Surgery Day #3 Saturday in Honduras

Wow a 3 day mission really speeds by...but with all I have going on now this mission worked out well for me timing wise. Last night when we returned to our room there was a note to pack up & as a surprise after we finished today we would be going to the Mayan Ruins in Copan - that was a fun change in plans!!!
They had minimized todays schedule with only 10 patients so that we could get packed up & head out not too late. Again in the morning we went to post op & saw the cases from yesterday & also some other patients thay had there...many of whom had very sad stories. A 13 month old who weighed about 8 lbs. Sister Paula & the nuns had cared for her & she actually has gained weight but she still is incredibly emaciated & also having lots of diarrhea. Come to find out they only have 2 bottles there & obviously aren't sterilizing them when they wash them so perhaps she is getting the diarrhea from not clean bottles & also since they have so little formula they mix maybe 1 scoop in a full bottle & then with her cleft the baby drinks maybe 2 ounces of...mostly water. Elizabeth our PI really tried to intervene & got the local foundation people involved to give this baby a better chance at surviving. There was also a mom that Michelle the speech person said slept on the floor last night (the very dirty, cold floor) under her childs crib for 4 hours just from sheer aghaustion from the travel here, her childs surgery, etc. Another woman "watched" her baby while she slept. So even though we can treat the children & give them surgery & a crib post op all we offer the parents is a chair (maybe - I dont think there was even one chair per crib or family) so the parents have no where to stay. The poverty is heart wrenching.
This is the 10th mission here at this hospital - it is a much needed service for the country. It was a LONG trip for the team to drive her from Teguchigalpa but we are with the poorest people in the country who need our help the most. They have a 4 bed UCI (instead of ICU) & there was a baby in there they thought had an intussusception but then they opened her tummy she had a large tumor so they just closed her back up. She has been getting worse & worse each day. The physicians do truly heroic things with the resources they have but their resources are so very limited....20 year old ventilators, minimal medicines, they used a feeding catheter for a central line, no IV pumps I could go on & on. It really is hard to wrap you head around it all. No matter what I have seen in the past or other places I have been it gets to me every time. So very sad.
Our last patient was a teenager who had a lip & nose repair...he was probably the most complicated patient of the day & while everyone was packing up & getting ready to go we had to remind them that as Op Smile says..."the last patient is just as important as the first". We ended up changing his dressing & doing all sorts of things to get him ready to go spend the night in the "mens ward" at the hospital. My PACU peers are calling me a "mamager" (cross of mom & manager) truly that probably is how I  lead...it's just a bit humorous!!!
The town of Santa Rosa seems cute & safe...we have been able to walk to the hospital in a group the last 2 mornngs. However I must say that probably 50% of all men I see do have a gun...guards with guns, men with pistols in their pockets or back of their pants or men with big guns. The religious festival & carnival ends today. When we did finish this afternoon we had an hour so we walked into the town square. We missed the parade but there was confetti everywhere!!! We also saw the "famous" (as in if you google the town that photo comes up) beautiful white church in the center of town. I think it was built in the 1700's & restored in 1809? It was very pretty but even better was when we went into the church one of our little patients Jesus & his mom were in the church praying. Unfortunately his palate was too large for us to repair (it would have been a very complicated case) so he didnt get surgery but he did get some teethg pulled & an obturator ( almost like a retainer) to cover the gaping hole in his palate so hopefully that will help him! I took a photo with him at the church.

Some of the team members are getting sick...just the basic GI stuff...I am always super careful what I eat & grateful to not be sick.  We had a 2 hour bus ride to the area of the ruins - which really ended up being more like 3 1/2 hours with the rainy washed out roads but Michelle the Speech Therapist shared some great Honduras info on the drive that I will blog about tomorrow (I am too tired tonight) The speech girls were stationed in the emergency dept & she also said that today a man came in blood running down his face with a machete sticking out of his head. I must say I am not disappointed I missed that! The drive took us up into the hills of Honduras, it is very lush & green everywhere. In the areas where people live there are horses, chickens, mules, dogs etc all wandering in the streets. On our way we passed an LDS Church - I would guess a ward building but I didn't have my camera out to get a photo op. It always makes the world seem alot smaller when I see a church knowing there are people here in this very different world who worship just as I do. That building was about an hour & 15 min from our final destination so there was no chance to go back. I did look up on LDS.org & there is a branch in Copan Ruinas where we are but I wont be able to get their either but I did get to talk to the guys at the hotel desk about where the branch was & they asked about the boys who have the "black nametags" the missionaries!
Probably the best part of our new plans is that we are at a Clarion hotel - mind you there are 4 of us in a room but it is a much nicer hotel then we have been in! The electricity still goes out & the AC is a swamp cooler in the room, the water isnt very warm but it's an upgrade! We had our team dinner/party tonight...the food was delicious!!! and as a PACU team we got to just visit for a bit before heading to bed. Up not quite as early tomorrow breakfast at & then off to the ruins - I am excited!!!

Friday Night in Honduras - Surgery Day #2

This may be a short post as I am pretty tired. We had a full day of surgery & they added a 4th Surgical Table so we did about 20 cases today and a few of them were the ones that fit into the saying the PACU has periods of both calm & chaos & moments with alot of chaos. We had alot of that chaos today with some complicated cases but they all did GREAT in the end. The PACU team is great I am blessed to meet & then work with some amazing people.
We started the day in the post op ward & it was fun to see the kids who has surgery yesterday & how they looked today - especially my little friend Oscar who was the child with dwarfism & a huge bilateral cleft lip - he looked so good! Also some of the "problem children" from yesterday were just perfect today!
The Child Life volunteer Claudia was so wonderful to give us a heads up when she had some of the kids in pre-op so that we could see them there - Emily who was having a palate repairwas a darling little girl she was doing medical play with & Jennifer Lopez (yep that was her name) was another! Denis was darling in pre-op but gave us some of that chaos in recovery with some respiratory issues. I took some cute photos with him.
There was a very young mom who was so sweet & quite worried about her little girl, she held onto her dress & doll when the baby went into surgery & she waited outside the recovery room external door for her instead of near the pediatric room so I saw her when her baby girl was returned to her arms & it was one of those tearful moments. All she wanted was for her daughter to be "normal".
I am super tired & will blog again tomorrow. I got to skype call my family today & that always makes my day!!! I love being able to do this & use my gifts & talents to help others but I do miss my family whether it is one week or 2 weeks so catching up with ALL of them was a blessing!
Good Night from Honduras!

Honduras Day #2 - First Day of Surgery!

