Pharmacology Department and Weekend

Friday and Monday I was posted in the pharmacology department. Since pharmacy is different in India the pharmacology department is more research based. It would be similar to a pharmaceutical science department or another type of pharmaceutical research degree in the United States. They teach pharmacology to the undergraduate students, have post graduate students who are doing research work, and also help run the research cell at Pravara. Overall, the pharmacology department is a pretty busy place.

The staff in this department were very kind to us and kept us pretty busy, which was nice. We started out by observing them give oral examinations to a batch of MBBS students. They were learning about the nervous systems as well as other body systems and getting quizzed on these drugs, how they work and their adverse effects. It reminded me of the things that we learned in our PDA (Principles of Drug Action) classes. I knew some of the information and also realized that I still need to do some refreshing on my drug mechanisms and adverse effects. I am also glad that I never had to take oral exams because sitting there being asked questions by my professors would have been very intimidating and I don't think that I would have done very well.

We had the opportunity to learn about a PhD students research project with genetics and warfarin. It was very interesting to see how she does the testing and also to see how passionate she was about her research. She really wanted to improve the way warfarin is dosed in different patients to better improve their outcomes and decrease the number of adverse effects. She also talked with us about her wedding and showed us pictures that she had on her computer. It was very interesting to learn more about the customs in India and how marriage works here.

Monday we spent time watching an experiment. They used a guinea pig ilium tissue to run their experiment. They were seeing what affects different concentrations of a drug had on the tissue contraction and using this information to determine what the concentration of an unknown is. It was very interesting to see this type of experiment in person because we did some similar things in school, but we were just given the data and had to figure out the unknown concentration. They also took us to the animal house and we got to see the rabbits, mice, rats, and guinea pigs that they use for experiments and research purposes.

Another part of our time in the pharmacology department was to visit the research department and learn about the proposal and approval process at PIMS for research to be conducted. As I don't have a lot of experience with research in the United States it was interesting to hear how it is done in India and to see the emphasis they try and put on research projects.

The people in the pharmacology department were also just wonderful to talk with. They told us places that we should go eat and things that we should eat at each place. They even wrote down the names so it will be easier for us to find them (hopefully). They also talked with us about tv shows, books, and movies and what they have been watching. They have seen way more American tv shows then I have I think.

This weekend we stayed in Loni and did a few activities. We met with Center for Social Medicine and discussed how things were going and got to see our tentative schedule for the rest of our time here. It was really nice to see what departments we would be going to as well as the rural health centers and mobile clinics that we would be going on. It makes me more excited for the time that I have left in India.

We rode a rickshaw to the post office and mailed some postcards to people at home. Hopefully the postcards will make it to people eventually, but only time will tell ;) We also tried out a couple of different restaurants in Loni. One is called the London Twist and has pizza and french fries (along with other things) but we ate that for dinner on Saturday night.

Sunday we went to the ophthalmology department's CME on cataract surgery in the morning. They had a nice program to open the day and then we listened to a couple of lectures on cataract surgery techniques. As I do not know too much about the eye I wasn't totally sure what was going on, but it seemed to me that they are doing some great things in the advancement of cataract surgery in India. I also decided that I would never be able to do surgery on the eye after watching some of the videos.

I'm really starting to enjoy my time in India and am enjoying all of the people that I am getting to interact with. Everyone here has been very gracious hosts and for that I am very thankful.

Riding in the rickshaw

post office sign

Friday Fives

Friday Fives are something that Courtney and Shelley do every Friday. It is where you think about the past week and come up with 5 things that you enjoyed and were positive things to your week. When we got to India and were wondering how we would survive the next 8 weeks we decided that we would start doing them here.

I've still been struggling lately to really enjoy India. I tend to really dwell on the things that aren't going well and how my expectations of this experience aren't being met instead of thinking about all of the things that I'm enjoying. Thinking about the 5 things that I've really enjoyed is somewhat helping me see the good in this experience when I sometimes think it was a waste of a rotation to be in India.

I would encourage you to also come up with your Friday Fives (feel free to leave them in the comment section if you'd like):

Here are my Friday Fives:

1. Being in the radiology department and getting to see ultrasound after ultrasound. Being able to actually identify the parts of the growing baby was amazing.

2. In the pharmacology department today a PhD candidate showed us her wedding pictures and explained somewhat about weddings in Indian culture.

