India Day #12 Monday January 23rd A tale of 2 villages, Kolkata & Heading HOME!!!!

This morning at 8 I met up with Pradeep & Olf (an anesthesiologist from Sweden) and we headed out the hotel gate to the right. And it was a totally different experience – a tale of 2 villages I am calling it!!! After about 100 yards on the dirt road outside the hotel there are more sturdy brick type homes – still very simple & humble but definitely more stable and an entirely different “village” from the one on the opposite side of the hotel. There was a temple structure back there from the 1800’s, a nice building that was the school & on this Monday morning kids walking to the school. All sorts of little “businesses” a man with fabric & a sewing machine who is the tailor there, a little market, an incense shop, several wells for water, some paved pathways, a newer temple and even a barber where Olf decided to support the local economy & get a haircut for 30 rupee (50 cents). People were outside their homes brushing their teeth. Women were washing their cooking pots and clothing in tubs of water outside their homes & some areas had overhead electrical wires & electricity!!! Pradeep had met the Chief Elder of the village and visited with him yesterday so he greeted us. His mother is the teacher at the school there. He showed us where they have all of their rice fields and then where they dry out all of the rice – which is a staple of their existence. Many people have their own cows or goats & if they don’t have a cow they trade good for milk from someone elses cow. It seemed like a very self-sufficient little village. I didn’t get the sense that a lot of people left there & went into “work” anywhere but I could be wrong. The kids were all dressed. Many homes had mini shrines outside their homes or on the road. I took a bag of cookies & candy that I had & we asked the parents & then gave it away to the kids we saw.    I am SO GLAD I went on this little hour or so walk with Pradeep – it was a hole different look from the village on the other side of the hotel. I did wonder why the people on the other side of the road aren’t a part of this village? I was told that there is a significant “class system” still very much in place in India which dictates some interactions???

We were supposed to head to Kolkata in 10 cars at 10 am but timeliness is not an India quality and all 10 cars didn’t get there until about 10:45. I was in a car with Sharon, Mayra & Peggy & Pintu was our driver. He spoke pretty good English & gave us info on our drive. Today was the birthday of a Freedome Fighter so there were several gatherings on the road to Kolkata that we “drove thru” Peggy was one of the OR nurse & I really hadn’t had much interaction with her this week – she is 67 and retired 7 years ago after 36 years in the airforce. She spent 3 years on the front line trauma hospital in Khandaahar as an OR nurse & had some horrific stories of her experiences there. She said that her Op Smile experiences have been healing her for her 22 missions she has been on. She still works in Victoria Canada & runs marathons!!!

We drove over the Ghanges river to get into Kolkata. Pintu pointed out the Queen Victoria palace – they were under British rule until 1947!!! I seriously regret sometimes my lack of recall of world history! There were lots of interesting statues (Indira Ghandi, Don Bosco etc) and buildings, and of course intensely crazy traffic. Once we got into Kolkata all the cars were to head to a hotel where we were dropping everyones bags and then could go off & “explore” based on when our flights were. George, Lori & I all had 6:30 flights so we stuck together in the car I was in with Pintu as we only had about 3 hours before we needed to head to the airport. Most of the cars were going to the Sisters of Charity Motherhouse to see the resting place of Mother Teresa & the would split up from there. When we got the there Mother house & the Orphanage were “closed” from noon-3 pm every day. We knocked & were told that they were closed so the sisters could do some of their work but I wasn’t giving up!!! I went down & knocked again & explained why we had been in Indai & that we only had this time now & pleaded if we could come in & they said yes!!!

The place of her resting was very serene. There were a few nuns sitting near there praying and a sign for it to be a reverent environment. My Aunt Natalie (my dads sister) was a nun in the sisters of Charity order & I know that she spent some time in Indis (not sure if it was here or elsewhere) but I definitely felt a connection to her & my Catholic heritage here. These nuns have an orphanage that they run here & also a hospice center – it was very touching to see their selfless service. I wanted to make a donation so they took me into a little room and the Mother Superior came out with her “financial assistant” and they accepted the donation and “blessed me”. I know that these sisters take avow of poverty so that all the money I was able to give them will go directly to helping the children in the orphanage and the people in hospice. They gave me all sorts of Mother Teresa cards etc so when I came out I was able to share them with whomever wanted them. On the top of Mother Teresa’s tomb in flower petals were the words “Love Seeks to Serve”…..what a reflection of Mother Teresa’s life. I was so grateful to have this opportunity today. If there was one thing I had wanted to do it was to get there.

