Sunday, July 24, 2011

A day trip to Kenscoff

June 22
The hall outside the clinic was more crowded today than I have ever seen it. There were a huge number of clubfoot cases. Dr Bob Cady was here to supervise. Things were very crowded so we split up and started with OR cases as well as the clinic. Brock began with the patient with the very comminuted intertrochanteric hip fracture. The fracture table was a big help. He did a really good job on a tough case. I am very impressed with him as an orthopedist. He takes his time and does thorough evaluations of patients in the clinic and is skilled and confident in the OR. I really enjoy working with him.

June 23
We scheduled 10 cases today and were able to do them all. Adeel had a great time working with me on the patient with the malunion of a tibia fracture that occurred in the earthquake. We put on a Taylor Spatial Frame and osteotomized the tibia and fibula. We’ll get her x-rays and measure the mounting parameters and deformity. Then we’ll get her prescription for adjusting her struts. I really enjoy doing those cases. The patient with the infected tibia was also a very good case. We removed his SIGN nail and made an antibiotic coated one that we put back in after reaming the tibia several more millimeters. Both Jonathan and Erick helped us either running the C-arm or helping with anesthesia observation.

June 24
The Friday clinic was bigger than usual but was handled very efficiently
Hybiscus flower in Kenscoff
by Rick Wilkerson. He came yesterday with an anesthetist and an OR nurse. He is working on setting up an orphanage here in Haiti. He is going to help me this coming week also. He is in the process of adopting Junior. Junior is now with them in Iowa even though the process is not completed.

We also had 5 more cases scheduled that Brock and Adeel and I were able to get finished by midafternoon. Our daughter, Summer, and her husband, Tim, arrived in the afternoon. It’s great to have them here. This has been a very good week. We have been able to do 32 cases and see a lot of patients in the clinics. I suggested we go on an outing up to the high country around Kenscoff tomorrow and everyone is interested. The heat and humidity here in Port au Prince has been very much on everyone’s mind this week. Emanuel is going to find a driver who will take us tomorrow. I asked him to try his best to get us a decent vehicle that will be reasonably comfortable. We have an early morning dressing change under anesthesia then we will head for the high country.

June 25, 2011
We got the case done early, made rounds and piled into the vehicle that Emanuel had arranged for. Our only ER case of the week came in just then. Fortunately it was just a clavicle fracture so it didn’t slow us down much. JJ wasn’t able to come but three of the other translators came. There were 12 of us besides the driver. The traffic was pretty heavy through downtown and Petiionville but then thinned out. Parts of the road to Kenscoff are heavily rutted and it is quite steep. A 4 wheel drive vehicle would be a must to do that road even infrequently. It was a bit cooler already as we passed through Petionville and steadily got better as we got higher.

Enjoying an outing to Kenscoff with the Cummings team
Nearing Kenscoff, we found a spot with great views back toward Port au Prince and took advantage of it to get photos of the whole group. We hiked up the road and on some trails from that point. We explored off the main road some and found a spot where we enjoyed some spectacular lightning on some higher mountains in the distance. Then it started raining fairly hard. The vehicle which was otherwise very nice and looked fairly new, was equipped with fairly smooth tires. It was unable to get the heavy load up a steep section that was slick with rain. We all got out to lighten the load and the driver tried a bunch of times. He was a bit timid to get up enough speed until finally he got talked into a longer start up run with more speed. He finally succeeded and we ran up after him and got back in. It was a very fun outing. Just getting out of the heat and humidity of the city for the day was great. We all had watermelon in the evening and talked about the really good experience that we all had this week. Brock and Brad would really like to come back again sometime early next year. I hope to arrange things so that I can come at the same time and then go to Cabarete in the DR for a few days. They would have their families meet us there. The Cummings – Tym team leave early tomorrow. They have been one of the best teams to come. Brad is totally efficient and the cases just seemed to get done so efficiently. Brock really understands how things work here and needed very little help with the clinic process or surgery.

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