I ABSOLUTELY LOVE Op Smile missions but I have decided they are alot like Childbirth you sort of forget how hard it is until once again you are in the thick of it...like on day 4 of 5 surgery days...
The night nurse (who is from CHLA) has the absolute hardest job of everyone - she was supposed to have another international team member who cancelled last minute so it has been her & a Bolivian volunteer who works a full time job then comes to volunteer at night. As you can imagine the volunteer needs a few hour nap in the night leaving Lorena with about 50 patients - the 25 from one day & 25 or so pre ops & a few hold overs...so Linda from the recovery room went to nights with her leaving Erika & I in the recovery room - but since Linda & I did it with 2 yesterday we figured we would be fine with 2 today & tomorrow.
The morning excitement (for some) or interruption (for others) was that "Miss Bolivia" came to visit & do a photo shoot...she was very nice but at the time she came in the PACU we had 4 "screamers" & it wasn't a pretty sight - oh well....it was a steady flow of patients today & less chaotic that yesterday - probably because we didn't lose a single IV :) HOORAY!!! I did however hang abut 30 new IV bottles - that was part of today's theme for me...not sure why but everytime I looked up an IV bottle was empty...we had some wild patients but typically not all at once.
The definite story of the day & perhaps the mission was Juan Jose - the little patient from La Paz with the low hemoglobin that Gayle got the team to add on. He was supposed to have surgery on Tues then got sick so we started him on antibiotics & weren't sure if he'd get better for surgery by Friday or not but he did & today was his day!!! A few more details to the story of mom's 30+ hours of travel...on that bus ride the reason it took so long was there were 2 roadblocks on their journey. At the first one many on the bus persuaded the driver to try a new route which would add time but they were all willing - so the driver complied. The 2nd roadblock however was later in the trip when many were tired or hungry & I think she said it was in the middle of the night & many were sleeping. The driver was going to turn around & Juan Jose's mom & I think a few other women were awake & asked the driver to let them try to clear the road. They spent several hours in the dark removing whatever it was blocking the road so they could continue their journey...talk about doing whatever it takes to remove the obstacles in our paths to achieve a goal...WOW!!! and they weren't even guaranteed that there wouldn't be another roadblock ahead....all I could think of was would I do that...do whatever it takes to get to my destination or would I be deterred??? What is my level of commitment to my ultimate goals??? what am I willing to do to make sure I achieve them & who else do I get to help me??? when I get past one roadblock do I muster up even more resolve to get past the next one or do I get discouraged???
When Juan Jose was passed "over the wall & into surgery" today we were all there taking pictures & she told us that she wanted to save her money so that he could become a Doctor & help people like we were doing...another tearful moment...when he came off the table about 90 min later the transformation was AMAZING!!! we knew his mom would be so happy with his new smile & couldn't wait to bring her in the recovery room - as expected she got very teary when she saw him & said - that is my baby? & she thanked & hugged everyone...that was one of my defining moments this mission. She also said "everyone in my town told me when he was born that I had an ugly baby but he was never ugly to me and now they will see he has always been beautiful" - another life lesson... It was a neighbor who told her about Op Smile & told her to come to Santa Cruz - her husband told her she was crazy & no one would give them surgery for free - that she was going on a crazy trip...we think that was why she couldn't have returned without the surgery or she would have been shunned & scorned even more....I am fairly certain I will never forget Juan Jose & his mom...before leaving tonight I had to take some supplies up to Post Op & saw her again - & he looked SO SO CUTE...I hope she & her son have a bright future the best they can in their world - some friends from church had give me $$$ to use as I thought best & I gave her somethings to help them on their journey.
I will share before & after pictures when I get home!
There were many other memorable patients today...a darling 1 year old boy with a sweet 18 year old mom & very sweet grandparents who were there with her - they asked if I was LDS & I said yes & they said they were too & were from about 10 hours away...it was busy when I was caring for them & discharging them from the PACU but I also saw them tonight & was able to help them on their journey - really others at home are helping them thru me. Near the end of the night we had some 12-16 yer old girls - they always remind me of my own kids & I often think of how these teenagers lives are changed in a one hour procedure...
