Monday, May 6, 2019

Monday May 6th Surgery Day #1 20 Op Smile Patients & Lots of Team Patients

So at breakfast before we went to the hospital we found out that there were A LOT of team members sick – mostly with Montezumas Revenge – (vomiting & diarrhea). The 4 students from the student team & the Program Support person from OSI HQ didn’t even go with us to the hospital & the students are from Mexico???? The team doctor was handing out medicine like candy…. I felt a little queasy but I thought it was just because I haven’t been eating well so I had some liquid protein in water to start my day & that seemed to help – I am actually 100% committed to only eating the food I brought for now.

The first day is always a slow start – we left the hotel about 7 & got there about 7:15 but the first patient wasn’t on a table until 8:30 by the time we go thru all of our emergency training – which included the exit route in case there was an earthquake – that was a new one for me! The first patient in the recovery room was actually patient #1 the first child screened so that was sort of fun – he didn’t get to us in recovery until 10 am & his name was Lucas. A few things about a Mexico mission that I forgot…parents cannot come into the recovery room to be with their children, there is this “magic line & bench that divides the sterile from non sterile area in the operating room & recovery room area. The patients are passed across the line & bench & those of us in the OR or PACU cannot go on the non sterile side – even for the bathroom that is 20 feet away – we have to go thru the sterile side & enter thru there – but it is the same room??? Also in Mexico Op Smile does not send Cargo so we use all in-country supplies which can be a bit challenging – like the face masks & shoe covers.
In the Recovery Room (PACU) it’s Katrin ,me & Estela a PICU nurse from UCLA plus Domy a “Nurse in training” here at the hospital. At 11 the mission photographer came in to the PACU not feeling well 0 she had been sick yesterday. She was pretty pale so Tom the Team leader of Anesthesia put an IV in her & we gave her 2 liters of fluid. Less than an hour later one of the Pre-Post Nurses came in in tears – she was miserable so she too got an IV & 2 liters of fluid & both rested in 2 of our 4 PACU beds for about 90 min each. In the mean time we had patients coming in but were managing it. Then around 1 pm the Medical records volunteer had a headache, burst a blood vessel beneath here eye & had a Blood Pressure of 182/90 – not good. I always tell people that I don’t do “Big Patients” but really I had no choice. The team doctor called a friend of his & we ended up getting her some oral blood pressure medicine & watching her for a couple of hours. Then the Speech Therapist came in with almost the same things headache, high blood pressure & a blood vessel burst in her eye. It was CRAZY!!! I made up handwritten charts for them so I could see their BP & meds etc. I really felt like I was running an urgent care 😊

This afternoon they did “Combo Repairs” meaning both lips & palate repaired on 2 older boys 18 & 19 years old who were brothers. For whatever reason their mom never let them have surgery but now they were old enough to consent themselves & came together to have surgery. It was super cool & when I showed the 18 year old his “new face” on my I phone photo screen he gave me a thumbs up & HUGE grin!!! They were both 3 hour surgeries. By 2:30 we only had 9 of 20 patients completed bit we got a rush & by 5:30 we only had 5 patients left. Somewhere in there was a lull & I am pretty sure I nodded off for 30 minutes. The next 3 patients came out in a steady flow….Guero who was the 230th patient screened & was fortunate to have surgery today on Monday. He had 8 older siblings & was the only one with a cleft & I am sure this family would LOVE his new smile. Karin was also one of the last patients she was 8 months old & had cute little pigtails. Then we had a HUGE stall for the last 2 patients…tonight was my night to be on call so at 7 we sent Estela & Domy home & Katrin stayed for the last 2 patients with me but the last one would not wake up from the anesthesia, so I sent Katrin home & then I finished at 9. It was a long day but not exhausting & my call night is done!!! I do miss not having the parents come in because the moments when a mom or dad sees their child with a repair is magical. All in all it was a successful day #1 – tomorrow will be busier – we have 25 patients & 13 are palate repairs :/
On another note the missionaries’ text me the info re the fungal medicine so I am going to try & get that taken care of tomorrow for that sweet mama & her son. I am off to bed!!! Good Night

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