3rd & Final Day of Surgery - this went fast!

It is hard to believe that the "mission" part of the mission is over - it went sooooo much faster than Kenya - partially because it was a 4 hour flight instead of a 24 hour flight, only a 2 hour time change from Calif., and 2 less days of surgery...I enjoyed this mission alot - it was very different from Kenya in some ways & much the same in others. 

Differences:  the hospital, supplies & equipment here were alot nicer & more plentiful, I didn't have as many "traumatic type patients or experiences" in Mexico as I did in Kenya...

Similar:  The days were just as long & we worked just as hard, the patients & families were still very poor & in desperate need of the medical care & just as humble & grateful for our care, the teams most of whom only met on arrival worked so well together all in behalf of the kids, AND...once again I had experiences that confirmed to me I was supposed to be here this week - for my own learning & growth & hopefully to also touch lives.

Today was a little bittersweet....in the morning we took our team picture in front of the hospital & then went up to the post op ward to check on the kids from yesterday.  Again I got to see some sweet patients & take some pictures.  We also checked on Rosa...I was happy to hear that her mom Juana had gotten some sleep on the hospital floor on a blanket while the grandma (her mother in law) was there with the baby.  The nasal trumpet we put in was fine but we needed to see how she would do if we took it out & she didn't do well at all.  The nasal tube was replaced & a decision made to bring her back to surgery today & see if the plastic surgeon could do anything to improve her ability to breathe well on her own.  Before that thought we had a full schedule of patients & the first round on all 5 OR tables were all babies so I was able to give away almost all the baby clothes I brought & the ones I had left over I gave to the nurses who had babies or grand babies :)

We took lots of pictures today of the team, patients , with the Mexican local team, with our translators & that was fun.  Rosa came down about 2 pm & we got her settled on the table & all was well & I went out for a break - I was only gone about 15 min when I was found in the break area & told to come back things weren't going well with Rosa - the surgeons tried all maneuvers to help her to breathe but her nose passages were just too tight & for the last 2 days she had been working to breathe & hadn't had many calories in IV or by mouth so she was weaker & that caused some problems too...in the end they ended up placing & sewing in nasal trumpets (airways) into both nostrils & then also Intubating her (putting a breathing tube in) & I came back as we needed to take her to the floor under the care of a Local NICU Nurse.  Juana - Rosa's mom was in a heap on the floor, it was a chaotic transfer, their "NICU ventilator & equipment" was soooo old (like 25  years old stuff I remember from when I graduated from Nursing school - but at least they had it), & their practice is just much more simplistic.  Christoph (the Intensivist & I ) tried to get as much in order to our liking as we could but ultimately at this point we had to turn the care over to the local team.  The plan is just to keep her sedated & on the ventilator overnight then take the breathing tube out in the morning & she will go home with the nasal airways in & be followed by Dr. Blas the local Plastic Surgeon here who runs a Cleft Lip/Palate Clinic at this hospital.  So not every Op Smile mission patient gets the fairytale ending to their story & I was really sad that this was happening to Rosa & more upset that her sweet young mom had to go thru this.  I was able to spend about an hour with her after everything got settled but still my heart was broken for her - I just wanted to bring them both home with me & get them more advanced care & some emotional support - it was a tearful good bye.

Luckily after that I went back down to the Recovery room & we still had about 10 patients to go & our very last patient was absolutley darling - 5 year old Jesus.  He had a pretty big surgery & rough go of it post op in the recovery room so he was with us for about 2 hours (most are only there 30 -60 min).  He needed alot of oxygen & we needed to get that down so he could go to the floor - I stood by his bed & told him "respire profundo con mi"  (Deep breathe w/ me) & he tried so so hard - even if I moved to get something he would keep breathing so well.  Finally we got him to a good level & were ready to go & as we were wheeling him out he noticed the white Operating room hat her wore into surgery & he must've thought he needed to wear it out so he put it on himself...it was so darn cute.  Katrine & I got a picture of the 2 of us with him in  the hallways before they took him upstairs.  That end to the day was perfecto! & it was coupled with a baby being born in the one Operating room we left open for deliveries - hearing that cry of a healthy newborn was magical :)



Hard to believe it is over...I still need to process some things.  I miss being away from my family but one week was lots easier than 2 & I definitely was to go again...I just have no idea when or where  - I guess wherever I am needed & where I am sent.  Clearly my blog is inadequate in expressing the miracles that occur as surgeries happen & children's lives are changed....how blessed I am to witness this & be a part of it! I also know that God loves his children all over the world & answers their prayers as I have myself seen it happen at home, in Kenya & now In Mexico & I know it happens everywhere everyday

Tomorrow is our "team day" it should be fun & mostly I am just excited that I wont be getting a 5 :30 am wake up call!

OR Day #2 Thursday

Well I thought I was up late but poor Katrin & Christoph were on call for Recovery & had to go in at 2 am for a pt that had to go back to surgery...then when they were done at 4 the hospital elevator was broken & the patient area was up 4 flights of stairs & this was a BIG boy so they ended up staying there all night & then leaving at 7 am when we all got then only to shower, eat & return about 9 - I am on call tonight :/

I went to the Post Op area this morning - that is one of my favorite things to do cause when the kids come to me they are pretty sleepy but the next day they are smiling & look great!  I first went to Rosas family - she had a rough night & her poor mom didn't sleep at all - the Drs are going to re-evaluate her later today. Oh & our mission was on the front page of the Tlaxcala News - it was all in Spanish of course but I could figure out the basics & one of our translators Sergio helped w/ the rest.  I am bringing a copy home!

The Operating room seemed very chaotic this morning - there are 14 Plastic Surgery residents from Guadalajara here so about 3 at each table plus the "real doctors" nurse etc.  I did get asked to help start 2 IV's in one room on the 1st cases of the day & I was quite proud of myself that I got them both in - it has been AWHILE since I started IV's - a little tender mercy I think for both the patients & me...yep I am a REAL NURSE :)

One of the most darling 5 year olds EVER had surgery today...Diego - he was a little guy I screened on Monday w/ his mom so I met them for the hand off into the OR & went into the room with him then recovered him...he was SO PRECIOUS & SO BRAVE!!!  He had some airway problems after surgery so he had to stay in recovery awhile but it all ended well & I passed him off to his mom across the "magic line".  I took some good pictures of him!

There are the nicest "Pink Ladies" here - they seriously wear candystriper uniforms like I wore in high school but also have fun hats etc & they help entertain the kids before surgery - I took pictures of them - you will see what I mean!

This morning the local recovery room nurses went out to a street vendor about 9 am to buy tamales & bought me one...I was a little nervous but didn't want to offend them & they were being so kind so I ate it - it was really good! There seems to be no differentiation between meals here - rice, beans, meat, tortillas, tacos, tamales are pretty much an option at every meal....another bright spot in a BUSY day was that the Colgate people brought in 2 volunteers to give us 5 min massages - those really might have been the best 5 min of my day :)

Since Katrin had been up all night I sent her home at 7 & we still had about 6 cases to go....one of the last cases was an 18 year old boy who has no family as I understand...I didn't have all the details - he had a smooth Cleft Lip Surgery & all was well - when he woke Up & I was caring for him & talking to him in my broken Spanish I asked if he needed anything & finally thru a translator he asked me if he had to pay cause he didn't have any money....I told him no were were all here as volunteers & it was free & he just needed to go & do something good for someone else...as he left the Recovery Room I took a picture of him & he gave me the thumbs up sign!  Other later patients were Grey...a cute & very brave little girl who was so so happy when I gave her a sticker pack for being so good about taking deep breaths so I could get her off oxygen & up to the floor and also Diuyrth...I had the hardest time pronouncing her name!  She had both a cleft lip &v palate repair.

Cristoph & I got done about 11 pm - so from the 5 :30 am wake up call until my 1:30 getting to bed it was a 20 hour day...at times I was a bit tired but for the most part I know I am being blessed in my endurance & ability to do what needs to be done.  I cant believe that tomorrow is our last surgery day - this is really a short mission but I am having a wonderful time serving the children of Tlaxcala Mexico & their parents.  I really am SOOOO grateful to be able to be here.  More updates tomorrow....Adios! 

Working in the Recovery Room to the sounds of TYPEWRITERS?????

We had a really good 1st day & not too late...I was back at the hotel by 9:30 :)  Bil Rancic carried in the 1st patient as cameras rolled & the official mission surgery Day #1 started.  We ended up doing 24 cases (patients) who had 36 procedures (yes some pts had 2 or more).  One case was postponed at the end of the night & another one was cancelled.

The first cases on all 5 tables were babies & they all came to the recovery room within a 15 min span....so 5 patients 5 recovery room nurses each patient w/ a nurse, anesthesiologist & surgeon to give report & YES each pt w/ a 2 Medical Records Clerks to type the Operation report with carbon paper so they have 2 copies so another 10 people & typewriters not to mention a few crying children made for a very noisy & busy recovery room - it was a bit crazy to work all day as people typed - the unique experiences you have on a mission! 

I appreciated so many things - like the fact that we had enough sheets to change them between patients & we had blankets & oxygen masks & running water - it was great :)  The morning cases were mostly babies so I did get to give away some of the clothes I brought.  The littlest patient Rosa the 3 month old (who they typically wouldn't do) had her surgery & had a rough go of it - we had to do quite a bit of interventions & thought we might need to send her to the neonatal ICU for the night but we kept her with us in Recovery all day & by evening took her to the floor on a monitor, oxygen with an airway & IV fluids.  Her young parents were pretty scared & I got to spend some time talking to them.  I found out that the moms mother had passed away recently just before Rosa was born so it has been a hard few months for this new young mom  - to be grieving the loss of her mother, pregnant & have a baby with a Cleft lip & be a new mom w/o her own mom for help which is important in all cultures but especially so here.  The young mom was on the verge of tears all day & everytime I saw her I sat down & just held her hand as we talked.  I stayed after most of the team left at the end of the night to spend a little extra time with her just to reassure her all was going to be okay - I also gave her 3 dresses I had that were size 6 mos since I didn't think we'd have any other tiny babies!I will go back & check on them first thing in the morning :)

By the end of the night after being on my feet for 15 hours my feet were killing me - there was only one chair in the entire Recovery room & a few stools that the local nurses used....by about 8 pm we had the mission coordinator get us 4 folding chairs from the screening area & I don't think I have ever been so excited to just sit for a few minutes!!!
 
