Another Day in Paradise

 If there is one thing I have always been weary of in my job/role. Its unneccessary praise. I am not sure if its just me  or its from years of very subtle low key celebrations of our achievements as kids (!LOL ) but when someone starts ooing and aaing about something that is related to me... I kind of shrivel up and feel like Im being set up for a fall. I'd rather not people praise me just incase one day I dissappoint them. I dont know...sometimes I think maybe I think Im just a big fake and one day someones going to point it out lol. Other times I have all this energy fueling me to do something complete a project throw my energy at something- with my mums whispering in my head telling me I could do it, I can do anything if I just put me head to it. Talk about split personality lol.

So today was one of those days. PAtient after patient...I think its a cultural thing too...a whole lot of new patients today and all the conversations start off with praise- they had heard from who and who that this was the place to come...etc/ Sometimes I worry because their relative came in with a straightforward infection which required a simple antibiotic and bazzaamm...they were better (not really any magic in that but thats what people see here....) sometimes I think people are so used to all simple illnesses being lengthy and drawn out because when they see fofos with the same thing, I think the fofos just help ail their symptoms while their bodies go through a natural fight and recovery phase (that sometimes results in a loss!!) but to have the same illness resolved within days with a pill is nothing short of a miracle!  So I worry that now this man with terrible arthritis thinks I am gonna cure him...crap....so save your breadth buddy all the showers of blessings is not going to sugar coat the hard and fast truth I am going to have to tell you...and unfortunately only serves to make me squirm in my seat.  Anyways, now you know how I feel about the subject ha ha. I dont mind a thankyou after Ive done something, but i dont need the whole ula-lole type ordeal. Especially before Ive done anything!!

Penis-es. (if there is such a word) Man why are guys so obsessed with their willys. Even in the big ol Island, there is a constant murmur in the male grapevines on this subject.  Fortunately being a woman, I've not had to deal with these enquiries directly myself, but my poor husband, and brother in law. They are constantly being pulled to the side and asked I have in in my clinic "fualaau faaku ai le mea" and also "fualaau faa-kele" and "fualaau faaumi".....no jokes. OMG. Ok so the first one at least exists, but the other enquiries??OMG>>. One day my husband was sat in a delivery truck (his brothers') surrounded by other people and some random person he doesn't even know called him (who knows how he got his number!!) and was asking  pe maua gi fualaau e faalapoa ai le mea. What was even more hilarious is my husband actually had a hard time trying to convince this guy that no such pill existed. He ended his phone call with a "well ok if you find such pills in your search please let me know about it as well" :)   Fair to say his audience to the phone call were cracking up in fits of laughter after overhearing this.

Kids. So my eldest daughter is going to a pretty good school for the big island. Sometimes Im a little over impressed with some of the things they do (like make yr 1 students sit exams that require them reading an exam booklet and following instructions printed on it  etc when they can barely even read) etc etc etc....lately though. Ive been a tad egg-ed with them. Don't get me wrong I do believe that alot of your childs education starts at home and when I can I do try to read and do math and do writing etc with her at home. Sometimes she is a little short -attention-spanned but I figure what 5 yr old kid spending the afternoon inside doing this as opposed to climbing trees isn't? Anyways, when I do do work with her she is pretty good, she completes full pages of letters when working on her writing etc. However, lately her report card (and she gets this progress report card every week) actually, all of her comments on the report card have been along the lines of- "your daughter looks tired sometimes in class, you should put her to sleep earlier" and " she hates writing and reading, we pray that soon she will be able to write and read" and the last one " your daughter talks too much, but when it comes to writing she is hopeless and fiapepe...we hope and pray she can read and write soon" WTF is that?? honestly what about some constructive criticism mate...like could you point out what she is struggling with? which words vowels what?? the last parent teacher meet I went to all I got told was "yea she'll get there, shes a good girl" I would actually appreciate if I were told she is behind in a certain area she needs to work on some sounds or pronunciation.  Where is she lagging compared to other kids with writing??Honestly give me something I CAN USE. She seems ok when I do writing skills with her. Honestly "we hope and pray " like lets just all SLEEP and pray  on it and see if it will happen?? for goodness sake.errr... it just bothers me that I have no other options of anywhere else to take her on this island.....hmmmmmm eh

Anyways, just thought I would update you on the happenings in Paradise.:) Just another day in Paradise

small steps

Some things I am trying to achieve in small steps....
is shed the baby weight. Honestly I lost weight during pregnancy due to something going on with that tummy (nausea loss of appettite) etc but my ass exploded thereafter. And my closest most cherished family never hesitate to tell me- "ua kele a lou goo" thanks...
 so number 1 is- EAT HEALTHY
like I said . Baby steps. Before running a marathon and going on a radical diet, Im trying to make more nutiritional less calorie choices...like instead of toast 2 tablespoons of butter and marmite (yum) I had a 1/4 esi for breaky...don't worry, it was a big esi

the hubby is almost 99% sure he has gluten intolerance/coeliacs..and is staying away from pasta flour wheat bread... so lots of really healthy stuff as you'd be amazed (or appalled!) at what has gluten in it...flour bread, batter, sauces, flavourings, BEER...you name it. He cant have it. So Im trying to be a supportive wife and avoid all those finger licking gluten laden foods too.....just as well Savaii doesnt have pasta...or choices for good pasta....