The morning came quickly. We had breakfast at 6 & a team mtg at 6:30 & left for the hospital at 7. I realized at breakfast that I didn't do a very good job of packing food on this trip especially when the eggs & beans for breakfast weren't really looking that great. I do have protein bars & peanut butter but usually I pack more. No worries I wont go hungry!
We set up the recovery room & surgeries started by 8:15 - it all went really smoothly. I was told that most of these patients are from the Western part of Honduras which is the poorest part of the country. We are at the top of Honduras very close to the Guatemala border. There were 15 cases today 7 lips & 8 palates plus some dental procedures. Almost all of the kids here have teeth that are rotted out - it is so sad. We just take dental care for granted in the US. The hospital is VERY old & dilapidated but they have some very strict rules that we have to follow - one is that we are not allowed to bring the parents into the recovery room after surgery to see their kids & comfort them. That makes for alot more crying in the PACU & also is a bummer to me because one of my favorite things is seeing the parents see their child with a beautiful new face for the 1st time. We had some tension as we started just different ways of doing things but it all settled out nicely by the end of the day. Our Pediatric Intensivist has flight problems & got here at 2 pm - she is fabulous & totally mended the local & international team communication challenges.
2 of my favorite kids from yesterday had surgery today a 5 year old dwarf boy with a large bilateral cleft lip - his transformation was nothing short of miraculous. He was all smiles yesterday - not so happy today but looks amazing!!! Also a little girl from yesterday who was such a cutie.
We were told it was the rainy season here but that is a bit of an understatement - it started raining about 3 pm & 8 hours later really hasn't stopped - thunder, lightening, torrential rain & power outages have been the theme of the day. In the recovery room we had a few leaks but the were manageable. Some part of the hospital were fully flooded & the store room in the OR has a tin roof & in there you cant even have a conversation. Also we were supposed to have 3 OR's but we only have 2 because last Sun the roof caved on on the other one...
We finished at 8:15 - not bad for the 1st day & it was still pouring & we had to walk a few blocks to the bus. I decided to use a black trashbag as my rain gear (picture to follow) so I put my very large backpack on, made a hole for my head & put it over me - I am not sure why I didn't make arm holes I just want thinking but I definitely provided evening humor for both staff & families as I walked thru the hospital & for the most part I stayed dry! Sadly there were people sleeping on the wet floors of the hospital hallways...again a reminder of how blessed we are.
I am on call tonight so no sleeping aids for me in case I have to wake up & function but typically that isn't the case. So I am off to be excited for 6 hours of sleep!

A LONG but WONDERFUL Day & Night!!!

The day started early with our 4:30 wake up call & we loaded the bus at 5 for our 7 hour bus ride to the mission site at Santa Rosa de Copan. We actually left closer to 5:30 & I slept until about 7:30 when we stopped for breakfast at what is normally a roadside fired chicken restaurant. They served us beans, eggs, fried plantains & tortillas...not the road trip breakfast I had imagined & my first reminder that this is a mission not a vacation :) Also the guard with guns outside the restaurant that was only serving our group was another reminder.
The drive was nice, the countryside is very green & lush but the poverty is very evident everywhere. There are little huts along the side of the road with people selling fruits just to survive & these little stands are all selling plantains, watermelon, pinapple & are all right next to each other - I dont know how you decide who to buy from? Small "shacks" that people live in varied from pieces of metal to wood or brick or cement. Laundry hung on lines & I am certain there was no electricity in most places. I did see 2 missionaries on the side of a small village we drove thru & that made me smile.
We also drove by some Mayan ruins, a lake & a national park. At those times I wish I had just a few of my sisters geography expert genes to know more about the area.
Our 2nd pit stop was at a gas station with a convenience store think Circle K by my house with the exception of a guard with a gun who opened the door to allow you in. That was at San Pedro where w had a fork in the road & we went to Copan & not to Sula (the murder capital) The guard was actually a nice young man& I took a photo op with him & my Coca Cola Light!
We had box lunches on the bus and arrived at the "hospital" about 1:30. Patients had been there since 7 am & all their photos were taken & paperwork completed. I thought it would be less chaotic but it want there were children & parents everywhere. 80 were screened and this time I did something I havent done before (typically because someone else does it) but the 3 of us from PACU drew all the labs on all the patients. Lori could get all the hard sticks & we got them all done. Basically we were the place that made every child cry - not the best for photo ops!
There were so so many precious children about 30 palates & we will only do maybe 20? Several lips & some revisions to be done. The people were so gracious & sweet. I didn't really get to interact or get "their stories" because we were bringing them in our tiny closet room 2 at a time & poking them - not the best for pleasant conversation. I am sure I will learn more as we go thru the week. There were 2 nuns there with 2 babies & I did go out towards the end of the screening & talk to them. Sister Paula is my new BFF - she is from Spain, has been in Italy, Haiti, Bridgeport Conn. USA & now Honduras. She with 4 other nuns have a home where they care for 28 babies from age 3 weeks to 4 years. Many are babies who have clefts or for other reasons are extremely malnourished. They also "pay" for 5 assistants to help them some very poor women who need to support their own families. She took us over to the "hospital" to see one of her babies who was sick & getting an IV that they cant do at their home. Th baby was a year old & weighed 8 lbs - it was heartbreaking. I was so touched by her happy spirit & love. I asked her how I could help her help the children. She said that the hospital has no medicine & they ask the sisters to get it for them when they need it & right now there was a baby with a temperature over 104 who was convulsing & they needed tylenol...REALLY...TYLENOL??? I asked to see the baby, taught them some cooling measures & immediately gave Sis Paula $$ to go get tylenol. She had to wait for her driver (so I guess it is dangerous here - I was hoping she could walk to a store real quick) Once we had that done I asked her what she needed & she said right now they were low on milk & powder (formula). I told her about my friends the Smiths & Coles Compassionate Community & that yesterday was his ANGELversary & since I wasnt there for the candles at the beach I promised I would do something else & I knew this was what I was supposed to do - help Sis Paula & the children she was caring for. So I gave her money from me for Cole & from a sweet friend who gave me money before I left. It was not hundreds of dollars but would take care of their needs for a month she said... a month of milk and formula to help these children get fed. She said the goal is to get them to thrive and maybe give them back to their parents but she said in addition to not having food "some people have poverty of the mind & cannot care for these children so God needs us to help"
Needless to say my hour or so with Sister Paula was the highlight of my day...if I do nothing else I will have made a small difference here; but hopefully there will be more to do - for certain the surgeries that start tomorrow....as in my wake up call is in 5 hours so I need to get to bed.
The internet was out all day today so I didn't get texts or emails on wifi and didn't think I would be able to blog then 45 min ago my phone made some noise as the internet came back on. A little tender mercy so I could let my family & friends know about my day via my blog & a few other FB posts & instagrams. I am so blessed to be here & know when I serve others I am only being an instrument in Gods hands to do His work for His children. Off to bed - tomorrow is a busy surgery day & we haven't even set up the recovery room yet!       

