#we also came up with an idea for the meninges but way to complicated and I forgot

[lavendelhummel]

I hereby present a vegan alternative for human brain:

Throwback to the time we were *almost* anatomically correct and made Brodmann jokes (brot=bread in German; brodmann=old dude (anatomist) who found histological differences in brain regions and called and named them after himself, with absolutely no clinical relevance but joke potential) with cake. (See that temporal lobe?! We did do the most important structures - seeing, moving, feeling should have been possible for cake-human!)

Recipe: make cinnamon rolls (yeast dough with a cinnamon-sugar-fat spread) and don't roll them put fold them in a bowl shaped mold, we used a wok pan. Ah plus my standard cheesecake sauce: juice starch and sugar. cook it, pour it, cool it (poor cake-human's bleeding is a bit big but hey)

also hand eating advised. I mean, take a fork if you want to but I think the brain eating should require hands

Finally, a vegan alternative to human heart! Douse in ketchup and eat with your hands.

[heroes-of-olympus-next-gen]

Ryder’s birth story

I think the title it's pretty self-explanatory. Ryder's (2nd solangelo baby) birthstory.

Nico and Will had just put Bianca to bed when Will’s phone started ringing. The last thing they had expected that night was their son’s surprise arrival almost three months before his due date. They both got in the car and didn’t exchange one word with each other.

“It’s bad isn’t it?” Nico asked Will.

“It’s not my speciality. I don’t know.” Will lied to him while focusing on the road.

“You have three specialities in Cardio, neuro and general. Just tell me how bad it is. I can take it.” Nico demanded.

“It can be very bad. The baby is coming almost 3 months early. He doesn’t even have a proper immune system yet.”

Their surrogate was already taken to a c-section when they arrived at the hospital. 30 minutes later a doctor came into the waiting room. “Both the baby and Stacy are fine. He has a good heartbeat, even though he has some trouble breathing, but nothing that we can’t help out with.” The doctor said. “We are going to transfer him to the NICU and keep a close eye on him. And Will I want you to remember that you are his father, not his doctor, that means no check-ups or anything medically related. I am going to be his doctor and I promise that we will take good care of him.”

“Fine, nothing medical,” Will promised.

“By the information, I have at the moment if he makes it through the night, his chances of survival are high. You better come back tomorrow morning, it’s pretty late/” Dr Montgomery said, and they left the room.

Nico and Will sat in the car in silence. “He is alive,” Nico stated.

Will had closed his eyes and put his hands together. “Shut up, I am praying.”

“You are praying? To whom?”

“Greek Gods, Roman Gods, Jesus to anyone who will help him make it throughout the night. I need him to survive.” Will replied.

“He is going to be fine,”

The next morning after Bianca woke up, Reyna took her to her place so she could play with Alex. Nico and Will went back to the hospital trying to be as positive as possible. Dr Montgomery came next to them, “Good morning. Are you going to see the baby?”

“Actually, we wanted to talk to you first. How is he doing?” Will asked.

“He made it through the night.” He paused. “But he caught meningitis.”

“How did he catch it? He is not even a day old.” Nico said.

“The nurses heard him crying and we ran tests on him and diagnosed him. But the good news is that we found out early”.

“Oh, Gods. How bad is it?” Will asked.

Dr Montgomery looked down, “Will you know how it goes. He is a premature baby, and he is not vaccinated. I am sure you know better than everyone the complications of Meningitis. I want you to keep in mind that we caught it early and we are technically above him all the time, and he has parents that already care about him. I want you to be optimistic, you should go see him”.

Nico and Will went up to the NICU and got to see their son. He was so tiny, and he seemed to be in pain and discomfort. They had hooked him up to what seemed like ten different machines. “It’s so weird. I’ve been up here a couple hundred times, but I never expected to be the parent in this situation.” Will confessed as he stared at their baby.

“We are going to get through this. He is going to come home with us, and Bianca will be a big sister and we will move to New Athens in a month.” Nico said. “It’s nothing the two of us can’t handle together.”

