was a paralyzed from the waist down and obviously couldn’t walk. The other was a 70 year old man who was blind and had asthma. They had 4 wheel drive land cruisers and they said it was a quick drive down the road. I agreed and myself, the driver, and the village leader jumped in the land cruiser and took off. The drive was gorgeous with rolling hills and palm trees. The roads were gravel and the driver was telling me that this was a recent advancement and until a few months ago this area was practically impassible. The amazing part of the journey was that the roads led straight into small rivers. Our driver would just drive straight across the river. I asked him what happens when it rains and he said the water gets too high and they have to wait in order to drive across. The 2nd river we got to was long and much bigger than the first. We literally drove straight into the river which did have some current. The water was almost up to the door. Then then craziness began. We got stuck! Here I am in the middle of nowhere with 2 Papa New Guineans, in a land cruiser, stuck in the middle of a river. The other gentlemen got out and placed a rock under one of the tires. The driver then gunned it and we were back on our way. I did get a little scared just for a brief minute.

We kept driving and soon came to the village. We drive up and I get out to see the patients. The locals there were in amazement to see a tall white American in camouflage with a stethoscope and medicine coming to their village. The first patient I saw was the 20 year old who was a paraplegic. About a year ago another man was cutting down leaves out of a tall palm tree. He cut down a large branch and that branch ended up hitting this person in the head and likely broke his neck. He had been paralyzed ever since. The poor guy was very malnourished and he was laying down in a small wooden hut that was up on stilts. He was so weak that he couldn’t even lift his upper body up fully. He was complaining of neck pain and so I gave him lots of pain meds. He was very appreciative and I was touched by how friendly he was given his crappy situation. I said goodbye and went on to the next patient.

He was a 70year old blind man who was obviously having some difficulty breathing. It sounded like he had uncontrolled asthma and didn’t have any medication. I gave the meds to his son and explained how to use the meds. Hopefully the meds will help him breathe easier.

The whole experience was surreal to me. The biggest hurdle for these people was just getting around. The roads are horrible and only good 4 wheel SUVs can transit them. They have to walk everywhere. Obviously these 2 patients couldn’t exactly walk so I was really happy I had the opportunity to go out and help them. I just kept thinking about all the other people that weren’t able to make it to our medcap and I wished we had a better way to reach them. I guess we can’t help everyone, and we did help almost 700 people out at our camp so not all was lost. Maybe next time we could rent more drivers and assign them to go from village to village to bring sick people back to our medcaps. The people that can’t medically make it to our medcaps are likely the ones that need the most help.

I’m so glad I went out on this side mission and I know I got more out of it then those 2 patients. I just wish I would of brought my camera! Sorry for the LONG narrative here without pics, but I hope you enjoyed it. I will be leaving on more medcap missions off the ship to Kosrae in Micronesia and the Marshall Islands over the next 2 weeks. I will hopefully have internet access and be able to keep you up to date. Seeya! Peace out PNG!

PNG Medcaps

Hello everyone. Sorry for the delay in getting information out, but it has been so busy here. So we have been floating out near Madang PNG and doing plenty of good things out here. I was down helping out with surgeries the first couple of days. Most of the surgeries were hernia repairs and lipoma removals. I was able to help out with the anesthesia. One of the CRNAs I was working with let me run a few of the cases myself…of coarse with some guidance though. It was fun, but really busy. I was able to get some good practice and experience.

So the medcaps here have seemed surreal. I feel like I was transported to a national geographic magazine. This is a pic of us landing in Joesephstal which was a 30 minute helo ride up into a very remote village in PNG. When we arrived there were people all around us and most of them had never seen outsiders before. They were super friendly and even though several of them carried machetes around, I always felt really safe.

The medcap missions went very well. We saw a large number of patients and they were very appreciative.

One patient in particular grabbed my attention. She was a 7 year old girl who developed a knee injury one month ago.

As you can see her knee is eroded away and she had trouble bending it now. Her father carried her for 5 hours by foot through the jungle terrain just to make it to our medcap site. At the time we didn’t know her diagnosis, but we wanted to get her help. We were able to arrange a helo flight to the Madang General Hospital.

