I'm back...

The mirror asked: where have you been, strange face? Yes, it's been that long. My last blog was on Oct 2016, 2 years ago.

Allow me to re-introduce myself. My name is Annie Tedga. This blog was birthed by hardship. A medical student 7 years ago. My world was crashing down. And blogging became my only outlet. I talked about anything and everything.

Years later, I started residency...and I was over the moon! After all I'd been through, my dream of becoming a pediatrician was coming true. Ironically, that dream turned into a nightmare. I wanted to blog. I had so much to say...but I just froze!
If you're patient, the sun will shine again. I'm blogging again. Gold is refined by fire and what doesn't kill you makes you stronger. Jonas stayed in the fish for 3 days and when he came out he was so crisp that his message turned a whole nation around.

Hardship birthed this blog. Hardship will re-vamp it. All I have left to offer is my BEST blogs ever because the good and better are gone.

Sit down and relax...



Yours truly,

AT-O

Time to Check in (Part 1)

Whoever coined the phrase "time flies" was truly a visionary. It's been 3 months and 1 week since I officially became a pediatric resident. What can I say, my joy is complete but I'm not going to lie. Everyday hasn't been peach and that my life as a resident hasn't been a fairy tale. On the contrary, quite a few times I've regretted choosing this profession. Well, I swore to honesty when I started this blog; "raw and uncut" were the exact words. 
So far, I've complaint, sighed, wanted to punch some of my patients' parents and if I wasn't the tough girl that I am, I might have even cried a few times already. But as crazy as this sounds, I'm happier than ever. True, I've had some pretty rough moments in residency, but to be fair, this wasn't unexpected. Infact, all my predecessors had warned me about those moments when it's like a "dark cloud" falls over you. Those moments did come unfortunately. And more perhaps are yet to come. But I'm OK with that. I'm ok that it feels like I know nothing right now. I'm ok that there will be ups and downs. Most of all, I'm ok that I wake up the next day ready to take on a new challenge. This is who I was meant to be. I love it !!!

I looked back at my life 3 years ago. I was in Cameroon with one ambition: to come back to the US and train in a residency program. There were so many obstacles before me. There was a big ego to deal with. I was in such an emotional mess that I couldn't even gain weight (and I never pass on a meal). I really needed to change.  I'd always wanted to change (my attitude, my ways, my life) but I couldn't. Change is a difficult thing...but it's possible. I know this because it happened to me. Right before my eyes: complete transformation of my character, but before there was massive demolition of everything I once held on to. It was painful, very painful. I had "dark cloud" moments and asked myself why I ever picked this profession. And even then I didn't cry; I just tried to internalize what was happening and how on earth any of it was possible.
I wasn't too tough; wasn't too smart either. Just fortunate to meet a man, the only who could make this possible. I fell head over heels in love with this man and since then I changed forever. He goes by many names: Bright and Morning Star, Lily of the Valley, Rose of Sharon, Yeshua, Lion of Judah, El Shaddai, Jesus Christ and one of my favorites, Prince of Prince. He changed my life. It didn't happen immediately; it took time, time and time but look at me now. More than ever, I'm alive and I'm accomplishing my destiny. He can change yours too if you let him. He's standing at your door knocking. If you open the door, you'll meet a man who is so madly in love with you words can't express it. Please, open the door  =D

Yes, there will be tough times... but I can handle it. Nothing can steal my joy because my dream is turning into reality. I'm going to be a pediatrician!!!

KEEP CALM!!!
I'M GOING TO BE A PEDIATRICIAN

To God be the glory...

