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.