Since we (the PACU team was at the hospital so late they told us we could leave at 8 am instead of 7:40; basically the time for the bus to go to the hospital & come back. I stepped out of the hotel at 8 am exactly only to see the bus drive away…typically buses are sort of on time but this was a first??? No problem I am resourceful so I called an Uber & for $1.50 American I got there at about the same time as the bus.
We were doing all lips today so I assumed the day would go
faster & the patients would come back sooner – it sort of went that way…we
had a 2nd translator in the PACU in addition to Sis Wright – her name
was Amanda & she is 24 & a schoolteacher at an Portuguese/English
private school. She is one of the “LDS Church Helping Hands Volunteers”. Her
sister in law is Carlos’ daughter & Carlos was asking for all members who
spoke English to help and Carlos daughter planned to come but was unwell so Amanda
came in her place & was so sweet. She shared lots of cultural information
about Brazil. She has lived in PV for a year & moved from the center of the
country where there was more crime. The other Sister Missionary Sis Rueda has been the full time translator for the
Psychologist from Honduras who speaks Spanish as Sis Rueda speaks Spanish,
English & Portuguese, Sis Rueda has the most amazing countenance – she is
28, is so gracious and kind and has a calming sense of maturity and life experiences.
I am certain she brings so much to her missionary service. She taught English
in Mexico prior to deciding to come on a mission.
We have a total of 16 patients again & 3 age deviations
meaning we are doing lip repairs on 3 babies <6 months old (which is the OSI
criteria) but we can do younger if they are well nourished & meet other criteria.
They are all on Yumi’s table so I told her to look for me when she brings them
to to the PACU. I went into the patient holding area & saw the cutest lil 9
year old Greciane who has had an “unrepaired primary lip” her entire life. She
is Autistic and they have not been able to have it repaired. She had a play stethoscope
in her ears & a pretend microphone & was singing her little heart out 😊
I really thought we would have the first round of lip
patients out sooner but I guess they were doing a lot of teaching? The first
baby came in at 11:15 & the next 3 within 15 minutes so it got a bit busy
in our area. My fist patient was Giovnna & she was a sweet little girl that
took awhile to wake up. I snuggled her for quite some time & later in the
day the Op smile photographer sent me a photo of us that he took. It encapsulates
so much of my love for these babies & this
work. I had to pass her off to a volunteer when the 4th
patient came in as Norina & Allyson were also busy with patients.
My next patient was Petyro and he was a bit more fussy &
harder to calm but settled if I was standing him rocking him..like all babies.
The team dentist Flor came in & wanted to hold him & she sang some
Brazilian songs & did some dancing with him in her arms & he loved
that! I guess I didn’t have the right moves or language 😊
After that it got loud with 4 moms & 4 patients crying & my friend Greciane
came back & literally was screaming for at least 30 min – I cannot imagine
coming out of anesthesia not knowing what is happening. It was rough but I am
so glad she got her lip repaired – the mom said because of both eh autism &
her lip she has been ostracized most all her life ☹
I got “shamed” into trying the local lunch which today for
the Brazilians was a plate of rice, beans on top of the rice, lasagna on top of
that & shoestring fried potatoes on top of that for texture (they really
seem to care a lot about texture?). I opted to try the lasagna only 0 it had
both diced ham & ground beef in it – wasn’t bad…
My next to last patient had a crazy backstory the entire surgical
team was surprised about. Her name was
Kabatchogue & she was one of the babies from the indigenous tribes in the
area. She was 9 months old & 6 mos ago came to a local mission in another area.
She had a large bilateral cleft lip plus a palate. The chief in their town
believed she would bring a bad spirit to their tribe & banished the mom
& baby. At 4 mos of age Op Smile did not feel they could repair the full
lip but were concerned for her safety so they repaired one side of the lip. AT
this point the story gets a bit unclear because I don’t know if she was able to
go back to her tribe or has stayed away the past 5 months? On this mission she
came & we repaired the other part of her cleft lip & I believe she will
return to her tribe now? The baby will still need palate surgery. Mom &
baby were accompanied by an aide worker who could translate her dialect to
Portuguese – such sweet person.
Mid-day we got a text that there would be a tam dinner at a “Pizza-Pasta
Buffet” with buses leaving at 7:30. Sounded fine to n=me but my last patient REALLY
needed the extended stay at the end of his time in the PACU & I then became
doubtful if our team would attend (but don’t worry we did!). Anyway my lil guy
was only 4 months old & had both a nose & lip deformity. They did a 3 ½
hour surgery ti repair the lip & tried to do some reconstruction on the nose.