Made it to Tegucigalpa

Well I arrived in Honduras safely after my flights. I was able to sleep about 3 hours on the SLC-ATL flight but since we arrived at 6:20 it was really 4:30 am Utah time so I was still a bit tired. I made my way thru the ATL airport - its HUGE & has been awhile since I was there - it seems more like a GIAN Mall....I landed in terminal a & took the train to terminal E & since it was about 3 hours before my flight there was no one at the gate so my backpack became my pillow & I napped a bit (airport sleeping tips from Ryan & Kya). There were 4 other Op Smile team members on my flight to TGU. The flight was pretty empty - I was in an exit row by myself & after watching 2 movies we arrived! I got thru immigration & customs without any problems - I do think the Op Smile Bag tags help! Met up with our group, exchanged money & we were at the hotel by about 1 or so.
When they say "it's a nice hotel" you have to take it in context...nice in a 3rd world country. The rooms are what I would guess the inside of a motel 6 is like (I haven't been to one recently & thankfully) - not bad but the property is actually quite nice with patios & a pool area. I ran into & visited with Lori (4th mission) & Valerie (on her 7th mission) the other 2 Recovery Room nurses, so we have great experience for our area. Afterwards I came up to my room & took a good hour nap, shower & felt like a new person for our 5:45 pizza dinner & Pre Screening meeting.
We drove a short way to the Honduras Operation Smile Surgery Clinic that was opened here in 2007 - the 2nd fully operational clinic in Latin America. It is very nice & they do 2-3 surgeries here every Wed. Dr. Oscar Sarmiento is the surgeon at the clinic - I have been on 4 missions with him - he's great. The REALLY nice thing about the clinic is that those heart breaker patients that we see at screening & have to turn away wont have to wait 6 mos or a year until the next mission here they can go & get care in the clinic. That is the sustainable change the OSI establishes in may countries.
There are about 18 of us "international volunteers" at the hotel & the rest are from Honduras or neighboring countries. Its a small team compared to others & that will be nice. Since I have been on 5 missions in South or Central America there are familiar faces & reconnecting is always fun. The goal is 40-50 patients or about 15 a day - 5 per table/surgeon.
On arrival we were told again that unlike other missions sites we may have been to Honduras is not safe for tourists even for us to go out in groups - so we will be a little bit hotel bound except for team events which is fine with me. Every building has barbed wire on it. The mission site in Santa Rosa de Copan is actually a 7 hour bus ride away!!!! I think it could be 6 hours but we have to go the "long way" as there is a bridge that our bus can't pass over. That town is safer but still we aren't to go out. I guess the airport in San Pedro Sula is only 3 hours from the mission site but hey had us flu in here because San Pedro Sula has the highest murder rate in the WORLD!!! Things not to tell your mom....
My roomate Therese should be here anytime. Her flight arrived at 9:40 & then I am quickly going to bed cause we have a 4:30 a.m. wake up call & a 5 am departure & start to our bus ride. We will stop for breakfast, eat lunch on the bus & then go straight to the hospital to start screening at noon. Some of the local team is already there starting the paperwork, photos & labs & when we arrive we will set up all the other screening stations & move people thru. Then in the evening we will set up the hospital. So we are planning on a long day/night & arrival at our next hotel close to 10 pm or so.
That is all I know for now...I am happy to be here & excited to see the precious children of Honduras tomorrow!

Headed to Honduras...like right now!

I am sitting on the floor of the Salt Lake City airport waiting for my 1:07 am departure (yes that is not a typo) to Atlanta on a full flight (really!) that will then connect to my flight to Tegucigalpa Honduras. I am so excited & feel so blessed to be going. My new responsibilities at CHOC have made my schedule & life quite a bit busier the past 3 months. I was so busy that I forgot to even "sign up" or give availability for any fall missions. Typically mission teams are configured and organized 2-3 months in advance and for every mission there are MANY volunteers for each nursing position. I finally signed up on line but alot of the teams were already finalized. I reached out to some of the Program Coordinators & they said they would circulate my name. Miraculously I was offered the opportunity to return to Guatemala in Nov. & was so excited as the Op Smile Guatemalan foundation have alot if input on the team selection & they remembered me from when I was there & offered a spot to me. I tentatively said yes but when I asked my boss - she reminded me that we had our HUGE Unannounced Joint Commission visit sometime in Nov. I was devastated...these missions are what connect me to "WHY" I became a nurse...a pediatric nurse...to have a positive impact in childrens lives. I know I make a difference at CHOC but as an executive it isnt the same as giving direct care. Having to turn down that mission was really hard for me - I understood I was needed at CHOC but my heart was broken. SO I asked again if there were any needs & I was invited to go on "rotation" to Rwanda where they dont do alot of surgeries but they do alot of teaching - which is right up my alley. That was in Oct so I was hopeful BUT...it was 2 weeks & it finished just as I needed to go to Dallas to speak at a conference & I knew I couldnt be gone for 3 weeks. I asked that my name be put as available for "last minute needs" & a few days later got an email for this mission to Honduras. I called 2 hours later & in the 1st come 1st served approach - the position was already filled. Just about the time I was ready to give up on being able to go on a fall mission I got an email the next day that they needed one more Recovery Room nurse in Honduras & was I still interested...YES, YES a 1000 times YES. I already had most of this time off to be with my sweet friends on their sons "Angelversary" and move my girsl to BYU so I called all of them & independently but unanimously they all said GO!!! So I called my boss & asked her for a few more days off & she said ABSOLUTELY. That was all on Aug 13th. So here I am 12 days later packed & ready to go. When we are ready & willing God finds a way to use us to bless others - for me right now I get to bless others in Honduras.
This was supposed to be a "local mission" with all the volunteers coming from Central & South America. The unrest there has causes some of the volunteers to not be able to go there so now they have about 20 volunteers from the US & other countries coming in to complete the mission. It will be a smaller mission than I am used to. Only 3 surgical tables (instead of 5) and only 3 days of surgery. But for me it is PERFECT. One of the OR nurse & I were together in Kenya on my 1st misison and the OSI photographer was with me on a few missions & one of the plastic surgeons from South America is familiar too...so I will have a few old friends & make some new ones.
I didnt read the fine print in the information they sent us that mentions Honduras isnt really a very safe place & that we should "not leave the hotel premises without the Op Smile Program Coordinator". Guatemala was dangerous & I didnt fully realize it. I guess Honduras may be a little more dangerous? But OSI is always ver cautious & I have never felt unsafe..so I am not worried & I know I will be watched over & protected.

They are calling us to board right now...next post will come from Honduras!

    

Friday in Paraguay

How embarassing is this....months later I am finishing up my blog from Paraguay. Luckily I write notes as I go throughout the day so I can blog later. As I read the notes now I am amazed at the recall of these people whose lives mine crossed for a brief moment but they have changed my life forever.

Fridays or the last days of missions are usually less busy, typically no palates as the team would not be there for any potential problems in the next 48 hours. We got our T Shirts & took our team pictire in front of the hospital. As the most "senior" nurse in the PACU I did evaluations on all the local nurses. I got input from Brooke & then sat down with each of them. After things settled down we all worked quite well together & really they could probably do an "in country" or local" mission next time.

