Thoughts from home

Today is Abigail's 16 month birthday. She continues to explode in her verbal and physical development, constantly amazing and entertaining us. She says new words everyday, changing

so rapidly that it is hard to even keep up with it in a journal. Today she said "elmo" as we were reading one of her favorite books to her. The soft cloth covered book was her favorite to chew on and look at when she was younger. She's moved on to more substantial books like "Move Over Rover" (a prase which she also says) though she still loves the Eric Carle books like Brown Bear,

Brown Bear. I love that she will come and sit on my lap and lean up against me while I read her these favorites over and over.

April is almost done with her residency, her official end date coming in one week, Tuesday Sept. 2. This cannot come soon enough, as with both of us still working full time we haven't had the quality family time this year that we had hoped for- yet. I am convinced that it is coming. Thankfully we've had the help of great family and friends to get us through our babysitting needs over the last three weeks. Our friend Megan Stevens watched her today and put her hair in french braids! It was the first time that she's had her hair in braids and she looked absolutely beautiful! I hope to learn to braid her hair like that myself! After "night hawk" duty last night and sticking around for anesthesia this morning, I crashed in the call room for 5 hours or so. After coming home, I read to Abbi while April but together a fantasic dinner of baked chicken, roasted veggies, baked bread, and Riesling. It was so nice just to sit as a family and enjoy each other. I feel like I've been really out of the loop, having been on nights for the last week. I'm looking forward to curling up next to April for a decent nights sleep in just a few minutes.

Yesterday, John and I secured 160 pairs of sterile surgical gloves and a boatload of non sterile gloves for rick and jack- we look forward to sending these with meds, chocolate, and other goodies very soon. I've decided to try to get at least one pair of sterile gloves for each case to take with us. We will be in Zim for 5 months (roughly 150 days). At 4 cases a day, this winds up being 600 pairs of gloves. With each box of gloves holding 40 pairs, this is about 30 boxes of gloves for John and I. Wow. The glove logistics alone are already getting hairy.

The Banks, Epplerys, and us have talked a lot about getting a bible study going, which has been shamefully lacking to this point. Being out of touch with the Bible leaves me feeling like a man without water, dry and wanting. It also begs the question: what are you doing all of this for? Doing this apart from the firm foundation of Christ is asking for failure.

Tomorrow is a new day- I'm excited about seeing Abbi in the morning and about sleeping next to April. My girls, my treasure.

Killing Time

So,

It's 2:30 in the morning and I'm hanging out on the labor and delivery floor. I've only had 3 admissions tonight while acting as faculty for the residency. It's pretty strange being "faculty." It's definitely cemented the idea that I'll be a "life long learner." I've got two ladies in labor now that should deliver on my watch and some eager residents who will call and keep me "updated" AKA sleepless-until morning. This month I'm on an anesthesia rotation, which has been really great. I've had an opportunity to really cement my airway skills and focus on neuraxial anesthesia (spinals and epidurals). It's been a remarkable experience and all of the anesthesiologists and CRNAs have been more than helpful to me. Among the other issues I've been able to come closer to mastering are rapid sequence intubation and the drugs/dosages that pertain to that, difficult airway, inhaled anesthetics, IV sedation, and handling potential complications of those things. I definitely have a greater appreciation for the complexity and difficulty of the anesthesia profession! This week of faculty work has been difficult, as it is a week of nights. Occasionally a shower and coffee will get me through to the next day and give me enough of an edge to push on and get my hands dirty in the OR and on the L&D floor. Sometimes, though, I've just got to call it a day and crash in the call room till noon or later after coming off of my shift. Being busy has allowed the girls to get back to KC and see family while I'm stuck at the hospital. I got a chance to do epidurals on the ladies that I am supervising for tonight, so that might make it worth it! I'd better get some sleep!

The fellowship begins

So, Ive neglected this blog for awhile. I told myself that I'd be better about writing down thoughts from this year, as it is a huge milestone in the life of our family.