“I hope so. I don’t want to lose him; he is our son.

Hazel came into the NICU in the late afternoon. Nico was still next to the incubator. “He is adorable,” she said getting a better look at her nephew.

Nico looked at his sister. “I am sorry I didn’t call you yesterday, Ι wanted to make sure that he would make it throughout the night before I called you.”

“You shouldn’t be getting through this on your own,” Hazel stated. “You were 20 hours in the hospital with me when I gave birth to Emily. I should have been here since yesterday.”

“You have your own life, and problems and troubles. You don’t need mine too.” Nico confessed.

“We are a family. When you have a problem, it’s my problem as well. That’s how families work” Hazel half-smiled. Then she noticed something that made her realise why Nico didn’t call her. “Do you feel something?”

Nico silently nodded. “He is a part of my life for like what? A day? And I don’t know what I will do if I lose him. We still haven’t even picked out a name”.

“I am sure everything will work out for the best. A new day will come tomorrow, and he is going to be better. I have a good feeling.” Hazel consulted her brother.

You would have thought that would be very hard for someone to sneak into the NICU in the middle of the night, but the God got in fairly easily without even getting recognized. He went above the baby’s incubator and took him in his arms.

“So, listen little guy. I am going to heal you because I don’t want my son to be sad. I’ve seen your future and you play an important part. You don’t deserve to leave this world so early”. Apollo said to the baby, and he blessed him.

The next morning Nico and Will started making their way up in the NICU when Dr Montgomery came towards them with a file in her hand. “I’ve got news for you.”

“Good ones I hope,” Will replied.

“Yes, definitely good news. I don’t know how it is possible, but he got rid of meningitis in 12 hours. I have never seen anything similar happening. He still has a few more days in the NICU but he is out of immediate danger.” Dr Montgomery said.

Dr Montgomery left them to go and see their baby. It was the first time the doctors let them hold their son as there were fewer machines in the way. “Do you think that there is a chance that Apollo cured him?” Nico asked Will.

“Positive. Or maybe something got into him. Not even the best antibiotics can cure a baby that fast.” He stared down at their baby. “Not that I complain. There was definitely some magic involved.”

“We have to pick a name”. Nico stated.

“I’ve been thinking about it.”

“Any ideas?” Maybe we should name him Ryder. He is a fighter and that is what the name means.”

“It’s a good name, but don’t you think that we owe Apollo that he is alive?”

“So, you want to name him after Apollo?” Will turned to Nico. That was the last thing he had expected Nico to propose. “I am sure he is going to-“

“Not exactly what I am trying to say. We could give Ryder a middle name that also honours Apollo. Like maybe Phoebus? It’s just an idea, you don’t have – “

“I think it’s a great idea. So, it’s decided, Ryder Phoebus?”

“It’s decided.”

[reeceabi-blog]

There must be something in the genes

Besides the aforementioned causes, sepsis could also be associated with meningitis (inflammation of the membranes that cover the brain and the spinal cord). The risk of infection in newborns is associated with complications associated with pregnancy. Infants are susceptible to infections as their immune system is undeveloped.

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[kristineandthings]

South Africa APPE: #5 International Rotation Recap

I can’t believe it’s been 7 weeks since I was last in South Africa! In addition to adjusting back to the time zone in the East coast (a 6-hour difference), I also had to learn the new pharmacy regulations that updated within the 6 weeks I was away. The field of pharmacy always surprises me how quickly it moves and adapts; it’s true what they say that one must be a lifelong learner to go into pharmacy! While I’ve had this time to get back into the swing of things in America, I’ve also had time to reflect on my experience completing one of my rotations abroad. My conclusion? It was the best decision I made in my 5-going-on-6 years of pharmacy school!