I had tried to connect with Pres. Sujal via phone & finally did & had Pintu speak to him. Kolkata is a big city and with the crazy traffic getting anywhere is a challenge. He was 25 km away from us not in any direction we were currently headed. George & Lori wanted to go to the Kolkata market area & I didn’t want to impact their time so I tried to brainstorm with Pintu & pres. Sujal what our options were. I wondered why he couldn’t come close to us or meet us somewhere in the middle but it just didn’t seem possible. All I wanted to do was give him some $$$ to support Sis Kumbhaker someone I hadn’t ever met but who was a part of this little congregation of 20 members of the LDS church & who wanted to serve a mission or our church but didn’t have all the financial resources she needed. Pintu  said that is we got back to the hotel by 2:30 & left for the airport then we could maybe do a drive by….I was doing a while lot od praying while also not wanting to interfere with George & Lori. We did the market area in about an hour – there really wasn’t anything to buy so that helped & then we went back to get our luggage. It looked like we could literally do a “drive by” & I could pass an envelope off to Pres Sujal. I had already written a note the night before when I was packing. Traffic was a little crazy but WE DID IT!!! All thanks to Pintu – I was in his car for a reason that was for sure. He pulled over Pres Sujal was there. I handed him the envelope – shook his hand & got back in the car. Honestly I could not pick him out of a line up if I had to it all went down so fast. He & Pres. Hodges emailed me later that night thanking me for the efforts to get them the donation. I will never ever see them again & I will never meet Sis Kumbhaker but I know that she was part of the reason I was in India!!!

We made it to the airport within or time range, I got my bags checked all the way to LAX (but I had to pick them up in Newark to go thru customs). We had about an hour at the airport and I did a little shipping at a government type store there that raises money for villages. The 2 ½ hour flight to Delhi was 100% packed & I just tried to remember I just needed to get past this flight then I would have an upgraded next flight. When we got to Delhi George. Lori & I parted ways & I thru some trial & error found my way thru immigration in order to leave the country & got the the International terminal with only an hour before my flight. Despite the upgrade the 15 ½ hour flight from Delhi to Newark was LONG. I m not a good plane sleeper even when I am exhausted and while the flight left at midnight I was trying to figure out when to sleep so I might sort of be on a US timezone – that didn’t work so well. They served food right as we left & then made the plane dark. I think I slept maybe 4 or 5 hours  in total but rested too and watched some movies TV. In Newark I had to gather my bags, go thru US customs & immigration & recheck my bags. I only had about 3 hours there and it took awhile to do all of that. One more 6 hour leg of my trip was left!!! The Newark flight was not upgraded but at that point I knew I was getting close to home so I didn’t care & there was an open seat between me & the person at the window so that was nice. We got into LAX 30 min ahead of schedule but since the gate wasn’t ready somehow we ended up on the runway for an hour… I thought that time would never end!!! FINALLY I was HOME (or at least close). Doug was there to meet me – it had been a long time to be away. I was travel weary – tired, sort of hungry, and ready to really get home and take a hot shower!

As always I had an appreciation for all the things I typically take for granted day to day – clean water, hot water, breathable air, not crazy traffic, familiar food, the ability to communicate and be with family and  friends, a soft bed…the list goes on & on!!! It is a sacrifice to go but always so rewarding. I appreciate these opportunities to serve. I don’t think I will be able to go again until probably next fall. I met some incredible people, had some amazing experiences and believe I was right where I was meant to be these past 2 weeks….it may take a while to recover from this one though – the travel time was intense and I am pretty tired!

Sunday January 22nd – Last Day of Surgery, Pack Up & Team Party

My 2^nd Sunday in India and our last day of surgery. As we left for the hospital there were already families gathering at the river’s edge and a soccer game going on in a dirt field. We only had 5 tables going today (instead of 6) and 15 on the schedule so we anticipated a shorter day but it was a little longer than expected. Sometimes the older patients that they schedule for the last day of the mission have more complicated cases and anatomy after having their defects for their entire lives. I was repping Ethicon today & wearing the scrubs that my friend Kim sent me J.  They got off to a slow start because some of the scrub nurses that were supposed to come from the hospital staff didn’t show up but somehow they got it all worked out. While we waited for our first patients we already started some “clean up” of excessive supplies we had set up & knew we wouldn’t need today so we did some returning of items to the makeshift “store-room”. Since this is OSI’s first return mission to India & they plan to be very involved here again everything will stay in India as local cargo for future missions. Richard who is over OSI India was in the store room so I spoke to him about how to help one patient we saw who needs to go to Mumbai for a special procedure. I saw her on screening day but then not again since her needs weren’t something we could do here. He said they could identify her from her chart number & we could designate money to assist in getting her there – so I am figuring that out.

I did go to post op in the morning & took some pictures of some very happy parents & children with new smiles – it is so amazing to see them at screening, in recovery when they are often times screaming, uncomfortable & scared & then the next day when they are just happy little kids with their parents & a new smile! I took a few more photos and it was fun to see some of them in their CHOC shirts, with their new baby dolls etc. My one suitcase is now empty & with the broken handle so I am going to leave it & they are going to pack student or child life stuff in it for future missions – a little part of me will stay in India J

One of our patients today was 11 year old Sarathi – I saw her in the morning in pre-op & noticed that she was on her mat by herself but didn’t think anything of it because that place is a little chaotic in the morning with lots of people getting seen & prepped for surgery. When she came to recovery post op she was so sweet – we had the students go get her parents & it was her 20 year old brother that came back. He was the one who had brought her, they lived 300 km away (about 4 hours) & his parents couldn’t afford to miss work and also pay for for the travel to bring her here so her brother came with her & seeing his face as he saw his sleeping sister with a totally new look to her face after her large cleft lip was repaired was priceless – he just kept staring at her & wanting to wake her up so that she could look in the mirror. It was so tender to see this big brother helping his little sister – because he brought her- her life is changed!

