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6/30/04 (Wednesday)

6:30 AM.  Since arriving in Quito I have had a continual frontal headache.  At times I feel a twinge of nausea.  I wonder if the problem is altitude?  I notice more heavy breathing just walking.  I should acclimate to the altitude since we are not planning much activity today.  Tonight, I speak to the residents.  Jane wants to pick my brain today on managing a variety of gyn problems she may encounter.  With email I can at least help fill in the blanks for her at other times, even in San Lorenzo.

9:18 PM.  The day has been slow and I am feeling better.  Today, Jane and I sat and talked with her asking gyn questions and me giving her what insight and information I could to equip her better in the clinic.  Jorge called from San Lorenzo to report Jose with the nose repair was in and the tissue was a deep purple with a zone of pink on one side.  Jose is now 6 days post repair and this was very good news.  By now it should have sloughed if it wasn’t taking.  Jane is going there next week and will keep me updated via email.

Jane also introduced me to a family doctor who works with the residents.  She is interested in coming to Fort Wayne to spend a month learning more ambulatory gyn and some high risk pregnancy.  She speaks English also.  We talked about arranging a trip for her.  She will get dates to me about when she could come.

At 5 PM Jane and I met with family practice residents and we discussed HRT, abnormal bleeding, osteoporosis and other topics.  We talked for 2 hours with Jane translating for me.  We had some pizza there and then went to a sandwich shop to finish our supper.  I am now all packed and ready to go.  Jane picks me up at 5 AM.


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