Saturday's Team Bonding/On Baby Watch/Red Carpet LATE Dinner/Baby Drew!

So the Friday night team mtg was really an overview of the Champion Program. The first site was Rwanda & now Guatemala - so it is a very new program and in the development phase. These mtgs tend to go a bit long & then dinner is even later one of the many things I have forgotten about missions after not having been on one for 2 1/2 years, Still it is a really wonderful organization & I love being apart of it.

I was a bit distracted knowing Sarah was supposed to go in to the hospital for her induction between 6-9 pm based on "open beds" but by 10:30 pm when I was ready for bed she hadn't been called yet but at 11 pm she was headed in - I knew nothing would happen over night so I was ready for a good nights sleep. I woke up to some text updates & stayed pretty connected to my phone all day.

This morning we all got Covid tested & we will test again I believe. Masks are required indoors everywhere. Today the team leaders had a meeting with the local university about the partnership and the rest of us had a team bonding day in Antigua a colonial city about 90 minutes away. I had gone to Antigua 9 years ago when I was on an Op Smile mission here so once we got there the town square & a beautiful cathedral from the 1500's  looked familiar along with the very primitive cobblestone roads. One of the Op Smile Guatemala Board Members Carlos & his girlfriend Maida & her son Denzel were our "Tour Guides" & really showed us a wonderful day. 

On arrival I was reminded that I was not "mission ready" as I needed to use a restroom & hadn't put my own toilet paper in my backpack - fortunately someone else had some & I was well stocked on hand sanitizer :). We first saw the old buildings from the 1500's & wow what history...then we went to a market & Maida (who is an attorney) was quite the "barterer" for anything we wanted to buy. I forgot how mountainous Guatemala is - we drove up  a really steep windy road to see the famous Volcano Agua  that towers over Antigua that I had not seen last time - it was really pretty & then we planned to go to a restaurant on a cliff but our van couldn't make it up the road!!! So the local volunteers suggested we go to Pollo Campero...a fried chicken chain restaurant & we did,,,not quite the cliffside restaurant but fun getting to know each other. I had been getting updates from Kelli all day about Sarah's labor progression & was wishing I was there while knowing all was being taken care of. We arrived back at the hotel at 4:40 & had a team mtg at 4:45 where we were also supposed to be ready for a "fancy dinner". we all took 10 min to at least change clothes. 

The "meeting" went from 5:30-7:30 & we were supposed to have left at 6:30 but time seems relative, We went over all the new charting system which allows Op Smile to collect more data, do more research & have a dashboard re. theory outcomes. It has only recently been used so we spent alot of time reviewing it & then there was a BIG presentation about this Guatemala Champion program, their values, pillars & goals - it was actually quite inspiring. We loaded buses after the mtg & went to a very fancy restaurant where they greeted us on a red carpet & background w/ all of our names on it & a photo op. It really was quite nice. They gave us our team shirts to wear for screening tomorrow & a fanny pack. Dinner was slow to come out & we were not done eating until 10 pm...so my table of friends & I got on the first bus back about 10:15. 

BY this time Sarah was at the point she had been pushing for an hour or so & I didn't want to bug them for info but was also anxious to know how things were progressing & just after 10:30 Kelli test me to say he was here & Sarah did great! They had some skin to skin time so we didn't get his info until later & his weight was 5 lbs 14 oz & 18.5 inches long born at 10:32. Drew Jordan Jackson. 

In the first phot I got of him on Sarah's chest he looked SOOOO TINY (& in the Kuehner/Kraus family we do not have tiny babies). Later in other pics he looked a little bigger but since her was born at 37 weeks he will be in preemie diapers & clothes for a little bit, While I was not there she had amazing support from Kelli at the hospital who having just given birth to Ford a year ago was probably a much better resource than my experiences > 25 years ago. Then Kelli had Kya's help as she watched Ford so Kelli could be at the hospital. So so blessed by family love & support. I Facetimes Sarah before I went to bed & felt such a relief that all had gone well.

Tomorrow is screening & hospital set up...I really need to pull out of the crevices of my brain all that it takes to be in mission mode!!!

Made It To Guatemala- Good things are already happening

 It's been a busy week w/ longer than normal hours at work & lots to do at home in order to be ready to leave. I had my bag packed & downstairs before I left for work yesterday which was my goal so that there wasn't a last minute "packing frenzy". I always LOVE the little "tender mercies" that become part of the plan you never knew about...Monday morning I was not on the CHOC Covid Command center call where they said we had some items that were donated in Oct 2020 & per the hospital guidelines after 2 years are "expired for CHOC use" (even though they aren't really expired?) & what could we do with them....I got texts from 2 people during the call who knew I was headed out on this mission; so I immediately messaged Ambra the program coordinator to ask if they could be of use on this trip AND she was AT THAT SAME TIME on a call w/ the in country team in Guatemala talking about supplies and YES  in this 3rd world country they are grateful for anything . So Tuesday after work I did some "shopping" in the CHOC storeroom for "expired items" & got about 1000 adult masks, 500 pediatric masks, 30 containers of Hand sanitizer gel & foam, probably 30pkgs of sanitizing wipes, 50 pair of goggles, & a box of Face Shields. Doug helped me pack them in a duffle a friend had given me several months ago & all that was 37 lbs so on Thursday I "shopped" some more & added more masks, more gel & wipes to get closer to the 50 lb weight limit...it will be a HUGE blessing to the people of Guatemala-all for  a $40 2nd bag fee. :)