Gloomy Days Ahead-Part 3 (the Finale)

When I fell to the bottomless pit and found the deepest darkness all around me, that's when I realized that truly man is nothing. Man is nothing and life is meaningless. Two years ago, I was on top of my game, planning my future. I had worked hard in med school and made the right connections. I'd checked all the boxes so what on earth could stop me? Statistics were on my side and did I forget to say this: I never lost. Winning!
But pride happened. While I was busy memorizing my path to smooth up-pery, a voice from heaven must have said something like "You fool! This very night your life will be required of you. Then who will own what you have accumulated (in my case, what you were planning to accumulate)?" (Luke 12 :20). For those of you who know me well, you know the events that ensued. I landed in the wilderness. No, people, Cameroon wasn't fun (not at first, at least). I suffered there. I learnt what it meant to be exploited. Learnt what it meant to lose control and hated it. I fought and lost an eshaustive battle. And when I was tired of asking "how could this be", I realized I'd fallen rock-bottom. Blow after blow after blow. I cried in desolation, frustration, powerlessness and some more frustration. And where was my pride? Gone like a gold-digger bride. But does it even make sense for me to say this: that when I died, yes, my power to control everything and claim all my successes for myself died also, and that's when I came alive. Because I realized it couldn't have been me. Here was I in sinking sand yet couldn't get myself out. It had not been me all this while. It couldn't.
Those were perhaps the darkest days of my life. I'd lost all purpose known to life. I didn't know who I was but I definitely knew what I wasn't. I wanted answers but wasn't sure where to get them. Hell hath no fury as uncertainty, doubt, question marks. I felt so uncomfortable in my own skin. And where was my future? The glam, the flossing flossing. When I look back, I'm instantly filled with a reverential fear for pride. Humility is our friend, not foe. Pride will only destroy you.
Then the quest for answers was my only drive. I had to understand why things weren't the way they were. Why was I powerless and who had the power that I thought I had? I spent every bit of energy I had and almost went mad. But what I did find, as mind-blowing as it sounds, became the core of my very existence. I can't explain it, but every human can experience it too. If you haven't then I encourage you to take the trip; it's beyond anything you could ever imagine.
I got answers but beyond that, I got Jesus Christ. He destroyed my complete existence, which was made of lies, and gave me a new one. He found me in that pit, carried me on eagles' wings and fed me love, life, truth, peace, joy and every good thing I ever desired. And he gave me back control. But this control is through his name, the name that is above all other names. Through him, I am. And without him, there is no me. I matched into my top pediatric residency this year and as I kept thinking to myself "it has finally happened. My life is going to change" I was so humbled. I remembered my days in Cameroon, I remembered the question marks...and had a full appreciation for them. God found me then, broken and desperate and he turned me into this victorious figure. From a toothless bulldog into a roaring lion. Tell me, why would I live for anyone else??? With him, the sky is the limit. With him, I can't fear gloomy days ahead...

Now to Him who is able to do infinitely more than all we ask or imagine, according to His power that is at work within us, to Him be the glory in the church and in Christ Jesus throughout all generations, forever and ever. Amen (Ephesians 3:20)

A night without skype...

I was on call. Yes, in a fancy clinic. No real patients. No headaches. Just rich folks looking for an excuse to sleep out of their homes. Because yes, these rooms were posh. Marble floors. Plasma TVs. Jacuzzis and even maid service. Definitely, an excuse to sleep out of the house. And I was a fresh grad looking to make some quick cash so this was a match made in heaven. During night rounds, I felt like a nuisance. These folks weren't sick; they didn't need me yet I had to smile and ask for complaints. I'd get a polite nod or barely an acknowledgement. "Doctor or housekeeper?" sometimes I doubted my own identity yet managed to keep the pleasantries until my rounds were over.
Then I'd return to my office (yes, I had an office) and skype away...till either a pseudo-complaint came through or my eyes could no longer struggle with gravity. 

The nurse informed me of a new admission so I followed her to the patient's room hoping to make it rather snappy and return to my favorite past-time. I met there a young man on the bed with two adults around him - a man and a woman. Quickly scanned him; stepped out and the nurse followed soon after. One look at her and I wanted to demolish her very existence. How the heck could she admit a patient like this? Unconscious! This was a clinic, not a hospital. Where was the equipment to monitor him? He needed a head CT Scan, an EKG, even X-rays; we didn't have any of that!

