Final Days

Echo Ambasadors of Forsyth Tech!

Greetings everyone! I know it has been a week since we returned from Nicaragua and Whitney actually had the final post written about 3 days ago but I'm just now finding the time to write our final words for the November, 2008 excursion. Each trip to Nicaragua gets better and better. I learn something new each time I go about how we can better serve the people in Nicaragua and in our own community. This is a tremendous learning experience for everyone, both at home and abroad. I have gained many interesting case studies for those students who have not had this opportunity and have learned of many more possible future opportunities for students. This blog is only a small taste of the entire trip, I hope you have enjoyed hearing about it. There is so much more and if you would like to hear more about it, please let us know.

I have many people to thank for generous donations for this trip. First of all to Dr. John Paar for inviting me to serve on these teams in the first place and for extending the opportunity to my students. And to Dr. Conley Winebarger, Jan Overman and Linda Yurko for their tremendous support and encouragement, you can't begin to know how much your support has meant to everyone involved. Without the kind and generous support of Bob Kaylor and General Electric it would not even be possible to operate two teams and see the number of patients that we were able to see. Bob was instrumental in procuring the laptop equipment and loaning it to us for the week once again. Thanks again Bob! Mr. Taufiki Lee of Saunders publishing kindly donated several cardiology textbooks to give to the physicians in Leon who were very grateful. And last, but certainly not least, Natalie Inge and her friends from Summerfield Recreation Association, Wesley Long Lab Dept. and Cornerstone Baptist Church in Greensboro, NC for the baseballs, stuffed animals, toys and candy. As you can see from the pictures below, they were very appreciative of these things.

My hope is to extend this opportunity to many more students and faculty in the future, including general sonography students. So keep this mission in your prayers so that we can continue to use ultrasound to serve others throughout the world. Keep your eyes open for opportunities that may be available and keep your minds open so that our opportunities won't be limited.

Here's Whitney's final post.

Hi everyone, this blog is a bit late but with the slow internet connection in Nicaragua, we decided to wait until we were back home to write our last blog.

The study of the prevalence of rheumatic heart disease in the population of Nicaragua ended on Friday. Now, hopefully, there will be a vaccine available that will reduce the occurance of rheumatic heart disease in the area.

I scanned a couple of pediatric patients which was very challenging! One boy did not want to lay down, so I had to scan him sitting up while he sat in his mom's lap. It is so different scanning peds patients because you focus on obtaining enough information to answer the specific question at hand...whether the anatomy is normal or not. Because they aren't going to have a degenerative disease going on at their age, so it is a different thinking process entirely. But it was good to scan them because I haven't had much experience with peds patients.

I am pretty sure that I could tell if a patient has rheumatic heart disease now. After seeing patients with the disease first hand, my knowledge of the disease has increased so much.

Our flights were great coming back to the U.S. which was good. It is hard to get used to this weather again after being in a subtropical climate for a week. I miss it already. I miss Leon too. I miss the atmosphere/spirit of Leon more than I do the actual city because to be honest, I like my clean town of Clemmons, but I miss how the people down there do not complain about every single thing and are really laid back and only worry about the neccessary things in life, which is probably one of the most significant things I learned while in Nica this past week. How we are so blessed to live in America and not have to worry about where our next meal is going to come from or whether our kids are going to be able to eat and be clothed properly and have the bare necessities of life. I am so much more thankful and appreciative of everything I have now and hope that I can share that with others and visit/work in Nicaragua again someday.

Dia Quatro

Buenos Dias! We are still down in Nicaragua and working very hard! It has been a really busy day. We saw around 50 patients today at least, so we had no down time today. But that is okay, that is why we are down here.


We had some follow up patients today from previous studies and some had improved and some had not. It was good to see that some had improved and that their symptoms were not getting worse and maybe the ones that are getting "better" will get better at some point via medication or recieve the proper treatment through another method. We did have new patients today as well and quite a few of them were normal, which was good, but a few were definitely positive Rheumatics.


Even though we do not communicate with the nurses well, we do have something in common. We all love ABBA!!! We took the laptop down to the hospital yesterday afternoon and today and let the nurses listen to ABBA on itunes. They absolutely loved it! They are so funny.


While Wendy and I were eating dinner at El Sesteos (for the 3rd time, haha) there was a parade of the Gigantonas that came through, which was pretty cool. It is this tradition they celebrate down here where they make fun of the Spaniards. They have this huge doll with dark hair on stilts and a doll with blond hair and a "big head" that walks down the streets while they play drums and music. It was neat to see. I felt like the big tall thing though because every one down here is so short! I feel like a "giant" girl compared to the 5 feeters down here! But anyways, we had a long but successful day.