I asked Krishna one of the local anesthesiologists & the team lead about the high incidence of clefts in India – part of it is just the volume of population of people in India & one other possible cause in all 3^rd world countries while not 100% of all cases seems to be a dietary deficiency in pregnancy – specifically folic acid. The country has recently started a campaign to provide pregnant women with Folic Acid supplements and that has decreased the incidence. Unfortunately however not all pregnant women in the most impoverished areas get any prenatal care so the incidence is still high. I also asked him why they don’t get them repaired when several organization are in India to help them & he said for many of these people it is #10 on their priority list after food, shelter, work, safety etc. Many of them think that their child will be a laborer carrying items or working in a field so what does it matter and others here have the same defect. He said the cost to go from a more remote area (even where we are) the 2 hours to Kolkata for all of this could mean 6 days of lost wages & with 5 family members dependent on that one person’s income they just can’t sacrifice the basic needs of the entire family for something like that. It was very sobering information about the reality of their lives. Such hard decisions they have to make that we don’t even think about.

A couple of today’s cases were canceled & we ended up doing only 10 real cases & some locals. I think the final surgery count was 179 – just one short of the goal they had for 180 cases this mission – still that’s A LOT of surgeries in 6 ½ days!!! We “clapped out” our VERY LAST patient who was another 13 year old girl – just our little way of celebrating!!! My Jordanian nurse friend whose shoulder I had slept on the day I got sick came & gave me a keychain from Jordan – that was so nice of him!!! I gave small gifts to the local nurses & some of the volunteers. They are so appreciative. We finished about 2 pm & then did all of our take down, pack up etc. and were done by 3:30 & back at the hotel about 4. Since really there has been no where for us to go outside of the hospital or hotel they brought in a woman with Sari’s to sell. Some people bought them to wear to the final party tonight & the local nurses said they would “dress them” (it is definitely a learned art!). Others of them bought them just to have as wall hangings or table cloths etc. It was a $20 souvenir J so I did get one! The party was starting at 7 or 7:30 so I decided to spend a little time starting to pack up all my stuff!!!

The party was right at the hotel on a grassy area. The photo video of the week is always my favorite part. It is crazy to think that we go here not even 2 weeks ago & all that we have done in that time. I am always amazed at what a small group of compassionate and dedicated strangers can do in 10 days -2 weeks. It is also fun to see everyone dressed up & the girls in the Sari’s looked awesome!!! There was lots of food but I am still “eating light” and Bengali music for dancing & fun!!! In order for them to be able to serve alcohol they had to get a “special permit” and that permit was written as a wedding for Valentina & Bhaskar LOL!!! By about 10:30 though I was done and ready for bed. Pradeep had taken a walk out of the hotel to the left (opposite the way I had gone) this afternoon & is going to go again in the morning so I am going to go with him! I also had some emails with Pres. Hodges & Sujal – we are trying to coordinate a meet up in Kolkata tomorrow. AND I had tried to use miles (way too many to divulge) to get an upgrade on my flight & it looks like I have it for the long leg from Delhi to Newark – that will be AMAZING if that is the case because I am not looking forward to 36 hours or travel other than the fact that I am going HOME!!!           

Saturday Jan. 21, 2017 India Day #10 – And Day #6 of Surgery – 169 Surgeries at the end of tonight!!!

I had a wonderful 8 hours of sleep & woke up feeling nearly 100% & good to go. I was starving & went & had a hard boiled egg & toast for breakfast. I stood for the bus ride & it seemed less bumpy….I know I mentioned the driving here the first few days but truly it feels like you take your life in your hands when you are in a car here. Lane lines are only suggestions, police let people drive however they want even the wrong way on the road & only intervene if there is an accident. The weaving around truck, buses, cars, bikes etc is quite the maneuvering and obstacle course. I am fairly confident that anyone who visits here would have to hire a driver – driving here is like a crash course with nonstop honking. The dirt road to the hotel fits one car max & our bus barely if any other vehicle is on the road it becomes a standoff as to who will go in reverse.

