Sleeping in until 7 was so nice....I actually "got ready" today (ie wore makeup & did my hair in something other than a pony tail) Had to be on the bus at 8:30 to go to another hotel fro the "Educational Conference" I didn't really know what to expect since I had never participated in this before...I had put together a Pediatric Advanced Life Support (PALS) talk on recognition & management of pediatric shock. There were about 35 Bolivian nurses there & I had a translator...I wanted it to be interactive & relevant to how they practiced & it went surprisingly well & was a great experience for me. With a case study & questions what I thought would be 30 min was just over an hour & they took notes & everything - I am really glad I did that :)
After my talk I took a taxi to the hospital where others were setting up etc. On the way I noticed things I hadn't seen before...first of all the kids go to school on Saturdays here, there were a bunch of fruit stands & some big trucks of watermelon being sold on the side of the road along with some sort of cold juice drink in big jugs - advertised usually on a handwritten sign as "...frio" I passed a "Gymnasia" their version of a gym - quite different that LA Fitness I must say! and the way we went there were lots of areas where it seemed building materials were made & sold (wood, brick, stone)
When I go to the hospital the recovery room was looking really good & with just a few "tweeks" it seems like it will be just fine! The Clinical Coordinator (who is in my hotel "villa" with me) & doctors were finishing up the schedule & everyone was helping to put charts together. We had told people to come back at 1 for the posting of "he list" but at 2 they were still finishing it. I wandered out & saw Luz one of the patients we screened - a darling 8 year old who had surgery here in Santa Cruz 6 years ago & was here for follow up - she & I took some pictures & she followed me around awhile :) Loved that! I also saw a mom & baby I had talked to another day - they had travelled 20 hours to get there.
I had never been present for the "list posting" on my other missions so this was a new experience & one with experiences of both sheer joy & utter disappointment. They first read the list of "rechecks" kids that had a cold or other reason why we might not be able to do surgery - there were about 12 of them & after recheck I think 4 were added to the schedule. Then was the "too anemic for surgery list" that group Gayle the pediatric intensivist (also my roommate) spoke to telling the parents to feed them more green veggies etc & that milk & rice wont help & she also gave them all iron for their babies & told them to come back in June for a "local" Op Smile mission (smaller just done by a Bolivian team) & that their charts etc would be held. Those 2 sessions seemed fine but NOTHING prepared me for "the lists"
They actually read off every name & pt # as they were scheduled day by day Mon-Fri. Everyone anxiously waited to hear their name called & if it was they were filled with elation & quickly went to where-ever they were asked to "report to" As each days "List" was read you could almost feel the uncertainty in the area build with those who were still left. The last name on the last day was a 15 year old girl who had a small deformity on her face (a hemangioma). She was a priority 5 out of 5 (lowest) so when she came to me as the gatekeeper I knew it was remote but on the last day they will sometimes add some of those cases on...I watched her & felt SO BAD cause I was pretty sure she wasn't on the list then her name was read - in a 10 second period the look on her face went from complete sadness that she would always look that way to pure joy as her name was ready & she smiled the biggest smile ever...it was a truly miraculous 10 seconds & if that was all I got out of this mission it would be plenty...but I know there is much more joy to come
Unfortunately not everyone gets their "happy endings" & there were some disappointed & dejected parents & that just broke my heart...I stayed in the background just to observe but if it was clear you were a part of the medical team the parents of the children who were not selected for surgery would come up to you & hold out their baby to you with this look of "please cant you do something"...it was really more than I could take.
Even worse than that was the fact that about 20 of the "Not Selected" wanted more information & so Gayle (the intersivist) that was her role to talk to them. Some were fine & understood but one young mom (she was 20 & looked about 40) had a heart wrenching story. She had come on the bus yesterday from beyond LaPaz...the 36 hour ride because of several road closures. Apparently the Chairman of the Bolivia Op Smile Board had gotten a bank to pay for the bus to bring that group here - she told Gayle she had no money & would NEVER be able to get to Santa Cruz again....her baby had a primary cleft lip - a simple surgery but the baby was anemic with a Hemoglobin of 8.2 & our cut off for surgery is 9.0. She also told Gayle that her husbands family doesn't know why he married her & they believe there is something wrong with her & that is why the baby has this deformity. she was sobbing that she could not possibly go back without the baby having the surgery...Gayle was awesome - she went & talked to the medical team & told them the whole story...since the the baby was big & healthy they decided to go ahead & do the surgery - the mom fully embraced Gayle & did not let go for what seemed like forever...that moment even 2nd hand was priceless...we really are changing lives one smile at a time. The baby will have surgery on Tues & I know it will be an experience that touches many of our hearts.
Tonight was a team dinner at a very nice restaurant...we were all expecting to pay for ourselves but the owner is the same Chairman of Op Smile Bolivia who coordinated the bus & at then end of the night he took care of all the meals & drinks for all 50 of us...there are some VERY KIND & GENEROUS people all over the world - it is so nice to be reminded of that....Dinner was late & long (3 hours) & its already after midnight so I am off to bed as soon as I check Facebook to see the pictures Wendy took of Sarah before Mormon prom :) THANK YOU! My day was also made as I saw all the FB posts of my kids enjoying our traditional St Patricks Day celebrations & music in both Utah & Calif....Doug had green breakfast for Sarah & Kimmi & yes the leprechauns turned the toilet water green again this year! & Kelli & Ryan enjoyed a full course late night green dinner - LOVE that Doug & my kids are keeping the traditions alive! as for me I was seen in Bolivia with my green shirt on & at dinner with my Green hat & beads! Happy St Patricks Day from Bolivia!
Saturday, March 17, 2012
Friday, March 16, 2012
2nd Day of Screening 131 MORE Patients Screened!
This will be a short post cause I'm a little tired & want to get to bed...typically the 2nd day of screening is a bit slower than the 1st but not so much here. We had a pretty steady day & flow of patients...all very cute with such loving parents just hoping we could help their children.