3. Being able to purchase food that is somewhat familiar to me when I need something from home. (oreos, kit kats, and chips plus appy fizz)

4. Traveling last weekend and being able to see sites around the area as well as shopping

5. Being able to skype and chat with my parents (plus Isaac for a bit), Chris, and Carina

Here are a few random photos from India so far that I don't think I've yet posted on the blog:

We never thought we'd be excited to eat sodexo, but the KFC had this sign when we walked in

I'm pretty much an expert on ultrasounds now....

We spent the past 2 days in the radiology department and I would have to say it was one of the best experiences that I've had in a department (besides watching the surgery). We started out with one of the doctors showing us an overview of the department. He showed us the CT, MRI, X-ray, and ultrasound machines and told us about how they all worked.

Once patients started arriving we observed each of the machines and the residents in those areas explained a little how they worked. If there was an interesting case in another area a resident would come get us and bring us there. They did the best job I think of really explaining what was happening and making us feel somewhat involved and not just in the way.

I really enjoyed seeing how each of these machines worked since I’ve never had any of the tests done nor actually see them performed in real life. Some of the interesting things we saw were: a young man with a brain tumor so they mapped it out on the CT scan so they knew where to target the radiation, a CT assisted biopsy of the lung, a ultrasound assisted biopsy of the abdomen, and some MRI scans of cancer that had spread to the brain and had multiple malignancies.

We learned that most of the time patients don’t come to the doctor especially the radiology department until something is really wrong. They said that for the most part they don’t have to use a lot of contrast because the scans show up pretty clear when there is a problem since the growths are usually rather large. They said that in the US it is more common to need to contrast to pick up the problems since they are typically smaller masses.

We spent quite a bit of time in the ultrasound part and watched as mother after mother had an ultrasound done on her baby. It was really amazing to see all of the body parts and we were able to identify them as time went on. I wasn’t quite as good as Courtney, but was still able to pick out the body parts. We really aren’t experts, but now if the ultrasound is in position I can pick out quite a few body parts. We also learned how they measure the femur, head circumference, and abdomen circumference to determine gestational age and if the fetus is growing at a proper rate. We also discussed more about how it is illegal to tell the patients the sex of the baby and the professor/doctor we talked with showed us a powerpoint on this and really explained more about it.

They also were very concerned about what we did for fun, if we liked the food, and if we were enjoying our stay. They gave us some tips on places that we should visit and also some restaurants that we should try out. They were all really surprised that we ate in the mess hall because many of them said that they didn’t even eat there. These types of conversations have been common in most of the departments that we’ve visited, but they just seemed to be more interested in our answers and really gave us suggestions on things to do.

I've been slacking on my picture taking so I don't have any to add to this post so I apologize for that and will try to do a little better next time ;)

Thoughts on India after 2 weeks

Life in India has become some what normal now. We have our routine down: get up, go to breakfast, go where we are posted, break for lunch, go back to our post, then hang out in our rooms until supper, and then eventually go to bed. At times it feels like I've been each much longer than 2 weeks, but other times it seems as if I just got here and still have no idea what is going on.

I have pretty much accepted the fact that for the majority of the time I will not know what is really going on. We still haven't had our program clearly laid out for us with what is expected of us and I'm not thinking that will come anytime soon. I have decided that I am ok with this and I will continue to go to the sites where I am directed and get my schedule one week at a time. For those of you that know me well you know that I like to have things planned out and pretty organized. This is helping me to realize that it is fine to not have things all planned out and that I will survive it.

The past two days Courtney and I were posted in the skin department. The resident did a good job on the first day juggling seeing patients, giving and oral exam to students, and explaining things to us. He is actually the first person so far that explained to us what each patient had and what they were going to treat them with. I am not an expert on the skin or dermatology so some of the things I had no idea what they were or how we typically would treat them in the US. The main treatments that I knew about were ones that I have tried for acne and my keloid scar. The skin department doesn't see a whole lot of patients so there is a lot of sitting around that is done. Courtney and I occupied our time by playing candy crush, 4 pics 1 word, she drew, and I finished Ender's Game. The residents in the department spend their downtime studying for their exams so we don't really want to disturb them too much and we don't have a ton of questions about skin.

This sort of sitting around understanding only part of what is going on has become very common for us. Part of the reason for this is because it seems like most of the departments don't really know what to do with us since pharmacy is so different here in India. All of the doctors and residents that we actually talk to and have longer conversations with have been pretty awesome. They do a great job at talking with us and explaining how things in India work and for that I am very thankful. Most of them also seem very interested in how things in the US work so we explain that side of things as best as we can.