Yesterday before I left for the airport I called Donald Morales who is a local Guatemalan leader from my church who live outside Guatemala City. I told him I had some generous funds for humanitarian & church member support. He said there are several young men & women who want to do service missions in Central & South America but they do not have money to cover the $30 passport fees or enough clothing to take with them or even suitcases.  They are ready & willing to serve but need support. He is meeting me at my hotel after he is off work tonight - it was the only time that we could match schedules  & while I might not be able to go shopping w/ them or even meet all of them he is going to tell me about them & facilitate giving the financial support to these young men & women because of the generosity of followers of Christ in my congregation in California thousands of miles away. 

So my flight last night was delayed by an hour but we were already on the way to the airport so I arrived at LAX at 9:45 for my now 1:15 am flight. I went to the Delta Lounge to wait & it was quite nice, had some good food & gave me a chance to relax. Matt the Peds Anesthesiologist from Salt Lake City was connecting thru LAX and he arrived at 10:30 so we visited for about 90 min & then went to the gate where we met up w/ Reza the Caraniofacial Surgeon from UCLA - a super nice guy who has been to Guatemala often with Op Smile & other NGOs. He lives 20 min from LAX so he strolled in just before boarding :)

I have always been annoyed that Doug can sleep anywhere/anytime & especially on airplanes. So I channeled my "inner Doug" & once in my seat - I took a melatonin gummy, put on my sleep mask, pulled out my pillow & blanket & I was asleep before we took off. I woke & repositioned but slept pretty well until they said we were descending into Guatemala City...so a good 5 hours of sleep I think?

The 3 of us got thru customs, got our luggage & met Monica who was there from Op Smile Guatemala to take us to the hotel which is nice. My roommate was going to be Dusty Clegg who I roomed with in Nicaragua (where she got locked in our bathroom!) so that was nice to be with someone I know but an Op Smile friend who hasn't seen her in many years wanted to room with her & was in a private room & asked if I would switch - works well for me as I have some CHOC work & mtgs today. ) I ventured out to the local mini mart to get a stash of Coke Zero (no diet coke here) & realized how bad my Spanish is; perhaps that should be a goal if I will be coming here regularly

We were given some info on the area that I am including for my own "memories" as it reminds me why I am here. Guatemala is the largest country in Central America w/ a population of 15 million. Half the population lives below the poverty line & have no access to healthcare. In the US cleft conditions are repaired in the first few months of life in Guatemala there are thousands of people of all ages birth to adults who are living w/ Cleft Lips or Palates & have very very limited access to any healthcare. Op Smile estimates 10,000 clefts in children <14 years of age. In this country there are 3.6 surgeons, anesthesiologists and OB's per 100,000 population - WAY below the basic WHO recommendation of 20 per 100K & only 4 hospital beds per 100K people. Aside from clefts 47% of children her have stunted growth & development (6th highest in the world) because of malnutrition & there is a 25% child mortality rate...trying to wrap my head around 1 in every 4 babies born does not make it to age 5 years. The needs here are immense & that is why this work is so important. I am told that Escuintla where we will do surgery is a very impoverished area. SO that all takes me back to "MY WHY"...WHY do I or have I traveled far from home to be in rural countries with such poverty & lacking the basics we take for granted (clean water, electricity, plumbing etc) & WHY do I use my PTO to go to places like this instead of just on vacations? & WHY I/do I miss important events from high school dances to baby/bridal showers, wedding receptions, gatherings w/friends & even this time the birth of a new grandbaby...BECAUSE I have always felt that Nursing was more that my "work" it is my talent or gift from God, it is at the very core of who I am, I have regularly felt pulled or called to help...at home, abroad, wherever needed and so I go & here I am. I feel so grateful & blessed for these opportunities, for the humble patients & people I meet, the like minded team members also here serving, the friends & family at home who encourage & support me & this work in so many ways - especially w/ their love & prayers. I am SO HAPPY to be back doing this work & while this trip will be different with smaller numbers of surgeries, it is the enduring changes that we will be making that will matter. This time I can also make an impact on the future of healthcare in Guatemala by training & mentoring nurses here - it will help me come full circle. 