There were 3 handsome high school boys from a private school here who came to volunteer as translators & were very helpful but the best moment with them was when all 3 were in the recovery room & we had a fussy 4 year old boy & the Mexican nurse got these BIG boys to sing a Mexican preschool type song with hand motions to this little boy - it was a priceless sight :)

The system here is a bit different - in the Surgery area there are "magic lines" & "half walls" where no one can cross unless they are in scrubs & surgery attire.  So the parents walk or carry their child down to surgery & then hand them across the line to the nurse...very odd & at the end the patient is brought out on a gurney on one side of the line/wall & then transferred to another gurney on the other side of the line/wall or babies are handed back to their parents.  Also once you change into scrubs you are to sit on a bench & put one shoe cover on & swing that leg across the line then put the other shoe cover on & only then are you ready to be in the surgery area (as long as you have a cap & mask on too!)  Top it off with the fact that the shoe covers here are like putting pillowcases on your feet that you have to roll down & tie around your ankle....just a few more things to appreciate about Western medical centers :)  I guess those germs know not to cross that line!!!

Katrin is the other recovery room nurse with me & she is wonderful & Christoph is our intensivist & as a team with the Mexican nurses all went well.  We came home tired & just had dinner at the hotel. 

After 3 days on this mission I'm beginning to realize how many unusual & unique experiences I had on my Kenya mission - so many patients & events that are not typical - but all of which were very meaningful to me.  I already know I will have similar experiences here but perhaps not as dramatic - whihc is fine by me.

I was able to get on Facebook & saw that Sarah had a good 1st day of school so that made me happy from afar - thanks to dear friends who made her day by bringing her cookies after school :)  Gotta get to bed its after midnite again & the 5:45 or 6 am wake up call will definitely come way too soon!!! Buenos Noches mi familia y amigos!  

Screening Day #2 & Recovery Room Set Up & 1 Surgery

It was a busy but manageable day....I did screening again from 8-10 then went to set up the recovery room w/ the Pediatric Intensivist from 10-2 then helped with the last hour of screening & we did one case (more info later) so I was in the OR & recovery room for that.  I am reminded of something I already knew....that often life is all about perspective.  Before going to Kenya I had only medically experienced hospitals in the USA & while they vary there is a basic "standard of care & facilities".  Then in Kenya I learned that sometimes you just do your best with what you have.  Now in Tlaxcala I was SOOOOO THRILLED to walk in a "real recovery room" - of course it isn't at all like the recovery room we have for CHOC patients but there were 6 gurneys with clean linens that can be changed between patients, 3 oxygen & suction outlets in the walls (a bit antiquated & challenging to work with but still) & a REAL CODE CART & most of the supplies we would need - I was ecstatic!!!!  Now had I come to Mexico before going to Kenya I am sure I would have looked at this recovery Room much differently & just seen all its deficiencies...but having had much less I appreciate all.  Sometimes I think we need a "Kenya" in many aspects of our lives to appreciate so many things we take for granted to to realize how great all our "everydays" really are :)

During screening there were a few "special patients" that - stuck out to me...Alma a 17 year old girl who was the oldest of 6 children & had a cleft lip that they could never afford to repair - she was such a sweet girl - I took her picture - told her she was already beautiful but that we would make her smile even more perfect...I am excited to see her after surgery & to think of the change this will make in her life.  There was also Lupita - she was dressed in boys clothes & wrapped in a blue blanket & I thought she was a boy & had beautiful thick black hair - I took some pictures of baby & mom before I screened them.  At screening I fund out the baby was a girl & was 7 months old & was the 5th child & only girl of a very poor family.  They were actually from an Indian (vs Mexican) village 6 hours away & left their 4 boys & the parents had gone without food in order to travel with her to Tlaxcala - not having baby girl clothes for her was the least of their concerns.  With the help of volunteers we got the parents some food & she will be having surgery this week :)  Again perspective...did I ever realize that I had 20 or 30 new outfits for each baby before they were ever born?  I am so glad I brought some baby clothes & will be sure this family get 4 or 5 outfits for  Lupita.

We have a VIP visitor/financial donor on this Mission - some of you may know him but I didn't...Bill Ranscic?  He was on the 1st Celebrity Apprentice & his wife Julianna? co hosts E News w/ Ryan Seachrist?  Anyways he is a supporter of Op Smile & was here to film footage & take photos for awareness & a donation campaign in LA.  He sat with me in screening - I didn't get any pics but Op Smile did & was really nice.  He is why we did one case today...so that he could scrub in & observe a repair BUT we weren't set up for post op children so we did a 30 year old mom & mother of 2.  It went well & I recovered her & Bill did a very nice interview about Op Smile & his experiences 1st hand at seeing what is done vs just donating $$$.  He was very genuine & sincere.

I have to admit that after this trip I will be a little more positive in my feelings towards the Pepsi company :)  They are HUGE supporters of Op Smile not only w/ Volunteers but all the chairs & EZ ups we had for screening was from them, they have an endless supply of water, gatorade & soda for us & it is nice to see companies who do this.  Their South America Exec VP Jim has been here each day & been a translator or done whatever was needed from moving supplies to  translating or stuffing charts.  He told me that Pepsi's primary customers here are the owners of the small "tiendas or shops" that sell Pepsi Products - they don't sell to big grocery stores cause they don't exist & there are tiendas everywhere - so part of him being here w/ employees is to also connect with the tienda owners in the area to let them know they support this project in this pueblo - so cool!  He also told me the ethnic mix in this area is both "indians" & "mexicans" & that in Mexico in general there is a small middle class, a smaller upper class & largely a "poor" population & that is who we are seeing.

His comments were reinforced by one of the volunteers who had helped me the past 2 days.  As I was finishing screening she got a translator so she could talk to me at the end of our time together.  Her name was Rosario & she was a sweet woman probably about 60 just here to volunteer.  She had sat by me for all my screenings & when I finished with a family she would take them to the next area - while I practiced my Spanish on her - I must admit our communication was pretty basic.  Thru the translator she said that she wanted to Thank me from the bottom of her heart for leaving my country & may family & coming to help these families & children who were from the poorest of the poor many without food to eat on a day to day basis ...she just said with tears in her eyes - which then caused tears in my eyes - Thank you, Thank you, Thank you & gave me a giant hug & kisses on both cheeks...moments like that make the long days & hard work so meaningful...the opportunity to lift another is a tremendous blessing & can be done anywhere.....I want to remember that when I am not on an Op Smile mission. 

Its late & we were just told out wake up call will be 5:30 as we have a full day tomorrow so I better get to bed - its almost midnite...TeAmo from Tlaxcala   

Happy Labor Day from Mexico!

Happy Labor Day from Tlaxcala Mexico!

Aside from my technology challenges which are improving this has been a wonderful day :)  The schedule for the week is the same each day - wake up call at 6, breakfast at 6:30, leave the hotel & walk to the hospital at 7, arrive at 7:15 for a team mtg & then let the day begin. 

I was in "screening" all day & with all the rain we saw less patients then anticipated...about 75 & 55 of those were scheduled for surgery...I really liked screening - there were 2 of us - me & a nurse from Sweden Andrea  -who had just arrived at 4 this morning as her taxi ride from Mexico City took her 5 hours because of flooded roads) & we each had a translator (mine was Tony a wonderful woman & volunteer from Colgate) & a Mexican Volunteer nurse (my new friend Sylvia) from the hospital here.  I would get the patients history, take vital signs then pass the info to Sylvia who copied it all on their chart.  It was a very efficient system :)  I screened some REALLY CUTE patients & the beauty of screening was that if I thought they would be a surgical case I introduced myself to the parents in more depth & told them I would be with their child in the recovery room.  I also got to take some pictures....I had several "favorites" Patient #1 was a 13 year old who had a repair before but had problems w/ scarring so we will revise that for her...when she finished several hours later & had a surgery time she gave me a big hug & we took a pic together.  My other favorites were 2 tiny babies...one was 3 mos & the other 4 months.  Typically 6 mos of age is required for surgery but both of these little girls were well nourished & met the weight requirement so I think they will both get surgery.  One was all the way from Puerta Vallarta - a long trip & the other was from a tiny pueblo 6 hours away & the parents were young (early 20's) & this was their 1st baby & I could just feel the love they had for their little girl & how they wanted her to be able to "grow up normal" - yep at the end of the day when we were talking as a team about her & the decisions was YES I got a little teary.  I took before pictures & told her parents I would be in recovery with her so I will for sure get after pictures - she is ADORABLE & had a big smile that will even be more beautiful when our team is done! 