Here is a pic of her being transported. Her father was extremely appreciative and I was really happy that we helped her out. Upon return to the ship I did some reading and found out she had Mycobacterium ulcerans. It is treated through surgery and IV meds so taking her to the hospital should help. The US is picking up the tab for her treatment costs which is great. She was a trooper through the whole process. Can you imagine first having a medical injury like this, seeing a bunch of new different strangers, and then having to get on the largest helicopter in the world and fly away from everything normal that she was accustomed to? Simply amazing! I hope she does well!

We saw lots of interesting skin diseases including a common fungal infection. Due to the moistness of the jungle and the abundance of this fungus in the soil, many people have this painless fungal disease. It isn’t dangerous at all, but they didn’t like the looks of it. This child has it all over his body and you can probably see it on his face. The call it Pupa and it is easier treated with creams and sometimes pills.

The translators we had were great. They were from Madang volunteering and their English was great. Overall it was a great mission. Here are some pics of us leaving. All of the children actually helped us carry chairs and boxes down to the launch site. It was a blast.

I was Officer in charge of the next medcap 2 days later and I have some pretty amazing stories from that. I’ll try to place them by tomorrow. Thanks for stopping by again!

Papa New Guinea (PNG)

Well we just pulled into PNG and we are near Madang city. We are going to be here over a week doing medcap missions. I am going out on the 14th to be the officer in charge of the medcap. The rest of the time I am going to be on the ship working with CRNAs and an anesthesiologist during the surgeries. I am really looking forward to getting some hands on experience. I’ll be sure to send pics ASAP. Take care!

Singapore Sling!

Well hello everyone! The last 3 days I have had the distinct pleasure of being in Singapore. Singapore is one of the nicest and cleanest places I have ever been. It felt like a very US like city except most of the people there are Asian or Indian. It was founded by the British a long time ago and still has a lot of similarities. One, everyone speaks English, which was a nice change of pace. Their subway system was amazing. 90 cents to pretty much go anywhere. One had to “mind the gap” too as you boarded.

Here are some pics of downtown Singapore. Also are some pics of me and a few friends. They had Hoegarden on tap which was excellent. The food was also incredible. I had sushi, Thai food, and Indian food there. Beats any Asian or Indian food that I have had in the US. They only problem with Singapore is the price of beer. One beer cost about 10 US dollars…crazy! I did buy a Singapore Sling at the world famous Raffles Hotel. It was 26 Singaporean dollars which was about $17. I have never spent that much on a drink before!

We had a blast in Singapore and yes I did a lot of shopping. Jen, don’t check the credit card statement, it will be all worth it when you get the package.

Now I am back on the dreaded ship. We are steaming away to our next destination. We should be there in a few days. I’ll update everyone when we get there. I will be going on 1-2 more Medcaps there and working a lot in the operating room. I’m really looking forward to the OR time. I did find out that I will be going out on another excursion to Micronesia for a week coming up soon. It won’t be as rough as the Philippines, but it will be a week out on land doing medical missions. Should be fun. Well I love you guys and thanks for stopping in again. I’ll update you more when we get to the next place.

Liberty in Vietnam

Well I ended up having a pretty good time while on liberty in Vietnam. It was good to finally get free time away from the medcap missions. The top picture is of Matt and I at the Citadel. It was a large temple, but unfortunately we were not able to take pictures inside.

We were able to go out on a small boat one day and they had traditional Vietnamese music and dancers while we sailed.

The next pic is of me coming back from our last medcap at sunset.

I don’t know what the structure is in the next picture, but I really liked the view on the other side.

Of course I had to get a picture of me in my whites. We were required to wear them to get to the hotel. I spent one night ashore at the Sandy Beach Resort in Danang. It was fantastic with good food, service, a pool, volleyball, and a beach. It was a very fun 2 day stay there.

Overall, Vietnam was fun and a wonderful experience. We just left and we are on our way to the next port. I’ll let you know when I get there. The next port is strictly a liberty port for a few days. It will be good to have, because it might be the last vacation for awhile since we will be getting really busy soon. I’ll update everyone when we pull into port in a few days.

Seeya!

Fillin' in the gaps

These are a random assortment of pics that I took over the past few weeks. The top one is a picture of the volcano in Legaspi PI. It is still an active volcano. We flew a c-12 around it and they got close. It was a pretty amazing ride. I believe this volcano is one of the 7 wonders of the world, and we got to see it on a clear day.

