Friday, March 11, 2016

Day 4 is done - 5 lips & 19 Palates..some great & funny things happened today!


This system of me not going with the team in the morning & having an extra hour makes ALL the difference – I think all Clinical Coordinators should adopt it!!!  Seriously though most of the team leaves 1-2 hours before PACU & its just me & the 2 Program Coordinators, the Clinical Coordinator & Intensivist there til the end. Tonight we got back to the hotel by 9:30?  So a little better each day. This was our hump day – after today only 2 days left & Saturday will be nice as there are no palates done on the last day of the mission – but we will have had plenty before then!
The first round of patients were all Cleft lips – one on each operating table & those are always rewarding because you can visually see the difference immediately. Just about all of the moms were young (17-20 years old) and many families all live together so the abuelas or grandmas help care for the babies. We only let one parent come into the PACU because the space is small & it’s often chaotic. Today when the moms came in it was apparent that some of them were very scared, nervous & uncomfortable with their fussy baby coming out of anesthesia so I spent time calming babies then giving them to the moms & reassuring the young moms they were doing just fine holding & comforting their babies.

After that first round of lips it was all palates the rest of the day & quite a few young ones who did not come out of the “black hole” of anesthesia very well so for many there was LOTS of crying, thrashing, screaming no matter what we did, who held them etc…we try to let them calm on their own or with a parent but we did quite a bit of medicating today…of the patients & 2 rounds of Tylenol for the recovery room staff. For about 3 patients there was nothing we could do to calm them, meds, walking, rocking, parents & staff holding them…those are challenging & make the environment chaotic – poor kids have no idea what is going on!
After Sunday I thought I was done with my help for church members but on Monday I got an email from another Stake President/Church Leader here that I had also emailed. Pres. Rivolara had his clerk email me in English that they wondered what kind of help I could offer. I explained what I had done in other countries for missionaries etc & he replied back & said that when he read that I wanted to help someone preparing to serve a mission he immediately thought of Manuel. He also mentioned that to the Stake Pres. Who also said Manuel is the one person who most needs help. He is a young man of a very humble family, his maternal grandmother just died 2 days ago. He has an older brother serving a mission in Posadas Argentina. Manuel wants to leave on a mission but his dad thinks that Manuel should wait until his brother returns home so that Manuel can use the same luggage & clothes; but Manuel wants to go sooner so he is trying to get as much work as he can to buy the luggage & clothes.

My heart immediately swelled & I replied back that I would love to help. I can’t imagine that what seems to us to be simple resources (like a suitcase & clothing) would delay someone from serving a mission but here it does as resources are scarce & just getting the physical resources to have a son leave for 2 years really is a huge sacrifice. At home in the states most families go on a big “pre mission shopping trip” to get their son or daughter the needed items without much thought. Tues & Wed went by & I hadn’t heard back from them despite trying to call & sending emails. I was feeling a little frantic as I knew I needed to help Manuel even though I have never met him. Yesterday morning I called Pres. Wilson the mission president to see if he could help me connect & in ur very broken English/Spanish conversation he said he would have Pres. Rivolara call me today. So at the hospital I have not had much luck with my 3G international network on my phone & I have no idea why…before it got crazy I asked Bella a student who had been there that had been helping the last 2 days if I could connect to her wifi to check emails & there was an email from Pres. Rivolara saying he had come to the Military hospital to find me but couldn’t locate me. I had Bella reply in Spanish that I am up in the Surgery area & she gave him her phone # & he immediately called her phone & we had a 3 way conversation. He is going to come to the hotel on Saturday at the end of the mission with Manuel – I am so happy this will work out & again thru the resources of generous friends we can help this young man. All things came together today to get that coordinated…yes God is involved in the details of our lives!
Bella explained to me the private vs public hospital system & that this hospital is a public hospital for the very poor but people who are more well off (teachers, business, economic professions etc) have insurance to go to private hospitals. While that makes me feel a little better for some this public hospital in this country really has challenges we would never see in the states. The water & electricity are intermittent, there are flies & bugs everywhere, lots of roof leaks & water all over the floors, minimal supplies etc. No matter what time we leave at night there are always people sleeping on the floors or chairs in the hospital with bags of belongings – it is heartbreaking. And of course the bathroom situation is no better so I have just resorted to not drinking during the day to avoid them as much as possible!

Little Dalma was one of my special patients today – she wanted a 2nd armband on her that said princess & was wearing a crown! She was a 4 year old palate repair & was here with her mom & dad who were so nervous. We assured them pre op that all of us here are moms or grandmas & that we take care of these children as if they were our own. That seemed to calm them a bit & while she was a little feisty after surgery she did well & they were happy! One of my last patients was Marcos a very BIG 4 year old who weighed 55 pounds & was tall too. His mom was tall I bigger in stature & she said her husband was a big man too. He really looked more like he was 10 size wise so it was hard to remember he was only 4. He had some breathing challenges after surgery so he stayed with me in recovery for 2 ½ hours. Mom held him almost the whole time & I held him for a bit & he was heavy! He did well though & finally went to post op about 7 pm. When I helped take him up all the pre-op kids for tomorrow had checked in so it was busy up there. They had all just finished their happy meals – the McDonalds here donates 25 happy meals every night for the kids having surgery the next day – I am sure they done know it is their “last meal” for a few days!              
The last patient rolled in just after 8 pm – the local nurses had left about 7:30 to get back to their homes & families – I know how hard it is to be doing something as big as a mission but also be managing your “real life” home & family so I applaud their sacrifice & service to the mission. Francisco or “Franny” as his mom called him was a 14 year old palate repair. He had his lip repaired as a baby but then never got his palate repaired & his mom was crying & anxious for him to have surgery which made him anxious too. I brought her in to the PACU as soon as he arrived so she could see he was okay & she was very teary. He was pretty sleep with the anesthesia & it took him about an hour to wake up but her woke up well which was good. We got him to post op just after 9 & I put all the PACU equipment away, changed the sheets on the gurneys and got things somewhat set up for tomorrow!

Once we got the the hotel all I wanted was a decent bathroom so I went straight there & surprise I got locked in!!! Fortunately Dusty my roommate was in the rooms so she tried to call the front desk but they didn’t answer & she has minimal Spanish so she text Kim the PC who thought we were “punking her” & Dusty got dressed (minus one shoe) & took my phone & went to the lobby to pantomime the situation. I thought of taking a shower but really didn’t want to be rescued from the shower so I did brush my teeth & waited. There is no “maintaince dept” so the hotel front desk guy came & took the handle off the door to get it open. As soon as he left Dusty & I laughed hysterically…at the situation & in the text she sent Kim asking her to come help her explain this to the front desk it autocorrected to come expose yourself to the front desk. The entire situation in general was a humorous relief…we had a good long laugh! Between that & my sleep deprived “lost phone” encounter last night we decided we needed sleep & will be in bed by 11 tonight!
I am so grateful to be here for so many reasons…

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