Late Entry for Wednesday Surgery Day #3 -It was a DOOZY & 1st Load of Humanitarian Food received

 Again, there is no internet so I am writing this Thursday Morning for Wednesday in word & hoping I can publish it in my blog at some time.  Woke up Wed. after a short night to no rain & a sunny day that felt less humid but there are still LOTs of mosquitoes even inside the PACU so I am glad I am on Malarone the anti-malarial medication. At breakfast they announced that we will be condensing all the patients to 4 days finishing surgeries tomorrow & not have any surgeries on Friday. I was actually SO, SO GRATEFUL I thought to ask for my flight to be changed from Saturday late night to Saturday morning, . I am used to later nights & was concerned about finishing a half day of surgeries on Friday, packing up the PACU, packing up myself and then the drive to Accra. So now we will have the “Final Dinner” Thursday night I will get to sleep in Friday without a 6 am alarm &leave at noon to drive to Accra, stay at the same hotel I was at before & get the hotel transportation to the airport. That plan will be much less stressful 😊

Abi & I went straight to post op this morning in our street clothes to see all the sweet patients from yesterday – the last older patient Dennis & his sweet grandma, Phillip & Daududa who was sleeping. After that we went back to the ATM to withdraw my max cash amount before we connected with Salam to go and purchase food at the warehouse. So much for it not being humid because after I walked the 150 yards to the ATM & back I was a sweaty mess!  Classic reason why I don’t wear make up on missions.

Humanitarian Progress: Abi wanted to go with Salam & I to the warehouse so I let Princess & Eddy know we would be gone for 1 hour & hope to be back before too may patients got to PACU but Beatrice was “in charge” they seemed ok with that. We connected w/ Salam at 8:45 and drove about 40 minutes to the warehouse…do not think Costco or Sams club…we are talking a warehouse with dirt floors & food on wood palates this is where restaurants & stores buy supplies. They sold perhaps 10 types of rice in varying quality (bugs?), oil, canned sardines, large cans off tomato paste, sugar & things I didn’t recognize. I assume there are “food staples” in Ghana. We picked a quality of rice that Abi gets (I trusted her) then selected the oil & sugar & did the calculations of the quantity of each depending on how they were packaged. Each family would get 25kg of rice that was easy or so I thought until they came back & told us ALL of that brand of rice was already sold???? to the “store” we had been to on Sunday, and of course the store raises the price a lot. Instead we bought the same brand of rice but in bulk (not the  5 kg individual bags inside the big bag) & decided we would add a plastic storage bin for them to put the rice in that could also be bought at the market. Rice -DONE. Then we requested 13 of the 3 packs of oil…they only had 11 so we had to upgrade 1 of the 3 packs to a higher grade oil. The tomato paste came in too large of cans so those will be purchased elsewhere. The large bags of sugar they were going to divide for families were not available so we got the individual bags packaged in bulk which will be easier to those leaders who will be putting together the individual “baskets of food” for each family ( that itself is going to be so much work & they plan to do in the next week or so). Getting “checked out” with the “big boss of the warehouse” seemed like a process & I was concerned we had been gone too long so I pulled the we need to get back to the hospital card-showed a before 7 after phot of a patient & they seemed to move faster. I paid in cash, got a receipt, while Salam was coordinating delivery at the actual church building with the driver who said her would call her when he was on the way so she could meet him there w/ a couple of men who would help unload.  LOGISTICS!!!! They had added a few other families so it will be 40 total with food for 2 months & we are adding protein as well. We removed 2 elderly who need more “ready prepared food” (no clue what that means in Ghana??? We were back to the PACU by 9:45 just as the first patient was coming in from the OR – perfect timing-I didn’t miss a thing. Then at 11 Salam got the call the food was being delivered so she left the hospital & went to the church – she took a few photos & a video….I do want to see it – 2200 pounds or rice is A LOT – that made my heart so happy & I sent the phot to friends who either gave me money before I left or have so graciously sent money while I was here. Later in the afternoon when I had a 15 min break in the chaos (see below) Salam & I met to review what we had spent, what we needed in cash& what we had in cash with the ability to withdraw another $1200 tomorrow. That was all the humanitarian time I had today which was good because the PACU was CRAZY!!!

Mission: It was a very crazy, chaotic loud day the entire day between 90% of the patients coming out of anesthesia confused, combative & crying, the inability to fully “silence” alarms on our equipment, a few patients with complications, IVs coming out and the actual nursing needs it was a DOOZY!!! At one point my Apple Watch alerted me that I was in a LOUD ENVIRONMENT – I already was living that!

At 10:30 a simple lip repair came back with some oozing internal to the lip. Surgeons said the patient had no bleeding on the table & they we also in their next case. The nurse & I watched it for about an hour before I told Della – he wanted to put more pressure on it & watch it for 10 min. After 10 min he got the circulating surgeon to come check which is when all the crazy happened. The sweet little guy almost had to go back to surgery mostly because the surgeon didn’t have good visibility to where ethe bleeding was coming from. We sedated him in the PACU, applied gauze with adrenaline to hopefully vasoconstrict wherever the bleeding originated. We gave TXA a drug that helps with clotting about 12:30 & then we “on watch” for 2 hours.  During all of this the decibel level in the PACU had to be high. IVs coming out, patients screaming & needing medications to relax – there was definitely something in the air impacting nearly every patient even 1 or 2 from Table #1. We occasionally settled but it was an “off vibe” all day.

So SURPRISE when the 1^st bus left people did want to escape the crazy & I sent 4 of them back to the hotel and 3 of us stayed – I stayed since I am on call anyway. The last patient came to us at 6 pm and was an adult lip so after 30 minutes we sent her to the ward & tidied up, I was on the 3^rd bust to leave at 7:30. I got back to the hotel at 8 & went by the “hotel restaurant” to see Clover, Cherish & the students. I ate some of their pizza & went to my room to shower only to find out there was no water coming from my sink or my tub. I called at 8:30  they said 30 min but at 9 still no water so they brought me a bucket of “cool” water & I did a wash down. The internet was also out so I did not blog and was in bed by 9:30 which is probably exactly what I needed as I got almost  9 hours of sleep – it was GLORIOUS & I needed it so much!