I finished giving out all the dresses I had today - the last one was to the sister of our last patient & she was so excited to get it she put it on immediately & I got a picture :) I still have a few CHOC shirts & a few toys for tomorrow.
A few other things about the day. Gayle started the day fine but by 2 wasn't looking so good - we ended up starting an IV on her & I infused 4 liters of IV fluid (8 of the bottles I hung today). She is feeling better - a few others are down & I recognize how blessed I was to have such a mild case of whatever it is we are all getting! Claudia the Colombia pediatrician told me we are in a VERY DANGEROUS part of town...I knew it didn't look good & there are guards at the front of the hospital but when she said that she rides the bus to our hotel & then get a taxi from there it going an hour out of her way it was a bit of an ah ha moment for me...we are serving those who perhaps need it the most but I have felt safe.
Its almost midnight...I am tired....and tomorrow we have our final 20 patients plus take down. We are only doing lip repairs tomorrow no palates & also some are just local anesthetic...so hopefully we will be done & out by 5 or so. The final team party/dinner is at 7:30 & then Doug was able to change my flight from leaving at 2:30 am Sun morning to leaving at 2:30 am Sat morning (really just late tomorrow night) SO in 24 hours I will be en route to the airport & then a few hours later start my journey home...it seems unreal. But I am ready to be home, with my family, in my house & in my bed....after one more day....
Thursday, March 22, 2012
Wednesday, March 21, 2012
Feeling Much Better & a short day!!!!
So I woke up feeling MUCH better...however Gayle..not so much. seems like today it was her turn & Erika another Recovery Room nurse too. They both had exactly what I had maybe even worse!!! all day yesterday as I felt sick I just kept praying that I would get thru the day & I think I was blessed to do just that. I was scheduled to go on the later bus so the folks who arrived at the hospital 1st sent back Gatorade & meds for the "sickies" & I got Gayle settled before I left & didn't even know Erika was here sick!
Since Erika & Gayle stayed back that left Linda & me & Claudia a Colombian Pediatrician who now lives with her husband in Bolivia & regularly helps Op Smile on missions here. She was nervous to be in charge but she did great. We also had our 3 volunteers who each took a bed that they would "man" for basics while we did the medical care - BUT....it was a CRAZY day in there with alot of chaos. We decided it was a myriad of things - it seems that all the Palate repairs who came back had their nerve blocks wear off before they got to recovery so instead of coming to us somewhat sedated they came to us crying & screaming. These same kids we also decided were also the strong personality patients who fought just about everything we did & 5 of them managed to get their IV's out...which we had to restart usually with a team of 3. Isabella who at screening seemed like a delightful little girl was brought in by her surgery team & in Spanish they called her a wild devil child...I seriously gave her 4 doses of pain med in the span of an hour & she still screamed even after I brought her mom in to held her - the karma was definitely not working in our favor. Another patient lost quite a bit of blood & had a low blood pressure so I had to give some fluid boluses. Several had respiratory difficulties & I gave about 6 aerosol respiratory treatments, A few had fevers...is was as I sad a crazy day...and our volunteers...well I trained Villa on the fine art of pulling fluid from an IV bottle to help me with the 2 fluid boluses I had to give trained all 3 of them in holding/giving resp treatments & they all helped all of us with IV starts..so much for them "Manning a bed for the basics" they were a crucial part of he recovery room team & we took a picture of the PACU "Wednesday team" at the end of the day - one of the few pictures I took today & I didn't take many yesterday when I was sick so I have to make up for it the next 2 days!
4 patients were cancelled today because either they were sick or didn't return...so we only did 22 cases today & it was a miracle we were done by 6:30 & back at the hotel by 7. I had never left the hospital when it was still light. Rumor has it tomorrow will be a long day!