The next pic is of a sunset over Danang, Vietnam.

The USS Peleliu is in the next one. I am on board an LCU and we are approaching the ship after coming back from Vietnam for the day

You will see the Vietnamese flag being flown at a school in the next pic. This is where I will be tomorrow doing a medcap mission.

Yes I am in body armour in the next one. This was what we had to wear to transit in Jolo to our last medcap there. It was hot as ____ (fill in the blank)

Next is a pic of me with some of our workers and some of the Filipino volunteers. They did an amazing job translating for us!

This was a pic of the entire group after we landed back in Legaspi after our 18 days in the jungle. We were so happy to get back to the ship and I never thought I would be saying that.

The next 2 are pictures of Danang. Everyone is on bikes! The last pic is the 60 that took us up to Legaspi on our final day in the PI. Boy were we happy to fly in that. Did you know they actually have air conditioning in them!

More pics and stories to come from Vietnam after we do our missions here. Take care and thanks again for all the comments. You'd be amazed at how much they help out!

Good Morning Vietnam!

Well, I made it to Danang Vietnam! Today we pulled into port several miles off the coast of Vietnam. I rode an LCU in and we pulled up and I stepped on land. This is the first time since the Vietnam War ended that a US Navy ship has pulled up and allowed military personnel ashore. It was actually a really cool experience. The people were extremely friendly and most were very happy to see us there. We drove around and surveyed our medcap sites. Danang seemed like a very busy and industrialized city. Everyone was either riding a bike or motorcycle. We saw very few cars and everyone wore hankerchiefs over their mouths and nose to cover up from the exhaust...or possibly avian flu...I heard they take that illness very seriously here. We didn't get the opportunity to eat or hang out at all. This port is technically a work port with our medcap missions, but they are letting us take some liberty. Uniforms are a major issue. They only want us to go out into town in our summer white uniforms. Absolutely no flightsuits, coveralls, or camouflage uniforms are allowed. Our aircraft were also required not only to not fly at all near vietnam, but they needed to be stored away so that they are less visable on the ship. All of our flags on our ships are at half mast and we are required to fly the Vietnamese flag on our tall mast. Wow, lots of restictions, but I guess I understand since relations in the past haven't been that good with Vietnam for obvious reasons. Overall I feel this will be a really good experience. I am looking forward to participating in the medcaps on the 17th and 19th. I will be taking a tour and hanging out 2 days so at least I will have a little bit of fun. It is so hot here! I was sweating so profusley today in the sun..ahhhh. We also watched Good Morning Vietnam yesterday which was pretty funny to see. Well here we are in Danang! I'll be sure to post some pics of Vietnam and the medcaps shortly. See ya!

Cotabato MEDCAPS

Here are some more pictures of our adventures in Cotabato, PI. This particular day we did numerous surgeries removing sebaceous cysts and lipomas. Everyone thinks that they have cancer, so removing a small cyst can really go a long way in helping them out. they would much rather have a scar than to have the mass. One woman in particular had a lipoma on her neck, and her family said she had a hard time finding a huspand because every man thought she had cancer and didn't want to marry her.

In one picture above I am helping the nurse learn how to inject lidocaine in to the face. She did a good job, but I had to correct her angle or else she may have punctured through into the mouth...no cool points for that.

One woman had a cyst on her head, but was really scared of the pain. I assured her she wouldn't feel a thing and she agreed to the surgery. She felt no pain, we removed the cyst, and she was much happier.

I am curious to know what the infection rate out there was. We did our best to ensure clean instruments and a sterile working environment, but as you can see there were many challenges in front of us. we were basically doing surgery on school tables with limited resources. We only had one set of instruments that needed to be cleaned in between cases. I placed everybody on antibiotics just in case though.

There is a picture of us in zodiacs. That is how we got to 2 medcaps. It was so much fun!

Well we are finally done with all of our medcaps in the Philippines. We are just picking up some leftover gear and people now. After we pick them up, we will be moving over to Vietnam. it looks like I will be on 3 medcap missions in Vietnam which will be very interesting. More to come in the next few days...thanks for stopping by again.