I was working remotely most of they day & texting with the Hruskas about the service needs & they said they were nearby & did I want to go to lunch. That was such a fun surprise. They are Houston neighbors & friends of our friends the Packs & we had a really nice visit. They shared stories of their experiences here the past 2 years that were really interesting & inspiring-it is a tale of two cites a small percent of wealth supposedly from drug money & a majority of poverty. When I got back from that visit Donald Morales came by...what an amazing man. He is one of 9 children in a Guatemalan family raised in the Church of Jesus Christ of LDS and called to be a Bishop/Minister of a congregation at age 24 1 week after his wedding. Then at 29 he was a counselor to the stake or larger diocese in Guatemala for 10 years & now has been helping to lead missionary work here for 10 years. What a life of service to his fellowman. He has seen the church grow exponentially here & says Guatemala is full of good Christian people, He shared wiht me his plans for the money I gave him...the missionaries we spoke of yesterday, a family that needs shoes (that story was touching) & a father who needs some shirts because he uses all his income for his families needs, He will be in touch w/ me re. the details.

Tonight was a meet & greet dinner to get to know the team & mentees. It will be very low key & focued on teaching while doing some Cleft Lip surgeries. My "airplane sleep" is catching up to me so I am heading to bed.

Good Night from Guatemala City! 

Tonight is the team meeting & dinner so I am going to take a lil rest & will finish this post later.

Heading to Guatemala City on Thursday – excited for Operation Smile Mission #17

It's been awhile since I have blogged I wasnt sure if my blog was still here...

***Reminder this blog is my “journal” so this entry has a lot of what may be “boring details” of how this opportunity came to be – feel free to skip or speed read!

It has been 2 years & 8 months since my last Operation Smile Mission….with Covid all international missions were stopped & when they re-started mission in late 2021 they used more “locally trained” and “in country team members” in all specialties. I have been anxious to get back to my mission work. It fills a piece of my heart & soul that isn’t filled in any other capacity. Earlier this year I had several  “Mission Opportunities” that just would not work for a number of reasons…. Paraguay in March – but we were going to be in Maul, Madagascar in April but we had a wedding, Brazil in early June but the travel was over 36 hours & wasn’t going to work, Lima Peru the end of June also didn’t work. I was just recently considering Madagascar in Aug or Sept even though the travel would have been pretty horrendous. 

Then unexpectedly on June 7^th I got a voice message from someone I thought was “Sandra” about a “long term opportunity in Guatemala” that involved mentorship & education". She said she was on vacation in Italy but was trying to reach me specifically for this. I replied back to “Sandra” that I am very passionate about mentorship & nursing education & I had been to Guatemala in 2013 & loved the people there, but I am still working full time at CHOC & couldn’t consider a “long term opportunity”.   I said I had been hoping for a mission & could do shorter missions & would love to chat with her more, but I was leaving on a girl’s trip to Nashville the next day & with the time difference perhaps we could talk the following week. As I sent that reply via WhatsApp & then realized I had that phone # already in my contacts & it was AMBRA not Sandra who left the voice message…. Ambra was a program coordinator who I had been on 2 missions with in India & knew well. I quickly sent another message apologizing for not realizing it was her on the voicemail.  With the time difference she replied the next day when I was already in Nashville & said the “long term commitment” was actually short programs 5-10 days max but a long term commitment to a team to come back & work with the same mentees for 3-5 years. She said it was called a “Champion Program” & that was her new role at Operation Smile, that it was complicated to explain via text & we would talk after June 14^th. I told her that would be workable for me & an AMAZING opportunity & I was definitely interested & we would chat then.

So about 3 ½ weeks ago on June 14^th in the evening we spoke….the champion program has just been introduced by Operation Smile as a way to ensure sustainable programs & surgeries in different parts of the world…they just did this program in Rwanda & now will do it in Guatemala. It is a “hub & spoke” program. The main hospital in Guatemala City is the hub & then we will go out to surrounding cities (the spokes) & train people in these more remote areas throughout the country. The first place we are going on this trip is Escuinltla Guatemala…I have no idea where that is? My sister who teaches geography would be so disappointed in me!

There are 1-3 “USA Champions” for each of the roles on a typical team – in this instance a Medical Director, 3 surgeons, 3 anesthesiologists, 1 intensivist, 1 pediatrician, 1 clinical coordinator, 2 surgical nurses, 1 Recovery/Post Anesthesia nurse (that would be me), 2 pre & post op nurses, a night nurse, a child life specialist, a dietician, a Bio Med tech, Medical records, & translator. In some of these roles there are also Guatemalan partner champions who have done Op Smile Missions before & then 3 or so  mentees in each specialty, plus the Op Smile staff. So it is still a good size group of people. In order to be on this champion team you had to commit to the inaugural fact finding mission July 15-20. Before I could commit I needed to check on a few things I already had going on….a baby shower I was helping with, Sarah being pregnant & due on Aug 5^th, a Palm Desert trip w/ Kya & little girls & then getting off of work.

By the night of June 16^th I had all of that “figured out” and said YES!!!!! So I will be spending my birthday on July 16^th in Guatemala

We were traveling for July 4^th & I just got home today & now I am getting ready to leave in 4 days on a Red Eye – it’s coming fast. I truly feel like this was “meant to be”. It had been stressful for me trying to figure out if the “mission opportunities” would ever work out & the various travel. Now I know that I will go to Guatemala probably twice a year with a wonderful team of other champions who I will get to know better each trip & a Guatemalan team we will each mentor in our specialty. The travel is very manageable – a 6 hour flight direct from LAX to Guatemala city.  Plus, I just found out on July 4^th that a dear high school friend of mine has a friend who is doing missionary work in Guatemala City for the next 3 years – so I will be talking to her tomorrow & hopefully able to connect with her to do some humanitarian work each time I am there on a mission. What a blessing to not only help the patients & families but also others there. I love how God always has a “master plan” that we just don’t know about 😊 I have “sacred funds” from generous friends & I will simply try to be an instrument in Gods hands to help some of His children there – not only thru OSI but also thru my new connection Anita.