There were quite a few patients waiting for us when we arrived but we were done by 3 on our end & then I helped move them thru the back end.  One other thing I took pictures of was the "Medical Records" staff from the hospital here dressed in white uniforms each of whom walked out to the tables they were at carrying their own typewriter to complete the forms...I am actually not sure when the last time was that I saw a typewriter????  The bubbles & toys Vicki got for me were perfect & the kids loved them as they waited for long hours in the screening process.  We were assisted today by local volunteers from Pepsi & Colgate - both sponsors of Op Smile & while I am a "die hard diet coke girl" I was happy to have Pepsi Light with my Pepsi friends at lunch :)  We even wore Pepsi T Shirts today each w/ Spanish words on them saying "Abrazo" (hug), "Todo Bien" (all is good), "Animo" (Pick up your spirit - that was the one I had) & "Sonrie" (Smile)  Yep learned a few new Spanish words today & actually as the translator spoke more & more came back to me & IN understood more than I expected & could even say all the Vital Sign #'s to Sylvia in Spanish so she didn't have to wait to copy them down!  A small success!  The Pepsi Volunteers were from the local factory here so it was cool to see them helping in their own community & the Colgate volunteers were from Mexico City.  Speaking of lunch it was actually delicious - chicken, a Mexican version of cole slaw, yummy bread & cantaloupe - which was great because at breakfast I was a bit nervous when I saw rice, beans, tortilla chips w/ melted cheese & salsa (yes Nachos) all of which I am sure was good but just didn't match my idea of breakfast - there were some eggs too but they looked a lil scary - I opted for fruit & yogurt & was fine!

Mexican Independence Day is coming up on Sept 15th & the country is in full preparation mode with red, green & white everywhere, flags & decorations on every building etc.  Also at 6 pm right outside our hotel I heard a band playing taps & walked out to see a FULL Military Ceremony to take down the flag - which I am told occurs all over  the country at 6 pm in town squares.  Tlaxcala is a quaint little area there is a big park outside the hotel w/ 3 big fountains & trees & I am told there is another one around the corner connected to a beautiful Convent & church - we explored the square outside the hotel tonight & 10 of us got dinner at an outside cafe.  One of the locals told me that Tlaxcala is the smallest "state" in Mexico & the nearby areas are some of the poorest in the country.

Tomorrow I will set up the recovery room w/ Christoph the Pediatric Intensivistalot of "in country supplies"  We will see how it goes.  I am SOOOOOOOOO GRATEFUL to be here & have the opportunity to serve the people of Mexico - I love them already - they are a gracious people.  The team is wonderful & we will change lives by changing smiles.  It is a blessing to be here & I appreciate the support from family & friends - love & miss you all.  If all goes well from the technology side I will blog again tomorrow :)

Made it to Tlaxcala :) Sundays Post

Okay I made it to Mexico City but I have no internet....so I am typing on wordpad & will then cut & paste it to my blog but I am afraid if I dont write it now I will forget!!! Today was really a travel day & not bad at all I left Salt Lake at 10 a.m. I was certain when I read the AeroMexico Website I could travel with 55 lbs of luggage in 1 bag....well that is within Mexico not to Mexico???? So my 59 lb bag required some last minute readjustment & I got it down to 52 lbs but I am pretty sure that my carry on & my backpack were pretty close to 50 lbs each as well!!! Yes packing light is not my strength! But I brought a bunch of baby outfits, plus some toys (thanks Vicki!) & paper & stickers to label the kids beds (thanks to TT & MAMBI) & medical stuff. SO I will be MUCH lighter returning.

My nephew Marc met me at the airport & got me to the other terminal, helped me exchange $$ & brought me 12 pack of "Coke Light" aka diet cokes - for the week :) We found he Op Smile meeting place & then he & I went & had a nice "real mexican" dinner - Mole it was great. Then I had to get on the bus to come to Tlaxcala in the pouring rain - I guess it rains her most every afternoon or evening - it was actually nice. The bus ride was supposed to be 1 1/2 hours but it took us over 2 hours - there was crazy traffic that could compete with the 405 on a bad day. I spent most of the drive trying to get my phone to work....seems there was a system upgrade I needed to allow me to text so once again after I told everyone to text me cause its only 5 cents I havent had much luck - despite a lovely 45 min conversation with the verizon help desk! But I did just get a few from Doug so maybe there's hope.

The little pueblo (town) of Tlaxcala seems nice although it was dark when we arrived & we went direct to a 2 hour team mtg.....people that were here earlier said we are right in the middle of the pueblo & its very quaint. Supposedly there are some internet cafes near by so maybe tomorrow I will go there cause the internet at the hotel isnt working. Our team will have 80 people & 68 are from Mexico...yep wishing I had some spanish I could speak!

Tomorrow is our screening day & we are going to be set up outside a hospital under ez ups supposedly the hospital is "nice" but I have learned that word means different things to different people & cultures They expect only about 100 at screening tomorrow so we will see.

My roomate is Janet & she is an OR nurse from Florida & has done 8 missions so I am sure I will get some tips from her I am fairly certain that the man in the room next to us is a Mexican Opera Singer & he was practicing with his coach for about an hour tonight...sounded like he was right there in our room :) We just finished unpacking & Between Janet & I we can feed most of the team with the snacks we brought & several of the little ones will have a cute outfit & blanket from us - I brought outfits & she brought blankets....Its after midnite so I better get to bed....Buenos Noches!

A week from now I will be in Tlaxcala Mexico!

Wow - it doesn't seem possible but yes a week from now I will beat the Op Smile Team meeting in Tlaxcala Mexico.  I have gotten 3 team mailings so I am getting more informed about this mission but since I just got home from vacation last night & these next 4 days are a little crazy before I fly to Utah Thurs night then fly from Utah to Mexico City Sun morning I am starting to feel a bit unprepared....

I have made list after list of what needs to happen...at CHOC, at home, packing, at my store  etc to get me out of the door & leave things in order but the lists are a little daunting.  I did start packing tonight (got my suitcase out & threw in 5 pairs of scrubs), I hit up the clearance areas at Kohls & old Navy last night & got some good deals on onesies in sizes 6-24 mos as they said we will be seeing alot of babies in this area.  Have a trip to Target (for my stuff) & the 99 cent store for bubbles & toys on the plan for tomorrow, as well as right sided passport photos for my Mexican Medical License.

I found out a few things....Our hotel looks nice it is the is Mision San Francisco in Tlaxcala, Mexico.  You can view the hotel online at http://www.hotelesmision.com/mexico/tlaxcala/tlaxcala/hotels/Hotel-Posada-San-Francisco/description.aspx  The weather should be nice in September, temperatures in Tlaxacala will range from 55-70 °F/ for an average around 61°F & the coordinators who are already there prepping for the mission said it has been cool in the mornings & evenings.  In bold they say something I already knew....Do not drink the tap water in Mexico.

Tlaxcala is about 80 miles east of Mexico City & is a town of  about 75,000. It is home to three famous bullrings one seats up to 5,500 people and features a bullfighting museum. Not sure that I will get there but maybe?

There are 81 volunteers on our team & 68 are from Mexico or other South American Countries...so only 13 Americans or Canadians - yep I'm wishing I had better recall of my 2 years of high school Spanish or could have a 2 day crash course in conversational Spanish with the Rosetta Stone.  I arrive in Mexico City at 3 on Sunday then am scheduled to take a bus at 5:30 for Tlaxcala.  My nephew Marc is in Mexico City teaching at a private school & he is going to meet me at the airport & hang out w/ me the 2 hours I have there so I am really excited about that & having him there will get me off ot a good start - he's even going to meet me w/ a Diet Coke :)  

The Mission Schedule is:
Sun:  Team Mtg from 8-10 pm
Monday:  be at the "hospital" for screening beginning at 7 am
Tues:  OR & Recovery Room Set up for me while others continue screening  
Wed/Thurs/Fri Surgery days - they hope to do 90 surgeries or about 30 per day so those will be long days & in the Recovery Room we are the last to leave at night
Sat: Team Day & farewell event - maybe that is when I will see the bullring?
Sunday the 11th I will take a bus back to Mexico City & then fly home to LA

I am really excited....just need some "extra help from above" to get things ready & me out the door Thursday night.  Please keep me & the entire team in your prayers next week from Sept 4-11 - that we will be safe, that we will be able to provide care for the children & families in Mexico who come to us & that everyone on the team will be blessed in fulfilling their individual roles.  I sort of think that going on these missions is like having babies...you forget how intense the work is & how long the days/nights will be but they remind us that 
if we ever fel frustrated, remember what ultimatley inspires your work, and that everyone on the mission is working toward the same goal - while the work is long, hard & tiring the experience is uniquely rewarding :)

Next post will come from Mexico next week - wish me luck in packing 
Nancy  

Here I go again.....

I guess I need to change a few things on the header of my blog....because HERE I GO AGAIN......I got another one of "those phone calls" this morning from Operation Smile...asking if I could join them as a recovery room nurse on an upcoming mission that takes place in just 3 weeks. This time the destination is Tlaxcala Mexico a small village about 75 miles outside of Mexico City.  This is not a co-sponsored trip it is just an Op Smile trip but the Coordinator from my Africa trip was reviewing the LDS Social Services volunteer list from the Nakuru mission when another coordinator came up to her saying she needed a strong Recovery Room Nurse & my name came up & then I got the call.  I have to say I was SUPER EXCITED...I quickly checked my CHOC Calender for conflicts then the family calender....I was scheduled to be in Salt Lake City for Labor Day weekend for Doug's Nutrition store grand Opening & to help Kelli set up her apartment.  We fly in there Thurs night so I figured I could do all that Fri & Sat. The next schedule to check was with Sarah & her 1st day of school - her concerns - pictures & our tradition of homemade cookies after school...a few calls later & I think both of those can be covered.  Next check talk to the COO of CHOC & see if what I would miss meeting wise was okay - alot of hesitance because i have quite a bit of responsibility these days but w hen I said I really felt strongly that I needed to do this & that it truly keeps me connected to my passion of caring for children the answer was  YES...so by noon I had confirmed my participation to a trip to somewhere in Mexico I know nothing about.  All I know is that I have been blessed with the talents I have & I will share those talents to bless the lives of others.  It's gonna be a crazy few weeks - lots going on this week then vacation for a week, then home a week, Utah for a weekend & I will fly from Salt Lake City to Mexico City.  Lots of paperwork to fill out tonight to get a Mexico Nursing License - who knew I needed one?  But I am excited to go on another adventure...so grateful to my family who supports me in this & so grateful that I am blessed with this opportunity to serve....I will keep you posted as I know more :)

Final Day of Surgery & the last 2 dresses

Last Day & Night in Nakuru & last day of the mission…wow where has the time gone??? I have worked about as hard as I did in Houston after Hurricane Katrina & I left there thinking there were still so many great needs & I felt the same way at the end of today but IT WAS A REALLY GREAT DAY!!! First of all after we got back late last night Donna told me that since our patients don’t hit the recovery room til about 9 & since we had the night we did that why didn’t I sleep in an extra hour & the “local nurses” who volunteer like shift work 7 am-7 pm could get things set up. I did not argue & felt like I was just given the best gift ever. So I slept in til 7 & then proceeded to take a taxi by myself to the hospital - the fare was $4 & it was quite a ride. The driver stopped at 2 different gas stations & got gas at the 2^nd one….no idea why? The taxi drivers gas gages are always on empty I think its because they only put in the amount of fuel based on each ‘job” they get - they don’t have money to “fill up” - another simple thing we take for granted…having money for gas in our cars. The streets were totally bustling with activity…when we leave at 6:30 am & get back between 9 & 10 pm we miss all this activity & it is CRAZY!!!