By about 3 pm it was winding down & we were getting ready to go unpack Cargo & start setting up the recovery room. All day we had heard their was a "bus" of people coming but assumed it was just a rumor. Things were winding down & we had already screened almost 90 kids...then...THE BUS arrived. At first I thought "really???" cause I was ready to move on to the next task & get into the Recovery room area but as I saw these VERY HUMBLE BOLIVIAN people get off the bus, in somewhat dirty clothes w/ their babies in one arm & their bag of belongings in another I stopped & reminded myself that the reason I'm here is to help people like them...unpacking Cargo & setting up could wait. We were told they this group had travelled by bus for about 36 hours from just beyond La Paz - probably on dirt roads because about half of the roads we travel on are dirt roads. I appreciated the change in perspective as I imagined all they had gone thru to get here with their children...I was in awe of their determination & the HOPE they had for medical help and I immediately decided I was going to be extra kind to them & offer them water & just smile & appreciate that I could be a part of their journey....
In the bus of about 70 there were 40 children to be screened many who will get surgery this week & a few who are too small & will have to wait. There is a "shelter" for those who have travelled from afar at a catholic church where they can stay for free & get 3 meals a day all this week & I think for a few days after we finish here - but the shelter is 45 min away so Op Smile has a bus that takes them back & forth.
We did get in to the operating room & the recovery room - in comparison it is better than Kenya & worse than Mexico...its very small, we can fit 4 gurneys in the area but not real beds, there is not a sink in the room but there is one outside the room & down the hallway. No chairs for us & really no place for our equipment - it is going to be cozy :) But it will all work out - it always does
The best news is that our wake up call isn't until 7 am tomorrow - that seems like sleeping in!!! Tomorrow morning is an Educational Conference - I am giving a 30 min talk on Pediatric Shock complete with a translator - wish me luck!!! That is scheduled to finish at noon & then we will finish our set up & there is a group dinner tomorrow & our team bonding day is Sunday so it should be a not too stressful weekend!
before a very busy week....I'm off to bed & its only 10 pm here woo-hoo! Night all!
By about 3 pm it was winding down & we were getting ready to go unpack Cargo & start setting up the recovery room. All day we had heard their was a "bus" of people coming but assumed it was just a rumor. Things were winding down & we had already screened almost 90 kids...then...THE BUS arrived. At first I thought "really???" cause I was ready to move on to the next task & get into the Recovery room area but as I saw these VERY HUMBLE BOLIVIAN people get off the bus, in somewhat dirty clothes w/ their babies in one arm & their bag of belongings in another I stopped & reminded myself that the reason I'm here is to help people like them...unpacking Cargo & setting up could wait. We were told they this group had travelled by bus for about 36 hours from just beyond La Paz - probably on dirt roads because about half of the roads we travel on are dirt roads. I appreciated the change in perspective as I imagined all they had gone thru to get here with their children...I was in awe of their determination & the HOPE they had for medical help and I immediately decided I was going to be extra kind to them & offer them water & just smile & appreciate that I could be a part of their journey....
In the bus of about 70 there were 40 children to be screened many who will get surgery this week & a few who are too small & will have to wait. There is a "shelter" for those who have travelled from afar at a catholic church where they can stay for free & get 3 meals a day all this week & I think for a few days after we finish here - but the shelter is 45 min away so Op Smile has a bus that takes them back & forth.
We did get in to the operating room & the recovery room - in comparison it is better than Kenya & worse than Mexico...its very small, we can fit 4 gurneys in the area but not real beds, there is not a sink in the room but there is one outside the room & down the hallway. No chairs for us & really no place for our equipment - it is going to be cozy :) But it will all work out - it always does
The best news is that our wake up call isn't until 7 am tomorrow - that seems like sleeping in!!! Tomorrow morning is an Educational Conference - I am giving a 30 min talk on Pediatric Shock complete with a translator - wish me luck!!! That is scheduled to finish at noon & then we will finish our set up & there is a group dinner tomorrow & our team bonding day is Sunday so it should be a not too stressful weekend!
before a very busy week....I'm off to bed & its only 10 pm here woo-hoo! Night all!
Thursday, March 15, 2012
1st Day of Screening 159 Patients!
My oh my 5:30 came early! the drive to the hospital is 45 min on an old bus thru some very poor areas where there are horses, pigs, ducks & dogs roaming in the streets. Then in the middle of it is the Hospital Frances (the $$ to build it was donated by some wealthy Bolivian who now live in France?) So it is fairly new & nice in this very poor town. But apparently the govt hasn't paid the staff there (nurses doctors etc) so they are out protesting & there is no one in the hospital - unusual? I didn't really see the hospital area today as we were really out in a patio/clinic area for screening.
When we arrived at 7:15 or so there were over 100 people already waiting. I forgot how chaotic the 1st morning of screening is...you figure for the 159 patients we saw many come with 1 or 2 adults & 1-3 other children so really there was a crowd of about 600 or so in a very small area - I took pictures.
Pt #1 was Franklin...a cute little boy who I also took a picture of. Some of the people we saw are from only 30 min away, others 6,8 or 10 hours which requires many different buses, some 20-24 hours or 2-3 days. It is always humbling & amazing to see what these parents & families do to get their children the help they "might" get..there are no guarantees & the hardest part of today is there were 5 or 6 kids who REALLY need surgery but their blood counts are too low from their poor diets so we cant do the surgery :( We are hoping to get Iron drops to give them so they can have surgery at the next mission here in 6 months.
One sight I was not prepared for was a large population of Mennonites....they live about 9 hours away & came her from Germany? They have German names & speak German & Spanish. Their dress is very unique...the men wear overalls & plaid shirts & hats & the baby boys are in matching outfits. The women wear long skirts in a unique material with aprons, hats, long sleeves & sort of tights...all in a very humid 80 degrees. The women aren't allowed to talk & the men don't look at you when you talk to them. They don't like having photos taken & when holding their babies with Cleft Lips or Palates they put blankets over their faces so people dont see the deformity. I was not expecting that one....and after travelling 9 hours some of them then say they cant stay until Monday for surgery????
Some other interesting patients were identical win boys who were 4 years old with identical cleft lips, and in screening we ask the families if they have any idea why their child was born with this abnormality & let me tell you there are some interesting answers...mom got hit by thunder? (yes thunder not lightening), dad works in the fields, its Gods will, mom had a bad spirit visit her, they had an argument while they were pregnant...the list is quite long.