There was a “plot twist” this week, Sarah has had some pre-eclampsia & hypertension with her pregnancy & now they are going to induce her on the 16^th, The treatment for high blood pressure is delivery of the baby. She will be 37 weeks so I trust that baby & mom will do well but I would typically be right there at the hospital or nearby as she delivers so I had some angst. I could not back out of this commitment & Sarah totally understands but I did have a little heartache. She has some wonderful 2^nd moms in Utah plus Kya so I know all will be well. She may be in the hospital until the 19^th & I will fly directly to her on from Guatemala the 20^th. So I am getting a new grandson as the best birthday present ever!!!   

I am excited to get back to this important work of “changing lives one smile at a time” & also training nurses who can do this work in their own country…what a wonderful opportunity I have been given. I could not have planned a better OSI Mission #17. Now I need to get to packing & preparing to be gone again.

 

Agadir Day #9 Friday Nov 8th 2019 Final Day of Surgeries, Traditional Cous Cous Lunch & Final Party

So in 9 hours I board the first of my 3 flights & my 16 1/5 hours of travel home. I am happy to report that I feel I’m about 90% healthy & if I can be strategic about when I sleep on what flights hopefully I wont have too much jet lag!

I made it to the 6:30 am team meeting after missing it the last 2 mornings….it was a longer meeting since it was the last one, lots of Thank You’s by each team leader & we received our team shirts & took a team photo at the hotel before we headed to the hospital. I went to post op first and saw my sweet Youssef and his dad – they really might be my favorites from this mission. We took a selfie together that I will post on social media. Another boy in the same room also with a dad recognized me but I honestly didn’t recognize him – his dad wanted a photo of his son with me so I took one on my phone too 😊

There were 22 patients on the schedule today – all lip repairs. The first 10 were all smaller babies or toddlers which was perfect for the onesies I had left. My patient was an “age deviation” at 4 ½ months of age (typically they have to be 6 months) but she had been seen at the mission 6 months ago & her weight had gone down & they thought that her cleft lip & palate combination might be negatively contributing to her poor nutrition so that opted to do her repair & she also had (taped to her leg?) one of the obturators the dentists made with the tools we helped buy 😊 she was so sweet & so cute & her mama was so happy when I carried her back to her post op. We had the first 10 patients (one from each table) in by 11 so it was a bit of a slow start. The 2^nd patients on the tables were some older ones with a few interesting/sweet stories. One was a 13 year old girl who obviously came for screening & was scheduled & had to have come last night to stay over night (unless maybe she was local to Agadir) but the story was her mom didn’t tell her she was going to have the surgery until they arrived today. Not sure if she didn’t want her to be anxious or what but that was a new one. Also we did a lip repair on a 41 year old man who was over the moon GRATEFUL and told us in Arabic (via the local nurses) that now he can smile & be confident & not self conscious. He said his daughter was getting married in January and now he would be proud to be her papa in the photos.

Whitney who got whatever virus I got (together we think it was Tuesdays lunch) was worse off that me hydration wise so she came in the PACU for 2 liters of fluid & felt better afterwards. She & several other team members have flights scheduled on Lufthansa who went on strike Thursday night for supposedly 48 hours – everyone is watching closely to see if they return to flying tonight & the planes are in the right locations to get them home. THAT would be stressful…I LOVE, LOVE LOVE my mission trips but by day #5 of surgery I am ready to come home – which I why I have never added on travel after a mission. If I am going to travel I want to do it with family not op smile friends.

We finished by about 2:30 and packed up as much as we could along the way. The have Cous Cous here only on Fridays traditionally so we had that served family style for lunch – I have to admit I am a little gun shy of food; all I have had since Tues night is crackers last night & a piece of bread this morning. I tried a Kind Bar about 11 & that made my tummy rumble – perhaps not my wisest decision but Moroccan food was way out of my comfort zone. I went so that I was a “good team player” and ate only a little of the plain Cous Cous – so far so good.

They always have a big “Final Night Party” & the one for tonight was a BIG ONE as they celebrated the final mission of Morrocos 20 year celebration. The website looked fabulous, TONS of food, horses, Moroccan culture, Belly dancers, Fire Throwers & more…it reminded me of a combo of Midevil Times & a Luau but Moroccan style. The issue for me was I am still not eating a lot & the even had a departure from the hotel at 7 & return at midnite & I have to be in the lobby at 3:30 am for my flight. So I let Ambra know I wouldn’t be going. I might have a little FOMO as I see some of them add photos to the giant team WhatsApp but I am packed, showered, checked into my flights, it’s 9:30 & I plan to be in bed by 10 to get 5 hours of sleep. I will have a day of rest Sunday then be back at work on Monday & I didn’t want to start all of these flight not fully well & over tired – that is a sure recipe for disaster for me.  Whitney & I did go down the the beach behind the hotel & found some sorbet & a very mild pizza that worked for both of us & she even went to the party.

