India Day #7 – Surgery Day #3 - 29 cases so 85 Surgeries so Far!!!

I started  my day in Post Op & found Karisma – she was definitely less exuberant after her palate repair than before but her mom was so so grateful. I did take a photo of them. In Pre-Op there were some babies, children and young adults…also 2 women one is 45 & the other 47. They were so excited for surgery & wanted to take pics with me & hugged me. I don’t remember them from screening because I was so engrossed in the work & was glad I could see them today. It is interesting – most adults do not smile in photos & are very straight faced – even the school age children. Then when you take a photo of them & show it to them they smile & sometimes I will try to capture a 2^nd picture.

One of my first recovery room patients was Rittika who was 18 mos. Old & weighed 7 kg (about 15 lbs) the kids here are often petite & lean but she was tiny! She also had Dextrocardia & a cleft lip & palate. All we were repairing now was her lip.  Her mom put her hands to her chest and bowed as her way of saying thank you or from my heart to your heart– as many have done here. She was very sweet & I spoke to her quite a bit thru Amerita our translator. We talked about the dextrocardia and what type of care she has had – not much. Mom is 20 years old (we have had younger moms) and dad is 24. Neither can read or write and dad is a laborer. The dad wants to learn to be a electrician. After talking to them I felt a strong impression to give them 2000 Rupee = $35 US money. I did it very discreetly thru Amerita & told her to tell the mom that I had children their ages but no grandchildren & friends of mine & I wanted to help them. We folded the Rupee bill very small & put it in her hand. She became tearful and my heart was so full.

On missions I try to feel guided as far as how I can help others & leave a positive impact on the area I go to – I think I have found my direction here & perhaps I will be helping families one at a time just like we change their childrens lives one at a time. 2000 Rupee  is about 2 weeks wages and they are likely missing one week by being here. We took a photo together & the she left the PACU.

It was WAY MORE chaotic today than yesterday & I’m not sure why? The Indian people talk very loudly so if their child is crying unlike other places where you might talk softly to comfort them the parents are really loud & almost screaming at them or so it seems. We have been trying to encourage them to soothe them softly – sometimes it works & other times not so much.

We had more moms today who were distraught & nearly passing out despite Child Life showing them photos etc. They simply have no context of surgery or hospitalization. Claire the Child Life & I were talking that maybe when the child goes back the parents have to eat something before they can go into recovery room. I was able to talk to Bhashkar the local PC & offer to get food items for the moms. I then found out is was a bigger issue. Op Smile is feeding the families at the shelter and has a budget to feed the people in post op but there are many more people than expected & the daily food is running out. Earlier in the week I had asked if there were needs I could help with so they came & said it takes about 9000 rupee to feed everyone here in pre/post op for a full day (about 120 adults if 60 patients have 2 people with them. So with the generosity of friends I offered to cover the last 3 days of food that they wouldn’t have had because they have had overage charges from the people who make the food every day. Again I never thought that I would be instrumental in feeding the patients families in the hospital but I am excited to do so! People who are laborers (the ones I saw in the village at the coal mine, brickyard & in the fields earn about $2 US a day. They mostly eat rice & lentils. In fact when the older kids wake up & we offer them juice they often ask for rice – so funny! For fresh fruit 6 mandarins are 50 rupee or 1/3 of a days work so fresh fruit is a luxury.

Later in the day there were 3 more families I gave rupees to. I explained to Amerita that it was not based on anything in particular but if I felt prompted to do it I would & they didn’t need to be the patients I recovered they could be any of them but I wasn’t sharing the info with anyone but the interpreters. One of them was the family of Ahmat Raza – it had taken them longet to get here o they just arrived yesterday – the child was screened & fortunately was placed on the schedule today. Mom is 22 & dad is 28, they too are illiterate & the mom was so distraught that the aunt came in recovery to be with the patient & told us of their journey to get here-several days & many challenges. I was hoping the money would help them travel back more easily.

Because of the demonetization there have been issues with the scrub techs & nurses at the hospital not showing up because they haven’t been getting paid. Usually the hospital provides some of these folks to round out the team but that has not been the case here so there have been some challenges but we have not experienced it in Recovery – there are 3 of us international & 1 in country RN Sarita.

By 2 pm we had received 14 patients & were half way there. It seemed we had more flies in the recovery room today – I am sure the open windows, food, blood whatever attracts them? Sharon cleaned our bathroom in the PACU like no other – I am pretty sure it is the best one in the entire hospital.

As I walked patients to post op I noticed the families lining the hallways sitting on our flattened cargo boxes that were outside the storeroom – I asked Victoria if that was the intent & she said no people just started taking them so they weren’t sitting on the floor – necessity is the mother of invention – cardboard mats for all!   

We had high hopes that we would get out earlier today but that was not to be – we did some fo the older lip patients so bigger lips & patients=bigger problems. The older women looked totally transformed – I cant wait to see them in post op tomorrow. The highlight of the evening was Ganesh – I posted a pic of him & will do a before & after when I can. He is developmentally delayed & lives far away. They found him as part of the recruitment campaign. He was ALWAYs smiling ear to ear even with his cleft lip. He is very bonded to mom because of the devel delay & the lip. They have been inseperable his entire life. I didn’t find out if there was a dad in the picture. The OR folks had mom go in with him for anesthesia induction & then we had mom in the PACU as he arrived to us. He did wake up a little crazy  & mostly wanted his IV out. We showed him in a mirror himself & he just stared – not a dry eye in the PACU

We left the hospital at 9 pm & there was one pt left in the PACU. I was on call again so Sharon said shed stay. Pradeep the Intensivist was on the bus with us – not sure why as typically the PI stays until the last patient is gone & as luck would have it about halfway back to the hotel we got a call that the patient was vomiting & in pain – so we turned the bus abound – not an easy feet on the roads of India & went back. We finally got to the hotel at 10:30. I had a really scratch throat – not sure if its from the chemicals in the hospital, the Sevo gas or the smoke but my throat was reacting & all I did was shower & go to bed