Ethicon (a Johnson & Johnson company) has donated suture materials to Op Smile for 30 years = several million dollars. 7 Ethicon people are here visiting & volunteering...they are quite nice but you can tell a couple of them had no idea what a mission was like & were pretty overwhelmed today.
We had 2 DARLING 17 year old girls help us as translators Estefania, & Paola. They attend a private International (American) high school & are part of the Operation Smile Club at their hospital. They were with us from 7 am-6 pm & were such a big help & so much fun to talk to. They are from well to do families here with siblings at prestigious colleges in the US & Europe & parents who are professionals. They were FABULOUS & so kind to all those we saw - they will be back again tomorrow :)
That's about it - just a busy long day - we got back to the hotel at 7:30 pm. I love being here & having the opportunity to do this - thanks to my family & friends at home & work etc who are covering for me in my absence!
Oh P.S. Verizon fixed my phone so now I can text but this great International Blackberry has no Internet capability & calling is super expensive so I am basically carrying around a texting device???
THANK GOODNESS for Skype calls - its been great to talk to my family :)
Yikes wake up call in 5 hours & I still need to shower! Good Night from Santa Cruz!
When we arrived at 7:15 or so there were over 100 people already waiting. I forgot how chaotic the 1st morning of screening is...you figure for the 159 patients we saw many come with 1 or 2 adults & 1-3 other children so really there was a crowd of about 600 or so in a very small area - I took pictures.
Pt #1 was Franklin...a cute little boy who I also took a picture of. Some of the people we saw are from only 30 min away, others 6,8 or 10 hours which requires many different buses, some 20-24 hours or 2-3 days. It is always humbling & amazing to see what these parents & families do to get their children the help they "might" get..there are no guarantees & the hardest part of today is there were 5 or 6 kids who REALLY need surgery but their blood counts are too low from their poor diets so we cant do the surgery :( We are hoping to get Iron drops to give them so they can have surgery at the next mission here in 6 months.
One sight I was not prepared for was a large population of Mennonites....they live about 9 hours away & came her from Germany? They have German names & speak German & Spanish. Their dress is very unique...the men wear overalls & plaid shirts & hats & the baby boys are in matching outfits. The women wear long skirts in a unique material with aprons, hats, long sleeves & sort of tights...all in a very humid 80 degrees. The women aren't allowed to talk & the men don't look at you when you talk to them. They don't like having photos taken & when holding their babies with Cleft Lips or Palates they put blankets over their faces so people dont see the deformity. I was not expecting that one....and after travelling 9 hours some of them then say they cant stay until Monday for surgery????
Some other interesting patients were identical win boys who were 4 years old with identical cleft lips, and in screening we ask the families if they have any idea why their child was born with this abnormality & let me tell you there are some interesting answers...mom got hit by thunder? (yes thunder not lightening), dad works in the fields, its Gods will, mom had a bad spirit visit her, they had an argument while they were pregnant...the list is quite long.
Ethicon (a Johnson & Johnson company) has donated suture materials to Op Smile for 30 years = several million dollars. 7 Ethicon people are here visiting & volunteering...they are quite nice but you can tell a couple of them had no idea what a mission was like & were pretty overwhelmed today.
We had 2 DARLING 17 year old girls help us as translators Estefania, & Paola. They attend a private International (American) high school & are part of the Operation Smile Club at their hospital. They were with us from 7 am-6 pm & were such a big help & so much fun to talk to. They are from well to do families here with siblings at prestigious colleges in the US & Europe & parents who are professionals. They were FABULOUS & so kind to all those we saw - they will be back again tomorrow :)
That's about it - just a busy long day - we got back to the hotel at 7:30 pm. I love being here & having the opportunity to do this - thanks to my family & friends at home & work etc who are covering for me in my absence!
Oh P.S. Verizon fixed my phone so now I can text but this great International Blackberry has no Internet capability & calling is super expensive so I am basically carrying around a texting device???
THANK GOODNESS for Skype calls - its been great to talk to my family :)
Yikes wake up call in 5 hours & I still need to shower! Good Night from Santa Cruz!
Wednesday, March 14, 2012
The MANY Tender Mercies that got me to Bolivia & Day #1
Well I have almost been in Bolivia for 24 hours (not quite) the flights went well LAX to Panama then Panama to Santa Cruz...and while I will get to that its really the day before I left that I need to blog about...I made my 1st blog entry about this trip late Sun night/early Mon morning...I had so much to do seriously about 85 things on 4 different to do lists (CHOC, TT, Home/Family & Op Smile Prep) creating those lists was the last thing I did before I went to bed. I only got about 3 hours of sleep that night & was running late but knowing that SO MANY things stood between me & boarding the plane I stopped that morning & prayed that I would be "helped" in getting thru all that needed to be done cause I knew I couldn't do it alone - despite feeling tired I felt peaceful & knew I would be taken care of.
I had a nearly full day of work at CHOC in front of me....& about 20 things on that to do list - I did 2 of them on the way to work...& went straight to a mtg - at the mtg I went to pull out the lists & cross those 2 things off & the lists weren't in my pocket - I really did panic - those lists were my "brains" & what would get me out the door the next morning I excused myself from the mtg hung onto that peaceful feeling from the morning & retraced my steps believing I would find the lists...in the stairwell of the parking structure leading to my car I found the lists which must have came out of my pocket when I pulled my phone out (Tender Mercy #1). I had several back to back mtgs & told my asst some of the things on my list - as I finished a few mtgs she came in & had taken care of 3 or 4 things - activating my phone, getting handouts for a lecture I will be doing here etc etc (Tender Mercy #2) I was able to leave CHOC by 3:30 with everything on that list done.