A few fun things...one of the patients from yesterday came back to "model" her dress for me (I did get a pic of her!) They have these great things Cunapes at breakfast every morning & often as a snack in at the hospital..they seemed like cheese rolls to me but today I asked Claudia about them she said they are made from yucca & queso (cheese) & butter - sounds fattening & probably is cause they are yummy. I had one today when i was feeling better.
Other things I have noticed...last night when I was getting home close to 9 pm I couldn't believe that on many corners there were young mothers usually with a toddler nearby standing who were selling fruit or other things on busy street corners. The streets are crazy & because they done have money for signals (except in the main big cities) all streets lead to roundabouts because that way you have to (in theory) slow down & merge - to me it seems like a big game of :Chicken" cause no one really slows or stops - its completely crazy!!! There are also ALOT more stray dog wandering the streets than I initially realized - especially in the barrios near the hospital. As you pass peopled 10x10 place of "business" electrician, vet, car repair - whatever it seems they all just stand or sit in the doorway waiting for a customer to come to them...and then as we left the hospital tonight there was a young girl cooking meat in a grill that was over a wheelbarrow w/ the fire portion in the wheelbarrow - I wish I had thought t take a picture of that....
Its already 10:30 & I want a good nights sleep for a busy day tomorrow but I was glad I got to make some phone calls via Skype to my family & my office at CHOC & TT..all is well in my absence & that allows me to focus on what I need to do here...Buenos Noches from Bolivia!
Since Erika & Gayle stayed back that left Linda & me & Claudia a Colombian Pediatrician who now lives with her husband in Bolivia & regularly helps Op Smile on missions here. She was nervous to be in charge but she did great. We also had our 3 volunteers who each took a bed that they would "man" for basics while we did the medical care - BUT....it was a CRAZY day in there with alot of chaos. We decided it was a myriad of things - it seems that all the Palate repairs who came back had their nerve blocks wear off before they got to recovery so instead of coming to us somewhat sedated they came to us crying & screaming. These same kids we also decided were also the strong personality patients who fought just about everything we did & 5 of them managed to get their IV's out...which we had to restart usually with a team of 3. Isabella who at screening seemed like a delightful little girl was brought in by her surgery team & in Spanish they called her a wild devil child...I seriously gave her 4 doses of pain med in the span of an hour & she still screamed even after I brought her mom in to held her - the karma was definitely not working in our favor. Another patient lost quite a bit of blood & had a low blood pressure so I had to give some fluid boluses. Several had respiratory difficulties & I gave about 6 aerosol respiratory treatments, A few had fevers...is was as I sad a crazy day...and our volunteers...well I trained Villa on the fine art of pulling fluid from an IV bottle to help me with the 2 fluid boluses I had to give trained all 3 of them in holding/giving resp treatments & they all helped all of us with IV starts..so much for them "Manning a bed for the basics" they were a crucial part of he recovery room team & we took a picture of the PACU "Wednesday team" at the end of the day - one of the few pictures I took today & I didn't take many yesterday when I was sick so I have to make up for it the next 2 days!
4 patients were cancelled today because either they were sick or didn't return...so we only did 22 cases today & it was a miracle we were done by 6:30 & back at the hotel by 7. I had never left the hospital when it was still light. Rumor has it tomorrow will be a long day!
A few fun things...one of the patients from yesterday came back to "model" her dress for me (I did get a pic of her!) They have these great things Cunapes at breakfast every morning & often as a snack in at the hospital..they seemed like cheese rolls to me but today I asked Claudia about them she said they are made from yucca & queso (cheese) & butter - sounds fattening & probably is cause they are yummy. I had one today when i was feeling better.
