Firsts & Fireworks

Mar 20
That wonderful rest we all got yesterday has given us all a renewed supply of energy.  Dr Ron Anderson is an orthopedist from The Los Angeles area.   He came to HAH in the weeks after the earthquake.  He is back for another  2 weeks of helping Haitians with their orthopedic needs.  The compound was on lock down for the election so we concentrated on getting caught up with our cases.  Ron and Ben did a hip hemiarthroplasty and I made sure they had everything they needed.  Jeannie is off her back but the bug she had sapped her energy level and I don’t want her to overdo it. 

She had a ‘vegeburger feed’ planned for 7 pm for all of the volunteers and I wanted her to take it very easy in the OR.  For those of you who have never experienced one of her vegeburgers,

Ben, Terry, & Scott

you need to come to Haiti.  If you want to wait until November, you can visit us in Wisconsin and enjoy them there with us.  I know dedicated carnivores who would kill for the recipe.  The hemiarthroplasty went nicely.  Tim and Summer provided recovery services since nursing staff couldn’t provide any extra nurses on a Sunday.  That was really big because it freed up Dr Mulder, our anesthesiologist, to get right into the next cases without a prolonged delay.   Ben and I then did the distal femur fracture.  It turned out to be what appeared to be a nonunion that was possibly infected and took nearly 5 hours.  Fortunately, we had a periarticular distal locking plate for a LEFT femur. (now we have none).  We debrided everything completely and fixed him with the plate and screws and placed antibiotic beads.  Ben and Ron did two more cases together.  Then it was off to the feast.  As usual, Jeannie’s creations were a total hit.  It was a fun event to have all of the volunteers together for a social occasion in the break room.

Ben & Scott work on a TSF

Mar 21
The election yesterday went off with no apparent disturbances.  I was anticipating the typically huge Monday clinic but it was not big at all.  There could be two explanations.  It is apparently common after a big day like election day for people to stay home.  The second possible reason has ominous overtones.  The hospital started charging ALL patients 150 gourdes (about $4) for the clinic visit.  I hope it is not the latter.  If the charge (about half of what most other fee for service clinics charge) becomes an effective barrier for the true indigents, then it will have to be removed or there will be no point in me continuing to work here.  I didn’t come here to take care of people who have jobs and who can pay for their care. 

We had four good cases and Ben continues to be in seventh heaven. We had a hip hemiarthroplasty, bimalleolar ankle fracture, knee arthroscopy and ORIF BB forearm.  All of the cases went well.

I wanted to have Tim and Summer and Ben get a taste of “peekleez.”  We went to the Auberge and Steve, Ron and JJ went as well.  When we got there, another translator had included himself.  We got several pizzas and some rice and beans and peekleez.  Ron didn’t want to try the peekleez but everyone else thought it was really good.  Steve was stacking it on his pizza like there was no tomorrow.  I showed some pictures of Mardi Gras and we all had a great time.

Mar 22

First ever arthroscopic ACL reconstruction done in Haiti

It was surgery day.  We started with the first ACL ever done arthroscopically in the country to our knowledge.  I guess it was fitting that the patient was an earthquake victim.   It took a bit longer than the usual one at home.  The patient had a large bucket handle tear of the lateral meniscus.  Once we got the meniscus out, the case went like a standard ACL.  The second case was a high level soccer player who was playing several months ago, felt a ‘pop’ in his knee and got a big effusion.  He had the classic findings of grade 3 Lachman and positive ‘pivot shift.’  His case went smoothly.  His menisci were normal.  It will be great if these two patients spread the word and we get some more good arthroscopy cases.

New ACL graft in place!

It has the potential to bring good revenue in to the hospital.  The hospital certainly could use the support.  They were good cases for the resident since very few are being done at Loma Linda right now.  I hope it will motivate the powers to encourage the residents to come down for longer rotations.  I could certainly use the help.
 
Steve caused some excitement tonight.  He bought some rocket/fireworks in the delimart and waited until dark to set a couple off from the roof of the hospital.  The first took off high in the sky and exploded with the big blue shooting stars just like in a big pyrotechnics display.  It caused a lot of ‘oohs’ and ‘aaahs’ from the spectators.  The second misfired and twirled on the roof and exploded with a powerful bang roughly over room 209.  It caused some fairly serious concern on the part of the patients in that wing and Nathan put a stop to the show.  I'm not sure of all of the repercussions at this point but most of us that were in range are still trying to get our hearing back.  I saw Emily come in a bit ago apparently at Nathan's request or perhaps a patient's.  I hope we don't have to bail Steve out of jail.  Maybe he’ll have to sit in a corner with a dunce cap on for a little while.  We don’t have any cases scheduled tomorrow so maybe he will escape early to an orphanage or somewhere where it will be difficult for the police to find a 6 foot 9 inch white guy.