There is a pool at the hotel & I saw a woman in a full caftan/burka, leggings & head covering swimming…I had so many questions. Were these clothes different that the ones she wore in the day, different material? Specific for swimming? I wondered if other women also swam or this was a “one-off”. There was someone near me who clearly saw the perplexity on my face & had all the answers. Other call it a Burkini but I don’t believe the Muslims do & I hope that isn’t disrespectful to say. She sad she had seen a few other women in full clothing like that also swimming & actually it’s significant as in years past they were not allowed to swim – so I kinda wanted to cheer he on for just swimming her heart out & enjoying it so much. It has to be hard swimming with all that fabric no matter what kind it is – like when you get pushed in the pool with your clothes on & feel weighed down but I suppose the opportunity to swim was just delightful. I guess it is all about perspective…what I view as a challenging way to swim she views as wonderful.

My 12 days of travel might be seen as a lot like that…at least I hope it was…the missed flights, lost luggage, no luggage or belongings for 3 days, broken luggage on return, crazy 36 hours of sickness that continues to linger and the early mornings & late nights in the PACU could all be linked together & someone on the outside looking might think…why does she do this???(the same thought I had of the woman in the pool). She’s crazy these missions they are a lot of work & not in the greatest conditions or areas, why subject yourself to all of that, or that doesn’t seem enjoyable, or even that’s a lot of bad luck in a short period of time, or a long way to travel or why not a “real vacation” (trust me lots of people have asked these at various times). And even today someone asked me if you knew ahead of time you were going to have all of these challenges would you still have come & the answer was & ALWAYS will be YES…. Just like my friend at the pool it’s perspective & my perspective of all of these mission trips is that it is truly an honor to serve my brothers & sisters all over the world whenever I am given the opportunity. MY servants heart is full, I have loved, cared for, ministered to, laughed with & shared tears with wonderful people in Morocco these past 2 weeks & even knowing ahead of time I would have all these challenges I would have said yes let me come please!!! Until my next opportunity OSI Mission #16 is in the books & I likely wont blog about my travel home unless I need to document any new crazy just for my posterity – but lets hope not!

Agadir Day #8 After 36 tough hours I had a successful re-entry to the PACU & was back at the hotel by 9 pm – let me tell ya those are some miracles!

So even though I felt better I didn’t want to have a recurrence of yesterday so I paced myself by walking to the lobby then resting a bit there before leaving the hotel to be sure I was good to go. I am getting good ay\t hailing Moroccan cabs. The larger white/yellow/black cabs are plentiful in front of the hotel & want to take 3-4 people on longer rides. I have to look for the small orange colored Peugeots that specialize in 1-2 people rides – I have no idea why? It is 20 Dirham (just over $2) to get to thehospital. Some drivers ask for 30 & I confidently tell them is has been 20 all week – if they quickly agree I then pay them 30 – it’s a dollar for heavens sake!

Some team members have had personal items taken from the hospital – I am watchful of my backpack as it has all my money & passport in it behind 3 zippers but today I put my “lifeline” sports bottle with just the right cocktail of liquid protein & crystal light on a chair when I went into change & 5 min later when I came out it was gone???

Th PACU team applauded my return & I felt the love, plus I am on call tonight so I think they were relieved!!! I am definitely grateful the PACU is in close proximity to the bathrooms & kept myself on my clear liquid cocktail all day/night. I did walk into the men’s bathroom once & quickly turned around 😊

I stepped right into patient care & really was able to keep up the pace – totally different from yesterday – still have the GI symptoms but I feel good. Ibrahim from Egypt asked me about the 2 digital forehead thermometers I brought that we are using – he said they are so good for missions & are they expensive. Knowing he makes about $20 for each 12 hour shift & I bought them on Amazon for $35-40 I said “Don’t buy one take mine! My name is on them so you can always remember me LOL”

Whitney (child life) had my same symptoms & stayed at the hotel today & you won’t believe what happened. At 3 pm she text the student & child life team (I am an honorary member from our camel ride day) saying that the housekeeper at the hotel came in her room & in some mode of communication she knew Whitney was with Op Smile & said that her nephew had a lip repair from another organization & needs it redone – he covers his face at school because he gets taunted & bullied. Whitney Whats-App messaged Ambra our PC & Ambra said sent him down & he was added on to todays schedule  - she sent us the name & photo so we could look out for he & he was a little scared it all was happening so fast. So Youness had surgery today & was such a trooper. If that isn’t divine intervention with Whitney at the hotel sick I don’t know what is….