At the morning Team mtg Valentina (who is all of 23 & the PC for this mission) reminded us to think of the determination of all of these families to get here, to get to us for the help they needed, for their trust in us – complete strangers and when we are feeling tired to think of our own passion & motivation to be here – she is wise beyond her years. I was named “Queen of the Day” if that is because I got sick & then still came in the next day I would happily forego the recognition if it meant no being sick!!! We also got the good news that we have done ALL Of THE PALATES…only lips, hemangiomas & other types of surgeries from now thru tomorrow – YAY!!! Also Sharon the PACU nurse from UK finally got her luggage last night – she was so tremendously positive thru all of that – I don’t think I would have been able to manage & it reminded to pack more useful items in my carry on in case that ever happened to me. With her luggage arriving it was like Christmas – she had decorations for the PACU, treats & toys for the kids.

One table today was a local anesthesia table so those patients were coming off fast – we did have 6 that were canceled because the children were sick & clearly they won’t be better by tomorrow so that is always disappointing. They did add on 3 others so I am sure those people are very happy!

Today I gave away my final clothes, dolls, hats, etc. Moni Jana was my 10 year old patient who got the last doll & t-shirt. So places in India there are 30 kids walking around with CHOC T-Shirts and many with new dolls to love or clothes to wear thanks to the generosity of others -I have the best friends ever!!! Pradeep wanted to be sure I was okay & eating (which I was) but from a “doctors canteen” somewhere he brought me toast…who knew they even had that here???

Here they call the nurses “sister” like they do in Africa – it is kind of funny to be walking & hear someone trying to get your attention& say “Sister, Sister” but it is also a tender reminder that we truly are all brothers & sisters & how grateful I am to be here helping my brothers & sisters in India. One of my patients today – the mom was a nurse & I was curious why as a medical person she had not gotten her son surgery before now. She said she is a single mom, her husband left when her son was born, she pays a friend to watch him when she works 5 days a week. While there is a center in Kolkata that would assist in the surgery but by the time she traveled there, missed work & then returned it would be extremely costly – their needs are work, food, shelter even as a trained nurse – again very humbling to get a tiny glimpse of their lives here. I told her I wanted her & her son to do something  special together or get something they needed & gave her some rupee – she at first declined & the later accepted the longer we spoke & as I explained that there are good people all over the world & especially where I live who want to help others n matter who they are & they would want to help her. She was also talking to me about the weather & that there is a monsoon season from May-July with lots of mud and rain. I thought of the village near our hotel and what a good rain would do to their lean to houses and dirt road….

There was glimmer of sunlight when we left tonight which was so nice. Before I came here I had put the global clock for Kolkata on my phone & was perplexed at why it always said (usually at night) hazy, smoky, foggy in the description. Now it makes perfect sense because that is exactly what it is – the air is awful here for so many reasons. I can’t imagine how someone with asthma or airway problems would maange here. In the afternoon my roommate Mayra got sick & threw up once – I was hoping it wasn’t because of me!!! Several people have headcolds & many are on antibiotics. They sent Mayra home to rest which I know is exactly what she needed. When I got home she was resting, I made her some tea, got her some sprite & repaid to her the kindness she had shown to me. Fortunately she only got sick the one time. I went to dinner but want up for spicy curry so I opted for crackers & was quite content.

Karen, Sharon & I (the 3 international PACU nurses) visited out on the patio for awhile laughing about all the events that have taken place this week: some of the interesting physician personalities from India, the challenges that are common on missions and some humorous moments we have had – they have been so wonderful and easy to work with – energetic, competent, team players, compassionate and all around great women & nurses. I hope our paths will cross again sometime J

I got an email from Pres. Sujal the branch Pres. For the area that covers Kolkata – I think we are good to meet on Monday – fingers crossed & prayers that will work out! Time for bed – Good night from India.

 

Saturday Jan. 21, 2017-India Day #10 – And Day #6 of Surgery – 169 Surgeries at the end of tonight!!!

Saturday January 21st  2017 -

I had a wonderful 9 hours of sleep & woke up feeling nearly 100% & good to go. I was starving & went & had a hard boiled egg & toast for breakfast. I stood for the bus ride & it seemed less bumpy….I know I mentioned the driving here the first few days but truly it feels like you take your life in your hands when you are in a car here. Lane lines are only suggestions, police let people drive however they want even the wrong way on the road & only intervene if there is an accident. The weaving around truck, buses, cars, bikes etc is quite the maneuvering and obstacle course. I am fairly confident that anyone who visits here would have to hire a driver – driving here is like a crash course with nonstop honking. The dirt road to the hotel fits one car max & our bus barely if any other vehicle is on the road it becomes a standoff as to who will go in reverse.

At the morning Team mtg Valentina (who is all of 23 & the PC for this mission) reminded us to think of the determination of all of these families to get here, to get to us for the help they needed, for their trust in us – complete strangers and when we are feeling tired to think of our own passion & motivation to be here – she is wise beyond her years. I was named “Queen of the Day” if that is because I got sick & then still came in the next day I would happily forego the recognition if it meant no being sick!!! We also got the good news that we have done ALL Of THE PALATES…only lips, hemangiomas & other types of surgeries from now thru tomorrow – YAY!!! Also Sharon the PACU nurse from UK finally got her luggage last night – she was so tremendously positive thru all of that – I don’t think I would have been able to manage & it reminded to pack more useful items in my carry on in case that ever happened to me. With her luggage arriving it was like Christmas – she had decorations for the PACU, treats & toys for the kids.

