When last I wrote, I was not a happy camper. Tuesday and Wednesday were better though. I took over the child life area since we no longer had a Child Life Specialist. That person is responsible for explaining the surgery to the kids and playing with them and keeping them busy while they wait for surgery. I did therapy and post-op instructions while they were waiting and played with them. I was busy all day and had a lot of fun. I got to consult with the surgeon a couple of times about some pharyngeal flaps and palatoplasty so that was cool too. I also went in and saw surgery for awhile in the mid to late afternoon. The ORs are so small and there are 2 tables per room, so by the time you have a scrub nurse, anesthesiologist, and surgeon (or 2) for each table there is not much room so I didnt observe too much because I was in the way. The other room was much bigger, but they were doing skin grafts in there and no craniofacial surgery because it had all been done.
The skin grafts were pretty gruesome. One guy had had a car accident and the skin on his upper right face was missing all the way down to his skull. Yes, I could see bone. They took skin from his groin and patched him up pretty well. The other guy was a mangled mess on his face. He had hit a horse while riding his motorcycle and his face was scabbed, bruised, and bloody and his lower left eyelid had been torn off. They were going to do a skin graft on him but ended up being able to move some of the skin on his face around and take care of things.
Elsa, was a 17 y/o on Wednesday who got surgery. She had a complete unilateral cleft lip and palate and had NEVER had surgery on it. She was so embarrassed of her appearance that she sat all balled up with her hand or jacket pulled over her face at all times. She hated having her picture taken (and everyone was taking them), so waited until she was asleep in surgery. I want to be able to share the transformation. She came out of surgery with a beautiful new lip, but she hasnt quite found her smile yet. Shes still so shy and withdrawn.
Thursday there were just 3 surgeries and then we spent the bulk of the day packing everything up. Thats quite an ordeal!! We finished by mid afternoon and then a group of us went to tour a cigar factory. I wasnt really excited about going and just went for the camaraderie, but I am so glad that I did. It was absolutely fascinating. The cigars are completely handmade and it takes over a year from start to finish. I really enjoyed the tour although we were all coughing and wheezing from the tobacco particles floating in the air. The girls in the sorting room (sort through leaves and categorize by size and color) make $5 a day and the most expensive cigar they produce costs $15 US dollars. They produce over 60,000 cigars a day. $5 a day to produce thousands of cigars worth $15 each...something wrong with that picture, dont you think?
I spent most of today in a bus headed from Santa Rosa to Tegucigalpa. We were all so excited to have a nice hotel again without cold damp sheets and with a real bathroom with a real shower and toilets where you can actually flush toilet paper. Its the little things in life. Most of us just hang out at the hotel, ate dinner here, and did our final bit of shopping. It was a nice afternoon. Im about to go pack and rearrange my suitcases to make it easier to go through customs. I am so ready to be home!!! Pictures forthcoming.
(The apostrophe on this keyboard doesnt work, FYI)
Friday, November 16, 2007
Monday, November 12, 2007
Days 4 and 5
Day 4---We had a 3 hour bus ride to the Copan Ruins. These are huge Mayan ruins and it was very fascinating. There were lots of Macaw parrots there and some weird rodents that look like nutria. We also learned a lot about Mayan history. We were told to prepare for chilly weather since we´d be at a higher altitude, but it was actually sunny and quite warm. It was the first time here that I haven´t been cold and I even broke a sweat. We ate dinner in a quaint little town and then had time to roam and shop. There was some really nice jewelry and interesting things to look at. Then the long 3 hour bus ride home where we had to pull over when one of the team got sick and had to vomit on the side of the road. There was also the incident of driving the bus through a washed out dirt road (we didn´t get stuck) and when we were going about 50mph and our driver slammed on the brakes because there was a random horse in the road. The drive was absolutely beautiful though. I didn´t realize that Honduras was so mountainous. It is also very green and lush, so we´d drive through mountains covered with greenery and flowers and rivers flowing through. Santa Rosa, the town we are in, and the town we went to are like Honduran versions of San Francisco with the hilly, winding streets.