The other big adjustment that I had to make was learning to like the food. I still wouldn't say that I really enjoy eating, but have come a very long way in the past 2 weeks. I now can eat the food without feeling like my mouth is on fire. It is hard to get used to eating 3 pretty spicy meals a day and not having a lot of sweets. Luckily I brought quite a bit of sweet things from home with me so when I need that fix I have something in my room. Since there is always some type of bread product at all meals I have also been enjoying that. A store nearby sells a drink called appy fizz (sparkling apple juice) and so I've really been enjoying drinking that as well as getting some chips on occasion when I need something a little salty.

I've also decided that washing machines and dryers are great things to have. Having to wash clothes by hand in a bucket takes quite a bit of effort and I'm never really convinced that I am actually doing a good job of cleaning them. There is a strange washing machine here, but I'm not entirely sure how to use it and it kind of weirds me out so I will just continue to do laundry in my room once a week and hope that by the end of my time here my clothes don't smell too bad from my lack of washing abilities.

The other situation that I should probably update you all on is the creature situation. After posting about my lizard friend I am happy to report that there have been no other sightings in my bed. I have however seen more lizards in my room, but as long as they don't try to sleep with me I am ok with that. I did have a flying cricket attack me one night right before I was going to bed so I didn't really appreciate that, but I successfully killed it and haven't seen any more in my room since that time.

At this moment in time I am still really glad that I came to India and have the opportunity to learn more about another culture. Even though it hasn't been the clinical experience that I was hoping for the people are great and I am learning some things about myself as well as the country of India. I think I am also glad that I am here for 8 weeks because I think I will continue to learn more and adjust to life here and if I was only here for 4 weeks I would just be getting settled when it would be time to leave. Would I like to live in India long-term? No, at this point I'm thinking 8 weeks will be plenty of time.

What laundry day looks like

1st time breaking out the rain jackets

Weekend Trip to Aurangabad

This weekend we took our first trip outside of Loni to the Aurangabad area. It was fun to get out of Loni and see more of India and now whenever people we interact with ask us if we've been anywhere else in India we can say yes. I also took lots of pictures this weekend so I have only a small amount that I'm putting on the blog (still quite a bit). So if you'd like to see more sometime just let me know and I can show you. I will also probably upload more on facebook at some point.

Our weekend started off early Saturday morning at 6 am when our driver came to pick us up. We then headed to the Ellora caves, which are "caves" that are carved out of rocks with structures and such. They were really neat to see and it's really hard to believe that they were built so many years ago since the work is so intricate. This is also when we got the first taste of what being Americans or white means in India. We got asked tons of times to take our picture with random people. We obliged at first, but then as the weekend continued we just said no. We all decided that we would not be ok being celebrities and having random people come up and ask to take a picture of you or else just take pictures of you just standing around.

Group in front of the first cave we went into

Our backs were sweaty from all the walking so we looked really cool for a little while to air out

Then we headed to the Ajanta caves next. These are similar caves, but have a lot more paintings on the walls rather than carvings. I personally thought that these were better and enjoyed them much more. A lot of these caves were dark and had lights in them so it was a little harder to take pictures (especially of the paintings on the walls), but I still got quite a few good ones.

Sign when paying for our ticket. Don't worry I had my epi-pen and Heather was my lookout for bees since I never seemed to see them

Then we headed to Aurangabad and went to our hotel for the night. For supper we ate in our hotel, but they had American food on the menu. I ordered pizza and it was so good. It was also really nice to sleep in a comfortable bed with a normal pillow.

Sunday morning we got up and headed for Bibi Ka Maqbara, which is the mini taj mahal.

Then we headed to the Daulatabad Fort. This was a really cool place and I decided would have been a great place to take seniors pics. It included lots of stairs though so we were pretty tired by the time we made it all the way up the hill and back down.

The structures on the left side of the pictures towards the top of the hill is where we climbed to

After this we were a little tired of outdoor activities and walking around since that is what we had been doing the past 2 days so we headed to the Prozone Mall, which was like a typical American mall with extra security. We had to have our bags searched and go through a metal detector to get into the mall and then at most of the stores you had to check your bag before you went in and then pick it up when you were done. That part was a little strange, but otherwise we had a pleasant shopping experience. It was nice to be at a place that seemed very familiar and for lunch we even had KFC (which I made everyone, but myself that a picture in). It was also a little strange feeling since it almost felt like we were in the US, but then knew that we were in India. I ended up buying some shirts and some sarree fabric that I am hoping to make a blanket out of.

After our shopping experience we headed back to PIMS and got unpacked. I'm glad we went for our weekend trip, but now I'm feeling tired and like I'm not really ready to start our week tomorrow. I feel like I need a day to recover from all of this excitement.