Dia Tres

First of all, we apologize for the absence of our "case of the day". The internet is not cooperating with us and our efforts to send you all the video clips. Sorry about that. We will try to download the clips again so that you can view them.

We started off our day with a walk down to a little boy's house that the doctors and Wendy were familiar with. His name is Eliud and he was so excited to see them. We gave him and his brothers presents and they were so happy. One thing I noticed this morning was that the people down here are outside a LOT! They don't sit around their homes all day and watch television. They get out and interact with one another and live as a "community" instead of isolated individuals. Their homes are closer together but they still aren't afraid to get out and socialize with one another. The kids even stand in large groups and wait on the buses together in the mornings.

We had a few congenital cases at the hospital today! There were a couple of pediatric patients that came in who had congenital abnormalities, which was really interesting and a great learning experience. I have seen more abnormal cases here today alone, than in a month in the hospital back home. We had a couple of classic rheumatic fever patients. Pulmonic stenosis, which I had never seen. And a very special case that will be our "case of the day"...IF we can get the file to download.

My Spanish has improved since I have been here. I want to talk to every one I see but I can't and that really bothers me. I plan on taking some Spanish classes as soon as I can when I return home. I want to learn the language so that when I come back I will be able to communicate with the people more effectively.

Dia Dos

Day two here in Nicaragua has been very adventurous. We went for a walk around town this morning and handed out candy to a few children who were up at 6:00! Not many people were out in general though because today was a holiday for them.

We arrived at the hospital this morning at 8:00 and were warmly welcomed by nurses Sandra and Janet and they helped us tremendously all day long. We were also not so warmly welcomed by a plethora of cockroaches. Yeah, they were crawling all over the exam room door. There were so many of them just crawling around and the nurses came over to spray/kill them for us. It was disgusting to say the least but after the nurses sprayed the roaches died and we carried on. Our first patients didn't arrive until 10:00 or so, again because of the holiday. Many people stayed in. We only did a couple of patients this morning but the afternoon definitely made up for the morning because we had about 30 patients to come in about 3:00. It was great though.

I was able to scan a young girl who was 40 weeks pregnant and do a fetal echo. That was exciting! I loved it. Ruben does pediatric and fetal echoes, so he helped me with it. The right and left sides look opposite in a fetal exam. Because of the higher pressures in the right side, the RV is larger than the LV and has more trabeculations. Plus, the RV has the moderator band, so that helps to distinguish between the different sides.

Most of our patients were normal, which was a good thing but there is a "case of the day" blog for all who are intereste to view.

Dia Uno

Hola from Nicaragua! The first day here in Leon has been pleasantly "warm". About mid 80s or so. Quite a change from North Carolina.

We arrived last night about 12:30 after at least 12 hours of traveling. All of our flights went well with the slight exception of a delay when flying from Houston to Managua. When we did arrive in Managua we were welcomed by Jose, who transported us from Managua to Leon, which seemed to take forever but with the rain pounding on the windshield so hard you couldn't see 5 feet in front of you, the delay was understood :)

This morning we took a tour of the market. Quite a site to see.

Wendy practiced her Spanish while touring the market when a young lady began a conversation and explained how her baby needed milk but the young lady couldn't afford any. So we all walked down into the market and Wendy bought the girl some formula. I thought she did an excellent job communicating with her because all I did was stand there and nod/smile, lol.

So then we walked around the market some more and checked out the meat market as well. If anyone wants any meat while we're down here just let us know! We'll be happy to pick some up for ya.

Then we met up with Dr.Paar and Dr.Rose who are two very pleasant cardiologists, and we went to see the voting polls here in Leon because today was their election day! We didn't actually go inside to where the polls were but we saw the people waiting in line to vote, just like here in the states. They were voting for mayor and city council leaders.

Then...the Hospital!!! What a sight.The funniest thing was the pigeons running around outside the ICU! Yeah, that was crazy and the whole hospital was run down and dirty and pitiful. They are remodeling departments of the hospital and the new X-ray department looks really great compared to others.

Sanitation is not enforced in the hospital either. That was a bit disturbing.

For the evening we took a nice trip to the ocean! On the way, we ran into a herd of cattle. Fun, fun. While we were on the beach, these little boys came up to us and were trying to sell us necklaces that they had made but we bought them ice cream instead of buying the necklaces. After I ate, I gave them the rest of my food and they were sooo happy to get that as well. It was quite a shocker to me that someone would want a complete strangers leftover food.

I have observed a lot of new culture differences already here in Nicaragua and am ready to experience new ones each day that I am here. Monday here I come!