Other things I have noticed...last night when I was getting home close to 9 pm I couldn't believe that on many corners there were young mothers usually with a toddler nearby standing who were selling fruit or other things on busy street corners. The streets are crazy & because they done have money for signals (except in the main big cities) all streets lead to roundabouts because that way you have to (in theory) slow down & merge - to me it seems like a big game of :Chicken" cause no one really slows or stops - its completely crazy!!! There are also ALOT more stray dog wandering the streets than I initially realized - especially in the barrios near the hospital. As you pass peopled 10x10 place of "business" electrician, vet, car repair - whatever it seems they all just stand or sit in the doorway waiting for a customer to come to them...and then as we left the hospital tonight there was a young girl cooking meat in a grill that was over a wheelbarrow w/ the fire portion in the wheelbarrow - I wish I had thought t take a picture of that....
Its already 10:30 & I want a good nights sleep for a busy day tomorrow but I was glad I got to make some phone calls via Skype to my family & my office at CHOC & TT..all is well in my absence & that allows me to focus on what I need to do here...Buenos Noches from Bolivia!
2ND DAY OF SURGERY 25 PATIENTS & why I didnt blog yesterday
No it's not because I got called in Monday night when I was on call - THANKFULLY I was NOT called in. Monday night I went to bed feeling fine but in the middle of the night I started feeling queasy & getting the chills - I was hot then cold. By the morning my stomach was rumbling but I was determined to push thru it cause after all there are only 3 of us in the recovery room. On the bus to the hospital I got a little worse not better & wondered if I was to get sick how exactly that would work sitting on a bus with about 30 other people...when I go the the hospital I told Gayle my symptoms (aside from being my roommate & the Dr in the recovery room she is also the "Team Dr") She gave me some meds & they offered for me to go back to the hotel - I said I'd see how it went as I thought I could work in the busy spurts we get and it sort of worked. I kept myself on clear liquids all day to rest my gut & also stay hydrated. A few times I got chilled & wrapped up in blankets but it passed. All day they told me I looked terrible but I said no I only feel a little bad...denial...yep I was in it...
The 1st patient of the day was Damian & once again I helped carry him (actually his stuff - IV & Chart) out to his mom & once again she cried & then Gayle & I cried...something about the 1st patient of the day???? so emotional....
As if being sick wasn't bad enough (If you have a queasy stomach move to the next paragraph) Craig one of the anesthesiologists came in to share with us in great detail how he went to intubate a patient (put the breathing tube in) & pulled out a worm!!! I left the room for that conversation - but it got worse...when "worm boy" came to recovery I told Erika there was no way I was helping w/ him & good thing cause as she was caring for him she kept seeing something in & then not in his throat & it was another worm that they took out - I seriously had to leave the recovery room....we did get meds to treat him for that but definitely not what my stomach needed on Tues!!!
Linda who is also in the recovery room said she knew I was sick cause I wasn't "dressing the patients" (with the dresses, hats & shirts I had!) But when I was in the hallway 2 little girls - siblings to a little boy having surgery were so stinking cute & so I called them to the wall between recovery & the "transfer hall" & gave them dresses - they were so excited. I also sent about a dozen dresses with the 2 students on this trip to take to a small orphanage for girls run by a sweet nun Sister Corazon (Sister Heart) - they said she was so appreciative & was going to save them & give them to girls on their birthdays as their "birthday outfit" (Cheri Spjute you are making a difference here in Bolivia!)
I have found it refreshing that it seems the very well to do (the Op Smile Board members with all the $$ & ranches & restaurants etc) are here with us at the hospital doing absolutely whatever is needed - mopping a floor, holding a baby, running to get me or anyone else something we need, etc) They definitely are not just for show - they may be very important people by day usually or off playing tennis etc but for these 2 weeks they put their time where their hearts really are & that is with the children & families of Bolivia most of whom are from very desperate circumstances. The entire "local team" has been amazing!!! Mercedes (the owner of the ranch we went to & her friends Villa & Sabe plan to be with us in the recovery room all week.