Day 5-The official start of surgery. We only had to plastic surgeons (should have 5) because the other Honduran doctors decided not to come. Yes, lovely. We should have had 4 operating tables with a floater, so instead we had 2...and 4 anesthesiologists. One of them told me that there were basically 4 anesthesiologists inducing each child. Way too many nurses too, since we usually do 20-25 kids per day and we only did 9 with general anesthesia and 4 with local. I was bored out of my head. Usually there is one speech pathologist (SLP) on a mission and we have two. The other is Honduran and she is bilingual. She actually got her B.S. and M.S. at Baylor and came back to Honduras. There are only 4 SLPs in all of Honduras and they have no degree program here. So, since there is another SLP, she knows the culture, and she speaks Spanish, then there is really no need for me here. Generally there is additional scut work to do which I don´t mind doing, but since the whole mission is over-staffed, there isn´t even that. I did work with one teenager today and even tried to get him into surgery for a pharyngeal flap, but they said that he is likely to be a bleeder and they´d rather catch him on the next mission in San Pedro Sula in February. Michelle, the other SLP, is really great and has tried to include me. She wanted me to give the post-op education for a few pts. and she was the translator, but that´s just kind of redundant because she could just go ahead and do the whole thing herself. So I just hung out most of the day and shivered.
It´s been in the 50s-60s almost every day except for yesterday, overcast, and today a constant drizzle so it is a damp bone chilling cold where I just can´t get warm. Our towels never dry and my clothes feel damp when I put them on. Plus, I´m having to re-wear the few long sleeves that I bought, so everything is just icky.
A few cool stories about the kids. There is a little boy named Hernando de Jesus who is 6 years old. He looks about 2.5. He is as smart as a whip, but doesn´t go to 1st grade because his mom is worried about him being bullied. However, I found out today that she is not his mom. He was born with a bilateral cleft lip and palate and his mother left him at the house of this older couple who are raising him. His ¨dad¨ brought him tonight for pre-op and he´ll have surgery tomorrow. The kids are sleeping 2-3 to a bed and the parents have no place even to sit. Pray for the parents and kids...lots of waiting, lots of crying, lots of worry, and no sleep.
More info as I am able. We have free internet here, but it is very tempermental and only 2 computers for 44 of us.
Day 5-The official start of surgery. We only had to plastic surgeons (should have 5) because the other Honduran doctors decided not to come. Yes, lovely. We should have had 4 operating tables with a floater, so instead we had 2...and 4 anesthesiologists. One of them told me that there were basically 4 anesthesiologists inducing each child. Way too many nurses too, since we usually do 20-25 kids per day and we only did 9 with general anesthesia and 4 with local. I was bored out of my head. Usually there is one speech pathologist (SLP) on a mission and we have two. The other is Honduran and she is bilingual. She actually got her B.S. and M.S. at Baylor and came back to Honduras. There are only 4 SLPs in all of Honduras and they have no degree program here. So, since there is another SLP, she knows the culture, and she speaks Spanish, then there is really no need for me here. Generally there is additional scut work to do which I don´t mind doing, but since the whole mission is over-staffed, there isn´t even that. I did work with one teenager today and even tried to get him into surgery for a pharyngeal flap, but they said that he is likely to be a bleeder and they´d rather catch him on the next mission in San Pedro Sula in February. Michelle, the other SLP, is really great and has tried to include me. She wanted me to give the post-op education for a few pts. and she was the translator, but that´s just kind of redundant because she could just go ahead and do the whole thing herself. So I just hung out most of the day and shivered.
It´s been in the 50s-60s almost every day except for yesterday, overcast, and today a constant drizzle so it is a damp bone chilling cold where I just can´t get warm. Our towels never dry and my clothes feel damp when I put them on. Plus, I´m having to re-wear the few long sleeves that I bought, so everything is just icky.
