Saturday, January 8, 2011

New Year News from Orthopedic Ministries of the Caribbean

Here are the updates from Terry's journal, starting from post-evacuation to their return this week at HAH.

Dec 18 -19 -20

It is quiet!  No diesel generator cranking away in the background or honking of cars can disturb our current environment.  What  a great way to start the Sabbath.  Our long walk down the beach in Cabarete Bay gives Jeannie and me a taste of what God has in store for us when all of the hunger, unhappiness, heartache, disease, suffering, disasters, violence and death are things of the past.  None of these sad afflictions of humanity have seen fit to bypass the people of Haiti.  To the contrary, they seem to all be more prevalent, even intense in this country that was once the most prosperous of all French possessions.  Albeit, that prosperity was no doubt in large part founded on slave labor.  Is there a possibility that the permeating societal belief in voodoo could somehow be related?  My Christian beliefs make me aware of the satanic powers that Christ faced in his life and ministry.  Could the fallen archangel have an all pervasive influence on the entire country and somehow make misery Haiti’s currency of life?

We received some interesting news via internet today.  The OAS has approached the Haitian government with an offer to help resolve the current political/social standoff.  They are willing to bring a panel of international experts to Haiti to review the election results.  Perhaps, if the offer is accepted, a way may be found to avoid more violence and danger.  It may also just put off the inevitable unrest that would be felt by supporters of whoever loses the election.  Now we have to wait and see what decision the Haitian government makes.  It could take considerable time for the panel to be assembled and complete the necessary work.  That leaves us with more uncertainty.

Dec 21-22

We are back home – well sort of.  We are in the US.  Our flight to NYC from Santiago was uneventful as was the continuation to San Diego.  We arrived at our final destination at 4 am our biological time.  It made for a very long day made even more interesting by a highly unusual checkin and then a totally chaotic situation at JFK.  I had to hand carry an oversized bag to a different terminal so it could continue to San Diego.  Then we made several trips back and forth to a third terminal to go through security and get to the boarding gate.  It was freezing outside.   It was all worth it to be able to spend Christmas with our children.  It has been almost a year since we have all been together.  We are so blessed to have children who are well adjusted and productive and who enjoy spending time with us.  Our son, Cameron, has been dating a girl for several months and thinks she is the ONE.  We get to meet her family this weekend.

Dec 23-24

We didn’t expect to be able to do any Christmas shopping this year but these extra unexpected few days gave us that opportunity.  It is great fun to just be able to hang out with the kids.  We enjoy doing so many active things together.  The San Diego area has such good weather usually.  There has been heavy rain the past several days throughout Southern California including severe flooding in Laguna Beach.  The mountains have received more than 10 feet of snow in some places in the past few days.  It is the snowiest December ever apparently.  These last 2 days have been mainly sunny and delightful.  Our dinner meeting Courtney’s parents was a lot of fun.  We had a great meal and enjoyed the time together getting acquainted.  Courtney and her brother grew up in this area.  Her parents both keep very busy with their work.  Her dad is a gynecologist and her mother works part time as a nurse.  We will celebrate Christmas in their home tomorrow.

Dec 25

How fortunate we are – Christmas with the family.

Dec 30- 31

Golf with Bob and Cam and Courtney.  Jeannie’s shoulder is slowly improving.  We hit balls and she made some good shots.  She is generally sleeping better as well.  She still uses quite a bit of Ibuprofen.

Emailing for fundraising.  Played games and ate pizza to ring in the new year.

Jan 1 – 2   2011

Spent time at the beach with Courtney and her folks then went to the airport for our all night flight to Miami/Port au Prince.  Nathan was on our flights.  Everything was quiet at the airport and the drive through town to the hospital.  It is nice to be back “home”.  We are the first expatriates to return and we received a very warm welcome from the Haitians who met us.  There are only a handful of patients in the hospital and none of them are orthopedic.  I anticipate a monster clinic tomorrow since we have been gone for nearly two weeks.  Jerry King came in on an afternoon flight.  Jerry is a friend of mine from LLU.  He practices orthopedics in North Carolina.  He came to HAH about two weeks after the earthquake.  He is accompanied by David Brannon from Georgia.  David is an anesthesiologist.  We hope to get a lot accomplished in the next week.