A few things I have forgotten to write about in my blog…Jannae & I would text back & forth to coordinate patient from Recovery to Post Op they did have one phone in most wards - yep a rotary phone complete with the rotary dialing sound - the 1^st time I used it I was instantly catapulted back in time to my childhood home on Memphis Ave in Whittier with our old rotary phone! I even took a picture with it! I think I forgot to blog about 2 patients yesterday…Gladys who was 6 mos old & from a distant Masai Tribe. Her mom & dad had traveled with her 1200 km (over a week) to get to us!!! She was put on the schedule for today & was so stinking cute..I know I took a picture of her with the child life specialist Donna (who I also adored!)


And yesterday I made several trips back & forth to post op & on my 1^st trip outside the ward that connected to ours was a mom that I think our plastic surgeons helped & her 2 children..the little girl was about 3 & had beautiful sparkling brown eyes & the most beautiful smile & she waved at me as I walked by with a patient that I was taking in to the post op ward. On my way back to the “recovery room - I use that term lightly” I stopped & talked to her & her mom & found out her name was Faith & I was immediately in love!!! The next trip an hour or so later she was still out there so this time I asked if she would be there in another hour & that time I came back without a patient & with a dress for her - the cute striped one that had a little purse with it…she (& her mom) were so excited & grateful..I took MANY pictures - she was SO DARLING..Kelli & Sarah wanted me to bring An African baby home & if I could’ve I would because there were actually some moms who said this is my 5^th or 6^th child & I cant care for him/her so please take them…which many of us on the Op Smile International tram might have considered but there is a new law that you have to live in Kenya for 6 mos before you can adopt child. Personally I have always loved toddlers so if I could have I would have snatched Faith in a minute!!! But she had a very loving mother & perhaps that is why she was so happy J I was out of T shirts but I brought her brother some toys & he liked that too! Then today when I was taking some of our last patients to post op she was outside again & ran up to me & gave me a BIG HUG….ohh she made my day! (FYI any patient that can get outside does for the sun & also to get away from the pretty nasty stench that exists in all the wards)

Since it was our last day I brought all my scrubs with me to give to the nurses I was working with, I had also packed some other small gifts for them - they lack simple things we have all the time - bandage scissors are highly valued & I even brought & gave away a few stethoscopes. I even gave my VERY LARGE empty suitcase that brought all my dresses etc in it to John & he was going to use it to cart around baby manikins from place to place when he taught Pediatric Advanced Life support around Kenya J Nothing “extra” would go unused! When I got to the recovery room at 8:30 we hadn’t had our 1^st patient yet so all I missed was my morning trip to the Post Op Ward. All the other Kenyan nurses in Recovery room (John & Florence Sr - both with Op Smile & then Florence Jr, Beatrice &Wamboi - 3 from this local hospital) gave me a really cute purse made in Kenya & gave Andreas a safari cap with “The Big 5” on it (the 5 animals you want to see on safari - rhino, lion, elephant, leopard, buffalo). It was so sweet of them J I asked about the mom from last night if she made it & they said they thought so but the staff didn’t want to talk about it & so I let it go & wanted to be respectful of that.

It was a shorter surgery day with the plan we would be done by 2 pm…and we were pretty close to that time frame. Many of the kids who came to be screened later in the week were on todays schedule so we ended with a lot of cleft lips & that seemed to make the entire team happy - a one year old patient w/ a cleft lip even showed up today & the baby hadn’t eaten so we added him on for surgery. Joyce was also scheduled for her burn dressing changes today under Genl anesthesia - the plastic surgeons knew this would be her last “Western medical Treatment opportunity” so I think they wanted to do all they could. They had one of the Kenyan general surgeons assist them so that perhaps he would follow her & help her continue to get care & heal well after we left. She had colored me a zebra that her mom gave me so I attached it to my Op Smile nametag & wore it all day J

I had a few dresses remaining so the students went with one of the hospital nurses & took them to another pediatric ward…it was great to be able to bless over 100 childrens lives with the clothes & toys I brought from the service of so many - I was simply the instrument to share the love of A LOT of really Christ like people in California….

The end of the surgery day came quickly compared to the 8 or 9 pm nights we were used to & even the last surgery on the 1 year old who arrived today was as important as the 1^st to that child & family. When we were “all done” we basically dismantled the entire recovery room we had set up - monitors, equipment, meds everything & in about 90 min it was like we were never there (aside from 2 HUGE boxes of extra medical supplies we were leaving them)…. There was this sense that everyone just wanted to linger in the OR or at the hospital a little longer before we went back to the hotel.
I had 2 dresses still in my bag….and I wasn’t sure what to do with them….one of the locals was taking some extra toys back to a far away village so I thought maybe I would give them to him…then as I was walking to the front of the hospital to get to the bus I passed an adult ward & outside was a mom & 2 little girls…I stopped & gave them my last 2 dresses….it was the storybook ending to the 112 dresses….they held the dresses up to themselves & danced around & yes I took pictures!!!

Instead of taking the bus back John my Kenyan recovery room friend said I needed to ride in a “Tuk Tuk” so he got one & we went back to the hotel in this fun 3 wheeled cart. Reminded me of a golf cart w/ only 3 wheels & canvas flaps around it to enclose it - we got back to the hotel about 4:30 & the “Final Party” was at 6.…some of us went across the street to the “open market” to make some final purchases - ever since Monday the market wasn’t open when we left in the morning & was closed when we got back…I found my friend Moses & bough a hat for Doug from him as I had promised….I also got some final gifts for friends & family & found myself less concerned about “bartering” with them & mostly just wanting to give business to ones who were nice…paying an extra 100-200 shillings for something equals about $1-2 American….I am sure that the extra $20 or so I paid after all my shopping will have a bigger impact on their lives than mine at home.

The final party was nice….lots of speeches & thank yous from the Op Smile leadership, local Kenyan leaders in the country & in medicine - even the bus company owner who donated buses & drivers to take us back & forth every day & the people who cooked our lunch each day spoke .it takes SO MANY PEOPLE…yes an African Village worth to coordinate all the local details & needs of an Op Smile Mission The party/dinner ended about 11 but the “younger” team members continued the evening dancing at a local club near the hotel…as for me I needed to pack & even though I gave away so much stuff & offloaded one huge suitcase I filled up my 2 bags to come home. My “roommate” had left the day before so the last 2 nights I had my hotel room to myself & I just appreciated the quiet time to think about these 2 weeks & the truly amazing personal, spiritual, medical, emotional & truly “person to person” or “mom to mom” experiences I had….it has been a LIFE CHANGING EXPERIENCE to have been here on this mission & such a blessing in my life but…I do miss my family & will be ready to start the journey home in the morning.

Is it really THURSDAY????

THURSDAY…at least that is what I am told. I really have lost track of the days!!! Because of all the computer issues I have been having I am trying to get this written on a 15 min break I am taking while we have a lul & then at some point when the http://www/...  figures out I am here in Nakuru & the internet Gods decide to let me connect I will hit "post" for all I know that may be when I get home!!!

It was a pretty “normal mission day” today & by Wednesday it seemed we were all in our “groove” other than the occasional “emotional case” or some of the day to day funny things that happen  Really I almost felt it was running like clockwork here in Nakuru despite the fact we are in a somewhat primitive environment (probably advanced compared to other 3^rd world countries).  Everyone was doing their job & doing it well & working so great together - seriously not one person with an attitude. The team is awesome - an amazing group of people from all over the world.

The biggest difference in both a good & challenging way is that for the Kenyans the “Hakuna Matata” attitude that is very real…there is no sense of urgency for anything & some of the people have a “minimalist” approach to their work & their breaks are VERY important to them…we start work at 7 & at between about 10:30 & 11:30 everyone gets out of the Recovery Room for tea…no matter what…then there is lunch about 3ish & again about 4-5 everyone goes for tea. And it was a BIG deal because all the Op Smile volunteers were “taking tea” in the Doctors Tea Room near the OR & ICU. As you can imagine it frustrated them greatly that I didn’t want to “go for tea“ aka take a break every 3 hours….instead if it was slow I was poking my head in the OR or asking if anyone needed help…I always went to lunch & some days did take an afternoon break for a diet coke & trail mix and for me that was great cause I enjoyed stating busy and being near the kids. I didnt travel 10,000 miles to "take tea" :) but I also regocnized the importance of "hanging out" with the locals in the tea room & getting to know them better so I did that & also looked for ways to spend time with them whenever I could. I have some great notes all about the people & nursing in Kenya that I will write about another time!