One table today was a local anesthesia table so those patients were coming off fast – we did have 6 that were canceled because the children were sick & clearly they won’t be better by tomorrow so that is always disappointing. They did add on 3 others so I am sure those people are very happy!

Today I gave away my final clothes, dolls, hats, etc. Moni Jana was my 10 year old patient who got the last doll & t-shirt. So places in India there are 30 kids walking around with CHOC T-Shirts and many with new dolls to love or clothes to wear thanks to the generosity of others -I have the best friends ever!!! Pradeep wanted to be sure I was okay & eating (which I was) but from a “doctors canteen” somewhere he brought me toast…who knew they even had that here???

Here they call the nurses “sister” like they do in Africa – it is kind of funny to be walking & hear someone trying to get your attention& say “Sister, Sister” but it is also a tender reminder that we truly are all brothers & sisters & how grateful I am to be here helping my brothers & sisters in India. One of my patients today – the mom was a nurse & I was curious why as a medical person she had not gotten her son surgery before now. She said she is a single mom, her husband left when her son was born, she pays a friend to watch him when she works 5 days a week. While there is a center in Kolkata that would assist in the surgery but by the time she traveled there, missed work & then returned it would be extremely costly – their needs are work, food, shelter even as a trained nurse – again very humbling to get a tiny glimpse of their lives here. I told her I wanted her & her son to do something  special together or get something they needed & gave her some rupee – she at first declined & the later accepted the longer we spoke & as I explained that there are good people all over the world & especially where I live who want to help others n matter who they are & they would want to help her. She was also talking to me about the weather & that there is a monsoon season from May-July with lots of mud and rain. I thought of the village near our hotel and what a good rain would do to their lean to houses and dirt road….

There was glimmer of sunlight when we left tonight which was so nice. Before I came here I had put the global clock for Kolkata on my phone & was perplexed at why it always said (usually at night) hazy, smoky, foggy in the description. Now it makes perfect sense because that is exactly what it is – the air is awful here for so many reasons. I can’t imagine how someone with asthma or airway problems would maange here. In the afternoon my roommate Mayra got sick & threw up once – I was hoping it wasn’t because of me!!! Several people have headcolds & many are on antibiotics. They sent Mayra home to rest which I know is exactly what she needed. When I got home she was resting, I made her some tea, got her some sprite & repaid to her the kindness she had shown to me. Fortunately she only got sick the one time. I went to dinner but want up for spicy curry so I opted for crackers & was quite content.

Karen, Sharon & I (the 3 international PACU nurses) visited out on the patio for awhile laughing about all the events that have taken place this week: some of the interesting physician personalities from India, the challenges that are common on missions and some humorous moments we have had – they have been so wonderful and easy to work with – energetic, competent, team players, compassionate and all around great women & nurses. I hope our paths will cross again sometime J

I got an email from Pres. Sujal the branch Pres. For the area that covers Kolkata – I think we are good to meet on Monday – fingers crossed & prayers that will work out! Time for bed – Good night from India.

Friday January 20th 2017 - India Day #9 – And Day #5 of Surgery – 142 Surgeries so far!!! And I am on the mend!

I slept okay last night and didn’t vomit after midnight. I tried to sip sprite & herbal tea when I woke during the night. I set my alarm for six but I was in no shape to go in. Pradeep & Karen came to check on me & brought me some electrolyte packs to add to water – it taste nasty but I forced myself to drink it.  Valentina also came in & I told her that I thought if I slept a few hours I could go in later & asked if they would get me at 9:30 – so that was the plan…until I slept until 9:30. I tried to reach them to see if they had sent the car & fortunately they hadn’t so I reset the pick up time for 11 am & was confident that after showering I would be okay to go in and do some work. I felt about 75% of “good” but wanted to go in…I didn’t travel 10,000 miles to hang out in a hotel room & I was feeling much better compared to last night. I got down to the outdoor lobby just after 11 & after 3 calls the car finally came at noon – I think time is very relative in India. It did give me a chance to FaceTime Doug which was nice and Imessage a bit with Kelli & Sarah

My ride in to the hospital during the daytime thru the village was a different sight than even the Sunday we walked thru…with no electricity they are up at sunlight working in the fields, the coal pile & the brickyard – we have seen that when we leave at 7 am & it is actually a bit chilly at that time. In the mornings I have seen 5 women breaking up the coal to fuel the brickyard  -I am not sure why it is women doing that – it is quite a sight as they sit on a pile of coal breaking it into smailler peces with a chisel. There is always someone at the well getting water and at times just bathing there right next to the well.

