So yes Missions are a lot like childbirth…you may go thru a
lot of difficulties & challenges but that is not what you remember – you remember
the joy :0. Today really hasn’t been “a challenge” just LONG…waking up at 5 am
& getting back to the hotel at 11 pm makes for a 18 hour day. Mind you the
1st few hours were slow & not busy at all but none the less a long
day.
This was really the “first” full day of the mission with all
5 Operating tables running & “everyone” here including a lot of observers.
We didn’t get the 1st patient on a table until close to 9 so we got
the 1st patient in the recovery room at 10:30. It was nice because
it takes us about 45 min each morning to get our Recovery Room/PACU set up.
Unfortunately we cannot lock it so we have to take down all our monitors &
equipment etc and lock it up in the supply room otherwise it will get stolen in
the night??? The morning tims is also when I can sometimes go up to post op
& see the kids from the previous day who had surgery but I didn’t get there
today – I did get a little time in Child Life where the kids wait & that
gives me a chance to tell the parents I will take care of their child after
surgery & I will bring them to PACU to see them ASAP after surgery. It was
busy & chaotic by noon & stayed that way off & on all day/night
right until the end. We gave lots of IV pain meds, respiratory treatments, and
anti nausea meds today – more than normal it seemed to me - or again like childbirth maybe I am just
forgetting? The last 4 patients were the most challenging.
As always there are a few patients or families that “steal
my heart” each day…Venus was the first – a little 8 month old girl who was to
have her lip repaired but they couldn’t intubate her (get the breathing tube in
for anesthesia) 3 different anesthesiologists tried & she must have some
unusual anatomy. I had seen her & her mom in Child Life. Brining the mom in
to tell her that they couldn’t do surgery was sad – the Drs explained they aren’t
sure why & the good thing is that Op Smile will try to get her to an ENT
& then hopefully she can have surgery in the future. The mom was very
tearful – we told her not to lose hope & surgery can likely happen in the
future – still she was so very sad. I gave her a blanket & dollie & socks
J & she wanted to go
home from the PACU & not go back to the big post op ward which was
understandable. We also had what was to be a 1 ½ hour palate case that had 2
big fistulas once they got him in to the OR so it ended up being a complicated
4 hour case – which we typically don’t do on missions but he did fine!
Usually I bring & eat my own food on missions – often because
the lunches are rice, potatoes, bread & a questionable meat..todays lunch
was hamburgers with a fried egg on them plus a slice of ham & cheese??? Maybe
the Paraguay version of a Bacon cheeseburger but the egg??? I politely declined
& enjoyed pnut butter. As a Latin American mission it is also supported by
Pepsi so we have access to a large cooler with pepsi, 7 up products. I am not a
Pepsi fan in general…have always been a diet Coke girl but have had only about
3 since the 1st of January so it was easy to skit the soda &
drink water but there are a few other “coke product lovers” and tonight some
coke zero showed up in the frig so by about 8 pm I did have one J
A few other challenges today – the water in the hospital
went off for about 2 hours? That wont stop a mission we just brought in gallon
jugs of water for the surgeons to scrub in with, then after the water was
restored the electricity went out on the floor below us but not on the
surgery/recovery floor. I of course was on that floor to use the “better”
bathroom…in the dark. The hospital does not have air conditioning & the temperatures
here are about 88 with 94% humidity so it’s a bit “warm & sticky” to say
the least. We had some rain tonight so that brought the temps down but the
humidity up. There are windows open all in the hospital which moves some air
but also brings in flies & bugs. I don’t think to put bug spray on when
going to the hospital so I did get a mosquito bite…they say Zika is here but
Dengue fever is more common – I am pretty sure I will be fine!
Alec the 18 year old grandson of the OSI founders who was with me in
Nicaragua is at this mission too so it was really fun to catch up with him
& he helps us a lot in the PACU taking patients up to the 6th
floor post op ward & helping however we need so that has been really nice.
Jordan one of the surgeons from Nicaragua is also here & he is great too –
familiar faces are so nice!
We were halfway done at 4 pm & at 6:30 pm had 6 more
patients to go but 4 of those last ones were a little more intense or
complicated (woke us as fighters, some bleeders, pulled IV’s out etc) & if
that wasn’t enough when I was taking the next to last patient up to the 6th
floor and had a questionable elevator experience – maybe just because it was
late at night? They told us the elevators aren’t reliable but I would say more
than that. The main elevators have 3 but only one works the other 2 have the
call buttons pulled out & the one that worked would open the close so we couldn’t/didn’t
get in. The next set of 2 elevators on was an open elevator shaft you could
look or fall right into & the “functioning one” had an error message. We
finally got a military guy from the hospital to take us to the 3rd
back of elevators – this one also had an empty/open shaft but had caution tape
across it & had one that worked…I did make it to the 6th floor
with the patient & opted to walk back down…it’s the little infrastructure things
like that I never understand??? The last 6 of us on the team left the hospital
at 10:30 – me the clinical coordinator, the 2 program coordinators, the Intensivist
& a in country coordinator – we took a pic in front of the hospital then…for
womens day LOL!
Today there were a lot of dads who are the caregivers/single
parents of these children whose tender ways I observed just touched my heart. 7
year old Fernando was VERY NERVOUS for surgery his mom had gone into a hospital
less than a year ago & died after a severe asthma attack. He was here with
his mom & grandma & when we brought his dad in her was so sweet &
tender with him & very emotional himself – there were no dry eyes in the
PACU. Also one of the last 4 patients the dad came in & was extremely emotional
when we let him hold his fussy son-I was worried he was feeling queasy &
going to pass out so we brought the aunt in to hold the boy & helped the
dad outside to get his composure & make sure he was ok. He was fine it was
just that his wife – they boys mom abandoned them both when the boy (who is 4) was
born with a Cleft lip and now seeing it repaired was very emotional…for all of
us. SO yes while apparently today was “national womens day” I saw several very
tender dads in my part of the world who have the role of mom & dad. I will
post a dads pic on social media.
In the end we did 22 surgeries (3 were canceled because the
child was sick) – those are also a bit heartbreaking but it is the beginning of
the surgery week & if they can get better by the end of the week we can
possible add them back on the schedule. Back at the hotel we were going to get
food but everything was closed so we headed to the room & after a very “sticky
day” a semi warm shower felt great & the PC’s were so sweet & brought
us something to eat just about midnight. With the Clinical Coordinators support
I am making some changes to the PACU staffing…the local volunteers are at their
homes sometimes 2 hours away so they get in about 9 or 10 & leave by about
6. That leaved Brigid & me in the PACU in the evenings. So since we don’t get
patients until after 9 I am going to sleep in until 7 & get to the hospital
at 8:30 tomorrow & see how that works to try & avoid 18 hour days all
week. So yippee so 5 am wake up for me & I am ready to sleep!
*I got to talk to Doug during the day & Sarah & Kimmi
tonight, I caught Kelli & Clark yesterday so just missing Ryan & Kya 
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