A friend in Boise was sending me dresses to take & they hadn't arrived & were mailed a week before when I got home there they were (Tender Mercy #3) Once I was home I decided if I was going to get everything done I needed a "power nap" I slept from 5-6 & when I woke up felt energized & ready to go I gave myself from 6-9 to pack & that was a challenge as I stuffed the suitcases with all that I had bought or been given to bring here (dresses, blankets, beanies, toys, etc) - I could have 51 lbs a bag & they were very overweight & I decided I would just pay the fee & when I spoke to the Dr I'd be travelling with from LA about meeting at the airport in the morning she told me she was in business class & could check a 70 lb bag - so Id check one of hers & she"d check one of mine - after packing & repacking with Dougs help & weighing them at least 10 different times - we got everything in w/ one bag at 50 lbs & another at 70 lbs (Tender Mercy #4). By 10 pm I needed to stat of my store list (TT) deposits, notes, emails etc & that took me til midnite, then I needed to start on the home/family list & I was going at the list line by line feeling totally awake & positive the entire time until I went to bed at 2:45 am (Tender Mercy #5) there is NO WAY i could ever stay up that late on such little sleep the night before & feel so positive & be so productive without heavenly help - needless to say despite how late it was & that I'd only get 2 hours of sleep I stopped to offer a prayer of thanks before I went to sleep. The alarm was set for 4:45 - I got up 2 hours later, got ready feeling good & got the the airport & met Gayle & checked our luggage & went to our gate. At that point I KNEW that the prayers of friends who I knew were praying for me that day plus my own prayers were answered & I had really been carried through that time for everything to fall into place to get me out the door (Tender Mercy #6)
I slept a few hours on the 1st flight - had a row all to myself (Tender Mercy #7) had an hour layover & an uneventful 2nd flight & arrived in Bolivia at 1 am We had to go thru immigration, get our luggage & then go thru customs & yes when I pushed the customs button I got a red light meaning all my luggage was o be inspected but the inspector only looked thru 1 of my4 bags - the one with all the stuff I brought After seeing what I was bringing for the children of his country he didn't even open the others & let me go thru (Tender Mercy #8). By the time we got to the hotel & got checked in it was about 3:30 am - we took an hour to unpack a bit & get settled & went to bed at about 5: 30 a.m. Bolivia time.
We slept til noon then got going & since this was one of only 2 days we have any time Gayle & I went into Santa Cruz to see what we could Bolivia is larger than Texas but has only about 1/6th of the population that is in LA County - Santa Cruz is the most populated but even that is sparse. There is a typical "Center of Town" that includes a central park & is bordered by Govt buildings & a church. LOTS of people sitting in the town square. Quite a bit of poverty is evident but we felt safe. Gayle speaks fluent Spanish so that was a huge help. The taxi driver that took us to town from the hotel (a $2 fare) just ended up staying with us for the 4 hours taking us different places including a traditional Bolivian restaurant - we ended up paying him at his request only about $20 for all he did...
We had our team mtg tonight - as always the team seems great - a mix of Bolivians & international. Our wake up call is 5:30 every morning with the bus leaving for the hospital at 6:30. The next 2 days will be screening for patients & they expect we will screen 200 children tomorrow AND..I was asked to be one of the "Gatekeepers" again (I did this in Kenya) so 1 other nurse & I will review every patient to be sure they have had everything done & score them for prioritize base on all the findings & the Drs recommendation - its a BIG job so I better get to bed!
Sorry this post is so long...but i needed to mostly remind myself that YES I AM SUPPOSED to be here & all those tender mercies were clear reminders to me! Oh one last thing...my cell phone isn't working so well but I have great Wi Fi in the hotel & have been able to get onto all the websites I need to for CHOC & otehr responsibilities I have to keep up on plus I signed up for a month of free Skype international calling so I got to talk to all my kids except Kimmi today :( plus Doug, plus CHOC & TT....I have complete peace of mind & can focus on the task at hand here :) Good Night - wake up call is in 5 hours!
I had a nearly full day of work at CHOC in front of me....& about 20 things on that to do list - I did 2 of them on the way to work...& went straight to a mtg - at the mtg I went to pull out the lists & cross those 2 things off & the lists weren't in my pocket - I really did panic - those lists were my "brains" & what would get me out the door the next morning I excused myself from the mtg hung onto that peaceful feeling from the morning & retraced my steps believing I would find the lists...in the stairwell of the parking structure leading to my car I found the lists which must have came out of my pocket when I pulled my phone out (Tender Mercy #1). I had several back to back mtgs & told my asst some of the things on my list - as I finished a few mtgs she came in & had taken care of 3 or 4 things - activating my phone, getting handouts for a lecture I will be doing here etc etc (Tender Mercy #2) I was able to leave CHOC by 3:30 with everything on that list done.
A friend in Boise was sending me dresses to take & they hadn't arrived & were mailed a week before when I got home there they were (Tender Mercy #3) Once I was home I decided if I was going to get everything done I needed a "power nap" I slept from 5-6 & when I woke up felt energized & ready to go I gave myself from 6-9 to pack & that was a challenge as I stuffed the suitcases with all that I had bought or been given to bring here (dresses, blankets, beanies, toys, etc) - I could have 51 lbs a bag & they were very overweight & I decided I would just pay the fee & when I spoke to the Dr I'd be travelling with from LA about meeting at the airport in the morning she told me she was in business class & could check a 70 lb bag - so Id check one of hers & she"d check one of mine - after packing & repacking with Dougs help & weighing them at least 10 different times - we got everything in w/ one bag at 50 lbs & another at 70 lbs (Tender Mercy #4). By 10 pm I needed to stat of my store list (TT) deposits, notes, emails etc & that took me til midnite, then I needed to start on the home/family list & I was going at the list line by line feeling totally awake & positive the entire time until I went to bed at 2:45 am (Tender Mercy #5) there is NO WAY i could ever stay up that late on such little sleep the night before & feel so positive & be so productive without heavenly help - needless to say despite how late it was & that I'd only get 2 hours of sleep I stopped to offer a prayer of thanks before I went to sleep. The alarm was set for 4:45 - I got up 2 hours later, got ready feeling good & got the the airport & met Gayle & checked our luggage & went to our gate. At that point I KNEW that the prayers of friends who I knew were praying for me that day plus my own prayers were answered & I had really been carried through that time for everything to fall into place to get me out the door (Tender Mercy #6)
I slept a few hours on the 1st flight - had a row all to myself (Tender Mercy #7) had an hour layover & an uneventful 2nd flight & arrived in Bolivia at 1 am We had to go thru immigration, get our luggage & then go thru customs & yes when I pushed the customs button I got a red light meaning all my luggage was o be inspected but the inspector only looked thru 1 of my4 bags - the one with all the stuff I brought After seeing what I was bringing for the children of his country he didn't even open the others & let me go thru (Tender Mercy #8). By the time we got to the hotel & got checked in it was about 3:30 am - we took an hour to unpack a bit & get settled & went to bed at about 5: 30 a.m. Bolivia time.