Another funny thing - I understand alot more Spanish that I speak but I know some Spanish & a few of the other nurses here are so impressed that I can ask a taxi driver to take us somewhere or tell him we will call him to pick up up or when I talk to some of the Bolivian nurses - they have no idea I am really talking Spanglish or Spanish at about a kindergarten level!!! I really wish I had spent more time on Spanish now!!!
Today was the day of "bleeders" & I had 2 of them - we had to call the surgeons in the re evaluate & do some other treatments & one actually went back into the OR (not mine)
I kept taking medicine & drinking water but by 8 pm when the final 2 cases were coming off their OR tables I was "done" & all was well so they sent me home - by the time I arrived my head was killing me so I took more Tylenol, emailed my family to say I wouldn't be calling, skyping or on Facebook then went to bed...fortunately you will see in my next post I woke up feeling much better - it was just a 24 hour thing...but it was a pretty miserable one!
The 1st patient of the day was Damian & once again I helped carry him (actually his stuff - IV & Chart) out to his mom & once again she cried & then Gayle & I cried...something about the 1st patient of the day???? so emotional....
As if being sick wasn't bad enough (If you have a queasy stomach move to the next paragraph) Craig one of the anesthesiologists came in to share with us in great detail how he went to intubate a patient (put the breathing tube in) & pulled out a worm!!! I left the room for that conversation - but it got worse...when "worm boy" came to recovery I told Erika there was no way I was helping w/ him & good thing cause as she was caring for him she kept seeing something in & then not in his throat & it was another worm that they took out - I seriously had to leave the recovery room....we did get meds to treat him for that but definitely not what my stomach needed on Tues!!!
Linda who is also in the recovery room said she knew I was sick cause I wasn't "dressing the patients" (with the dresses, hats & shirts I had!) But when I was in the hallway 2 little girls - siblings to a little boy having surgery were so stinking cute & so I called them to the wall between recovery & the "transfer hall" & gave them dresses - they were so excited. I also sent about a dozen dresses with the 2 students on this trip to take to a small orphanage for girls run by a sweet nun Sister Corazon (Sister Heart) - they said she was so appreciative & was going to save them & give them to girls on their birthdays as their "birthday outfit" (Cheri Spjute you are making a difference here in Bolivia!)
I have found it refreshing that it seems the very well to do (the Op Smile Board members with all the $$ & ranches & restaurants etc) are here with us at the hospital doing absolutely whatever is needed - mopping a floor, holding a baby, running to get me or anyone else something we need, etc) They definitely are not just for show - they may be very important people by day usually or off playing tennis etc but for these 2 weeks they put their time where their hearts really are & that is with the children & families of Bolivia most of whom are from very desperate circumstances. The entire "local team" has been amazing!!! Mercedes (the owner of the ranch we went to & her friends Villa & Sabe plan to be with us in the recovery room all week.
Another funny thing - I understand alot more Spanish that I speak but I know some Spanish & a few of the other nurses here are so impressed that I can ask a taxi driver to take us somewhere or tell him we will call him to pick up up or when I talk to some of the Bolivian nurses - they have no idea I am really talking Spanglish or Spanish at about a kindergarten level!!! I really wish I had spent more time on Spanish now!!!
Today was the day of "bleeders" & I had 2 of them - we had to call the surgeons in the re evaluate & do some other treatments & one actually went back into the OR (not mine)
I kept taking medicine & drinking water but by 8 pm when the final 2 cases were coming off their OR tables I was "done" & all was well so they sent me home - by the time I arrived my head was killing me so I took more Tylenol, emailed my family to say I wouldn't be calling, skyping or on Facebook then went to bed...fortunately you will see in my next post I woke up feeling much better - it was just a 24 hour thing...but it was a pretty miserable one!
Monday, March 19, 2012
1st Day of Surgery...27 new smiles!!!