I had lots of cute toddler age kids today – Ramen was a sweet girl. I gave her my last “therapy doll” that a friends sewing class made & she held it & wave to me as she left the PACU. Melted my heart! On a not so fun note we had a patient with pretty nasty lice come thru, they discovered it in the OR & triple capped her. I didn’t take care of her but between that & the small army of cockroaches that greeted us when we arrived & turned on the lights Tues morning I think I will be less frustrated with my intermittent ant problem at home (1^st world issues).

At 5 pm we had 12 patients left to come back to PACU which did not seem bad since I think 10 of them were lip repairs. At 7 we were down to 4 patients 3 on the schedule & one that went back for bleeding. So everyone left except for me & Sallam from Saudi Arabia since we were both on call. The boy with the bleeding was so cute & was her with his dad which is so unusual. Often the dads are here but it is the moms with the kids in post op & during the entire screening & surgery process. He was the sweetest boy & so cooperative as we tried to stop the slow oozing but couldn’t & when we told his dad he needed to go back for a quick cautery he was clearly concerned. So when Youssef came back the 2^nd time his dad just put his head down in prayer & Sallam told me he was offering thanks to God (or Allah maybe?). It was both touching & humbling and is such a reminder that parents are parents no matter what ethnicity they are, country they live in, financial status etc. we all want & often pray for the best for our children. I had not taken care of him for his initial surgery today I only met them because he had to return to surgery. In the hour we spent together in the PACU just me & him & Sallam & David I found out thru the chart & Sallam that he was a single dad from far away (36 hours drive) & he had saved for a year to get his son transportation to Agadir. He was the very last patient in PACU to go to post op I gave him all the Dirham I had left in cash to use for travel & whatever needs they might have. His eyes filled with tears & he asked Sallam ”How did I know” & then my eyes filled with tears & I left him in post op – perhaps I will see him in the morning…I don’t know.I felt like this was a tremendous need I might never have been aware of if I wasn’t on call. So for now I have spent my “sacred funds” from friends & together we have been minor miracle makers for some families. Certainly, if something comes up tomorrow I can give some of my American dollars.

There are only 22 on the schedule tomorrow – all lips so hopefully we are out by 2 or 3, then it is the final party which I will likely only go to briefly as my flight home begins at 0500 Saturday morning. It is hard to believe this mission is almost over. As Doug said to me in a text it has brought me some unique challenges with my missing luggage for 3 days & my 36 hour intense illness. But we say in our family “Kraus’ can do hard things” and I needed to live that motto this week & be resilient & faithful & hopeful in the difficult times. I am also so thankful for the many people who I know were praying for me & the entire team for these 12 days. When I was “down” I pictured so many family members & friends praying for me & knew I would ultimately be okay.  I am a VERY BLESSED person – to have these opportunities to serve & grow and help make a difference in strangers lives – it fills my cup and is why I became a nurse to “Learn the Healers Art” which is the BYU College of Nursing Motto & then the University motto is “Enter to Learn-Go Forth to Serve”. I am so grateful for my nursing education at BYU and the Foundation it laid for my life personally & professionally.

It is 10 pm & I am going to bed & will hopefully post this in the morning – Good Night from a much healthier Nurse Nancy!   

Morning update – I went to bed at 10 & hadn’t had meds since 11 am. At 2 am I woke up a bit sweaty & nauseous but no chills. I wasn’t sure if it might be because I hadn’t really eaten in 48 hours. I took Zofran, Tums & had some crackers. Thankfully I went back to sleep and now its time to start the LAST DAY of surgeries!

Agadir Day #7 My Health Update & Some More Opportunities for Good 😊

So this is REALLY more of a health update & some wonderful opportunities that were presented to me in the 5 hours I was at the hospital. As I said in yesterdays post I decided to go in & arrive at 10 am. The problem was that by the time I did the ¼ mile walk to the front of the hotel & the ¼ mile walk from the front of the hospital to the recovery room I was totally spent of all my energy. I changed into my scrubs & went in but ALL the PACU team said I looked terrible & told me to lay down which I didn’t resist. They had only gotten 5 patients back from surgery when I got there and sadly there were already 8 cancelations of kids who were sick ☹ That is always so heartbreaking knowing they may have traveled from afar & now they will have to wait 6 months until the next mission somewhere in Morocco.

I slept for 90 min then got up when there were LOTS of crying babies & took a patient. As long as I sat down on the bed with them I did fine. I lasted about 3 ½ hours & took care of 4 patients then felt the wave of nausea again& told the PACU team I needed to “tap out” – in hindsight I think it comes about every 5 hours as my meds (Tylenol, Zofran, Tums) wear off. I went to sit at the “desk” area & one of the child life team came with a 5 year old who was frightened of any type of medical device. Peter wanted her temperature taken so I decided to show her it didn’t hurt by taking mine & taking the Child Life persons too – after that she willingly let me take her temperature & I told her I would be here when she woke up she was #205 & unfortunately that didn’t happen because when I had taken my temp with them her’s was fine & mine was 39 C (103F). So Peter got involved in my care & so did Chris & they said I looked terrible. Honestly I was pretty miserable  – again it had been since 9 am that I took meds & he had me take Tylenol, Zofran, Tums & added a Z Pack starter. TBD if I need to continue and sent me back to the hotel. I knew my roommate would be sleeping & didn’t want to disturb her so I asked Shauna if I could go in her room as she has a 3^rd bed & only 2 people. It’s a bit concerning that the front desk just gave me a key to her room without asking for my name or anything.