A few cool stories about the kids. There is a little boy named Hernando de Jesus who is 6 years old. He looks about 2.5. He is as smart as a whip, but doesn´t go to 1st grade because his mom is worried about him being bullied. However, I found out today that she is not his mom. He was born with a bilateral cleft lip and palate and his mother left him at the house of this older couple who are raising him. His ¨dad¨ brought him tonight for pre-op and he´ll have surgery tomorrow. The kids are sleeping 2-3 to a bed and the parents have no place even to sit. Pray for the parents and kids...lots of waiting, lots of crying, lots of worry, and no sleep.
More info as I am able. We have free internet here, but it is very tempermental and only 2 computers for 44 of us.
Saturday, November 10, 2007
Operacion Sunrisa Days 2 and 3
Yesterday I was too exhausted to update. We got up at 4 and we on the bus by 5. Our bus broke down about 30 minutes down the road and we had to wait for a new one and transfer all of our luggage. It took 7 hours to reach Santa Rosa. We were miserable on the bus ride because it was freezing and they had the air on full blast. We finally got them to turn it off.
My seatmate for the trip was Pam, the pediatrician. It´s an interesting group because we have 2 Pams, 2 Eileens, 2 Kathys (and 1 Katherine), 2 Lindas, and 2 Michis...crazy! I enjoyed talking to the other Pam about books, medical ethics, what peds learn about speech and language development, and everything in between.
We got to the hospital at about 2 and started screening at 3. We screening 58 patients that day. I was one of the last ones finished and got back to the hotel at 9:15 pm, having been up since 4. I never even ate supper and was too tired to think about eating...or blogging. I took a shower, ate a pack of cheese crackers, and went to bed.
This hotel in Santa Rosa is not quite as nice as the one in Tegucigalpa (an understatement!) I am rooming with Kathy, another pre-post op nurse from New Jersey. We have a double bed and a single and we barely have any room for our luggage. There is no dresser or closet, so we will quite literally be living out of our suitcases for the next week. That won´t matter too much since I will be wearing the same clothes all week as I am very ill-prepared for the weather. The internet said that it would be in the 70s and 80s, but it is pretty consistently staying in the 50s and is very damp. We are all having a hard time staying warm since we all mostly brought capris and T-shirts. We were all very cold last night and Kathy and I did get extra blankets for tonight. There is no heat in our rooms. We are also on the first floor and have a window with no covering on our shower. Really nice. Plus we have one outlet in our room. We moved my bed about 2 inches from the wall to plug in hair dryers and couldn´t open the door this morning. Crazy!
Today we screening 11 more kids. There are 52 scheduled for surgery and the goal was 100. As of now, surgery is only scheduled Mon-Wed and was supposed to go through Friday. Looks like we´ll gave lots of free time. I´ve gotten some great pictures of kids and gotten to see a few really interesting ones, including one with a partial facial cleft and a little guy with the most severe hypertelorism that I´ve ever seen. Our first kiddo today had scabies, so I´m a little paranoid about that, but I wore gloves and have been using antibacterial gel like crzay. We were finished by 1 today, so six of us walked around town and had coffee at a really neat coffee shop. The town is pretty boring on a whole and there is not much to do here. The shops were junky and we have seen no souvenirs yet.
Went back to the hospital at 4 for the posting of the list of who gets surgery and when. It´s so neat to see the faces of the parents light up when their child´s name is called. Even the older kids get really excited about being selected for surgery because they know it will change their lives. The only kids who don´t get selected are the ones who are too young, too involved (and they be seen locally later), or are sick (heart murmur, pneumonia, etc.). After that we came back and tried to nap, but this horrible band was practicing right outside of our window...the same 3 measures again and again, but at different times and not together at all for 45 minutes. Then, they finally played a song. It was horribly obnoxious! Hope it´s quite tonight, but from the sound of things that will not be the case. Thank goodness for earplugs.