This morning when I left at noon there were women walking about with water carafes or bags of rice or other items in their hands or on their heads. In the brickyard men have what looks like a balance…a piece of wood across their shoulders and equal piles of 20 or so bricks on each side they are balancing as they move them. Such manual labor. I saw 4 or 5 year old children carrying probably their siblings who were naked 1 year olds as they walk along the street maybe while parents were working. There was a man with a manual sewing machine working on something = perhaps that is his business? I would guess that maybe 90% of Americans have not seen poverty like this – I understand the social disparities in the states but this is a whole separate level of survival. Truly our issues while significant are 1^st world problems and sometimes I think people could benefit from a reality check like this to perhaps stop before they rant & complain about so many “problems” in their lives that really might just be minor inconveniences.

When I got to the hospital walking up the 3 flights of stairs to the recovery room seemed monumental – I just didn’t have any energy. They had only seen 8 patients before I got there but it was crazy busy. I managed patients and just sat down more. It could have been SO MUCH worse….really I was only out of commission 18 hours total & 6 hours of work time so I felt very blessed and knew that I was being carried by the prayers of many at home who I know are praying for me & this entire team. We had another bleeder that needed to go back to surgery so that always makes things interesting and chaotic all at the same time. I did not take many photos today & really “bond” with too many patients I was simply trying to do the work that needed to be done. There were 2 Nursing students here again & they were quite helpful – despite the language barrier I tried to explain what we did in the PACU – how we monitored the patients coming out of anesthesia. SO easy for me to go into teaching mode – which I love! They also helped me give away lots of the fun things I had brought J

The last patient I cared for was another Ganesh (must be a common name here) he was 23 years old & he had waited 3 days for his surgery. He was scheduled on Wed. then things got too late that night so they postponed him to yesterday (Thursday) & he was actually on the table still awake when that other patient started bleeding & had to go back to the OR so they postponed him again. Finally he was the VERY LAST patient today & he was so happy to be having surgery – his before & after photos are remarkable & I will try to post them. Another HUGE difference & when I had him look in the mirror he gave me a HUGE SMILE & thumbs up sign. He told the nurses on Pre-Op where he stayed for 2 days that he wanted to be able to “kiss a girl” which made me laugh!      

We left by 9 pm which wasn’t bad – it must be a bit “dangerous” on the roads here as when we leave late at night (or any time at night) they lock the “push in door to the bus” (that really doesn’t have a lock) by outing 2 wooden seats in the door area so that is can’t be opened from the outside. One night whenw e were on the dirt road of the village area one person did jump on & push his fingers thru the door but I think it was more of a “thrill ride” however it did make it all the way to the entrance of the hotel & then the guards shooed him away.

I was spent after just 8 hours or so & ready to go straight to bed – others went to dinner – which they start serving here at 8:30 pm??? Pradeep insisted on bringing me some rice & sweet yogurt her got from the kitchen. He is Indian himself (but from the US) so he has made friends with the hotel staff LOL. It was very sweet of him but I wasn’t really up for eating – I had a piece of bread & some almonds for proton – I really messed up not bringing the protein powder I usually go & buy & bring – oops! At this rate I can get 8 hours of sleep & to me that sounds HEAVENLY!!!

While the USA is preparing for the Inauguration of Donald Trump & people on both sides are complaining & protesting and saying hateful and hurtful things to one another I am pretty happy to be away from all of that. I truly believe that if we could all try to love, accept and be patient with each other even as we disagree the world would probably be less volatile and more positive – we have so much more in common that we have as differences and different isn’t wrong it is just different. If in the world different =wrong than whoever varies even slightly from your perspective will always be viewed as wrong instead of trying to understand and accept their perspective. We don’t have to agree but we can always be kind and respectful and LOVE everyone despite their differences. (end of soapbox)  

India Day #8 & Surgery Day #4 HUMP DAY…and then I got sick!

I survived being on call again without the need to go in & slept well. I decided to wear my pink scrubs for Hump Day but I was running late so it was yet again a no makeup day (which is almost always for me on missions) but I did put on lipstick & get several comments – makes me wonder how bad I have looked other days???

I tend to go to breakfast every other day & then eat bars the days I don’t go. Today I got creative with breakfast & made an egg & grilled tomato sandwich on this bread stuff they make.

At the hospital I did my pre-op & post op routine. I was in Awe of Ganesh & how transformed her looked. I posted a before & after photo on social media. He & his mom were so very happy! I also saw my friend Karishmi on post op – 2 days after surgery she was doing much better that yesterday & will go home today J Honestly with 30 or so post op families in the ward area I didn’t even recognize those I gave rupees too & that was fine – it isn’t about making them feel indebted – it is a gift to them. The 2 older women also looked fabulous with one bad twist…one of them had paid a man to drive here here. The Op Smile folks assumed they were family or friends. When she was taken from pre-op to surgery that man stayed at her bedspace in Pre-Op and stole all her $$$ (1000 rupee) and all her belongings including her clothes. That sort of put a damper on her surgery. Bashkar was going to reimburse her the $$$ but I asked him if I could please do that & I gave her 4000 rupee or about $60 US to cover her lost $$$, buy new clothes & pay a new reputable driver to get her back home. She was immensely grateful & I told her there are people all over the world that want to help her including some of my friends & we are honored to give her this.