He came to the PACU with a clear tube coming out of each side of his nose – &
had a bit of oozing around it but nothing too concerning aside from the fact
that the surgeon expected it to stay in for 14 days & the mom would clean
it each day??? News Flash she lives in a rural part of Brazil. He really was
doing ok in PACU. I syringe fed him some juice when he was awake & he
settled ok for me & mom. Mom was uncomfortable though as she only breastfed
& was engorged & the baby could not latch on…so the local PACU RN &
I “played McGyver” & made abreast pump from a 50 cc syringe. We cut off the
syringe tip, I covered the raw edge with tape stripes & we put it on her breast using the syringe
phalange to pull the breast milk out – WaaaLaaa it worked & once the baby
was crying the milk flowed freely into the big syringe & I fed him from a
small syringe. It’s all about innovation at the smallest level! Our PACU MD is on
the nutrition council for Op Smile & took photos of our “creation” haha.
Unfortunately about 30 min later – not certain of the reason his oozing of blood
around that tube increased. I applied pressure which made him more upset &
ooze more, so Teresa the PACU Dr sedated him & we applied more pressure
& ice. Since he was the last patient the majority of the team had left – I was
literally ready for him to go to the post op ward when this started. We out him
on some oxygen continues to control the oozing & called the surgeon on call
who came about 30 min later. In the PACU we all believed the tube was
irritating his nose, causing more swelling & more oozing – we were right.
The on call surgeon came in, removed the sutures keeping the tubes in place, I
applied more pressure while the surgeon created nasal packing with Vaseline
& gauze, Packed the side of the nose that was bleeding & then we put on a moustache dressing – it was
now 7 pm & he looked okay but they wanted to watch him for 30 more minutes.
The local Dr had to stay & Allyson offered to stay so I got an Uber for
Norina & me& we go to the hotel at 7:25 truly did a 5 min change &
made it on the bus to the dinner.
There was some VERY INTERESTING pizza combinations – dry beef
& cheese, carrot & cheese, banana & meat, shrimp, chicken &
corn, one with lots of meats & fortunately
marinara & pepperoni which I ate. They were also serving all sorts of
pastas I passed on & french fries? Then they had dessert pizzas that still
had a base of crust & cheese on them plus either lots of chocolate &
chocolate sprinkles, chocolate & strawberries, one with flan on top &
lots of caramel & another with all sort of m&m’s sprinkles & a
scoop of ice cream & chocolate syrup. We got one of each at our table &
all tried a bite. Very sweet!
They showed the traditional video – highlighting that this
is the 10th mission in PV & they have now done 400 surgeries
here so I don’t think they have ever done a big 90 patient mission here. Christina
the Local Executive Director Volunteer has been a part of the entire 10 year
history. It is always nice to se the mission from our 1st gathering thru
the training days screening, surgeries, recovery & post op. It encapsulates
the entire experience so well. I was in the
video with one of my sweet babies from today 😊 The event finished at 10 pm & we were
back at the hotel at 10:30 & some people were leaving for the airport at
11:30.As much as I typically am ready to head home right after the mission I am
actually grateful that I am not leaving tonight; for a few reasons. I am tired
& looking forward to a good nights sleep with no alarm to be set so maybe I
will come home rested – perhaps jet lagged a bit but rested. Tomorrow I will
get to make some other need purchases with Sis Rosemary the Relief Society
President. Also for those of us here all day tomorrow Nipson is arranging a 2
hour boat trip on the local river (not the Amazon River) to hopefully see the “Pink
dolphins” that are unique to this area of the world?
I am writing this post Monday morning so happy to report a
good nights sleep – Yumi & I slept in until 8:30 & it was wonderful! I
will make my last blog post likely after I return. If you have been following along
– THANK YOU for the love support & prayers during these missions. I am so
blessed & grateful to be able to use my skills for good all over the world with
Operation Smile & have these opportunities & I believe I have been
where I was meant to be this week in PV Brazil
Teaser – Ambra came to me yesterday asking If I knew some of
the plastic surgeons at CHOC who I do (Dr Jaffurs & Dr Elyas) as their group
& CHOC? would like to sponsor a mission in the DRC in about a year &
she wondered if I would be interested…
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