We did 17 patients total today & 5 cute babies. I took a photo of another sweet, sweet dad with his baby girl 8 months old Dani. This was another situation where the mom had rejected the baby wheb she was born with a bilateral cleft lip & the daddy took her & cared for her. The mom was not at all involved. He was so sweet - he told me he has to be the mom & the dad & that she is such a blessing to him. Well that of course made me teary. I hugged him & in my broken spanish told him he was a "papa muy bueno". He works an hour away from where he lives & his sister helps him with Dani. It was such a tender scene.

We also did a little spitfire 3 year old with a cleft lip - her name was Luana but we called her "little blondie" she was beautiful. She was atwin & her sister had a cleft lip & palate repair at this mission site last year but Luana was sick at the time & couldnt have surgery...but...good things do come to those who wait & she got her surgery this year. Her mom was very teary when she saw her & said "now she is pretty like her sister" :)

One of our last patients was #348 Victor a 16 year old who was just screened YESTERDAY after someone told him OSI was here & he got surgery today - talk about great timing! His mom called him a "blessed boy" & tolsd us "gracias para todo" & "you are Gods hands". He woke up very quickly & was super hungry - just as any teenager would be!

At the end of the day we packed up & all of a sudden I noticed a bunch of LDS missionaries helping us pack & move the boxes. Apparently 40-50 of them were here the 2 days before we arrived unloading all the cargo...the locals said they had a "Mormon Army of Missionaries" I took a photo of the 2 Elders helping us - one from Utah & one from Idaho & emailed the photo & a quick note to their families.

When we got back to the hotel I took Elaine to the Paraguay temple to check in - yes my VERY BAD & VERY BROKEN Spanish got us a cab, got us there, we found the temple patron apartments where she will stay, dropped her luggage then went over & wa;\lked around the temple grounds. Its amazing that no matter where you are in the world you can feel the beautiful spirit of the temple as soon as you set foot on the grounds - it was wonderful & a swwet reminder to me that these missions are part of Gods plan for my life.

We gor back just in time to change for the final party - it was at a "clubhouse" an hour away - it was nice but I was tired so after about 2 hours of fun a few of us took a cab back. My flight in the morning us super early so I have to be on the 5 am bus back to the airport - it is still going to be a short night!

I continue to be so grateful for these opportunities to serve these sweet wonderful children of God in different parts of the world...I am blessed!

Thursdays aka VIP Day

So today was VIP visitor day - I really wish I had known & I would have put on makeup & done something with my hair besides the permanent pony tail/bun just to stay cool. First there was a Press Conference with the Medical Director & Colonel? or commander of the hospital. It was right outside the PACU & I saw it all set up but totally missed it. Then there were 2 news crews & YES I was on the national Paraguayan news (as the nurse in the background seen in the PACU caring for a patient - no speaking part for me since yo no hablo espanol). Then we were told the Vice President of Paraguay was coming & his 40 or so security (think secret service, dark suits & earpieces plus attache bags I was told either had weapons or kevlar?) Anyway he came in & shook our hands - the Paraguay nurses were awe struck & took pictures with him - me & Brooke not so much! Later the Cammandante 4 Star General & commander of the Armed Forces of Paraguay came thru with a giant entourage of army men....He asked me where I was from & then if he could come visit??? All of this really created a little chaos & all we were trying to do was work :)

It was a nice steady day & being a bit more rested made ALL the difference in the world. Before we started a mom & dad brought an 8 day old with a cleft lip in for evaluation - he was too young for surgery but they got connected with all the local resources so that was good...he was so so sweet & I held him for a bit.

We had a good mix of lips & palates. The palates came out of anesthesia a little "wild" so Plinio our Intensivist from Spain had us give them his cocktail (3 drugs) to "reset their brain" - it seemed to work & the next time they woke up more calm.

Today was the day Christain got his surgery...he was the 2nd super star after Ramon. He is 10 with a VERY significant cleft lip & teeth in the wrong places. His mom did not want him to have surgery??? We never really figured out why but he wanted it done & begged his mom to take him so that he would not be teased all the time at school. He LOOKS AMAZING!!! completely different. It was so great & when we showed him his face in the mirror he was so happy!!! I have before & after photos - he looks fabulous.

We had a few patients with some respiratory issues after surgery so they stayed in the PACU almost 2 hours each which kept us busy. Our final 5 patients were all teenagers & all came out at once that was a little crazy.

The students today went to a "public school" in one of the poorest areas here - the kids are there from 7 am-5 pm no mater the age from kindergarten til high school (unless they have had to stop school to work). They leave at 5 pm but its not like their parents come pick them up or have dropped them off - there are some "shacks' in the area where they live & sometimes their parents leave to go away to work for days or weeks & they sort of look after each other. The public school spends about $60/year per child on all the supplies & some food as many of them don't have adequate food. Just listening to all of this was heartbreaking & seeing the photos was even more so. The head teacher (but there were not that many) appreciated what the students bought & told her what they needed. Because of generous friends I was able to connect with her & offer some support for these desperate children. It is nice to get them what they need or give money & know it will go directly to help these children.

As we walked home I looked around, thought of all I have seen & experienced this week I recognized how blessed I am to live in the USA to have all the comforts of food, shelter, healthcare, schools, water, plumbing, transportation, clothing, dental care, & all of our day to day needs that I often take for granted...why was I so fortunate to be born in the USA & not in a 3rd word country & why do these wonderful people here in Paraguay & other places I have been have these challenges...

Then tonight was the polar opposite of those situations. One of the student volunteers from one of the 2 prestigious schools here (the American School & St Annes) has been a local volunteer here on several missions & went to Toluca Mexico as a student volunteer with Joe our coordinator. As a thank you they invited the international team (the 35 of us not from Paraguay) to their home for a traditional BBQ - it was delicious, their home was very large in an area an hour away with their own armed guard out front They had chefs & chauffeurs & all sorts of Crazy stuff but they were VERY NICE people & are obviously teaching their daughters to serve others. More on that fun night later. I didnt get home until midnite so I didnt blog & now its midnight on Friday so its been another day and I fly home tomorrow . 

Surgery Day #3 Hump Day Hooray!!!

Oh my I was SOOOOO Tired most of today - I think the red eye Sat night where I got some sleep but not "good sound sleep" & getting about 5 hours a night the last 4 nights caught up with me today  - so I am writing this post then going to bed. There may or may not be an incriminating photo that was taken of me this morning with my lab coat rolled up & my head on it on a bed rail...early this morning of course before any patient had arrived & I was only "out" for about 15 minutes!!!