I slept in there for 3 hours til Shauna got home at 6:30 then went to my room to sleep. Like clockwork at 8 pm I woke up with the worst chills again so much that I couldn’t even open up the gauze that was taped up & had my Zofran in it but I finally got it opened & medicated myself. Hedde & Chris came to check on me & then David called an hour later & dropped off more meds. At 1 am it was the same routine I had bad chills as my temperature was rising the got all sweaty as it went down & I medicated again then slept pretty well til 6 & at that time just took my meds before the symptoms returned. I had promised Hedde & Chris that if I felt better I wouldn’t go in until noon & David called again this morning to check on me – so nice!!! And told me to come in at 1 so that is my plan to go in between 12 & 1.

This morning I have had 2 bouts of diarrhea & I actually think that is better to get the virus (or whatever it is out of my system) I do feel better, was able to shower & get dressed & rested without the need for instant sleep so I think I am on the mend! About 5 other people have the same symptoms including Shauna & Whitney who stayed back today.

In the few hours I was there I was able to close the loop on a few needs. The dental team had heard I had some funds & asked me Tuesday if I would consider buying 2 tools that need to make obturators (think retainers) in smaller children. We are doing A LOT of palates (about 30/day) & there were more that were too young to be scheduled. They had their lips fixed but need to wait until the next mission to get their palate fixed. An open palate impacts eating, speaking etc. They did not have the proper tools to make the smaller obturators so I happily said yes. They got the 2 tools & gave me the receipts (not that I needed them) & I gave them the Dirham to pay for them & the tools will stay with OSI Morocco for future missions. I think the dentists usually bring all their own tools. Also I found out that some families had challenging travel home & the PC’s were resistant to me giving the money for that because how do they determine who should get it among so many families? So I gave money Terry my roommate from  Post Op & told her that as they sent people home & saw how far they traveled to just shake their hand & give them the Dirham & tell them they are loved. This morning Terry said it was like they got to be Santa Claus & the families were so appreciative. I continue to pray to be guided to my Moroccan brothers & sisters who need a little help that I can provide thru generous friends.

So I am about to go into the hospital & hope I can last the full day – I am supposed to be on call tonight but I know that someone would cover me if needed.

2 Fun Facts Re. Morocco – there are Cats all over the hospital – walking the halls & outside. I have been on missions where they are stray dogs around the hospital but I don’t remember cats??? Apparently, people don’t have pet dogs here & there are animal people from other countries that come in to neuter the dogs so there are not so many on the streets. They have cats as pets in their homes (& I guess at the hospital) because the cats rid the houses of snakes, scorpions & rats. I’m not sure of that makes me feel better or worse that there are so many at the hospital?   

Also unlike the US where most of the poverty exists in the bigger cities (homelessness etc) here in Morocco those with the greatest poverty live away from the cities in small villages so that is why our patients travel from so far away. So it is a bit opposite the US I believe

Agadir Day #6 & the 2nd day of surgeries…. It was a great busy day & then 5:30-9:30 was really intense!

So I failed to mention that yesterday Samia got a migraine so her friends & the PACU docs took care of her most of the day & Luca one of the Anesthesiologists I know….maybe from Bolivia? did acupuncture on her. She came back today but rested on a bed & then we sent her home…poor girl ☹ We were down a nurse yesterday & today but did fine.

When we arrived at the hospital I went to post op to see a few of my “special patients”. I saw Ghita & her mom & her mom stood up & hugged me tight & said “thank you forever”’. Those moments are truly humbling. I also saw my 2^nd special patient with the palate repair & that mom said to me “I will always remember you & your bright smile. She took a photo of me & the baby & I took a few too but cant post them if it shows their incisions etc – out of respect.

Gayle found out the that post op patients were all supposed to go home on antibiotics & some on iron. In other missions that is provided to them but not here in Morocco…it seems a little risky assuming that they will all go get those so Gayle & I talked about what we even do at CHOC – “med to bed” which is that the discharge medicines are given to you when you leave. I asked Ambra if we could do that & just buy the meds…for all remaining patients it may only be about $150-$200 to impact everyone so I talked to Ambra about it today & I think it will work. I am again so thankful to be able to provide simple but necessary things. It is $1.50 to $2 a person & seems insignificant to us but it is significant to them. So this little miracle provided by friends is Moroccan Med to Bed!!!