It has been a LONG but wonderful day...we arrived at the hospital, had our mtg then our mock code & got started. We ended up reorganizing the Recovery room a bit for better access to our 4 gurneys & got our 1st patient about 9 a.m. Our 1st patient was Cristian a 10 mos old little boy with a cleft lip that I remembered from screening - he did great! Our set up is similar to Mexico - the parents pass their children over a half wall to go to surgery & when they are stable in the recovery room we either invite the moms in to hold them (especially if they are fussy) or if we expect it to be a quick lip recovery & they are resting well for the 30 min-1 hour they are there we just wait til they are ready to go to the post op ward & carry them out to their mom who sits in a wheelchair & hold them as they are wheeled up to the ward. Cristian was the first baby I carried out & when I handed him to his mom & she saw his repaired lip for the 1st time she burst into tears of joy...which of course caused me to get teary...it was a tender start to this 1st day :)
My next memorable patient was Adrian an 11 mos old boy from an Orphanage who weighed barely 11 lbs - the "matron" of the Orphanage brought him here & we all fell in love with him...he was "Everybodies Baby" & we showered him with clothes I brought a beanie & a blanket - it was hard to let him leave the recovery room & just broke my heart thinking of how he might grow up here - something that I am sure we never even think of in the States...
There were 2 Bolivian Nurses in the recovery room with the other 2 Op Smile Nurses (Erika Linda) & me
we are "credentialing them" - 3 missions are required so they be full volunteers - they were only with us from 7 am-1 pm but did great.
Another cutie was Luz - which translated means "Light" and you could see the light in her eyes when she smiled - we got her all "outfitted up" with a dress from my Friend Cheri in Boise & added a hair bow to - some of the surgeons accused us of "playing dress up" with the babies - we were just updating their wardrobe! Sebastian was another lover boy...& I remember him from screening too :) & got some photos of him.
We did 27 surgeries - they all went really well - no complications &as a team everyone worked really well together. One of the girls who is from the Op Smile office is sick so we treated her in the recovery Room with IV Fluids & 3 doses of IV Antibiotics & she is feeling a little better & hopefully is even better tomorrow.
My day ended much like it started - I am on call tonight so I got to leave at 8 in case I get called out (fairly rare) but the last patient I took care of before I left was Kristel a little 8 mos old cleft lip baby & when I took her out to her young mom she looked at her face - smiled, kissed Kristels forehead & started crying...and so did I....it is such a blessing to be able to have these experiences & be a tiny part of changing lives...I will never see these people again & most don't even know my name but I hope they feel the love & compassion I have for them. They are touching my heart & changing my spirit when I am in their presence
Good Night - cross your fingers I don't get called out - its 11 pm - so far so good!
My next memorable patient was Adrian an 11 mos old boy from an Orphanage who weighed barely 11 lbs - the "matron" of the Orphanage brought him here & we all fell in love with him...he was "Everybodies Baby" & we showered him with clothes I brought a beanie & a blanket - it was hard to let him leave the recovery room & just broke my heart thinking of how he might grow up here - something that I am sure we never even think of in the States...
There were 2 Bolivian Nurses in the recovery room with the other 2 Op Smile Nurses (Erika Linda) & me
we are "credentialing them" - 3 missions are required so they be full volunteers - they were only with us from 7 am-1 pm but did great.
Another cutie was Luz - which translated means "Light" and you could see the light in her eyes when she smiled - we got her all "outfitted up" with a dress from my Friend Cheri in Boise & added a hair bow to - some of the surgeons accused us of "playing dress up" with the babies - we were just updating their wardrobe! Sebastian was another lover boy...& I remember him from screening too :) & got some photos of him.
We did 27 surgeries - they all went really well - no complications &as a team everyone worked really well together. One of the girls who is from the Op Smile office is sick so we treated her in the recovery Room with IV Fluids & 3 doses of IV Antibiotics & she is feeling a little better & hopefully is even better tomorrow.