As far as the "Hakuna Matata" life ...when Andeas (our intensivist) wanted to move patients to post op cause we had some “incoming” in the next 20 min & we already full I would be the one to volunteer to take patients to the post op ward - my 100 yd walk just to be able to “take in” everything going on at the hospital & to see my friend Jannae in Post Op. The other nurses wanted the post op nurses to come pick the patients up from us but Post Op was always slammed (that by the way I think is the hardest job of the mission ) so I would go & convince one of them to go with me “for a walk“. So basically all my Kenyan co workers said I worked too hard…but for me it was perfect!!! They do however LOVE the fact that I brought an IPOD & speakers & we have had music in the recovery room for the whole time. In that small room when we have 5-6 patients 2 to a bed most of them crying & the surgeons & anesthesia in there giving us report the noise level does get a bit high though so I turn it off!!! They are also a VERY friendly people & we laugh & joke all the time when we have down time between patients & are setting up for the next ones.

Because of all the extra screening we had done Mon-Wed we ended up cancelling some of the Category 5 adult cases (about 30) and adding on more kids with lips & palates…which is great because that is our primary mission…and we did A LOT of surgeries related to burns..so sad . My friends from KSL left yesterday…I cant wait to watch their piece on our mission and today the 2 high students got to come in the OR & see cases - they were so excited & they have been a fun addition to the team. Karina from San Clemente (who I traveled with) & Century from Norfolk VA.

My FUN patient for today was a 12 year old named Ann…as she came out of anesthesia she kept asking “is my smile beautiful now” and told us she had a good sleep & no pain & kept saying “God Bless You, God Bless the Doctors, I Love You, God Bless You” she was SO SWEET..I gave her a cute dress & took her picture then showed it to her on my viewer on the back of my camera - she made my day!

Also today Florence an ICU nurse at this hospital & one of my co workers said to me yesterday & today that she brought her 3 year old son for screening because of 2 fused fingers after he burnt them (this is very common because I think with the burns they wrap the hand & burned fingers together & then they fuse as they heal). He was a Category 5 but she wondered why he wasn’t put on the schedule because other Cat 5 children like that were scheduled on the end of most days. It FINALLY struck me that I should advocate for her & her son as she would think it not appropriate to ask herself. I explained the situation to Donna our coordinator & she told me to get the chart so I asked Florence what her son’s # was (each child that comes thru is given a # that becomes their medical record #) it was #143 so I went & got the chart & took it to Donna & Dan the Medical Coordinator. I explained Florence was volunteering here all week (took work off without pay) & she has done other Kenyan missions. Even though she & her husband both work they cannot afford even this simple surgery. I told them that either way yes or no I thought she would appreciate knowing they looked again at his chart I let it go from there & about 10 min later Donna came into the Recovery Room & told Florence they were adding her son to the Friday schedule & could she get him here later today for labwork. Florence said of course & then came & gave me a HUGE HUG told me what a difference it would make in his life….such a SIMPLE thing to ask for something for someone who might not ask for themself.

Thursday Part 2....warning this is sad so skip if you want

Never would I have imagined….WARNING….this blog is somewhat a journal of my experiences & while I have not put “everything” in it & have scribbled some notes of things & experiences I will write about later elsewhere for myself this is the easiest way & place for me to “journal” & I need to do this now…what I will write here was VERY SAD SO PLEASE JUST SKIP OVER IT IF YOU LIKE & I DID NOT POST IT ON FACEBOOK as an update.

I was ending what I thought was a very “normal” Thursday…I had written the earlier post for today about 5 pm when we had a 20 min lull & now it was 8:30 I am outting that post ahead of this one).  Florence Sr. & I were waiting for our last 2 patients to come out of the OR & John had taken the previous patient to post op. The hospital had “staged” patients for surgery in the hallway all week - usually with no IV, no O2 & no medical person ever anywhere nearby so I noticed a woman on a trolley (gurney) & didn’t think anything of it. Florence went to check on the patients in the OR to see if they were close to being done & I was picking up from a busy day & setting up for tomorrow. When Florence went by the woman she was flailing her arms & not coherent - she called me for help & we wheeled her into our Recovery area put oxygen on her & put her on our monitor she was in pretty significant shock so we called Andreas (our intensivist) he yelled out to the hospital staff “does anyone know what is wrong with this patient” as we started an IV…someone at some point told us she was 36 weeks pregnant & was just brought here from the maternity ward where she had been having seizures (perhaps from Pre-Eclampsia) & was given medicine there (that’s why she was floppy) & now they were going to do an emergency C-Section cause they also thought she had a ruptured uterus??? Obviously “emergency C-Section” is the US is rush them in & get the baby out…here it was wait 30 plus minutes for the doctors to arrive & then start treatment??? We had no way to check on the baby but we gave the mom fluids, Andreas & an Op Smile Anesthesiologist intubated her & then theKenyan doctors came…it was about 10-15 min after we first discovered her….and somewhere in there we lost power & lights for a few minutes.

They wheeled the mom in the OR & Andreas told me & Donna who was there by now to prepare to receive & resuscitate the baby…so we did, got fluids, oxygen, suction, towels, drugs, airway & intubation all set up…about 5 min later they brought in a very limp little girl & also said the cord was around the neck. We immediately tried to resuscitate her according to the best American critical care standards - doing CPR & using all we had set up…we got an IV line in & gave drugs etc etc…we worked on her for about 10 min w/o success. It was so emotionally difficult on so many levels for so many reasons…what would have happened normally in this scenario if we hadn’t intervened? Is this what they always do with their patients? We intervened & still the baby died - if she had any chance we gave her the best one possible, if she was in another country the scene would have played out so differently & I know she would likely have lived. And in the middle of all of this going on our 2 patients came out of the OR & Teresa the plastic surgery resident on the team was so great she walked in & said “Nancy what can I do to help” & I just said recover that patient you just brought me & she said she had no idea what to do but she did great. This really is an amazing team!!!

When we could do nothing more for the baby we wrapped her in a pretty pink blanket (one of the blankets we have been giving each child all week) & the “on duty” Kenyan OR nurse took the baby to “the maternity ward” I didn’t know why they took the baby there & asked Florence & she said that the mother wouldn’t believe her baby had “passed” unless she saw it.
Andreas quickly turned his attention to the mom in the operating room & from his voice I could tell it wasn’t going well…he told me to bring all the IV fluids I had & then asked for a few drugs as well. The situation in there stabilized somewhat & we left with her still in the operating room…we all walked quietly to the bus that had gone to the hotel & then come back for us & was waiting there. I got on the elevator & just couldn’t hold back the tears…I went to Jannaes room cause I just felt like I had to tell or debrief with someone & she was so supportive….never in my mind could I have imagined a situation like this…but we did all we could - I know that for sure…still at the end of a LONG day it was difficult to process…I have so many questions for the Kenyan nurses I will be asking tomorrow

REVISED!!! Joyce got surgery & I was back from the hospital & at the hotel by 9!

Okay well I started this post last night & then the internet went out (as happens about every 15 min here & only part of it saved so it's morning now & I will post what I have & try to catch up later.

Today was 2 hours shorter than yesterday & I got back to the hotel just before 9 pm which was SO NICE!!! The BIG news of the day was that Joyce the little girl w/ the burns got surgery todays she was the one who I blogged about on Monday??? (I think it was then the days have all blended together!)

I guess the plastic surgeons talked yesterday sometime & decided thay could do some skin grafting for her...I was super excited when I saw them walk her into the OR mid morning - it was a 3 hour OR case and they did grafts to her scalp & both forearms.  I took care of her in Recovery & we kept her in recovery for 3 hours just because she needed closer monitoring than they could do in the post op area.  They had given her alot of anesthesia in the OR so her pain was well managed & she did really well post op coming out of anesthesia except for some temperature issues - & we even held down her post op pain pain.  She definitely has a long road & likely many more surgeries ahead of her but it is nice to think that we got her started on the road to recovery.  I have to believe that she got a better start w/ the Op Smile surgeons & team than she would have with the local doctors.

Medical care her is WAY different than in the US....first of all they have little to no supplies or equipment available - we have to lock up all our supplies every night so that the hospital staff don't "borrow" them.  Monday I made the mistake of not putting away the gloves that were in the boxes we taped to the ends of the bed & Tues morning when we came in there were no gloves in the boxes....and this morning the alcohol wipes were gone???  It makes no sense cause Op Smile will leave at this local "hospital" most all of our extra consumable supplies (except some of the drugs) but I guess there are some desperate needs.  Also here in Kenya if you have someone in the hospital then you basically take care of them...bring them all their food & wash their clothes, so there are wash buckets & clotheslines outside all the "wards" & the hospital provides the "medical care" & juice or tea. Also this morning when we were setting up the Recovery Room they were doing a C-Section in the one OR room that the hospital is using (we are using the other 3 rooms & have 2 OR tables going in 2 of the larger rooms for a total of 5 tables) but they are all kinda connected. Most of the C-Sections are done in another OR (or Theatre as they call it here) so I am not sure why this one was here..perhaps a tender mercy for this mom.  Anyway in the OR room they were doing the C-Section Delivery in the baby was delivered "blue & limp".  According to one of the Op SMILE OR nurses the Kenyan delivery team all just sort of shook their heads.  She yelled to us in the recovery room & we went in & with some stimulation & a little suction & blow by oxygen the baby perked up in a few minutes - It was a BOY!!!  What we did was just "the basics" in the US & here it was almost advanced care.  All day I wondered if they would have just let that little boy die???

I didn't get to the post op ward until later in the day - so I missed seeing alot of yesterdays patients since the cleft lip patients go home after one day & the cleft palate patients go home after 2 days.  I did get to see a darling little girl we had the other day who had to stay an extra day because of some respiratory problems. We nicknamed her "Miss Kenya" in the recovery room!  When I have them in the recovery room they are drowsy & out of it or crying...by the next day you can see their sweet personalities. I counted all the girl patients on the OR schedule for the next 2 days & went thru all the dresses I have left & then realized I will probably have about 30 extra.  The 2 high school students who are with us are going to an orphanage today so I gave the extra dresses to them & a bunch of bubbles to give out...they say they will take pictures.  The needs here are so vast & I feel like I don't even have a full comprehension of it...especailly those who live in remote villages.