We slept til noon then got going & since this was one of only 2 days we have any time Gayle & I went into Santa Cruz to see what we could Bolivia is larger than Texas but has only about 1/6th of the population that is in LA County - Santa Cruz is the most populated but even that is sparse. There is a typical "Center of Town" that includes a central park & is bordered by Govt buildings & a church. LOTS of people sitting in the town square. Quite a bit of poverty is evident but we felt safe. Gayle speaks fluent Spanish so that was a huge help. The taxi driver that took us to town from the hotel (a $2 fare) just ended up staying with us for the 4 hours taking us different places including a traditional Bolivian restaurant - we ended up paying him at his request only about $20 for all he did...
We had our team mtg tonight - as always the team seems great - a mix of Bolivians & international. Our wake up call is 5:30 every morning with the bus leaving for the hospital at 6:30. The next 2 days will be screening for patients & they expect we will screen 200 children tomorrow AND..I was asked to be one of the "Gatekeepers" again (I did this in Kenya) so 1 other nurse & I will review every patient to be sure they have had everything done & score them for prioritize base on all the findings & the Drs recommendation - its a BIG job so I better get to bed!
Sorry this post is so long...but i needed to mostly remind myself that YES I AM SUPPOSED to be here & all those tender mercies were clear reminders to me! Oh one last thing...my cell phone isn't working so well but I have great Wi Fi in the hotel & have been able to get onto all the websites I need to for CHOC & otehr responsibilities I have to keep up on plus I signed up for a month of free Skype international calling so I got to talk to all my kids except Kimmi today :( plus Doug, plus CHOC & TT....I have complete peace of mind & can focus on the task at hand here :) Good Night - wake up call is in 5 hours!
Monday, March 12, 2012
SO I'M OFF TO BOLIVIA in about 30 hours - YIKES!
Back in Nov. I got a call & was asked to join another Operation Smile Mission - this time to Santa Cruz Bolivia...and like Kenya this one would be 2 weeks. I checked with Doug & my family - found out I'd miss St Patricks Day (a pretty big tradition at our house) and a Church Spring Formal Dance for Sarah (she said it was okay & we have been able to get her dress etc & I have a friend to take pictures - thanks Wendy) then I checked w/ my work at CHOC & got the okay to be gone, talked to my store manager & other TT friends who will keep the store going, prayed about it & felt like it was the right time & place for me to go & serve once again... so I said YES!!!
Fast forward 4 months...now in addition to what I knew I would have to juggle I am planning a June wedding reception for Ryan (my son) & his darling fiance Kya who got engaged at Christmas, I am crazy busy at CHOC with all the Magnet work I do, there seems to be a million things to do around the house, its the 15th Anniversary month at my store with all sorts of events & I am working at CHOC tomorrow, have to go to the dentist to have a permanent crown put on & have 3 different to do lists & packing that needs to be done before I get in the car on Tues at 5 am to head to the airport.
I have to say a few times since January I have wondered...am I really supposed to go??? should I cancel this one - there will be more & so many nurses are on the waiting list to go. BUT everytime I get that same answer & a peaceful feeling that to me means yes you are supposed to go. Then I get all stressed out again & ask again & get the same answer. So it is really FAITH that propels me out the door on this next mission - and knowing that I will be helping 125 children get new smiles & changing their lives & helping their families. Going out of my comfort zone is hard for me - even when it has such a great purpose...but we all have to do hard things & this hard thing will be very rewarding I know!
Here's what I know so far....we are going to Santa Cruz Bolivia - it is a 12 hour flight for me. I fly from LAX to Panama then Panama to Bolivia. The weather is supposed to be hot (80-90 degrees) day & night & humid. It looks like we are staying in a nice place in apartment type suites with 5 to a room so I will quickly make some new friends :) We will have to travel 30 min by bus to where we will have our "hospital" which probably means 5 am wake up calls & on the bus by 6 then the recovery room crew (me) is often the last to leave so hopefully back by 9 pm? It is a very international team of about 45 coming from the USA (CA - me, a Dr & a resident, FL, WA, MA, UT, OR, VA, OK) Canada, Sweden, Bolivia, UK, Spain, Uruguay, Italy & I don't know any of them but I am flying with a Dr from LA so that is nice!
We will be a 5 table mission (so we have 5 Plastic Surgeons & Anesthesiologists) with a objective of 125 cleft lip or palate surgeries - about 25 a day on avg. Wed is when everyone arrives, Thurs & Fri are screening days when we will see all the hopeful patients. Saturday we will set up the OR's & recovery room - we were told we'd have 1 OR room from the "hospital" where we will set up 2 OR tables & then we will set up 3 more in what is their "Recovery Room" & them my group will actually create a Recovery room from a patient room? I am envisioning small with room for 3 beds I hope. We will also provide the local nurses with some education on Sat so I am giving a 45 min lecture on Pediatric Resuscitation (with a translator of course!). I was just asked to do that yesterday so it will be my in flight project! Sunday will be the team bonding day :) Always FUN! Then surgeries Mon-Fri with take down on Fri & team dinner Fri night & everyone starts to leave on Sat.
Once again the children & people of Bolivia will be greatly blessed by some wonderful friends of mine....one suitcase is almost full with fleece blankets, knit beanies, T shirts, toys, stuffed animals & I am expecting some pillowcase dresses too! I have hit the dollar aisle at Target & the clearance racks at Kohls & am THRILLED that I can bring all of this with me to give to those in need....
I am setting my morning alarm for 5:30 tomorrow & thinking it may be an "All-Nighter" tomorrow night but I wanted to get this started....so keep me & the entire team I will work with in your prayers, also my family who I know will be fine but I still think its hard to be minus a mom for some things. If you're interested I will keep you all posted as best I can.