They got the first 9 pre-op patients on the table quickly – I don’t know what the delay was with the 10^th table but it gave me the opportunity to go out & meet another sweet mother Fatima whose daughter Yassine was patient #161 & she was getting a cleft lip repair. This mom too was anxious & again thru the interpreters I explained my role & told her I would care for Yassine. She actually wanted to give me her name & phone number & told me to come visit her! Right after she went in to the OR & no patients were back in the PACU yet they brought up the next 10 patients in the 2^nd spot of the schedule. This time I got on the floor & played with the kids & another youg mom was taking all sort of pics of me & fortunately so was Whitney. I told her too that I would be with her little boy Imrane who was a year old. She tearfully told me thank you & kissed my cheeks. I do know the Arabic word for thank you & try to use it often myself. It is the only word I know :/

My first patient in PACU was Adam who I remembered from screening – he was 6 months old & I was sure to get him a onesie. We typically just take the next patient coming out if we don’t have a patient & somehow thru divine intervention I did get to recover both of those babies & walk them back to their moms in Post Op. I checked today & post op is .25 miles away from PACU so .5 miles round trip. We have to walk each of our patients back to give handoff to the nurses there & with a minimum of 6 patients I am at 3 miles in my steps just there.

There are a few people on the team who are sick with vomiting & diarrhea – so glad its not me & I don’t eat much food aside from m own – but since Peanut butter sandwiches are my dinner when I get home I did eat the yummy Tanjine today at lunch. For the most part I feel like I am working with a A+ team most of whom they hand selected. There are a few locals who prefer to socialize instead of work but maybe this is their chance to connect with friends so they take very long coffee breaks & lunches.

At 4:30 I took a patient to post op & then I was really dragging. They told me to go to coffee after & I talked to Gayle & my coffee break was a 25 min power nap in their crash bed – I needed that & may make that a habit the next 2 days. I got back to the PACU at 5 pm & it wasn’t “swamped” not everyone had a patient. At that time we had 10 more patients to come out  I actually thought we might be done by 8 pm. I took the next patient who was a palate & was next to Angelica who had a baby with a complex history. The child was a 4 year old boy Walid who was to have a palate repair but his tonsils were too big & were blocking the palate needing repair. I don’t know the whole story but there was an ENT here who went in & removed the tonsils then the Plastic Surgeon repaired the palate. Again no idea of the why but in the 30 min I was there he was going into respiratory failure...he looked like the videos of kids in the Peds Advanced Life support class slides. I helped Angelica give a respiratory treatment but to no avail – he was head bobing to breath, had chest retractions & his lips were blue. His oxygen saturations went to to 80-85 so we gave steroids & another treatment without much success. We had to MacGyver a rebreather mask for him with peep with an Ambu bag & that finally helped bring his sats up. Angelica is a clinic nurse so she let me basically be the nurse for the resuscitation that lasted almost 4 hours until 9:30. We drew a blood gas & gathered all of the emergency equipment so we could go a few buildings over to get a  chest xray. Ibra was sitting behind him holding him in an upright position & securing the oxygen while I did all the meds, treatments etc. By 8 pm after A LOT of interventions he ended up starting to turn the corner…all of this was ABSOLUTELY a Moroccan Miracle…with an English speaking intensivist for closed loop communication it made sense to have an English speaking resuscitation nurse & that was me. These situations always make me ask some “what ifs” and then confirm that I was exactly where I needed to be right next to that patient. By 9 pm he was drinking & talking & off oxygen. It had been 3 ½ intense hours. Rania & Angelica are on call tonight so I gave them both handoff report & then headed to the hotel & got there just after 9:30. There was another patient that had some mild bleeding they were taking back to the OR so they left Walid & his mom there until they decided what to do. The mom was holding him when this all started then we had her step out & brought her back in when he was stable & he even drank water for her. This could have gone in several other very bad ways & I am so grateful it did not. The mom thanked Ibra & I profusely. Then as I walked out of the PACU into the hallway this man grabbed my shoulders & it was his dad -  he had been watching thru the open door, saw us fieldtrip to Xray with all of our emergency equipment & asked if his son was good. I assured him yes & he gave me a huge hug.  I will never see this family again or the other 2 special families that I cared for today but all that matters is I did what was needed in the moment. I am physically & mentally exhausted & headed to bed at 11 pm. Will post some pics on social Media now & this blog in the morning. Good night family & friends.

PS So the physically exhausted was a little more – I went to bed & was FREEZING as in I put on socks & my jacket over my pj’s.  I didn’t think much of it until my phone rang after midnight & when I got up I was super nauseous & dizzy. So much so that I couldn’t even stand up to try & find any medicine. I went back to bed & when My alarm went off at 5:45 I was still nauseous & very dizzy – so much that I couldn’t even stand up to put water & liquid protein in my sports bottle. So I sat on the bed to do that & text Ambra that I was just nauseous & dizzy but hadn’t vomited or had any diarrhea but I needed a few more hours to rest & see if I would feel better. I went back to sleep until 7:30 and had been sipping on my protein water when I woke up. Terry got back from night shift about 8:30 so she found my Tums, & gave me some Zofran for the nausea. I stayed in bed until 9:30 then was okay to get up. I also had a horrific headache so I took Tylenol. I got ready slowly & took it slow on the ¼ mile walk from my room to the hotel lobby. I attribute it ALL to the lunch I ate at the hospital yesterday – so no more Moroccan food for me…. It’s 10 & I will take a cab to the hospital so I can “get back to work” All prayers accepted for my improved health today!