We sold our house in May. Really, that was a fairly crazy time around the McQuillen household. Having spent weeks sorting through our stuff, we had a garage sale just before moving in which we got rid of 25% of our stuff. I think we probably threw out, gave away, or craigslisted another 25% of our stuff prior to that. After we sold the house, we stuck the rest of our stuff in a 1o X 18 ft. storage shed and couch surfed for

three weeks. We had no idea how stressful it would be hopping from house to house until we could move into the apartment in which we now live. Don't get me wrong, we had three very nice places to stay, it's just that it's tough for a toddler to adjust to all of those new places. During the months of June and July I took off for a Tropical Medicine and Parasitology course in West Virginia. It was a very good course. The course content was an in depth exploration of items that were just presented as side notes in medical school. Below is the long list of stuff we learned about. Again, it was very exciting, particularly modules 2 and 3- but I haven't sat in class that many hours in a row in years...I'm not very good at being stationary.

Module 1 Lectures	Course Overview /Introduction to Global Health Epidemiology of Tests Primary Care and the Health Care Worker Essential Drug List Role of Women in Health Famine-Displaced and Refugee Populations Nutrition & Growth Monitoring Family Planning Geographic Distribution of Infectious Diseases Global Epidemiology & Surveillance Global Disease Eradication Air Pollution & Climate Change The EPI Vaccine & Preventable Diseases EPI Cases I, II Emerging Infections HIV Epidemiology & Control Role of International Organizations & Volunteer Organizations in Global Health Global Burden of Psychological Diseases Antimicrobial Resistance Protein-energy Malnutrition Key Micronutrient Deficiencies & Their Prevention Disaster Planning Medical Management of Bioterrorism Causal Inference Community & National Responses to Malnutrition Measures of Morbidity Measures of Mortality & Survival Analysis Epidemiology of Communicable Diseases & Epidemic Investigation Vector Control Tropical Water Supply & Sanitation Rural Development Population Transition & Health Measures Ethical Issues in International Health Environmental Health Occupational Health Cultural Issues in Global Health Introduction to Epidemiology Screening Programs Study Design I, II, III (Descriptive Studies, Analytical Studies, Clinical Trials & Meta-analysis) EPI Cases I, II, III Global TB Eradication Module 1 Review
Module 2 Lectures	Module 2 Overview Travel Medicine I - Advice to Travelers High Altitude Sickness Respiratory Diseases in the Tropics Poisonous Plants and Fish GI Diseases in the Tropics Tropical Ophthalmology Cardiovascular Diseases in the Tropics Surgery in the Tropics Urologic Diseases in the Tropics Dermatology Cases Dermatology in the Tropics/Infectious Skin Diseases Infective Endocarditis Viral Encephalitis Pediatric Respiratory Illnesses Eosinophilia Hepatosplenomegaly Neurologic Diseases in the Tropics Animal Bites and Rabies Prevention Travel Clinic Tropical Medicine Cases Web-based Resources for Travel Medicine Infectious Diarrhea & Fluid Management Enteric Fever (Typhoid) Bone & Joint Infections Skin & Soft Tissue Infections Venomous Insects & Animals The Ill-returning Traveler Prolonged Fever & FUO Heat-Associated Illness Travel Medicine II Dentistry in the Tropics Surgical Dressing/Suture Lab Improvised Splints Lab Immigrant & Refugee Health Pediatric Travel Introduction to Clinical Malaria Cross Cultural Medicine Hypothermia Aviation & Diving Medicine Obstetrics & Gynecology in the Tropics Dermatology for Dark Skin Peoples Burn Care in Developing Nations Culture Shock & Re-entry Shock Module 2 Review/Jeopardy
Module 3 Lectures	Module 3 Overview Introduction to Parasitology Intestinal Protozoa/Tissue Amoeba Intestinal Protozoa Lab/Film Blood & Tissue Protozoa - I (Leishmania, Toxoplasma) Blood & Tissue Protozoa - II (Trypanosomiasis) Blood & Tissue Protozoa Lab/Film (Protozoa and Stool Contaminants) Malaria Malaria Lab Schistosomiasis Other Trematodes Stool Exam for Ova & Parasitology Lab/Film Intestinal Nematodes Cestodes/Larval Cestodes Filariasis & Tissue Nematodes Parasitology Case Studies - I(Protozoa) Parasitology Case Studies - II(Trematodes, Ectoparasites) Parasitology Case Studies - III(Cestodes) Parasitology Case Studies - IV(Nematodes) Nematode Lab/Film Trematode Lab/Film Control of Parasitic Infections Parasitology Practicum I, II Parasitic Jeopardy Competition Medical Entomology (Arthropods, Ticks, Mites, Lice, Bugs, Fleas, Mosquitos, Flies, Myasis) Medical Entomology Lab/Film Entomology Case Studies (participants) Cestode Lab Parasitology Review Clinical Parasitology by Organ System I-II Drugs for Parasitic Infections Video: TBA Module 3 Review
Module 4 Lectures	Module 4 Overview Hansen's Disease Cases Diphtheria/Pertussis/Tetanus Pulmonary Tuberculosis & Screening Extra Pulmonary Tuberculosis Cutaneous /SQ Fungi Systemic Mycoses/Opportunistic Fungi Antifungals Zoonoses Syphilis & Other Treponematoses Non-tuberculous Mycobacteria STIs I, II Rheumatic Fever & Other Strep Lymphadenitis Acute Lower Respiratory Infections Non-Dengue Hemorrhagic Fever & Arboviral Illnesses Hematology in the Tropics Molecular Techniques HIV Global Overview Viral Hepatitis Blood Smear Lab ID Case Studies Rickettsial Diseases Oncology in the Tropics Microbiology Lab Peds Procedural Pearls Meningococcemia & Other Bacterial Sepsis Cases - TB Serologic Diagnosis/ Case Presentations Dengue Shigella & Amebiasis Measles HIV Presentation & Management Typhoid Peds HIV Influenza & Avian Flu Urinary Tract Infections Prevention of Pneumonia Globally with Vaccines Neonatal Resuscitation in the Developing World Leptospirosis Diarrheal Diseases Diarrhea/ORS Peds TB Cases Neurologic Cases Practical Aspects of Microbiology Lab in Developing Country HIV Management - Opportunistic Infections (Cases) HTLV I - II Module 4 Review/Jeopardy