One part of this post that didnt get saved was that at leat a dozen people usually older men have asked me if I have been to the small village not far from here in Nakuru where President Obama was born...another dozen mostly women have told me that he comes from "their tribe" there are abut 42 tribes in Kenya I am told & now this one has gained stature, & still others have asked how I like having their "Native Son" as my President.  They definitely have Obama Fever here he's on T Shirts, Posters & there is even Obama Bubble gum with pictures of him  & his family on the packages. I'm just saying that I know the US Govt did their part to investigate where he was born & decided it was Hawaii but they might want to just come to Kenya and chat with a few people here...
 

An even longer day....seriously exhausted & hitting a wall...

Ok I am not sure when I have been more physically or emotionally exhausted...I know there have been times like this for me before but the passage of time has graciously erased the memories...

It has been about an 18 hour day from wake up til now when I just got back to the hotel.  I decided to quickly do a SHORT blog entry before I shower then I will eat a granola bar & trail mix & go to bed!

The day starts at 5:30, breakfast is at 6, there's a team meeting at 6:30 & we leave for the hospital at 7 & the 1st five surgeries start at 8.  Being in the Recovery Room we don't get our 1st patients til about 9 so this morning I went to the Post Op ward to see some of my little patients from yesterday & that was SO FUN & SO REWARDING.  When I have them they are "coming out of the black hole" of anesthesia & while their faces look "fixed" they are drowsy...this morning they were awake & smiling & happy & wonderful!  Even little Joyce was there in that area with fresh bandages over all her burns, in a little dress & while I dont think there was a smile yet her eyes looked just a little brighter :)

By 9:30 things were hopping in recovery & unlike yesterday when we got lots of patients in & then had a lull today was just a steady stream of patients with occasional chaos for one reason or another but multi-tasking is something I can do even in another country!

One of the highlights today was when Salome came to recovery after her surgery (the 14 year old I blogged about on Saturday).  we have 3 beds & rotate the patients to each bed & she came to mine :)  She looked great with her cleft lip fixed! I found out that someone helped her mom get busfare to Nakuru from Nairobi so she was there with her daughter...we had her mom come into recovery once I had her settled (as we do with all the kids whenever possible) and as soon as her mom came in she teared up & then bowed her head & started praying aloud in Swahili. All of us in the room also bowed our heads as she prayed & there was such an amazing spirit in the room. Florence (a Kenyan nurse I am working with in recovery) translated the prayer & said that mom thanked her Lord for this miracle & all those who have helped "her girl" an asked for blessing for everyone involved & prayed the Salome would take this good gift & go on to make a difference in the world and pass the kindness on to others...it was definitley the best part of the day.  A KSL news crew (the Salt Lake City affiliate of NBC) has been here with us all week (they leave tomrrow) & Brooke Walker the reporter is darling & has been so fun to get to know.  They picked 3 stories for an Op Smile series they will be airing in April & Salome's story is one of them...so I may have gotten some camera time in recovery & then they did interview me...so friends in Utah may see me on the news or maybe not - I will keep you posted when it airs they also said the local NBC affiliate in the LA area was interested in picking up the story so who knows...none of that really matters but I do want to see Brookes series about this mission & Op Smile.

Because of all the "add on's" the day went on much later than expected & honestly I do think I have hit a wall...I am feeling SO GRATEFUL to be here & be haing these experiences but I am a little homesick & miss my family (altho I did talk to all of them today), I have been gone for 8 days living in a very different environment, I am not getting alot of sleep & am working hard & long days...I am not sure when the "getting more rest" will be a possibility so I just keep moving forward as does all the team.

My last tender experience happened late tonight...we have been doing some adult patients but with the influx of new kids yesterday the adults have been delayed until the end of each day.  Tonight we had a 20 year old girl who was getting surgery for some old burn scars on her face & neck (burns are a huge issue here because they cook indoors over an open flame with oils...there are so many people & children with burns I have been amazed!)  Anyway she was to have this done & then be able to go home. I recovered her & then walked her to Post Op to gather her things & in pretty good english she told me she was married & had 2 young children. When we go to the post op area because of the add on surgeries it was over crowded & they had some babies sharing beds. As I told the night nurse she could go home the young woman said she lived 12 km away & had walked her but now at 9 pm it was unsafe for her to walk home so she would need to spend the night.  I had to go back to recovery but as I walked back there I thought "really she has to share a bed in a hospital & not be home with  her kids & husband?" So since I had taken a cab back to the hotel last night & it was 300 shillings (about $4) I asked the Kenyan coordinator Diana...can't we just call a cab for her I will pay???  Diana said that others might want the same thing etc but I felt like I just needed to push the issue & advocate for this young mom.  I asked Diana how much she thought a cab would be for 12 km & she said maybe 500 shilling ( $6) I said let me do it please so we went back down there & I found her doubled up in a bed with another teenage patient.  Diana talked to her in Swahili & then took her to a more private area where other patients wouldnt hear the offer & she said yes she really wanted to go home & all she needed was 200 shillings ($2.50)...I already had given Diana 500 shillings so she gave her 200 & the girl thanked me profusely & I just said "go home to your children" & just that got me choked up.  It was a very simple thing..anyone would've done I am sure; I was just the one put in the position to meet her & then help her...there was no reason for her to stay & I am glad she got to go home...it ended my very long day on such a positive note :)  How many times do I misplace a few dollars or waste it on something or buy a large diet coke & I never think twice about it & here in Nakuru $2.50 made a difference.

There were some other intersting parts of my day...like the ventilator tubing I saw hanging out to dry on a clothesline or the fact that I never imagined myself walking 50 yards from teh recovery room on slightly pave but very bumpy & on some placed dirt paths to get a patient to the post op area at 9 at night in the pitch dark using my flashlight to guide me! (not logistically the best but it is one of the nicest buildings here), that I would be so excited to have the a "Tuna Lunch Kit" & right now that taking a shower & getting to bed is almost as good as Christmas! so goodnight!

LONG DAY #1 & a little girl who broke my heart

Well it's almost midnite here & I am pretty sure I am the only Op Smile Volunteer still awake & I am definitley the ony one in the hotel lobby (only place I can get internet) ohh aside from the hotel guard who yes does carry a weapon.  I have given up on the idea of ever posting pictures before I get back...there is just no time to upload from the camera but I am taking lots of them.

It was a long first day...we had our wake up call at 5:30 a.m. which will be our wake up time every day so yes that is about 5 hours from now...

Today was our 1st day of surgeries & getting all the areas organized, pre op, surgery, recovery room (me), & post op.  We also had about 50 more people show up to be screened even though it wasn't supposed to be a screening day so that was a challenge but somehow it got done...I wasn't anywhere near there but I heard it was busy & there are now several surgeries that were added to the schedule & we will likely have long days Tues/Wed/Thurs.  It went well in recovery we had time to get organized before the 1st round of patients came to us but then all of a sudden we were swamped in our tiny little space as 5 patients came back in about a 30 min time span... we had 2 to a bed & moved them thru as quickly & safely as we could.  Then we'd get a brief lull once we sent them all out to the Post Op area & then the rush would happen again.  That went on 5 different times as each OR table was scheduled for 5 patients today & then they did a few add ons.

The little girl who broke my heart wasn't even one of our surgery patients...first thing in the morning one of the volunteers came to me to ask for a dress for a little girl who was in the pediatric ward where our patients were waitng to go to surgery - she said it was SO SAD & I really needed to see her & how happy the dress made her.  She is 8 years old & her name is Joyce....she & her family were among many displaced in 2007 after all the unrest that occurred after the elections (I know nothing about this myself but John who is Kenyan & in the Recovery Room with me explained it to me a little)  Anyway her family has lived in a tent since then...yes for 4 years!!!  3 weeks ago the nylon ten caught on fire she & her younger sister were inside & tried to get out but the tent essentially melted & burned on them & her sister died.  They came to this general hospital we are working at & she has been her the whole time as she didn't qualify to go to the burn center an hour away...I can't quite imagine why because her burns were so extensive...her entire scalp, back & shoulders & arms were badly burnt & the wounds looked fresh & painful & her eyes had both a look of terror & pain in them. They brought her to the an area outside the Recovery Room so the Op Smile Plastic surgeons could look at her.  We made a solution to cleanse her wounds, got her some appropriate pain medicine & the Docs made a plan that the ward nurses could follow....I have been a PICU nurse for over 25 years & seen alot of pretty horrific things (not burns because we don't do those at CHOC) and this really rattled me.  I ended up giving her 3 dresses & some flip flops & books etc.  Her mom asked our Chief Mission Plastic surgeon if she could get skin grafts but he said not this week while we are here - her wounds needed more time to heal & then she asked if Joyce could ever grow hair again & when he said it was very doubtful the mom just looked so sad & defeated & walked away to spare her daughter from seeing her moms own sadness. It took me awhile to shake that brief 15 min experience (it was between rushes of patients) so getting busy & back to work helped.

I dont want this blog to be full of sad stories...but there are many AND there are some GREAT ones too...lots of kids got new SMILES today & looked so darling after surgery & those moms had tears of joy when we showed them their kids....every child who lef the the recovery room left with a dress or T-shirt & usually a toy or flip flops or something & that was fun...the 5 Kenyan volunters I am woking with in Recovery were so good to be sure "their patients" had something from my bags before they left us & one time one of them picked a darling dress out for her patient & then we were all a little embarassed when we realized it was a boy!!! - quick change to a T-Shirt & no problem.