It was a very odd day - often there is one like this on missions & maybe it was because i was so tired...We again went to Pre & Post Op to see the kids from yesterday & the ones we would have today. Then it seemed the rest of the day went in slow motion - it felt like a much longer day than it was - we finished at 8:30 pm. Many of the patients seemed to be VERY FUSSY in recovery - LOTS of CRYING & LOTS of pain meds given - probably more than the prior 2 days combined!
For some today was a really good day & for others a day of disappointment

Early in the morning we went to the area where the parents & kids wait before going in to surgery & saw all the 1st "little ones" ....fairly quickly after that little Bruno was brought to us because after they started anesthesia & before the actual surgery began he had too many secretions in his airway (probably from an undetected cold) & they thought the risk was too high. He was 1 year old & his mom was COMPLETELY Devastated...she traveled quite a ways & had been her the last mission 6 months ago but he was too small & needed to gain some weight - which he did & now this. The thought of him living with this bilateral cleft lip for another 6 months was too much for her to bear. I think we truly don't realize how blessed we are to have access to healthcare pretty much whenever we want or need it. They are in the midst of finalizing an Op smile Supported clinic here in Asuncion that may be open by August & they will do some surgeries - hopefully he can be one of their first cases - still that is a 5 month wait - it was so heartbreaking :(

Another 3 year old palate repair was also canceled as she had gotten sick also in the past 3 days.
A  bigger heart breaker was a 16 year old girl who had a repair when she was little by another organization but it never healed quite right & was still really impacting her life - she felt ugly & wasn't attending school etc. She was seen in screening & placed "on hold" then called to come for a "recheck today". after further review they decided she really needs her lip revised & also her nose - they thought about just doing the lip as the "combo surgery" wasn't something we could add to the schedule but the risks of 2 surgeries & 2 anesthesias is too great - it needs to be done as one big case but again not on this mission. She was in tears....like floodgate tears in the recovery room because that is where the exams & discussion took place. She is actually a beautiful girl & what she sees as horrifically ugly really is fairly minor but being a teenager is hard enough in any country & this added "scar & past surgery" is something she just cant get past.  I was so sad for her & her mom who brought her & was also in tears...again I thought I have 3 daughters...that could be me & I would want to do all I could for my child but sometimes all you can do still wont "fix things". they actually have a wonderful psychologist here so they sent here there & I never herd anything further - hoping they can help her next mission.

Later in the afternoon there was a patient another nurse was caring for & she came up to me & in spanish mentioned that the little 1 year old David had a single dad & no mom & did I have clothes for him?  I did & found the right size & the dad was very sweet & hugged me :) I found out later that the mom had rejected the baby when he was born with a cleft lip & left him on the dads doorstep (they were not married) so the dad kept him, lives outside the city but has brought him to the clinic in Asuncion, gotten the special cleft lip feeder for him & gotten him to the weight he needed to be for surgery & now today David had surgery!!!!  a HAPPY story after the sad ones. The dad is young probably under 20 & he has done all he can for his baby son...all by himself - SUCH GREAT LOVE!

One of my last patients was a 16 year old boy with a revision of his lip...he did great & as I talked to the mom I found out she had 12 CHILDREN!!! and he was her youngest - her oldest was 40 & she had him when she was 15!!!!Just thinking of that made me tired - she was so sweet!

One other very funny thing - 3 of the girls who are student translators came up to me & asked if I would take a photo with them because I looked like one of the nurses on Grays Anatomy?  I have never watched that show so I have no idea what they were thinking & no one else has ever mentioned it so I am thinking they just have a case of mistaken look alike identity - but I did take the picture with them!!!

We did 25 or 27 cases today I am not certain - and tomorrow is our last LONG DAy - it always goes by fast  after "HUMP DAY"

Day #2 in Paraguay - 29 Patients - Home at 10 pm

An interesting day for so many reasons....

First after the rain (there was more during the night) then add the heat & what follows bees & mosquitos...I am 100% sure I left my bug spray on my dresser at home but fortunately we haven't had too many iin the PACU they are all mostly in the hallway & patient rooms because of the open windows. always something new :)

Before the day started we went up to Pre Op to see some of the patients we will have today and then went down to the post op area to see all the patients we did yesterday...Ramon was dressed up in a blazer & sunglasses all ready for a new life!!!

We again had all lips for our 1st round of patients which can give you a false sense of security. Today was definitely one of those PACU days where there are moments of calm & then times of chaos - the chaos seemed to win today. The 2nd round of patients were all palates - most of them 2-3 years old & wild ones at that - someone walking in may have thought we were having a screamathon. The local nurses prefer not to give as many pain meds & it is not my roll to change their practice & usually the kids do settle down but I am more apt to medicate just a little - so I have altered things a bit when working as a team.

Manuel one of those palate repairs who was 3 had a tough day - some bleeding, some respiratory problems, ...we had to suction him, give a variety of meds, gave 3 respiratory treatments - he really required full on critical care needs. He stabilized out & we sent him to the post op ward about 1:30 but they were uncomfortable with the care he needed so he came back an hour later & we kept him til 6 & in those last 3 hours with alot of work we got him all spiffed up so that he was drinking juice & waved good by as he left us.

By 2 pm we had only finished 12 cases & has 18 to go...things just seemed to stall out then came in steadily. We usually start & end the day with  lips & all the palates are in between. One palate William was an add on palate for today - he had a "story". His mom had 7 children from 3 to 14 (he is the youngest) but she left them & went back to Argentina. I heard that the 5 older ones were scattered in homes & a very sweet woman had William & the next older one. William's left arm has been amputated just before the elbow...the "shelter mom" said it was due to an infection that wasn't treated. With tears in her eyes she said he is a "perfect boy" - what a saint of a woman - I was touched by her generous heart.

Near the end of the night we had 2 bilateral cleft lips - so their defect is on both sides of their nose...both 10 months old a boy & a girl. I got photos with them before surgery & posted some on instagram & FB. Mia was a tiny 10 mos old because of all the trouble she has had in eating...I connected with her mom at the shelter on the "party day" & then in pre op this morning & later today just before surgery & told her I would be with Mia right after surgery  in the recovery room. as always the transformation for a Bilateral Cleft is the most remarkable - Mias mom came in & was SO HAPPY...she did not get teary but was simply OVERJOYED & kept saying to all of us BLESS YOU, BLESS YOU. I have LOTS of photos of her. The 2nd one was Jordan - he had protruding teeth & was also tiny. His mom was very young & when she came in she was completely overcome with emotion & tears which of course then i get all teary. she gave me a hug & held on so tight...
The later patient were all older....and they always make me think of my own kids & how grateful I would be to people who would help them...

As the final group to leave there were 7 of us who got back to the hotel at 10 - not bad....tomorrow is another day 27 on the schedule!!! 

Day #1 is DONE!!! 24 Surgeries & Out by 8 pm :)

Just as we arrived at the hospital this morning it started to rain really hard -  we have had 30 min to 1 hour thunderstorms a few times a day everyday but this was different it was pouring for hours..all day until about 5 pm. Unfortunately it actually flooded many of the roads into Asuncion so some patients trying to get  back couldn't make it but they will be rescheduled later in the week. The rain with the warm temperatures really increased the humidity. There seemed to be many leaks in the roof of the hospital too...so in some places it was raining inside as well. Not in the PACU or OR's but there were "mini streams" in some hallways & quite a few buckets catching the drips. We are at a military hospital, like we were in Guatemala - very heavily guarded. I am not sure if they are more accessible to Op smile than say "private nicer hospitals" (if those exist) or if most all hospitals in South America are military hospitals???
We reviewed our emergency procedures & they started the surgeries around 9. Our 1st round of patients on all 5 table were all cleft lips all under 1 year. I didn't get any pre op photos as we were finishing our set up of the PACU. There are 4 local nurses all very competent so with 6 of us it is almost "low key". We have a nice room with 5 beds & rotate taking the patients. It is only day #1 & I dont want to jinx myself but this may be the "easiest, least exhausting mission" I will have been on. 