Pre Op seemed to have patients of all ages & as always some real cuties. We had a pretty quick start to the day with the 1^st 4 patients off & into recovery within 10 min of each other but it didn’t seem too chaotic (at that time anyway) We also had 2 Nursing Students & 2 Translators all from a University 2 ½ hours away so the extra people & hands are always helpful. The translator Akash was so sweet to everyone – once we told him the routine & what to say & ask he would just go around talking to all the parents without us even prompting him.  One of my early patients was another young family – the mom was 19 (but she literally looked 15 & the dad was 24 – I was able to discreetly give them 2000 rupee with Akash’s help.

There was one little one a 5 mos old age deviation  Ghouri & since the anesthesiologists were getting behind on starting IV’s Karen started her IV before surgery – what a great idea!!! She is a Neonatal Nurse Practitioner from Australia & I am loving working with her. I also gave Ghouri one of the blankets & did a good job at giving out some dresses, hats & clothes. The food for the families arrived – Victoria was going to have me go see it so I could take pics of the humanitarian service we provided but that didn’t happen today it was just too busy. It did seem to help though we had less moms come in ready to faint! With a lot of palates on the schedule it was a busy day , plus we had lots of kids screaming as they came out of the black hole of anesthesia & a few we put back to sleep to see if they would wake up happier on round #2, we also seem to have an increasing number of flies joining us in the PACU every day & fanning them off the patients in just the norm.

It was so busy that by 5 pm I had a huge headache because I hadn’t had lunch – I was also feeling nauseous & thought it was because I hadn’t eaten but it all went downhill after that…(no need to read the detail of this paragraph – as always this is mostly for me & I am sure you are wondering why I want the details about getting sick??? It’s a nurse thing) when I went back in PACU I felt worse so I took a Tums, I told Predeep the Intensivist I wasn’t feeling well & he said to take Zofran so I did with no improvement. I was going to go get fresh air (not that there is much of that here) & stopped in the store room with Victoria & told her I thought I might throw up – she said room 122 had a decent bathroom if I needed it & gave me the key. I went straight there but didn’t quite make it & threw up outside the door in the hallway – patients were watching & I am sure they were concerned!!! I went inside & threw up 3 more times. I actually felt better after that & thought I could manage the rest of the night (it was about 7 pm) I retook the Zofran & started Cipro & went back to room 122 & laid down on a stretcher. While I had this issue there was a patient who was bleeding who ended up needing to go back to surgery so that created a lot of chaos for the team. A car was leaving about 8:30 so I went in it & sat next to one of the Jordanian OR male nurses who smoke nonstop & wasn’t sure if I could get thru the 30 min drive with  - that smell so I rolled down the window. I felt really nauseous again & prayed I would last the car ride. About halfway to the hotel I also asked to put my head on his shoulder because I literally could not keep it up. I made it back to my room & vomited on arrival 4 more times & was pretty miserable & just laid on my bed. My roommate came in about 10 & was very sweet to me. I got sick again about 11 & vomited 4 more times & by then I had no idea what to do – take more meds etc. So I woke Mayra up & asked her to get Pradeep or Victoria or Valentina. The girls were gone & it sounded like Pradeep was in the shower. She finally got him about 11:30 & he was very kind & said try tea etc. At that point all I wanted to do was sleep. I was achy & miserable & went to bed praying I didn’t vomit again  -which I did but just once at midnight. I have only been sick one other day on a mission so I consider myself fortunate & I have no idea wher this came from – food I ate, a virus shared by the little ones I cuddle, who knows but this kind of sick is never fun. I did fall asleep after that & slept fairly well.

India Day #7 – Surgery Day #3 - 29 cases so 85 Surgeries so Far!!!

I started  my day in Post Op & found Karisma – she was definitely less exuberant after her palate repair than before but her mom was so so grateful. I did take a photo of them. In Pre-Op there were some babies, children and young adults…also 2 women one is 45 & the other 47. They were so excited for surgery & wanted to take pics with me & hugged me. I don’t remember them from screening because I was so engrossed in the work & was glad I could see them today. It is interesting – most adults do not smile in photos & are very straight faced – even the school age children. Then when you take a photo of them & show it to them they smile & sometimes I will try to capture a 2^nd picture.

One of my first recovery room patients was Rittika who was 18 mos. Old & weighed 7 kg (about 15 lbs) the kids here are often petite & lean but she was tiny! She also had Dextrocardia & a cleft lip & palate. All we were repairing now was her lip.  Her mom put her hands to her chest and bowed as her way of saying thank you or from my heart to your heart– as many have done here. She was very sweet & I spoke to her quite a bit thru Amerita our translator. We talked about the dextrocardia and what type of care she has had – not much. Mom is 20 years old (we have had younger moms) and dad is 24. Neither can read or write and dad is a laborer. The dad wants to learn to be a electrician. After talking to them I felt a strong impression to give them 2000 Rupee = $35 US money. I did it very discreetly thru Amerita & told her to tell the mom that I had children their ages but no grandchildren & friends of mine & I wanted to help them. We folded the Rupee bill very small & put it in her hand. She became tearful and my heart was so full.