About a hundred other things happened today & I really need to write more just to I remember but right now I have to get to bed wake up time is coming quickly...

On a lighter note..a day of team bonding!

So today was our day for "team bonding" to unite all the Kenyan Op Smile Volunteers (about 75% of the team) with the International Volunteers (25% of the team).  Except for the fact that the "bonding day" started a little early with a 5 am wake up call (which is someone from the hotel knocking on your door until you respond...no phones in the rooms)...it was great :).  We went to the Lake Nakuru National Park...Schoolbuses & drivers had been donated for our transportation (that was interesting!) and we had to pay $75 to get in (more than Disneyland!)...but it was worth it especially since I am not staying after to go on a Safari.  We drove all thru the park on non paved roads & saw SOOOO many animals....before we went in we (meaning the non Kenyans) were so excited when we saw the monkeys at 6 a.m. little did we know that by the end of the day Zebras would barely get our attention because we saw so many of them.  We were able to get out of the bus & up close - except for near the lion...and we saw....baboons, water buffalo, gazelles, white rhinos, giraffes, lions, monkeys, flamingos (what the lake is famous for but alot had migrated), hyrex (an african varmant), a variety of lizards (Sarah you would've hated that!), ostrich, water bucks, hyenas, zebras, pelicans, impalas, elands, warthogs & probably a few things I am forgetting.  Yes it pretty much made me want to start singing all the Lion King songs!!! We were there for 8 hours & I took a TON of pictures.  Then went to the "Rift Valley Sports Club" (African Version of a Country Club) for lunch - interestingly enough it was just a nicer version of the hospital lunches - must be standard fare...cabbage salad, rice, cooked spinach or collard (looks like cooked grass to me), beef in a sauce (really good) & they had chicken too.  The Kenyan team members did some singing & dancing for us - I did a video of them - they were great! We finished at 3 & then at 4 the eight Latter Day Saint members of the team had a brief church service & then I took a much needed nap before our team mtg. 

A few other "Fun Facts"...at dinner one night the "Amazing Race Spain" teams w/ their camera crew came in the the same restaurant (3 teams of 2) & one rule is they couldnt buy dinner after 7 pm so the Op Smile team bought them dinner...I am sleeping under a mosquito net every night although I have yet to see or be biten by a mosquito (but other have so no complaining & I am still taking my malaria medicine), the "Pantry" of food I brought has been a lifesaver as I can only eat so much African Hospital food for lunch & my friends on the mission are calling my room Wal-Nancy (like Walmart) becasue I seem to have everything everyone needs so I am feeding many!, it was odd to be at the African outdoor market & hear Justin Beiber blaring from the speakers, they feed us a wonderful breakfast each morning - a chef that makes omlettes & fruit & lots of African food I have tried but not added to my morning routine, I bought a Kenyan cell phone (a Nokia actualy) a SIM card and 300 minutes & texting to the USA for $35...best money I have spent here so I have talked to all my family & that makes me much more focused on doing the work that needs to be done here w/o worrying about home!

And let me tell you about the "Diet Coke Miracle"...finally yesterday I was able to walk to a grocery store a few blocks away (being out on the streets here in & of itself is an experience).  I was tired of getting bottle "Coke Light" at the hotel & other team members told me to go there & get the plastic bottles so I could take one each day to the hospital to have when I "hit a wall" mid afternoon.  It was a nice store & I immediately went to the soda aisle & NO COKE LIGHT (except in bottles)...imagine my distress!!!  I stopped a store clerk & asked about it & he said they were out of stock...the rest of the Op Smile team had gotten their first & bought it all!!!  arghhh was I really going to have to buy & lug bottles? I decided to ask another clerk when it might get restocked...he took me to their "office" looked on the computer for inventory & then took me to another office & another computer & said there should be 1 case in the wholesale section of the store.  I followed him dowstairs to some sort of a basement (yes I was desperate & yes it was safe) & there were cases of all kinds of soda everywhere, he moved about 30 cases around & found me the last case of 20 oz bottles of Coke Light in all of Nakuru I am sure...he said it was packaged to be sold as a case & I said no problem I will take it :)  So between the phone & the coke light I am ready to take on the week!  It was added to my pantry & I have already shared with other team members!

So tomorrow the chaos starts (so I am told) the 25 surgeries for tomorrow checked into the hospital tonight at 5 & will get bathed & prepped for surgery & we will head over there to set up at 6 am w/ the 1st surgeries at 8...there are 5 surgical tables & our tiny recovery room w/ 3 "beds" so the patient flow should be interesting, also the post op ward is about a 10 min walk outside from the recovery room. I am sure it will all work out after all Op Smile has been doing this for almost 30 years!!! & over 160,000 smiles. I will let you know how it goes but I gotta get to bed - big day ahead of me! Love to everyone & check in on my family its week 2 & things might be getting scary there!     
 
P.S.  Probably can't upload pics tonight sorry!

Setting up the Recovery Room & 2 Special Girls

What an incredible day….I was all set to be the gatekeeper day #2 when Donna (the mission coordinator) asked me to go with Andreas )the Pediatric Intensivist & her husband) to set up the Recovery room..this is his 1^st mission too but Donna has been on several so she gave me her advice & off I went. Since I didn’t know I would do this today I didn’t bring any scrubs so I had to borrow some from the hospital…very interesting since they have very few & wash them by hand & hang them to dry behind the hospital. The “recovery room” was….lets just say less than ideal…a 10x10 room maybe with dirt & trash everywhere, one bug infested bed, a leak in the ceiling & everything was rusted, dirty or otherwise disgusting & there were open windows w/ flies coming in & ants all over the floor…after I took it all in & was in shock I gave myself a “pep talk” I said “I can do this”. I took before & after pictures that I will try to post tomorrow…there should have been 3 recovery room nurses setting up but my 2 Kenyan partners were gone so it was just me - the OR Nurses were busy setting up the OR but they tried to help me when they could & when I needed a translator. Andreas (the doctor) said “set it up however you want” - so I instantly liked him & when he helped me unpack 12 BIG boxes & figured out a way to duct tape boxes of gloves to the end of the 3 beds & I rounded up I loved him!!! I adore the intensivists at CHOC I have worked with for so many years but he was running a close second! 4 hours after I walked into the disaster I had 3 beds all set up - yes I had to keep the buggy mattress but I cleaned the heck out of it & getting a sheet for the 3^rd bed didn’t happen so I did a makeshift one..it was all good. I had the students & volunteers use the unpacked cardboard boxes to make my IV arm boards & “no no restraints” - so the kids cant bend their elbows & touch their face). Usually the recovery room nurses do that but since it was just me they were lifesavers. Anrdreas & I went thru all 3 “Crash Boxes” & set them up how we both liked….my roomate Poly made cardboard dividers for my empty small cardboard boxes so I could have all my supplies at each bedside just like awe do at the hospital & I taped all the “emergency supplies” I needed above each bed…organized the one shelf I had with all the other supplies, stored the extra stuff under the beds & at the end I was REALLY HAPPY…I wanted everyone to come tour my “beautiful” recovery room…it is all about perspective & doing the absolute best you can with what you have.

The OR & recovery room are in the same building as the 3 bed ICU….I again was a little shocked as I saw 3 rickety beds there w/ mosquito nets over them & in one bed was a 6 year old girl Penina who motioned to me as I went by…I asked the nurses if I could go to her bedside…she didn’t speak English & I don’t even know what was wrong with her but I held her had & talked to her & smiled & the nurse translated a little then I hurried off & brought her 2 dresses & her eyes it up & I cold not hold back the tears….she is so precious & I told her I would visit her again on Monday.

Then at screening I was just helping as needed it was a slow steady stream but very manageable so I didn’t volunteer to be the gatekeeper!!! I had already had a BUSY day. But one of the patients that came in totally stole my heart…perhaps because she spoke English & spoke quite well…her name is Salome & she is 14 & has a cleft lip…she lives in Nairobi & came with her 27 year old eldest sister who had saved all her money for a month to pay for the busfare to bring herself & her little sister here…their dad was recently unemployed & the mother is a “housemom” (stay at home mom) so they didn’t have money for the parents to both come so her sister brought her. There are 8 kids in the family 6 girls & 2 boys & Salome is the 5^th child. All her life she has asked her parents why she was the only child with “this lip” & said all the kids at school had teased her all her life & boys don’t look at her & she just wants to be normal & wants her lip fixed so she can sing better (she sang for us) & wants to sing praises to her Lord. Her sister said the family had always prayed to have a way or the money to help her but they never could. Again…lots of teary-ness the entire time….I cant even imagine the life she has lived & how a 45 min surgery will change her entire life…when we told her she would have surgery on Tues her older sister & she both cried….her sister was going to call to see if she could be off work &to stay here w/ Salome & they were going to stay with friends in the area….the love of this family & especially these sisters was palpable in every sentence….I thought of my own girls & how I think they too would do whatever they could to help each other….this day was one of those when I again KNEW I was meant to be in Africa on this mission perhaps for my own person & spiritual growth as much as for the ways in which I am able to help the team.
There is really nothing else of importance I could possibly say…tomorrow is our “team boning day” & we are going to the Nakuru Natl Park…I am sure it will be fun…although we have to be up at 5 & leave at 6...so I need to go to bed…the amount of emotion in each day along with the real “work” makes me a tired girl! LOVE to all of you! I bought a phone here & can now text & call home - best $35 I spent so if you want the # call my house!
P.S. Sorry this was so LONG!!! I will try to uplaod pics tomorrow bu the iternet here is spotty

Screening Day #1

I am honestly not sure I can capture the essence of today in a blog post...I truly cannot put into words all that I experienced but I will try... our wake up call was at 5:30 & we then were supposed to board the bus at 6:30 but...it didnt come so they started sending "key people" in taxis...yesterday they Mission Coordinator asked me to be the "Gatekeeper" & I said "sure" not really knowing what that meant...when they told me I should go in the taxi cause I was the gatekeeper I knew I was in trouble.  Basically on the screening day the patients go 1st to Medical records, then to Patient Imaging to get pictures taken, then to the pre & post op nurses, then to the plastic surgeons, next the anesthesiologists, then the pediatrician, to the dentist/oral surgeon, speech pathologist & then ME!!! My job was to check & see that everyone else saw the patient & filled out ALL the paperwork then note what priority they are & thru the translator send them for labs if we for sure will do surgery (the priority 1,2,3) & tell the 4's & 5's to come back Sunday to check the schedule & see if they are on it... & the NC's (not a candidate for our mission for a variety of reasons) tell them that too...broke my heart...then send some off to get labs & they came back to me then I passed their chart off to the "local hospital" medical records, then to Op Smile Electronic Medical records then back to me & I did this for 148 patients,  It was a VERY busy day - I had to use my ICU Nurse & mom multitasking abilities all at the same time in concert with a translator & sometimes 2 translators.  I didnt even take a break for anything :) and I LOVED every minute of it :) except for the few times I had too many patients backed up & lost my helpers!