I was able to give all the babies in the 1st round a little onesie & socks I bought at Old Navy with a donation from a friend so that was fun. I had 24 sets so there are more to be given!!!One of our early patients in the 2nd round was Abigail...she was 19 months & definitely had an "attitude" in her pink gown & pigtails. She was a little fireball & gave you a "scrunchy smile" on request. The anesthesiologist said she kicked & screamed all the way back to surgery which usually means they will be "crazy" waking up - but she actually did great! Junior was another cute patient one of the few blondes   & 8 mos old with a lip repair. another sweet patient was one that Nina the student was following Marco - with a very young sweet mom - I did get photos of him at the "party" & today he had a beautiful new smile & his mom was overcome with joy.

Here in Paraguay there is a McDonald's & they are a HUGE support of Op smile. The other day they brought 150 Quarter Pounders for the team & students for lunch & they are bringing 25-30 Happy Meals over each night for the pre-op kids to have. So I am happy to continue to support McD's with my diet cokes & ice cream cones!!!

The "Surgery Star of the Day" was Ramon - I posted about him on Facebook yesterday - he is 28 & a bit developmentally delayed. For his entire life he has stayed home with his mom helping her with chores & cleaning - all the while knowing her is "different". His mom wanted to protect him from the taunting & teasing of others. He & his mom heard about Op Smile on the radio & walked several days to get here. When he first arrived he sat separate from everyone else, after hearing her would have surgery & with some TLC from our student Sami & others he gradually started integrating with some of the other kids (much younger than him of course) & playing soccer. when he checked in last night for surgery I am not sure he fully comprehended what was going to happen. Today as he walked into surgery he was giving everyone a huge smile & high fives. Today he got not only a new smile but perhaps a new life....in just an hour because of a whole team of volunteers. When he cam into the PACU he had an entourage of people who wanted to see his "transformation" where there once was a gaping hole in his mouth where his lip belonged was now a fully repaired lip. Sami the student had stayed with him all day & followed him thru surgery she was emotional when she came in & got very teary. I gave her the mirror in my pocket to show Ramon his new smile & then he got teary which made everyone in the PacU teary & the floodgates really opened when his mom came in - she too had a new smile on her face seeing her son with is new smile.

If that was all we did today it would have been totally worth it BUT...it wasn't...we did 24 cases 7 have 29 on the schedule for tomorrow!!!

so grateful for these experiences....

Happy St. Patricks Day from Paraguay

REPOSTING AFTER I ACCIDENTLY DELETED-will try to reorder it later!

So despite this being a very Catholic part of the world they don't really celebrate St Patricks day here but I did wear green, played the Irish Rovers on my phone & will have a belated celebration when I get home!

A few fun facts...the "C" in the shower is not for COLD it is for CALIENTE or HOT...I didn't notice the other handle said "F" for FRIO or COLD. Coke Zero is available & I bought cans one for each day. Despite being in a "nice hotel" the electricity goes off & on all night which I know as I begin to sweat when the wall A/C turns off & I have to get up to turn it back on (at least we have it!). I think I could handle the 90 degree weather if there wasn't about 80% humidity...at least all my pores will be clean...I do think I sweat more today than I ever did even in Africa - but maybe I just forgot. The "blow dryer" is one from the 60s or 70s with tubing that is the size of vacuum cleaner tubing.

Today all the patients were told if they would get surgery...in past missions it has been posted or announced to the group - here they did it in the most personal, wonderful way ever because of the 100's of student volunteers that have in the country. Each family was escorted by a student to an area where they were told in private & if they were not scheduled for surgery on this mission they were given resources & if they were they were given great parent teaching. Seriously it was AMAZING!

The local in country volunteers are a well oiled machine - hence why there are only about 20 international volunteers from other countries (most from other parts of Latin America. Mercedes who is the in country coordinator has done 40 missions all over the world...they have us all set up & organized like I have never seen before.  I am sure we will have some fine tuning tomorrow but nothing like past missions. It will be Brooke & Me & 4 Paraguay nurses in PACU - not sure if they will all be there every day or not?

The hospital is close enough to walk but the plan is to take a bus in the morning - to get everyone there at the same time & then walk home - hopefully not at crazy late hours. Today the bus wasn't available so we walked back & forth a few times & yes it was very humid - but the PACU has an A/C unit so that will help.

I am excited to get started tomorrow & be a part of changing lives. Today we had a 2 hour city tour & saw some of the poorest areas which was in stark contrast to our "Country Club" meal. This I am sure is where many of our patients come from...it was very humbling to see their "lean to" shacks, with piles of garbage near by & stray dogs & even pigs??? in the area.

 Tomorrow I will have names & faces & stories of the wonderful people here that I am blessed to serve but knowing it will be a LONG day I am heading to bed. Wake up call at 6 - bus leaves at 7.

Good Night & Happy Irish Dreams!

Day #1 is DONE!!! 24 Surgeries & Out by 8 pm :)

Just as we arrived at the hospital this morning it started to rain really hard -  we have had 30 min to 1 hour thunderstorms a few times a day everyday but this was different it was pouring for hours..all day until about 5 pm. Unfortunately it actually flooded many of the roads into Asuncion so some patients trying to get  back couldn't make it but they will be rescheduled later in the week. The rain with the warm temperatures really increased the humidity. There seemed to be many leaks in the roof of the hospital too...so in some places it was raining inside as well. Not in the PACU or OR's but there were "mini streams" in some hallways & quite a few buckets catching the drips. We are at a military hospital, like we were in Guatemala - very heavily guarded. I am not sure if they are more accessible to Op smile than say "private nicer hospitals" (if those exist) or if most all hospitals in South America are military hospitals???
We reviewed our emergency procedures & they started the surgeries around 9. Our 1st round of patients on all 5 table were all cleft lips all under 1 year. I didn't get any pre op photos as we were finishing our set up of the PACU. There are 4 local nurses all very competent so with 6 of us it is almost "low key". We have a nice room with 5 beds & rotate taking the patients. It is only day #1 & I dont want to jinx myself but this may be the "easiest, least exhausting mission" I will have been on. 