On missions I try to feel guided as far as how I can help others & leave a positive impact on the area I go to – I think I have found my direction here & perhaps I will be helping families one at a time just like we change their childrens lives one at a time. 2000 Rupee  is about 2 weeks wages and they are likely missing one week by being here. We took a photo together & the she left the PACU.

It was WAY MORE chaotic today than yesterday & I’m not sure why? The Indian people talk very loudly so if their child is crying unlike other places where you might talk softly to comfort them the parents are really loud & almost screaming at them or so it seems. We have been trying to encourage them to soothe them softly – sometimes it works & other times not so much.

We had more moms today who were distraught & nearly passing out despite Child Life showing them photos etc. They simply have no context of surgery or hospitalization. Claire the Child Life & I were talking that maybe when the child goes back the parents have to eat something before they can go into recovery room. I was able to talk to Bhashkar the local PC & offer to get food items for the moms. I then found out is was a bigger issue. Op Smile is feeding the families at the shelter and has a budget to feed the people in post op but there are many more people than expected & the daily food is running out. Earlier in the week I had asked if there were needs I could help with so they came & said it takes about 9000 rupee to feed everyone here in pre/post op for a full day (about 120 adults if 60 patients have 2 people with them. So with the generosity of friends I offered to cover the last 3 days of food that they wouldn’t have had because they have had overage charges from the people who make the food every day. Again I never thought that I would be instrumental in feeding the patients families in the hospital but I am excited to do so! People who are laborers (the ones I saw in the village at the coal mine, brickyard & in the fields earn about $2 US a day. They mostly eat rice & lentils. In fact when the older kids wake up & we offer them juice they often ask for rice – so funny! For fresh fruit 6 mandarins are 50 rupee or 1/3 of a days work so fresh fruit is a luxury.

Later in the day there were 3 more families I gave rupees to. I explained to Amerita that it was not based on anything in particular but if I felt prompted to do it I would & they didn’t need to be the patients I recovered they could be any of them but I wasn’t sharing the info with anyone but the interpreters. One of them was the family of Ahmat Raza – it had taken them longet to get here o they just arrived yesterday – the child was screened & fortunately was placed on the schedule today. Mom is 22 & dad is 28, they too are illiterate & the mom was so distraught that the aunt came in recovery to be with the patient & told us of their journey to get here-several days & many challenges. I was hoping the money would help them travel back more easily.

Because of the demonetization there have been issues with the scrub techs & nurses at the hospital not showing up because they haven’t been getting paid. Usually the hospital provides some of these folks to round out the team but that has not been the case here so there have been some challenges but we have not experienced it in Recovery – there are 3 of us international & 1 in country RN Sarita.

By 2 pm we had received 14 patients & were half way there. It seemed we had more flies in the recovery room today – I am sure the open windows, food, blood whatever attracts them? Sharon cleaned our bathroom in the PACU like no other – I am pretty sure it is the best one in the entire hospital.

As I walked patients to post op I noticed the families lining the hallways sitting on our flattened cargo boxes that were outside the storeroom – I asked Victoria if that was the intent & she said no people just started taking them so they weren’t sitting on the floor – necessity is the mother of invention – cardboard mats for all!   

We had high hopes that we would get out earlier today but that was not to be – we did some fo the older lip patients so bigger lips & patients=bigger problems. The older women looked totally transformed – I cant wait to see them in post op tomorrow. The highlight of the evening was Ganesh – I posted a pic of him & will do a before & after when I can. He is developmentally delayed & lives far away. They found him as part of the recruitment campaign. He was ALWAYs smiling ear to ear even with his cleft lip. He is very bonded to mom because of the devel delay & the lip. They have been inseperable his entire life. I didn’t find out if there was a dad in the picture. The OR folks had mom go in with him for anesthesia induction & then we had mom in the PACU as he arrived to us. He did wake up a little crazy  & mostly wanted his IV out. We showed him in a mirror himself & he just stared – not a dry eye in the PACU

We left the hospital at 9 pm & there was one pt left in the PACU. I was on call again so Sharon said shed stay. Pradeep the Intensivist was on the bus with us – not sure why as typically the PI stays until the last patient is gone & as luck would have it about halfway back to the hotel we got a call that the patient was vomiting & in pain – so we turned the bus abound – not an easy feet on the roads of India & went back. We finally got to the hotel at 10:30. I had a really scratch throat – not sure if its from the chemicals in the hospital, the Sevo gas or the smoke but my throat was reacting & all I did was shower & go to bed