My day ended much like it started - I am on call tonight so I got to leave at 8 in case I get called out (fairly rare) but the last patient I took care of before I left was Kristel a little 8 mos old cleft lip baby & when I took her out to her young mom she looked at her face - smiled, kissed Kristels forehead & started crying...and so did I....it is such a blessing to be able to have these experiences & be a tiny part of changing lives...I will never see these people again & most don't even know my name but I hope they feel the love & compassion I have for them. They are touching my heart & changing my spirit when I am in their presence
Good Night - cross your fingers I don't get called out - its 11 pm - so far so good!
Sunday, March 18, 2012
Sunday in Santa Cruz....
It was somewhat of a low key day - our "team bonding" day they call it....we had breakfast at the hotel then at 10:30 went about 45 min away to a "ranch" that belongs to Mercedes - one of the Op Smile Bolivia Board of Director members (I really think everything is 45 min away from every other location?)
The ranch was 100's of acres...interestingly enough it is set up for entertaining but doesn't have a house on the property? It has beautiful grounds - a pet Macaw that lives in a tree, a sports field & a BEAUTIFUL HUGE Stable that houses about a dozen horses, plus 2 large horse rings - someone mentioned that the Bolivia Olympic Horse Jumping team trains here? & that is probably the case as there were photos of them in the barn & I think Mercedes son may have been on the team at some point.
We relaxed, they had caterers BBQ what seemed like >100 lbs of meat, they played Bolivian music, we ate & had a nice day...but it was pretty warm so it was nice to enjoy the pool. About 4 we played the "Name Game" - done on every mission & you really do learn everyones name which is helpful since we will be working so closely this week. After that we had our team mtg & specialty mtg.
There are 121 patients scheduled 25 each day Mon-Thurs & 21 Fri so it will be a busy week - wake up calls at 5:30 a.m. & I don't anticipate getting back to the hotel til 8:30 or 9 each night. I packed up my bags of stuff to give to the kids (thank you to so many friends!). Tomorrow 18 of the patients are boys & only 8 girls...funny how that is but we have lots of girls he rest of the week!
I am going to help Gayle with the mock code for all the team in the morning & then we will get started. I am excited for the work to begin - truly changing lives one smile at a time. It is such a blessing to be able to participate in this mission & I am ready to work :) Been gone 6 days...missing my family but so glad I have been able to Skype for calls & video....I will update tomorrow :)
The ranch was 100's of acres...interestingly enough it is set up for entertaining but doesn't have a house on the property? It has beautiful grounds - a pet Macaw that lives in a tree, a sports field & a BEAUTIFUL HUGE Stable that houses about a dozen horses, plus 2 large horse rings - someone mentioned that the Bolivia Olympic Horse Jumping team trains here? & that is probably the case as there were photos of them in the barn & I think Mercedes son may have been on the team at some point.
We relaxed, they had caterers BBQ what seemed like >100 lbs of meat, they played Bolivian music, we ate & had a nice day...but it was pretty warm so it was nice to enjoy the pool. About 4 we played the "Name Game" - done on every mission & you really do learn everyones name which is helpful since we will be working so closely this week. After that we had our team mtg & specialty mtg.
There are 121 patients scheduled 25 each day Mon-Thurs & 21 Fri so it will be a busy week - wake up calls at 5:30 a.m. & I don't anticipate getting back to the hotel til 8:30 or 9 each night. I packed up my bags of stuff to give to the kids (thank you to so many friends!). Tomorrow 18 of the patients are boys & only 8 girls...funny how that is but we have lots of girls he rest of the week!
I am going to help Gayle with the mock code for all the team in the morning & then we will get started. I am excited for the work to begin - truly changing lives one smile at a time. It is such a blessing to be able to participate in this mission & I am ready to work :) Been gone 6 days...missing my family but so glad I have been able to Skype for calls & video....I will update tomorrow :)
Saturday, March 17, 2012
WHAT A DAY!!!! HAPPY ST PATRICKS DAY FROM BOLIVIA!
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!
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!
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!
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