number 2 is - LESS FREAKEN TECHNOLOGY- and specifically- PHONE TIME.
if I had a dollar for every time I exclaimed that phones are driving people NUTS I'd be rich. Seriously. We are missing out on life because we are checking facebook on our phones. We are forgetting how to interact with people...thats all FINE for your merry loser introverted self, make that decision, but we also imposing it on our kids. Sometimes I feel like (and I am one of the ones that has fallen into this habbit) we are not even raising our kids...because "this is my me time" "im just reading a paper" etc...all our kids see is their parents staring at their phones and not talking to them. in 20 yrs time I am almost conviinced the studies will start rolling out- this behaviour is going to make our kids either stupid-er, introverted psychopaths or at least some radiation induced tumor will have been linked...they just dont have the data now because, we are the first generation living this kraze.

3. Be nicer to people. Not everyone understands what a shit day I might have just had, and like da momas are always telling us, that short fuse and quick tongue may one day come back to bite us- I need to remind myself that I also dont know what shit people have gone through prior to seeing me. Perhaps we have all had shit days but we needed to see each other and our days will get better as the result of our meet, but we bring the sack of shit that happened int he morning and let it affect the afternoon?? Anyways , you get my drift. This is a typical me on a wednesday when Ive rushed from the hospital not having a break (and not to mention the horrendous morning there) and people at the clinic raise their eyebrows and exclaim how long theyve been waiting...lord-help-me  but also help them, they had a boil the size of a breakfast plate on their ass so now I get why they were so eager to see me.....sorry

4. Get-to-church. Stop saying it and do it. Stop letting the moment pass because- it got to busy, they were sleeping and I didnt want to wake them, I need to help make lunch/toanai....etc etc. Just do it. For good ness sake ..(note to self)

5. Keep in touch with people...this whole no news is good news saying- its shit unless you are at war someone fighting. Keep in touch with people or regret it.


ok thats all for now. All the above in baby steps. Watch this space for the progress:)

OMG Krazy day...

OMG having one of those nutty days where every other person I see is a 'raised eyebrows' kind of consult. May I vent for a second, while at the same time sending a faasilasilaga to people who obviously have never or may never see me anyways so really quite pointless in aiding my frustrations BUT makes me feel a little better to say it...to the laptop....

PUH LEASE, and ESPECIALLY , if I have never seen you before/are related to you/are a work colleague acquaintance etc....don't come to see me and ask me for - A medical clearance....for ...one of your relatives ...who is now already overseas and cant come see me himself, to get a clearance to..wait for it...travel and live in that country that he already is in. OK, that's just dumb...like I really legally, need to physically see him measure his blood pressure and prove he aint got some fatal disease or TB etc..I can NOT just fabricate that crap. Please don't come and ask me for medical certificates for last week, when apparently you were rolling around in pain with some mysterious bug which has miraculously cleared completely now leaving me nothing to actually be convinced you were actually unwell...especially if you are not a regular client of mine and I don't know you..or your brother who couldn't come but you've come to get his pepa mai. I am not a paper pusher.

Please don't come and be rude to my receptionist at the front, this office, is not your village...you may have everyone at your beck and call when you are sat in your throne at your village, but here at this medical center, the receptionist is not your fai- feau , she is not obliged to run to the shop at the front and buy your coke, and when she politely tells you she cant leave her desk/cash register unmanned, it is not fitting for you to lose your marbles....please dont pester her to harrass me to get prescription meds without a docs review or a prescription...especially for things that could potentially kill you...e kasi a le mea e ave ai enquiries ga o le ofisa leoleo faamolemole lava.

Please don't ever come to see me , to get that medical letter that you need apparently, to "kala your NPF" because you have decided to build a house but NPF say the only way they will release NPF savings early is if you leave the country permanently or , if you are disabled permanently and are verified by a doctor that you can not physically work anymore. When you walk into my office with a mouth full of instructions without so  much as a twitch in your eyelid or a limp...you can work. Full stop. You don't get to just tell me " I haven't worked for 30 yrs, last job i had was when I was 20, so I know I cant work anymore" ...Mate, it aint as simple as that. OMG...and then please don't proceed to have an argument with me about this and my job...my job is most certainly not to- receive a mere 20tal from you, and then aid in your illegal fiasco to release thousands of trallas from the NPF..mate, this thing on my head...yea you see it..its called a brain...not a mirror.