We all went to dinner tonight at 7 and didn´t get out food until after 9. Yep, Honduras is just like Nicaragua in that regard. By the time our food came most of us weren´t even hungry anymore. We just back back to the hotel at 10:15 and some were going to a disco tonight. While it would have been fun, I´m still exhausted from the week of my defense and I need one more night of good sleep before I´m game to do anything late at night. Tomorrow we have a fair amount of travel to and from the Copan ruins for our sightseeing day and then we hit the ground running with surgery on Monday.
My seatmate for the trip was Pam, the pediatrician. It´s an interesting group because we have 2 Pams, 2 Eileens, 2 Kathys (and 1 Katherine), 2 Lindas, and 2 Michis...crazy! I enjoyed talking to the other Pam about books, medical ethics, what peds learn about speech and language development, and everything in between.
We got to the hospital at about 2 and started screening at 3. We screening 58 patients that day. I was one of the last ones finished and got back to the hotel at 9:15 pm, having been up since 4. I never even ate supper and was too tired to think about eating...or blogging. I took a shower, ate a pack of cheese crackers, and went to bed.
This hotel in Santa Rosa is not quite as nice as the one in Tegucigalpa (an understatement!) I am rooming with Kathy, another pre-post op nurse from New Jersey. We have a double bed and a single and we barely have any room for our luggage. There is no dresser or closet, so we will quite literally be living out of our suitcases for the next week. That won´t matter too much since I will be wearing the same clothes all week as I am very ill-prepared for the weather. The internet said that it would be in the 70s and 80s, but it is pretty consistently staying in the 50s and is very damp. We are all having a hard time staying warm since we all mostly brought capris and T-shirts. We were all very cold last night and Kathy and I did get extra blankets for tonight. There is no heat in our rooms. We are also on the first floor and have a window with no covering on our shower. Really nice. Plus we have one outlet in our room. We moved my bed about 2 inches from the wall to plug in hair dryers and couldn´t open the door this morning. Crazy!
Today we screening 11 more kids. There are 52 scheduled for surgery and the goal was 100. As of now, surgery is only scheduled Mon-Wed and was supposed to go through Friday. Looks like we´ll gave lots of free time. I´ve gotten some great pictures of kids and gotten to see a few really interesting ones, including one with a partial facial cleft and a little guy with the most severe hypertelorism that I´ve ever seen. Our first kiddo today had scabies, so I´m a little paranoid about that, but I wore gloves and have been using antibacterial gel like crzay. We were finished by 1 today, so six of us walked around town and had coffee at a really neat coffee shop. The town is pretty boring on a whole and there is not much to do here. The shops were junky and we have seen no souvenirs yet.
Went back to the hospital at 4 for the posting of the list of who gets surgery and when. It´s so neat to see the faces of the parents light up when their child´s name is called. Even the older kids get really excited about being selected for surgery because they know it will change their lives. The only kids who don´t get selected are the ones who are too young, too involved (and they be seen locally later), or are sick (heart murmur, pneumonia, etc.). After that we came back and tried to nap, but this horrible band was practicing right outside of our window...the same 3 measures again and again, but at different times and not together at all for 45 minutes. Then, they finally played a song. It was horribly obnoxious! Hope it´s quite tonight, but from the sound of things that will not be the case. Thank goodness for earplugs.
We all went to dinner tonight at 7 and didn´t get out food until after 9. Yep, Honduras is just like Nicaragua in that regard. By the time our food came most of us weren´t even hungry anymore. We just back back to the hotel at 10:15 and some were going to a disco tonight. While it would have been fun, I´m still exhausted from the week of my defense and I need one more night of good sleep before I´m game to do anything late at night. Tomorrow we have a fair amount of travel to and from the Copan ruins for our sightseeing day and then we hit the ground running with surgery on Monday.