This international rotation has given me opportunities to grow and develop professionally as a future pharmacist. It challenged me in ways that I would have never encountered if I did not study abroad. Because pharmacists in South Africa earn a Bachelor's degree and do not typically attend ward rounds, it was a challenge for me to take initiative and face an environment where doctors are not as welcoming to pharmacy as I am used to in the U.S. I felt that I had to prove myself, therefore it challenged me to be 100% certain in my recommendations and in my responses to any follow-up questions doctors may have. It motivated me to be an advocate for the patient and the field of pharmacy itself. I learned how to be more confident in myself, in my knowledge, and in my delivery of my interventions. Although physicians were mostly not receptive to my suggestions, I know I made an impression on the medical team. I especially made an impact on the South African students in their last year of medical school because I would discuss with them the medication errors I noticed daily. By showing the important role pharmacy can have in the in-patient setting to the next generation of physicians, I hope I can change the environment where pharmacy is more accepted in ward rounds to improve patient care.

(above: interior of the pharmacy building at Helderberg Hospital, a public district hospital)

South Africa has the highest population of people living with HIV and the highest number of cases of MDR/XDR (multi- and extensive multi-drug resistant) tuberculosis. Before this rotation, I’ve only seen one case of HIV and one case of tuberculosis during my time in pharmacy school. Therefore, this rotation strengthened my knowledge of TB and HIV because most of the patients I saw had either or both diseases. Additionally, some of these patients also experienced disease complications that I have only ever learned about but never witnessed before this rotation, such as cryptococcal meningitis and progressive multifocal leukoencephalopathy (PML). I also had the opportunity to shadow a physician for a week in the HIV clinic at the hospital. Despite being an HIV clinic, patients often come for a multitude of complaints – from a cough to arthritis – because HIV such a stigmatized disease that patients do not even want to see their primary care physician for these complaints. In addition to treating complications that come with having HIV, these physicians must also be prepared to treat anything, and it’s amazing to see how much they can do with limited resources.

We also had a highly accomplished preceptor to guide us and to learn from. Dr. Coetzee is incredibly smart and challenged us with clinical questions regarding our patient cases that would make us think critically. He was also very responsive to our thoughts and ideas. For example, one of my classmates on this rotation with me had an interest in pediatrics and Dr. Coetzee coordinated with the pediatric ward at the hospital to allow him to shadow in that ward for a week. He also was a wealth of knowledge regarding the tourist activities we wanted to do and made sure we made the most of our time in South Africa.

(above: selfie with our preceptor, Dr. Renier Coetzee in Delft, a township where we worked with the NGO, Touching Nations)

Just because this rotation was in another country didn’t mean it was a vacation! You must be willing to learn a new set of laws, guidelines, drug names, and a new way to do pharmacy in general. Pharmacy school taught me all I need to know about the drugs, but this rotation showed me a different way to apply my knowledge that I would not be exposed to otherwise. I was also given a lot of autonomy; therefore, students interested in this rotation specifically should be highly self-motivated to learn and work on your own to be successful. I also had to handle the challenges that came with working in wards where pharmacy is not typically part of the medical team. Therefore, you also must be willing to overcome adversity in a professional manner. This international rotation is also self-funded so costs for items like flights, housing, food, etc. must be considered. However, there are scholarships available for students to apply (like the one I received!).

Overall, I would absolutely recommend this experience for future students! The American healthcare system was all I knew and I naively assumed that other countries would have similar infrastructure. However, I learned personally that healthcare is very different outside the U.S. and can vary majorly country to country. It allowed me to gain perspective to value what we have in America – such as electronic medical records – and where we can improve. I also grew professionally to become more confident, assertive, and responsible. It was exciting to be treated not as students but as pharmacists, and to have the ability to make recommendations and decisions autonomously. I know this experience will make me a better pharmacist in the future!

(above: Me and my rotation-mates at Christian Barnard Memorial Hospital, a private hospital)

As always, feel free to leave me any questions and comments you may have and I’ll do my best to answer them! Also, check out my previous blog posts about my South Africa APPE rotation:

#4 Ward Rounds

#3 Community Outreach Education with Touching Nations

#2 First Few Weeks in Cape Town

#1 Pre-Departure Thoughts