Nancy
Fast forward 4 months...now in addition to what I knew I would have to juggle I am planning a June wedding reception for Ryan (my son) & his darling fiance Kya who got engaged at Christmas, I am crazy busy at CHOC with all the Magnet work I do, there seems to be a million things to do around the house, its the 15th Anniversary month at my store with all sorts of events & I am working at CHOC tomorrow, have to go to the dentist to have a permanent crown put on & have 3 different to do lists & packing that needs to be done before I get in the car on Tues at 5 am to head to the airport.
I have to say a few times since January I have wondered...am I really supposed to go??? should I cancel this one - there will be more & so many nurses are on the waiting list to go. BUT everytime I get that same answer & a peaceful feeling that to me means yes you are supposed to go. Then I get all stressed out again & ask again & get the same answer. So it is really FAITH that propels me out the door on this next mission - and knowing that I will be helping 125 children get new smiles & changing their lives & helping their families. Going out of my comfort zone is hard for me - even when it has such a great purpose...but we all have to do hard things & this hard thing will be very rewarding I know!
Here's what I know so far....we are going to Santa Cruz Bolivia - it is a 12 hour flight for me. I fly from LAX to Panama then Panama to Bolivia. The weather is supposed to be hot (80-90 degrees) day & night & humid. It looks like we are staying in a nice place in apartment type suites with 5 to a room so I will quickly make some new friends :) We will have to travel 30 min by bus to where we will have our "hospital" which probably means 5 am wake up calls & on the bus by 6 then the recovery room crew (me) is often the last to leave so hopefully back by 9 pm? It is a very international team of about 45 coming from the USA (CA - me, a Dr & a resident, FL, WA, MA, UT, OR, VA, OK) Canada, Sweden, Bolivia, UK, Spain, Uruguay, Italy & I don't know any of them but I am flying with a Dr from LA so that is nice!
We will be a 5 table mission (so we have 5 Plastic Surgeons & Anesthesiologists) with a objective of 125 cleft lip or palate surgeries - about 25 a day on avg. Wed is when everyone arrives, Thurs & Fri are screening days when we will see all the hopeful patients. Saturday we will set up the OR's & recovery room - we were told we'd have 1 OR room from the "hospital" where we will set up 2 OR tables & then we will set up 3 more in what is their "Recovery Room" & them my group will actually create a Recovery room from a patient room? I am envisioning small with room for 3 beds I hope. We will also provide the local nurses with some education on Sat so I am giving a 45 min lecture on Pediatric Resuscitation (with a translator of course!). I was just asked to do that yesterday so it will be my in flight project! Sunday will be the team bonding day :) Always FUN! Then surgeries Mon-Fri with take down on Fri & team dinner Fri night & everyone starts to leave on Sat.
Once again the children & people of Bolivia will be greatly blessed by some wonderful friends of mine....one suitcase is almost full with fleece blankets, knit beanies, T shirts, toys, stuffed animals & I am expecting some pillowcase dresses too! I have hit the dollar aisle at Target & the clearance racks at Kohls & am THRILLED that I can bring all of this with me to give to those in need....
I am setting my morning alarm for 5:30 tomorrow & thinking it may be an "All-Nighter" tomorrow night but I wanted to get this started....so keep me & the entire team I will work with in your prayers, also my family who I know will be fine but I still think its hard to be minus a mom for some things. If you're interested I will keep you all posted as best I can.
Nancy
Sunday, March 11, 2012
Final thoughts on Tlaxcala Mexico Mission
I thought I should finish up some final thoughts about this mission since I am heading off to a new one. When I'm on a mission I jot down notes during the day so I wont forget things but...I didnt really do that on the "Team Day" so I am relying on my memory - 5 months later that's a little scary.
The team day festivities weren't going to start until noon so Katrin & I took off about 9 in the morning & went exploring. we found a really HUGE market area that was just amazing & full of all sorts of sights & smells. There were probably 100 different people selling fruit, vegetables, beans & grains, fish & meats & cooking alot of that & selling it too. we also found some little craft places on the side of the market & wandered all around..almost missing the bus!!!
For our team day they took us to Huamantla - a "Magical City" about an hour outside of Tlaxcala. The Rotary Club sponsored the day for us & there were big banners hanging in the town square when we arrived that were Thanking the Operation Smile Volunteers. They had a VERY FULL day planned for us...it was an opportunity to experience some of the culture in the area. We started out a a presidential palace that was beautiful then walked to the National Puppet Museum that has been visited by renowned Puppeteers from all over the world. It was started by 2 brothers in 1837 & was really cool - some of the early puppetry originated here & it was really neat to see. They had a full orchestra of puppets set up, or wedding parties or presidential parades - it was very elaborate. we also went to The Plaza de Toros - one of the oldest bull rings in the area & a Bullfight museum luckily but there was but no bull fighting today...we also visited a BEAUTIFUL OLD CATHOLIC CHURCH built in 1528 - the oldest church in Tlaxcala. It was HUGE & amazing...lots of gold & stained glass, several statues of the holy family & saints, there was several smaller side chapels or areas & in one a baby was being baptized & in another a very old couple were kneeling in there praying....it was my favorite site of the day :). As we exited the church to meet up again in the town square there was a whole Quincenera Party walking thru the 15 year old girl in a beautiful dress with all her friends in purple...it looked like a wedding party!
The rotary people arranged for an "ice cream cart" to come & serve us a snack mid morning & then they took us to a very pretty meeting hall (I think it belonged to the Rotary Club) where they served us a traditional Mexican. We took LOTS of photos and really had a fun time. I spent the day w/ Katrin & Christoph (our PACU team) & Neils one of the Anesthesiologists who pretty much does this full time. We had some shopping time & I found some treasures to remind me of my trip & some for friends & family too. BY the time we got back to the hotel it was almost 8 pm & there was a small open air market near the hotel open until 9 so we went over there & then ended the night. My flight home was at 8 am but since we had an hour ride to the airport & they wanted us there 2 hours early I was on the 4 am shuttle....Some were gathering in the bar so I went in & said my goodbyes & went off to pack...