After pacing for about a minute, which felt like 20, I went back in there to break the news. "Sorry. We can't keep him because our facility isn't equipped to handle critical cases". Then I caught his wife's eyes...I mean, she was looking at me like I was her only hope. How can you put your hopes in someone like me??? I just wanted to surf the internet; I had no idea what was wrong with him and what to do with him. But till today, I can't explain what happened to me. I suddenly awakened and took control! I told the nurse to start an IV line and while taking his vitals, I took the history. We took his blood sugar, which was very low. We immediately administered hypertonic (high sugar) fluids, and in seconds literally, he came to life. In minutes, he was as good as new, like nothing had ever happened.

The story goes thus: his boys came home before dinner and dragged him out to the bar. He drank on an empty stomach and suffered from alcohol-induced hypoglycemia. Patients have described symptoms such as hypothermia, nervousness, rapid heartbeat and sweating (American Diabetes Society), but coma occurs when the blood sugar level falls very very low, which can happen quickly if fasting or exercise precedes drinking. Why does this happen? Because alcohol blocks the liver from making glucose (gluconeogenesis) so that you run out of energy in no time.

Mayo clinic website

The treatment is giving the individual glucose: 1 teaspoon of sugar or fun sips of coke or (even better) indulging on hard candy- ok, maybe a couple! However, if the person is comatose like in our case, an intravenous infusion with hypertonic fluids (20-30cc of Dextrose 30%) should wake him up. We had a less than ideal concentration, but still flushed it down until he woke up. As long as he got the glucose...
I did retire to my office after my patient was fully up and chatty. But I couldn't skype that night. I began reflecting. What if I hadn't checked his blood sugar? This was Cameroon; I was the patient's 911. What if I wasn't prepared for this? And then I realized that I was my greatest obstacle. And that I had to get out of my comfort zone!!!

References:
American Diabetic Society
uptodate.com
get.smarter.com
cs.stedwards.edu

Cradle of Humanity

Who are you? How old are you? What are your achievements so far? Are you happy with them? Or do you want more? It's that time of our lives, right? We ask these questions and scrutinize our responses more intently than ever. 

I just turned 32. My name is Annie. Or Naariah (child of God), an awesome metaphor! I aspire to change lives. Perhaps I'm doing that already but only God can answer for sure. I am of African descent. Cameroonian. Sometimes, culturally jaded; I moved to the US at 19, lived there for 10 years then moved home for 3 years then moved back to the US again. I wanted to become a flight attendant, then a journalist, then a sales professional. Never a physician...yet that's what I became.

Is it possible for someone to have "so much" yet so little? Think about it; I'm sure it makes sense. You know, like you have a job, a nice circle of fr-amily and a busy social life...yet something's missing. 

The first time I heard about "cradle of civilization" I remember asking myself "how come Africa?" We are the most underdeveloped, needy and most vulnerable. It was quite ironical; how come the place where humankind was nurtured in its earlier stage, is today in several respects, still the baby of the family? It didn't make sense, just as much as that inner hollow people feel despite their palpable success. But I wanted to dig deeper. And then it hit me that perhaps I was going about it the wrong way. It wasn't about being the perfect place, but about a good home, where the right values would be taught and would make us whole. 

 www.goaway.com. Kruger National Park, South Africa.

I was in Cameroon for 3 years. I still don't know if Africa is the cradle of humanity, but that's what she is to me. There's something about that place that does something to you; it's like going back to basics (you've got to experience it for yourself!). And after everything, I can say I found what I was looking for. It was sitting somewhere in the midst of that simplicity and serenity, and found solace there. So... where is your cradle of humanity? 

Tell them to be compassionate...

"Doc, you don't want to go into that room" The nurse was giving me heads up. I was about to do my rounds, and although the comment was welcomed I still had to see my patient. As we walked towards the room I tried putting away any prejudice.
So I put on my mask then walked into the room; after all, this was the isolation ward with numerous TB patients. Soon after my entry, I realized that no amount of cover-up could mask the stench that filled my nostrils. I walked to the patient's bed. Her very massive left leg, oozing foul-smelling pus, immediately caught my attention. She was there, seemingly clueless as to what was happening to her body so for her to keep whatever was left of her dignity I had to act normal (even though my nose was having a heart attack). I inquired about her life and the course of her illness. I turned to her husband who'd been standing there the whole time. I had a mask and was complaining about the smell yet this man hadn't left his wife's bedside.