Jan 3

The clinic today was much smaller than anticipated.  It still took us most of the day.  We didn’t have an xray tech until after 10 am.  I wound up having a fairly long meeting with Nathan, Madame Clotaire, and Dr Simeone.  A patient came in to the ER with an extensor tendon laceration.  Jerry did a nice job of repairing it while I stayed in the clinic.  A patient came in to the clinic with what appeared to be an infected distal femur fracture s/p ORIF with plate and screws.  We took her to the OR and removed the plate and screws and debrided it.  We made antibiotic beads as well.

Tim sent me 2 long emails with the initial outline for the coffee table book so I responded to them.  Andrew also sent me a very nice response and expressed an interest in helping with the project.

Jerry told me that Dr Brock Cummings had come down also in the aftermath of the earthquake and would probably consider returning.  He grew up in Ukiah and my dad had him in his classroom in the fifth grade.  He practices orthopedics in northern California.  I called him and he is very interested in helping me for a week or two later this year.

Jan 4

Today wound up to be a shorter work day even though we had 4 cases scheduled.  Three cases including a bilateral knee arthroscopy were cancelled for various reasons.  Jerry and I did the ankle fusion and it went well in spite of having a quite limited selection of large cannulated screws.  Having a reliable source of replacement screws and plates, especially the nonstandard types, would be a really big help.  The C arm worked very nicely which delights me.  The clinic was bigger today than yesterday even though it is supposed to be a “nonclinic” day.  The clinics will undoubtedly continue to grow larger as the word gets out that we are back.  At this point it is somewhat difficult to know how to plan and give recommendations to the larger teams that are scheduled to come down.  I am reluctant to tell them to bring specialists, especially extra anesthesiologists, not knowing what the volumes will be in the next 3 to 6 weeks.  We haven’t gotten any fresh femur or tibia fractures yet but I’m sure they will eventually come.  I just hope I don’t get hammered when I’m by myself.  I have heard from several new teams that have been here before and want to return.  That gives me more reason for optimism that I will be able to survive this year in a reasonably intact state.

Jan 5

The clinic today was larger than yesterday not even counting the quite large clubfoot clinic that Bob Cady was here for.  I had only met him briefly in November.  He is a retired pediatric orthopedist who has a special interest in clubfoot treatment.  He has been involved in teaching the Ponsetti method for many years and has made many trips to Haiti in the past.  He does clinics in different places in the country.  It has been a delight to get better acquainted with him.  He is an avid golfer and loves to fish.  He and his wife live in New York state but spend a good share of the year in Naples Florida.  We have played some of the same courses in the Naples area.  He is reading the latest Tracy Kidder(“Mountains Beyond Mountains”) book and plans to leave it with me when he leaves this weekend.  Our surgical cases went well.  One patient had a healed femur fracture that was infected and draining since ORIF with IM rod 3 years ago.  The surgery was performed at Hospital Dario Contreras in Santo Domingo.  The patient was living in the DR at the time he had the fracture.  He speaks excellent Spanish. Jerry did the case.  He debrided the sinus tract and windowed the bone and removed the rod.  It was pus filled.  He made a methacrylate/antibiotic coated rod, over-reamed the canal and put in the rod.  We didn’t have blood cross matched but the patient had a hematocrit of >40 so we thought it would be safe.  I got the great news that Lucia will be able to come tomorrow and assist with the spine case on Friday.

7 year old Alexander with his brother.
I saw another very interesting case in the clinic today that typifies the years of neglect of orthopedic work in this country among the indigent.  Alexander is 7 years old .  He had a normal right leg until he was two when he sustained a severe burn around his knee.  The burn created a contracture that caused the knee to flex to greater than a right angle.  The peroneal nerve was also apparently damaged severely.  He hops on one leg everywhere.  To add to the tragedy, his mother died of some disease nearly a year ago.  He was brought to the clinic by his aunt and 13 year old brother, Stanley.  His father lives elsewhere and is not supportive or helpful.  A team approach with plastic surgery may be able to successfully give him a good functional leg.  I got a video of him hopping.  It will be great to have a comparison video with  him walking with a straight leg.  He might even be a rival for Staille on Youtube.
Severe contracture caused by burns.

1 comment:

  1. Gradual distraction with Ilizarov might be a good option for this youngster.