This mission went so fast...I met some really amazing people & we left many children with new smiles & helped some families who needed just that....a few memories of Mexico....Stoplights are "optional" people drive a little crazy, there were dogs howling every night - I would have sworn they were running thru the halls of the hotel! Plus since it was almost independence day there were huge sounds that seemed like BOMBs going off all night - fireworks or firebombs! and green/white/red everywhere. I loved the cobblestone streets & the walk each morning to the hospital. Another great experience...THANK YOU Operation Smile!
The team day festivities weren't going to start until noon so Katrin & I took off about 9 in the morning & went exploring. we found a really HUGE market area that was just amazing & full of all sorts of sights & smells. There were probably 100 different people selling fruit, vegetables, beans & grains, fish & meats & cooking alot of that & selling it too. we also found some little craft places on the side of the market & wandered all around..almost missing the bus!!!
For our team day they took us to Huamantla - a "Magical City" about an hour outside of Tlaxcala. The Rotary Club sponsored the day for us & there were big banners hanging in the town square when we arrived that were Thanking the Operation Smile Volunteers. They had a VERY FULL day planned for us...it was an opportunity to experience some of the culture in the area. We started out a a presidential palace that was beautiful then walked to the National Puppet Museum that has been visited by renowned Puppeteers from all over the world. It was started by 2 brothers in 1837 & was really cool - some of the early puppetry originated here & it was really neat to see. They had a full orchestra of puppets set up, or wedding parties or presidential parades - it was very elaborate. we also went to The Plaza de Toros - one of the oldest bull rings in the area & a Bullfight museum luckily but there was but no bull fighting today...we also visited a BEAUTIFUL OLD CATHOLIC CHURCH built in 1528 - the oldest church in Tlaxcala. It was HUGE & amazing...lots of gold & stained glass, several statues of the holy family & saints, there was several smaller side chapels or areas & in one a baby was being baptized & in another a very old couple were kneeling in there praying....it was my favorite site of the day :). As we exited the church to meet up again in the town square there was a whole Quincenera Party walking thru the 15 year old girl in a beautiful dress with all her friends in purple...it looked like a wedding party!
The rotary people arranged for an "ice cream cart" to come & serve us a snack mid morning & then they took us to a very pretty meeting hall (I think it belonged to the Rotary Club) where they served us a traditional Mexican. We took LOTS of photos and really had a fun time. I spent the day w/ Katrin & Christoph (our PACU team) & Neils one of the Anesthesiologists who pretty much does this full time. We had some shopping time & I found some treasures to remind me of my trip & some for friends & family too. BY the time we got back to the hotel it was almost 8 pm & there was a small open air market near the hotel open until 9 so we went over there & then ended the night. My flight home was at 8 am but since we had an hour ride to the airport & they wanted us there 2 hours early I was on the 4 am shuttle....Some were gathering in the bar so I went in & said my goodbyes & went off to pack...
This mission went so fast...I met some really amazing people & we left many children with new smiles & helped some families who needed just that....a few memories of Mexico....Stoplights are "optional" people drive a little crazy, there were dogs howling every night - I would have sworn they were running thru the halls of the hotel! Plus since it was almost independence day there were huge sounds that seemed like BOMBs going off all night - fireworks or firebombs! and green/white/red everywhere. I loved the cobblestone streets & the walk each morning to the hospital. Another great experience...THANK YOU Operation Smile!
Saturday, September 10, 2011
3rd & Final Day of Surgery - this went fast!
It is hard to believe that the "mission" part of the mission is over - it went sooooo much faster than Kenya - partially because it was a 4 hour flight instead of a 24 hour flight, only a 2 hour time change from Calif., and 2 less days of surgery...I enjoyed this mission alot - it was very different from Kenya in some ways & much the same in others.
Differences: the hospital, supplies & equipment here were alot nicer & more plentiful, I didn't have as many "traumatic type patients or experiences" in Mexico as I did in Kenya...
Similar: The days were just as long & we worked just as hard, the patients & families were still very poor & in desperate need of the medical care & just as humble & grateful for our care, the teams most of whom only met on arrival worked so well together all in behalf of the kids, AND...once again I had experiences that confirmed to me I was supposed to be here this week - for my own learning & growth & hopefully to also touch lives.
Today was a little bittersweet....in the morning we took our team picture in front of the hospital & then went up to the post op ward to check on the kids from yesterday. Again I got to see some sweet patients & take some pictures. We also checked on Rosa...I was happy to hear that her mom Juana had gotten some sleep on the hospital floor on a blanket while the grandma (her mother in law) was there with the baby. The nasal trumpet we put in was fine but we needed to see how she would do if we took it out & she didn't do well at all. The nasal tube was replaced & a decision made to bring her back to surgery today & see if the plastic surgeon could do anything to improve her ability to breathe well on her own. Before that thought we had a full schedule of patients & the first round on all 5 OR tables were all babies so I was able to give away almost all the baby clothes I brought & the ones I had left over I gave to the nurses who had babies or grand babies :)
We took lots of pictures today of the team, patients , with the Mexican local team, with our translators & that was fun. Rosa came down about 2 pm & we got her settled on the table & all was well & I went out for a break - I was only gone about 15 min when I was found in the break area & told to come back things weren't going well with Rosa - the surgeons tried all maneuvers to help her to breathe but her nose passages were just too tight & for the last 2 days she had been working to breathe & hadn't had many calories in IV or by mouth so she was weaker & that caused some problems too...in the end they ended up placing & sewing in nasal trumpets (airways) into both nostrils & then also Intubating her (putting a breathing tube in) & I came back as we needed to take her to the floor under the care of a Local NICU Nurse. Juana - Rosa's mom was in a heap on the floor, it was a chaotic transfer, their "NICU ventilator & equipment" was soooo old (like 25 years old stuff I remember from when I graduated from Nursing school - but at least they had it), & their practice is just much more simplistic. Christoph (the Intensivist & I ) tried to get as much in order to our liking as we could but ultimately at this point we had to turn the care over to the local team. The plan is just to keep her sedated & on the ventilator overnight then take the breathing tube out in the morning & she will go home with the nasal airways in & be followed by Dr. Blas the local Plastic Surgeon here who runs a Cleft Lip/Palate Clinic at this hospital. So not every Op Smile mission patient gets the fairytale ending to their story & I was really sad that this was happening to Rosa & more upset that her sweet young mom had to go thru this. I was able to spend about an hour with her after everything got settled but still my heart was broken for her - I just wanted to bring them both home with me & get them more advanced care & some emotional support - it was a tearful good bye.