Characteristic KS lesions: violaceous plaques 

This wasn't TB; it was Kaposi Sarcoma, a common condition in AIDS patients. She was 23-years-old and had four children at home. Uneducated, she could barely keep her story straight. Her husband, a farmer twice her age, filled in the blanks often. I was touched by their humility but saddened by reality. So much that I asked Mr Sam, her husband, to test for HIV. When he declined I realized he too must have been dreading the same thing. After addressing his concerns, he finally took the test and..........was HIV positive as well. Giving him post-test counseling was difficult and emotionally draining, but his wife was very sick and needed our complete focus.
Kaposi Sarcoma is a cancer caused by the human herpes virus 8 (HHV8). There are four different forms of KS, but the AIDS-related variant is most likely what my patient had. KS is an AIDS-defining illness meaning that its diagnosis along with a documented HIV infection is conclusive for AIDS. KS can also affect HIV-negative people (as is the case for other forms of KS), but it tends to be more aggressive lethal even in HIV-positive people especially if their immune system is very compromised (CD4 count below 200).
AIDS-related KS isn't curable but the lesions will regress if the immune system is reconstituted with Anti-retroviral therapy (ART). Chemotherapy could be of additional benefit if the disease is widespread as was the case with my patient.

So the cancer team came in and wrote my patient up for chemotherapy. Mr Sam, with a lot of difficulty, managed to pay the 1st of four rounds of chemo needed for his wife's regimen. Unfortunately, she died before we could even administer it. I felt a deep compassion for Mr Sam and his bereaved children.



References:
1) Image1:"<a href="http://commons.wikimedia.org/wiki/File:Kaposis_Sarcoma_Lesions.jpg#/media/File:Kaposis_Sarcoma_Lesions.jpg">Kaposis Sarcoma Lesions</a>" by OpenStax College - Anatomy &amp; Physiology, Connexions Web site. <a rel="nofollow" class="external free" href="http://cnx.org/content/col11496/1.6/">http://cnx.org/content/col11496/1.6/</a>, Jun 19, 2013.. 
2) Image2:"<a href="http://commons.wikimedia.org/wiki/File:Kaposis_sarcoma_01.jpg#/media/File:Kaposis_sarcoma_01.jpg">Kaposis sarcoma 01</a>" by M. Sand, D. Sand, C. Thrandorf, V. Paech, P. Altmeyer, F. G. Bechara - M. Sand, D. Sand, C. Thrandorf, V. Paech, P. Altmeyer, F. G. Bechara: Cutaneous lesions of the nose. 

Cleaning out the attic...

This man I know gave a testimony in my church. He'd been in a motorbike accident the previous day and had his pinkie finger cut off. Yet he stood there with a huge smile on his face, thanking God. I felt like asking him to shut up. Was it irony or just plain insanity? Well, it turns out after examining his injury, the doctor had told him that the whole hand would be amputated. And since he was a carpenter, that would have been a major disaster. So I can totally understand that he was grateful to keep his hand, but I wasn't over the fact that he'd lost a finger. I realized that this man was in a place, emotionally, that I couldn't access. That he had something that I wanted but wasn't sure how to get it.
So there I was walking through Central Park, New York. Four years ago, in this same city, I had a serious falling out with close friends, which led to a cascade of other events that unmasked personal issues that I've been struggling with. That's when it dawned on me that perhaps all this time, I was the problem. And that I was holding on to things such as unforgiveness and selfishness that had become a hindrance to me.

Then I thought about God. A verse in Psalms says that as high as the sky is above the earth so great is his love for those who seek him. He loves me more than my mind could ever fathom, and this fact challenged me to be better. It challenged me to let go of whatever was holding me back. Maybe this trip to New York wasn't random after all. It was time to clean out the attic. And maybe after doing that, I could finally behold the full measure of joy that the man had experienced. The kind of joy that makes you praise God even when circumstances dictate otherwise. I thank God for opening my eyes to see my faults; I thank God for new beginnings and I definitely thank God for New York City (ah-may-zing)!!!