OMG...and please last but not the least. I am not a vet. Full stop. One day, your antibiotics and BP pills you keep feeding your dog, might be bad/the wrong dose/the wrong thing altogether to give him..and he may die...and I kinda don't want to be part of that. Full stop

good bye

GOUT and morphing peoples personality.

Gout. Ever since I arrived in Samoa, more so in Savaii, it has amazed me how little people understand about GOUT and its management. It doesn't surprise me that from their own childhood education they may have never heard of it (ie health education in schools is minimal..down to the basics only ie. the birds and the bees and stds and thats it) But the fact that they GOT an attack, got seen by a doctor and got started on painkillers - kinda blows me that at no point did someone NOT tell them about uric acid, and Allopuriol. 

For those of you who have not heard of or know anyone with- gout is a type of arthritis caused by a build up of an acid called URIC ACID.Many meats and foods are high in this acid so heavy consumption of certain foods brings on an attack. These attacks can be severe and debilitating. It may not look so bad (ie a red joint of big toe) but don't be fooled, this baby will make grown men cry...What baffles me is the number of people on rescue remedy only. Wait for gout attack (which may be as often as every week- ie imagine 2 or 3 days of every week being incapacitated by a sore foot which can not even touch the floor for fear of excruciating mind blowing pain resulting in 2 or 3 days of absolute dysfunction (ie in bed all day) ) and then Voltaren Voltaren Voltaren. To make matters worse, along the way  someone may have slipped them some "Superman" pill..also known as steroids ...also known as Dexamethesone resulting  in a quick but FAKE improvement of pain due to its powerful anti inflammatory effect. Anyways, my point is these remedies treat the PAIN only. And not the culprit- uric acid. Which means that these individuals just run these vicous circles of not treating the cause but treating the symptom of  pain only, at the same time  abusing Voltaren and Dexa...which later results in CUSHINGS SYNDROME (another illness) Hypertension , Ulcer (from Voltaren abuse) and kidneys that are SHOT.

What I am battling now- is explaining this to patients who have done 10 yrs of this. And now look at me funny like Im lying to them- Allopurinol?? (the treatment remedy which over time can rid excess uric acid from the body and thus improve and hold off gout attacks forever if you are compliant ) what is that?? Are you sure? no ones ever mentioned that to me before?Oh wait a minute, thats that tablet you take once a day?yea it doesnt work I took it for 2 days and it did nothing to the pain (Where I then explain it does not treat pain and still get funny looks)  Why do you want to stop my Voltaren addiction?? and worse yet- WHY are you not giving me DEXA??arrhhhh.... where I worked overseas..we were forbidden to prescribe dexamethasone..this was reserved for specialist consultant only in clinic or for admitted patients in hospital. IF you were bad enough you'd get Prednisone (hospitalised  patients get- Pred is a weaker Steroid) but never Dexa. In Samoa , there is a dexa craze. Every time I see someone on it, they almost always have the Cushings Side effect , and when you decline giving it to them again, they mutate into these angry stubborn begging beings- ie. "Please please please give me dexa, I can not live a normal life without it!", I promise I wont take it until absolutely necessary (which when out of my site is like, everyday according to the patient)  bla bla bla. Sometimes, the husbands send the wives in to get it...and they do the exact same thing, whine, complain, beg, lie....from - but this is my husbands standing order, and who and who said he needed to take it everyday, to please my husband will beat me if I dont come back with it...and then I find out, that he initially got it from a friend of a friend who shared some of his- ….OMG , but that is a norm in Samoa.

Honestly, the sweet little old lady in a muumuu suddenly gets all huff and puffy and angry when I don't prescribe these things, and the men just go bezerk...they pull out every excuse in the book like its a life and death matter and then give me the "I'm a Matai" look and just do as I say line..sorry bro..not gonna work- my policy is FIRST DO NO HARM....it is  most certainly not  a life and death matter...you walked in here without as much as a hobble...you don't need Dexa!!

Seriously, getting people off these terrible rescue remedies that lead to a continued vicious circle of attacks (and not to mention terrible side effects)  and onto the needed Allopurinol is just a mission. You'd think I was dealing with a drug addict trying to come off morphine or something. 

Thats not to say there aren't people who Allopurinol does not work for- like any drug, there are some who it doesn't work for, for whatever reason, as well as those who get bad side effects. But for a lot of people, this drug would really do them so much good if they only gave it a good go. 

I've made a pamphlet now, that explains it all. Prevention, treatment, etc....seems like when you give someone a piece of paper it seems a little more truthful then when it comes out of my mouth. I tell myself not to take it personally as I think many people think I am younger then I actually am (thanks for being vertically challenged! )  and so I guess are a little less trusting of a young doctor maybe?? Anyways...I've also had patients come in Absolutely gobsmacked at the improvement since starting Allopurinol. Like seriously these people did not think they could ever live normal lives again, and now can...so that is pretty satisfying. I just hope that more and more people learn about this and realise there is actually a treatment for this debilitating illness:) Thats all for now have a great week everyone!!