Thursday, November 8, 2007
Operacion Sunrisa Day One
I got up at 4:00 this morning and was at the airport in Baton Rouge by 5:30 am for my 6:30 flight. I actually arrived early in Houston and was in Tegucigalpa, Honduras by 12:30 pm. There were about 8 other OpSmile volunteers on my flight from Houston. We got to our hotel--a very nice Clarion Hotel--and then a group of us walked a mile to the mall and ate something at 3:00 since none of us had had lunch yet. Came back and took a little nap and had our first team meeting and pizza at 7:00. It´s almost 8:30 and I will be going to bed VERY shortly.
My roommate is Michi, a pre-post op nurse from Oregon. She´s going to be great--very funny and full of life! One of the anesthesiologists, Mike from Arizona, is from New Orleans so that was cool. He actually brought an LSU shirt here as did I, so we talked Louisiana stuff. There is no one on this mission from my previous one, but there are people who know people from my previous mission. One of the nurses, this is her 13th mission!
Tegucigalpa is very much like Managua, except it is located in a valley and there are lush green mountains all around. I can´t believe it, but they actually drive worse here! Didn´t think that was possible. I just close my eyes in the bus and hope for the best. Nothing like zipping through the streets of Tegucigalpa in a bus with the horn honking every few minutes and Abba blasting on the radio. The Honduran missions are usually here, but for some reason we are going to Copan this time. I´m glad as we have repeatedly been told that it is not safe here on the streets, although in a group during daylight we had no problems.
When I checked the weather before I left it was supposed to be in the 70s all week. A cold front has moved in and we´ll be at a higher elevation tomorrow and it is supposed to be in the 40s. I mostly have scrubs, capris, sandals, and short sleeved shirts, so it should be interesting. Hopefully it won´t last long. I do have a couple of sweaters and long pants, so I may just wear the same thing every day and do lots of laundry.
My time on the next is running out, as I paid 3 bucks for 30 minutes, so I´ll sign off for now. I have no time to proofread and I am typing on a Spanish keyboard, so there are likely many typos and no time to correct. Off to shower and hit the sack. Hopefully, more tomorrow. (Right now in the lobby, there is a live band and the guy is singing Ain´t nothing but a hound-dog)
My roommate is Michi, a pre-post op nurse from Oregon. She´s going to be great--very funny and full of life! One of the anesthesiologists, Mike from Arizona, is from New Orleans so that was cool. He actually brought an LSU shirt here as did I, so we talked Louisiana stuff. There is no one on this mission from my previous one, but there are people who know people from my previous mission. One of the nurses, this is her 13th mission!
Tegucigalpa is very much like Managua, except it is located in a valley and there are lush green mountains all around. I can´t believe it, but they actually drive worse here! Didn´t think that was possible. I just close my eyes in the bus and hope for the best. Nothing like zipping through the streets of Tegucigalpa in a bus with the horn honking every few minutes and Abba blasting on the radio. The Honduran missions are usually here, but for some reason we are going to Copan this time. I´m glad as we have repeatedly been told that it is not safe here on the streets, although in a group during daylight we had no problems.
When I checked the weather before I left it was supposed to be in the 70s all week. A cold front has moved in and we´ll be at a higher elevation tomorrow and it is supposed to be in the 40s. I mostly have scrubs, capris, sandals, and short sleeved shirts, so it should be interesting. Hopefully it won´t last long. I do have a couple of sweaters and long pants, so I may just wear the same thing every day and do lots of laundry.
My time on the next is running out, as I paid 3 bucks for 30 minutes, so I´ll sign off for now. I have no time to proofread and I am typing on a Spanish keyboard, so there are likely many typos and no time to correct. Off to shower and hit the sack. Hopefully, more tomorrow. (Right now in the lobby, there is a live band and the guy is singing Ain´t nothing but a hound-dog)
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