I was able to give all the babies in the 1st round a little onesie & socks I bought at Old Navy with a donation from a friend so that was fun. I had 24 sets so there are more to be given!!!One of our early patients in the 2nd round was Abigail...she was 19 months & definitely had an "attitude" in her pink gown & pigtails. She was a little fireball & gave you a "scrunchy smile" on request. The anesthesiologist said she kicked & screamed all the way back to surgery which usually means they will be "crazy" waking up - but she actually did great! Junior was another cute patient one of the few blondes   & 8 mos old with a lip repair. another sweet patient was one that Nina the student was following Marco - with a very young sweet mom - I did get photos of him at the "party" & today he had a beautiful new smile & his mom was overcome with joy.

Here in Paraguay there is a McDonald's & they are a HUGE support of Op smile. The other day they brought 150 Quarter Pounders for the team & students for lunch & they are bringing 25-30 Happy Meals over each night for the pre-op kids to have. So I am happy to continue to support McD's with my diet cokes & ice cream cones!!!

The "Surgery Star of the Day" was Ramon - I posted about him on Facebook yesterday - he is 28 & a bit developmentally delayed. For his entire life he has stayed home with his mom helping her with chores & cleaning - all the while knowing her is "different". His mom wanted to protect him from the taunting & teasing of others. He & his mom heard about Op Smile on the radio & walked several days to get here. When he first arrived he sat separate from everyone else, after hearing her would have surgery & with some TLC from our student Sami & others he gradually started integrating with some of the other kids (much younger than him of course) & playing soccer. when he checked in last night for surgery I am not sure he fully comprehended what was going to happen. Today as he walked into surgery he was giving everyone a huge smile & high fives. Today he got not only a new smile but perhaps a new life....in just an hour because of a whole team of volunteers. When he cam into the PACU he had an entourage of people who wanted to see his "transformation" where there once was a gaping hole in his mouth where his lip belonged was now a fully repaired lip. Sami the student had stayed with him all day & followed him thru surgery she was emotional when she came in & got very teary. I gave her the mirror in my pocket to show Ramon his new smile & then he got teary which made everyone in the PacU teary & the floodgates really opened when his mom came in - she too had a new smile on her face seeing her son with is new smile.

If that was all we did today it would have been totally worth it BUT...it wasn't...we did 24 cases 7 have 29 on the schedule for tomorrow!!!

so grateful for these experiences....

Arrived in Asuncion Paraguay...so happy!

My red eye from Miami to Asuncion wasn't that bad. The flight only had 80 people on a plane with 160 seats so when I got on I staked out the row behind he & sat there like a squatter - when no one came I was able to secure a row of 3 seats all for me & rested pretty well for a good 5 hours of the flight. I breezed thru immigration, got my luggage & then went right thru customs. Robert an Op Smile Driver was there with a sign to meet me & drove me the 25 min to the hotel. We passed their version of "Central Park" which I appreciated having just come from NYC, a few "plazas" a botanical garden & the Presidents mansion where he slowed so I could take a photo. Roberto says he's a good president....
At the hotel I checked in & in the lobby saw Lisa the Clinical Coordinator who is really amazing & also saw Joe & met his trainee James so the 4 of us had breakfast.I found out this is Joes last mission - he is taking a job at John Hopkins in relation to Health Management. I got to my room by 9 & met my roommate Deann an ER nurse from Denver Childrens. We didn't have to be anywhere til noon so I took a 2 hour nap then got ready to go out for our team day. The hotel is nice - we have 2 small twinbeds  in our room & a window air conditioner - the beds are very low to the ground & must be on wheels I learned when I sat down & almost ended up on the floor! It does have wi fi so that makes me happy!!!
W drove about 45 min (not sure in what direction) t the wealthiest of wealthy areas in Paraguay where we were hosted by someone at the Asuncion Yacht & Golf club - it was on a river & there were some nice boats there plus clay tennis courts, a really nice pool area & our meal in the dining room would rival any country club I have been to...a huge buffet with 6 to 8 stations of food - rumor has it there has never been a more elegant "Team Meal" & honestly I felt a little guilty until I realized this is probably the only 2 hours of indulgence I will have in these 10 days so enjoy it :)
The team went back to the hotel but I went to the shelter with the student team - talk about small world - one student Nina goes to Northwood high & lives in Portola Springs, the other student Sami is from Malibu & the 3rd student Kristen is friends with one of the students who was in Ethiopia with me. They screened 344 patients yesterday - I think that may be a record but they said it went SUPER FAST & SUPER SMOOTH as they have over 100 high volunteers from 13 high schools here in Paraguay who translated & helped in many ways - that always touches my heart seeing the more "privileged" students helping those so needful in their own country. They also said that some of the LDS Missionaries here in Asuncion came to help & will be coming back - that will be fun! Perhaps my favorite volunteer on the team so far is Elaine from....LOGAN UTAH - yep Doug will love that. She is here doing medical records & she is 85!!! For the first little while I was with her I was worried when we were walking around at the Yacht Club - not wanting her to break a hip but I quickly realized I had no need to worry & I just hope I have the health & desire to serve that she does when I am 85. This is her 7th mission - she started when she was 79 after her husband passed away.  I will be keeping an extra eye on her this week :)
At the shelter there are about 50 patients - those who have traveled the farthest - the local volunteers here in Paraguay were having a "party" for the kids there to help them feel comfortable in those surroundings & keep them happy - they have had a foundation here for 7 years really do so much for their fellow citizens I was very impressed. As soon as I got to the shelter & saw the kids the few hours at the Yacht Club were just a nice memory - these kids & families are what gets y heart doing flips. I saw lots of the kids, played with them, talked to the parents in my "spanglish" and was in my element. These are the moments I am reminded that for these 2 weeks I am exactly where I am supposed to be - I connected to my purpose.
We were there for 2 hours & then walked back to the hotel - it is a area with poverty but not as bad as Africa. I get a little more settled in my room & then again went out with the student group & their sponsor for a simple dinner of empenadas...yep they are famous for those here. I always seem to gravitate to the teenage students - perhaps because of my years in the youth programs of the church, or with so many at my store or my own 4 kids & all their friends we have enjoyed in our home. So I hang with them instead of the 25-35 year old crowd & love every minute of it!
Tomorrow breakfast is at 6, the bus leaves at 7:30 & they will gather all the screened patients (all 344) & announce which 135 or so will be scheduled for surgery.  Even if say 94 of those patients we saw were rechecks from prior missions & prior surgeries that will still leave over 100 children & families who will be heartbroken and 135 who will be overjoyed that we will be able to change their childs lives with a 1-3 hour surgery.
We will se up the PACU - I am working with a great nurse from Primary Childrens Brooke who seems awesome & a nurse from Paraguay. Our intensivist canceled last minute due to illness so the recovery room will be covered by one of the anesthesiologists. I am sure it will all be fine. The are expecting perhaps 50 or more palate repairs - those are the more complex ones so I am already gearing up for late nights & 16 hour days...but there is no where I'd rather be - although I do always miss my family when I am away.
Buenos Noches from Asuncion - I better get to bed its just about midnight already.

Op smile Mission #8 - Asuncion Paraguay Here I come!