A complete overview of the course can be found at:

http://www.hsc.wvu.edu/som/tropmed

It was difficult to leave April and Abbi for several weeks during the beginning of the course. But, driving out to WV with three of my best friends crammed into my VW sedan was the most fun I think I've ever had on a 16 hour car ride. The day before leaving, I emptied the meal monies on my residency name badge on energy drinks, so we were definitely wired for sound on our epic journey eastward.

We arrived at our desination, a little college house that we had rented out for the duration of our class work, in the wee hours of the morning. We were greeted warmly by our good friend Logan, who had been involved in the course for 2 weeks prior to our arrival. Being the only one in that 1000 sq. ft. house was getting a little lonely for him.

Together, we endured over 3oo hours of class room time (though the Via Christi guys did the first module online). The little house logan had to himself quickly felt much smaller as the five of us shared the small living space with one bathroom. The feeling of togetherness only became stronger when we were joined by three of our wives and three children. Thankfully, my single buddies, Jack and Rick were able to stay at a nearby apartment while the families were in town.

Overall, we had a great time. After returning from the course, Jack and Rick took off for Medical Missionary training and service at Karanda hospital in Zimbabwe. Information on the hospital can be found at:

http://www.teamzimmoz.org/kmh.html

Rick is currently keeping a blog at:

internationalfamilymedicine.blogspot.com/

While the guys are forging ahead with work overseas, John, Logan, and I are completing the stateside leg of our International Family Medicine Fellowship. Information on the Fellowhship can be found at:

http://www.vcfm.net/fellowships/international-medicine-fellowship/

I hate to abbreviate the part of the blog that pertains to the WV Tropical Med course, as it really was a great experience. I think if I had my dithers, I'd change a couple of things about the course, but overall it was an essential part of training for work overseas. Hopefully the lessons will stick with us as much as the memories of our more extracurricular activities!

I am currently completing a month of anesthesia training at St. Joseph hospital in Wichita, KS. But, that is another post altogether!