Luckily after that I went back down to the Recovery room & we still had about 10 patients to go & our very last patient was absolutley darling - 5 year old Jesus. He had a pretty big surgery & rough go of it post op in the recovery room so he was with us for about 2 hours (most are only there 30 -60 min). He needed alot of oxygen & we needed to get that down so he could go to the floor - I stood by his bed & told him "respire profundo con mi" (Deep breathe w/ me) & he tried so so hard - even if I moved to get something he would keep breathing so well. Finally we got him to a good level & were ready to go & as we were wheeling him out he noticed the white Operating room hat her wore into surgery & he must've thought he needed to wear it out so he put it on himself...it was so darn cute. Katrine & I got a picture of the 2 of us with him in the hallways before they took him upstairs. That end to the day was perfecto! & it was coupled with a baby being born in the one Operating room we left open for deliveries - hearing that cry of a healthy newborn was magical :)
Hard to believe it is over...I still need to process some things. I miss being away from my family but one week was lots easier than 2 & I definitely was to go again...I just have no idea when or where - I guess wherever I am needed & where I am sent. Clearly my blog is inadequate in expressing the miracles that occur as surgeries happen & children's lives are changed....how blessed I am to witness this & be a part of it! I also know that God loves his children all over the world & answers their prayers as I have myself seen it happen at home, in Kenya & now In Mexico & I know it happens everywhere everyday
Tomorrow is our "team day" it should be fun & mostly I am just excited that I wont be getting a 5 :30 am wake up call!
Differences: the hospital, supplies & equipment here were alot nicer & more plentiful, I didn't have as many "traumatic type patients or experiences" in Mexico as I did in Kenya...
Similar: The days were just as long & we worked just as hard, the patients & families were still very poor & in desperate need of the medical care & just as humble & grateful for our care, the teams most of whom only met on arrival worked so well together all in behalf of the kids, AND...once again I had experiences that confirmed to me I was supposed to be here this week - for my own learning & growth & hopefully to also touch lives.
Today was a little bittersweet....in the morning we took our team picture in front of the hospital & then went up to the post op ward to check on the kids from yesterday. Again I got to see some sweet patients & take some pictures. We also checked on Rosa...I was happy to hear that her mom Juana had gotten some sleep on the hospital floor on a blanket while the grandma (her mother in law) was there with the baby. The nasal trumpet we put in was fine but we needed to see how she would do if we took it out & she didn't do well at all. The nasal tube was replaced & a decision made to bring her back to surgery today & see if the plastic surgeon could do anything to improve her ability to breathe well on her own. Before that thought we had a full schedule of patients & the first round on all 5 OR tables were all babies so I was able to give away almost all the baby clothes I brought & the ones I had left over I gave to the nurses who had babies or grand babies :)
We took lots of pictures today of the team, patients , with the Mexican local team, with our translators & that was fun. Rosa came down about 2 pm & we got her settled on the table & all was well & I went out for a break - I was only gone about 15 min when I was found in the break area & told to come back things weren't going well with Rosa - the surgeons tried all maneuvers to help her to breathe but her nose passages were just too tight & for the last 2 days she had been working to breathe & hadn't had many calories in IV or by mouth so she was weaker & that caused some problems too...in the end they ended up placing & sewing in nasal trumpets (airways) into both nostrils & then also Intubating her (putting a breathing tube in) & I came back as we needed to take her to the floor under the care of a Local NICU Nurse. Juana - Rosa's mom was in a heap on the floor, it was a chaotic transfer, their "NICU ventilator & equipment" was soooo old (like 25 years old stuff I remember from when I graduated from Nursing school - but at least they had it), & their practice is just much more simplistic. Christoph (the Intensivist & I ) tried to get as much in order to our liking as we could but ultimately at this point we had to turn the care over to the local team. The plan is just to keep her sedated & on the ventilator overnight then take the breathing tube out in the morning & she will go home with the nasal airways in & be followed by Dr. Blas the local Plastic Surgeon here who runs a Cleft Lip/Palate Clinic at this hospital. So not every Op Smile mission patient gets the fairytale ending to their story & I was really sad that this was happening to Rosa & more upset that her sweet young mom had to go thru this. I was able to spend about an hour with her after everything got settled but still my heart was broken for her - I just wanted to bring them both home with me & get them more advanced care & some emotional support - it was a tearful good bye.
Luckily after that I went back down to the Recovery room & we still had about 10 patients to go & our very last patient was absolutley darling - 5 year old Jesus. He had a pretty big surgery & rough go of it post op in the recovery room so he was with us for about 2 hours (most are only there 30 -60 min). He needed alot of oxygen & we needed to get that down so he could go to the floor - I stood by his bed & told him "respire profundo con mi" (Deep breathe w/ me) & he tried so so hard - even if I moved to get something he would keep breathing so well. Finally we got him to a good level & were ready to go & as we were wheeling him out he noticed the white Operating room hat her wore into surgery & he must've thought he needed to wear it out so he put it on himself...it was so darn cute. Katrine & I got a picture of the 2 of us with him in the hallways before they took him upstairs. That end to the day was perfecto! & it was coupled with a baby being born in the one Operating room we left open for deliveries - hearing that cry of a healthy newborn was magical :)
Hard to believe it is over...I still need to process some things. I miss being away from my family but one week was lots easier than 2 & I definitely was to go again...I just have no idea when or where - I guess wherever I am needed & where I am sent. Clearly my blog is inadequate in expressing the miracles that occur as surgeries happen & children's lives are changed....how blessed I am to witness this & be a part of it! I also know that God loves his children all over the world & answers their prayers as I have myself seen it happen at home, in Kenya & now In Mexico & I know it happens everywhere everyday
Tomorrow is our "team day" it should be fun & mostly I am just excited that I wont be getting a 5 :30 am wake up call!
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