So this mission kinda came up on me more quickly than I realized....and as always in a way not according to "my plan". My Plan was to go last week to the Chiapas Mexico mission with Katrin who I haven't seen since our Tlaxcala Mission together & with heather from my last mission in Guatemala. BUT....I was too late to that party & all the recovery Room Nurse spots were already committed to Katrin & 2 others. I was REALLY BUMMED because it is always nice to work with people you have worked with before. Yet again I realize that when I choose to do these missions...it is NOT ABOUT ME...it is AlWAys about where I am needed & going where I am asked to go.

Joe my wonderful PC from Guatemala said he would be happy to have me on another mission of his...I think the night shift showed my commitment level :) jk anyways he offered me the opportunity to go to Honduras or Paraguay. Another thing for me is that it is also very much about how it fits in with my many "worlds"...CHOC, family, TT, other commitments. The Paraguay dates were better that Honduras so Paraguay it was to be - still with things I had going on I am arriving 2 days later than the rest of the team & missed a day of screening which really is one of my favorite things.

Also dont tell my sister who is the Geography teacher...but I had not clue where Paraguay was - I thought South America & that would mean "easy travel" not quite...I soon learned where it was when we made my flight plan - LA to Miami then Miami to Asuncion a total of 13 hours in flight & a Red Eye arrival - better than Africa - not quite as simple as Mexico :)

I started packing last night at 7, did a Target Run at 9 & hoped to be in bed at midnight then up at 5 to get everything ready for an 8 am ride to the airport. Well midnight turned to almost one then at 1 AM the phone rang - which is rarely ever good & it was Kelli & Sarah - seems Kellis car had a close encounter with a Deer as they were heading home from Park City. Kelli was in shock, Sarah was calling 911 & the car wasn't running & well the deer - lets just say he or she went to heaven. So that all happened from 1-3 am & I slept from 3ish to 5 am - maybe an hour & a half. Not the best way to start a mission but oh well. Today the girls are fine, the car is at the dealer & Doug is going to figure it all out.

I am currently in Miami - the first leg of my travel was fine - not alot of sleep but my next flight is less full & with a sleep aid I am planning on sleeping the entire flight - fingers crossed!!! Since I am arriving alone someone will meet me & take me to the hotel for our team day. There are only 5 or 6 americans on the medical team - we have US students & a few other visitors but the majority of the team is from Paraguay & South America - I REALLY NEED TO LEARN SPANISH!!!! Rosetta Stone maybe? The other recovery room nurse is from the states so that will be nice & the intensivist too - I am sure we will have a great team - truly anyone with Op Smile is all about helping kids :)

I am SOOOOOOO IMMENSELY GRATEFUL that I can do this - I have sweet friends who support me with things to bring to the people I will meet, others who cover for me at work, a husband who is 200% supportive, friends who encourage. I feel like I go & take a part of so many people with me. I am excited to serve the children & families in Paraguay - to hear their stories & learn abut their lives, to care for their children as if they were my own & to witness how God loves all his  children on every corner of the earth. So here I go....to do what I love to do the most which is help children & families with the gifts & talents I have been blessed with....my sacrifice is small & the rewards tremendous! Adios - next post will come from Asuncion Paraguay!!!

Thurs Nov 15th part 2 the night shift...never posted

so about 5:15 things were quiet in the PACU & someone asked me to take my roommate Anne her camera back in surgery. I gave it to my new BFF Heather who then said to me "We have some cute babies on all the tables why don't you take some pictures. (Tender mercy #1 was Heathers suggestion - Tender mercy #2 was me saying yes)
I went in & out of all 5 surgery rooms - I had just stepped out of room #4 when I saw Judith our Intensivist & Doug the Team Leader running into room #3. So like any good PICU nurse I followed...the baby was flat lined & I asked the obvious "Do You Want More Help?" to which they said yes so I called for the OR crash box then RAN at full speed sliding in my shoe covers on the slippery floor & went into the PACU to get the Pre Drawn emergency drugs we had ready then raced back telling Mary Laura to come with me as the PACU nurses are often the code response team.  When I got back CPR was in progress Mary Laura arrived later so I drew up drugs & she gave drugs...we gave a dose if Epi with no improvement so we doubled it & got a heart rate of 79 back with a 3rd dose it went up to 170. The vigorous hand ventilating gave her a distended tummy so we decompressed that, we gave bicarb & lasix then prepared for rapid sequence reintubation. Heather was in as the recorder & right hand helper as well as a room full of onlookers. When things were a bit stable we carried her to the PICU for some resp treatments and 100% oxygen. Poor Joe out PC was white as a sheet - he said in all his missions this had never happened.

I held her & rocked her in the PACU for an hour with continuous treatments & Oxygen. Mom came in & we explained it all - this happened at the conclusion f her surgery so her repair was done...We could not get her off the Oxygen & she couldn't go to Post Op needing so much nursing care. There was not an ICU at this hospital so the option was to transfer her to another hospital with an adult ICU Mary Laura & I said at the same time - "NO don't send her out - we will stay & take care of her"

All the team leaders had to have a meeting to review all the options & in the end Mary Laura & I set up our own little PICU in the "crash bed" on the floor with all that we needed and were able to stay over night. They were all a little worried to leave us but we were fine...before the team leaders  all left for the night EVERYONE of all faiths...Jewish, LDS, Catholic, Non Denominational Christian etc all agreed that God had His hand in providing help to this sweet little Sandy....from Heather telling me to take pics, to the route I took so I was near the room, to having Judith & Doug back there outside that OR....so many "What Ifs?" but ALL of us were put together on this mission for many reasons however this may have been the most important.

Joe ordered us Pizza & Diet Coke to get us thru the night & Mary Laura & I took 2-3 hour shifts. We really could not get her weaned from the oxygen but we at least gave her the chance to "declare herself" under our care. In the morning they were able to coordinate with a pediatric friendly ICU & she was transferred there to be watched (post story since I am writing this so long after the fact she did great & they got her home 2 days later)

Friday was a half day of surgery & packing up - ML was wired on Coffee & insisted on staying then took a nap there - I went home with the night nurses...and that was a crazy ride...our driver barely nudged another car & that driver got out & basically threatened our driver unless he paid him $$$. It was crazy. I got to the hotel showered, slept for a few hours then called the hospital to go back & pack up & they were already done!!!

When Heather got back we got a cab & went to the Guatemala City temple which was not too far away - it was fun to see & right next to it was one of the South America MTCs so we saw LOTS of missionaries coming & going. We met a sweet couple & their son who was staying at the temple childcare area while they attended a temple session. Also another sweet lady who hugged us & called us her sister. It is times like these when you see just how small the world & our worldwide church is...

Friday night was the team party at our hotel which was nice so we didn't have to go anywhere. It was a fun party & a GREAT TEAM. I am SO VERY BLESSED to have opportunities & experiences like this. Truly this is what nursing & the Healers art is all about - helping those who so need what we all can offer.