So that was the scenario...I had taken a few dresses & shirts to give away but was so busy I couldn't even do that so I told Zippee & she would identify those most in need & bring them to me & we got them stuff - I gave away about 15 dresses today & 5 or 6 shirts.  We are going to have a better system tomorrow plus I will be able to give dresses etc on all the surgery days as all the kids pass thru the recovery room I am not at all worried that every item will find a good home. I did get some pics today (or actually Zippee did w/ my camera!) Tomorrow is another screening day & since it didn't rain today they expect perhaps even more people.  We will also be setting up the recovery room & "John" the Kenyan RN who is my lead in the recovery room just found me here in the lobby on my computer to tell me that he has to go back to his home area so he can work tomorrow & the other Kenyan nurse who is with us doesn't come until Sunday so I will be setting up the Recovery room with the help of the OR nurses late tomorrow after I finish another day of being the "Gatekeeper".  He did say we can go double check things on Sunday - good plan!  I appreciate the vote of confidence but clearly no one got the memo that this is my 1st Op Smile mission w/ the responsibility they are giving me :)

Now....on to the important stuff before this post gets so long no one reads it.... I was amazed that we actually had alot of adults come to be "screened" with a variety of problems...they all were priority 5 & as I understand it if we have any "extra time" we will do them the last day...clearly no one told them "Nurse Nancy ususally doesn't do big people"  Guess I will have to make an exception here in Africa! Screening in the morning was slower that normal (# wise) they said likely because of the rain but we started about 8ish & by 10 it was getting steady & more kids were coming thru...they are SO PRECIOUS (& actually a few of them were named Precious, Happiness,etc).  I was so busy "doing my job" that I had to remind myself to pause from the "busyness" & stop & talk to the moms or kids & hug or hold the little ones or tell them how beautiful they are.  Many times I felt myself get teary when I realized that we are here changing lives.  The end of the day was especially amazing...a busload  (about 20) of tribal Kenyans arrived after travelling from 850 kilometers away...they had walked for 4 days then were on a bus for 2 days & arrived late in the afternoon....all of them adults & children with such tremendous needs & not just medical....first they had little to eat the 5 days of their travel & most were barefoot or clothed in tattered garments - kids & adults...we gave dresses to all the girls there :)  They were so grateful...I think most all of us who are parents would do whatever we could for our children but at home those things we do & sacrifices we make seemed so small compared to what these parents had done.  Just the hope of getting help....compelled them to walk & get a bus to go 850 km & 5 days for help.  They will stay at the "hospital" now until we start surgery on Monday & they will be the 1st cases so we can see them recover before they return to their village....if that was all I experienced here my time would be so well spen BUT...I still have 9 days...I am the one blessed to be here & blessed to serve...truly tht scripture that compelled me to go to Houston after Katrina rings true here....inasmuch as ye have done it to the least of these....ye have done it unto me....

Sending my love to all fo you from far away in miles but not in spirit or heart....

Now in Nakuru

Well the adventure has begun!!!!  I didn't sleep well last night because I had slept on the plane.  I was on the internet til midnite then slept a few hours & about 2 a.m. if started POURING RAIN & I woke up & rained almost all night.  We ate breakfast & then left Nairobi at 10 for our 3 hour drive to Nakuru that really took us 4 hours on some small unpaved roads with some REALLY crazy drivers...my new Kenyan friend Zippee (thats what I call her - her real name is Zipporrah) tells me that driving here is pure madness & all about survival & she is right...all cars converge to the same point on round abouts its like a standoff as to who will edge the other out & of course we were doing all of this is on a "bus" - more like a oversized & very old van. 

On the way we stopped at an overlook of the Rift Valley - it was green & lush & beautiful.  At that stop some Kenyans had "stores" selling items they have made.  Despite the fact Zippee said I was overpaying I just had to but a few things - she said many of these people live on $1 a day - mind boggling.  As we drove we passed all sorts of people just sitting or standing on the sides of the roads or in the grassy areas & many people walking in all directions & I really have no idea where they were headed.  I saw some women w/ bushels of sticks on their backs, men with donkeys & goats, people on bikes & all sorts of slums with a variety of things being sold on the roadside - it was very humbling.  We got stuck for about 20 min where they were doing roadwork - it was a little crazy & we even saw a baboon on the side of the road. 

We got to our hotel & its a little nicer than the one we were at last night which is great since we will be here for 10 nights.  It was nice to get unpacked!!!  I feel like I am very well stocked & have a pantry, pharmacy, medical supply area & kids clothing & toy dept all in my room - my poor roomate - her name is Polly & she is a "visitor" on the mission until 4/7...she "bought" the trip at an Op Smile Auction.  We are right across the street from a "marketplace" with local vendors.  Zippee took me & about 8 other Op Smile team members & she did all our negotiating in Swahili for us - unfortunately one of the locals heard my name & seeing I was making purchases all of a sudden everyone was calling "nancy" come see me - it really was overwelming.  One man Moses made me promise to come back & buy a tie from him to help him feed his 3 boys...I told him I would be back & I will.

Zippee is teaching me Swahili - dont be too excited so far all I know are things you can learn from the Lion King - Jambo=Hello, Rafiki=Friend, & Hakuna Matata...more to come!  We have a team mtg tonight from 8-10 & then tomorrow our wake up call is 5:30, breakfast at 6 & we leave at 6:30 to be at the hospital at 7 & set up the screening area to Open at 8 until 6 pm.  I am told that people will already be there waiting when we arrive & many will have traveled several days walking or on bike or burro to get to us - that in itself brings tears to my eyes & as I think of the rain (its raining again) I think of people walking in the rain today & tonight to get to us. I find my thoughts are totally focused on the mission now knowing that starting tonight that is my purpose for being here.

I will blog again tomorrow if I can but the power here (& in the area we will be working) goes out several times a day as does the internet.  Still no text messages rec'd & fyi I am 11 hours ahead of Calif (8 hrs is from the east coast).  Love you all!

Arrived in Nairobi!

Well I made it to Nairobi….it was a LONG 2 days of travel….Tues noon was LA to Amsterdam = 10 hour flight then Amsterdam to Nairobi = 8 hour flight & with the 8 hour time difference & transit & customs its already midnight on Wed.  I did sleep 6 hours on the Nairobi flight so that was good & I am feeling great & SOOOOOOOOO excited to be here.  But let me catch you up....

My 50 lb suitcase became 65 lbs by the time I kept adding the things I had piled in my room but the KLM Airline folks in LA were kind & saw all my Op Smile Tags on my luggage & didn’t charge me. Now my “carry ons” were another story J I had a standard carry on size roller bag & then a giant Beach bag we usually take boating to carry about 8 folded beach towels in which I placed my backpack, camera, magazines, laptop & everything else that wouldn’t fit in my luggage. I am certain it weighed 50 lbs itself. I tried to pass it off as my “purse” but another KLM guy at the LA Airport wasn’t buying it so I had to get a supervisor to approve it. Then of course I had to carry it on my shoulder as if it was a purse so as to not draw attention that it was a GIANT HEAVY bag!!!

The “international cell phone” Doug got me got from Verizon instantly had no service once I landed in Amsterdam so i was worried...but as soon as I landed in Nairobi I had service & called home.  I have also sent some texts but havent received any texts so someone please text me!!!  You have to put in 011 254 then my # it is supposedly only 5 cents for me to receive a text...not sure what it would cost to send me one???  Didnt think about that!!! & remember I am 8 hours ahead of you. Once I get a text I will let you know so stay in touch & stay tuned re. that.

There we about 15 Op Smile volunteers on my flight from Amsterdam to Nairobi but I didn’t meet any of them till we landed & gathered & we all went together to purchase our Kenya Visa & exchange $. The exchange is 80 shillings =$1 and so I feel really rich!!! We waited for our luggage & I was SO HAPPY to see mine arrive.  No problems going thru Customs - they didnt even ask me ?'s or look in my bags I just walked thru whihc I was grateful for mostly cause once I open a bag I wont get it closed again.  I am glad to know that 75% of all I packed will either stay here in Kenya or be used here & I should be travelling light on the way home.  We took a bus to the hotel in Nairobi & it really isnt bad...running water (you just have to turn water heater on 45 min before you shower), the toilet leaks but not bad & there is a bed...what more could a girl ask for?

I have met about half of the team & they are all REALLY nice...some are first timers like me & some have been on Op Smile Missions before...we will meet outr Kenyan counterparts tomorrow.  Now its time for bed cause we have an early morning tomorrow & a 3 hour bus ride to Nakuru where we will be setting up. So I will update my blog again tomorrow & hopefully have more interesting things to report! THANKS for all the love & support & if you’re in South Orange County check in on my family!