June Winds Down

June 26
It is Nathan’s birthday today so Jeannie made waffles for everybody.  Summer and Tim brought us a waffle iron and strawberries so we feasted.  It was really good.  I had planned to get some work done on the taptap today so focused on that for several hours.  Dr. Wilkerson is staying with his team at the Auberge.  He invited us over to use the pool so we accepted.  It felt really good to cool off.  I talked with Rick in the pool about all of his overseas involvement in Iraq and Afghanistan.  He was surprised to hear that Loma Linda has a significant involvement there.  He is a mountain climber and has climbed many of the Fourteeners in Colorado as well as Mckinley in Alaska and also in the Himalayas.  His wife has climbed some with him also.

June 27
We had another big clinic and 5 surgical cases today.  Another anesthetist, Carol Crawford, from Pennsylvania arrived today.  She should be able to help with the case load.  Rick has such a positive attitude.  He jumps right in to everything.  He is a joy to work with.  The AC went out in OR 1 again today.  I hope it can get fixed promptly.  The clinic went surprisingly fast.  I did an 18 month old child with severe arthrogryposis of all four extremities.  I did posteromedial releases and talectomies on both feet.  Rick did a hemiarthroplasty on a patient with an nonunion of a femoral neck fracture.   Adeel worked with him.  Both Jonathan and Erick are getting lots of opportunities to scrub in and assist.

June 28
Today was disappointing.  More than half of our scheduled cases didn’t show up.  We were still able to do 4 cases.  A patient with a fractured femur and head injury was brought to the ER.  He fell out of a tree.  He has an open depressed frontal skull fracture that extends into the orbit.  He is unconscious but responds to painful stimuli.  I had Adeel clean up the head wound and put in a tibial traction pin.  Lynn called Medishare and they agreed to accept him.  Erick went in the ambulance with him.  The rented hospital generator stopped working this afternoon.  It took nearly 5 hours to get it started.  That meant no water for showers or even for purifying and of course no fans to help cool us off a bit.  There was a bit of a breeze on the roof and we were planning to sleep there but the generator started working again about 9 pm.  The water came back on so we all took showers.  The cool water really felt good.  With the fans blowing on us we were able to get a good night of sleep.

June 29, 2011
Today made up for yesterday.  We had good power all day and the AC started working again in room 1.  I was very surprised.  Dr Wilkerson and his team had to leave today to work on his orphanage project.  I wish they could have stayed longer.  Anthony Fenison came before noon and we saw patients together in the clinic.  Anthony practices orthopedics in Southern California.  He is here in Haiti with a church group doing a building project.  His wife and two teen aged children are working on the project.  We finished the clinic by early afternoon.  One of the surgical patients from yesterday came today and a couple of others that had been cancelled previously also came.  Anthony did the morbidly obese patient with the femoral nonunion.  He got the rod out and the SIGN nail in but locking was virtually impossible.  The aiming arm wouldn’t fit over her huge leg.  He got one locking screw in above the knee but couldn’t get C-arm visualization for anything proximally.  She presented a hemodynamic challenge as well.  Pulmonary issues could also complicate things.  We’ll have to watch her overnight in the PACU.  I did an arthroscopy with Jonathan the medical student.  He was totally stoked getting to hold the arthroscope and probe the knee and then suture the portals.  We have a lot of cases tomorrow and just one anesthetist.  It will be an interesting day.  Maxi, our patient from Cap Haitien with the infected open tibia fracture that Pat Yoon helped me with so much came in to clinic today.  The proximal pins in his ex fix are loose.  The fasciocutaneous flap has all healed nicely.  We admitted him to revise his ex fix tomorrow.  We continue to have power issues.  The rental generators all seem to start off working well then act as if they are starved for fuel.  Randy thinks it is water in the diesel and the filters are being overwhelmed.  The big diesel tank needs a thorough cleaning apparently.

June 30
Our cases went nicely.  Anthony is a very good surgeon.  He relates well to everyone and is really fun to be around.  Carol  with Tim’s help got the cases going with good efficiency.  The last case was an ACL reconstruction in a soccer player.  Anthony and Adeel did the case.  Our set up and instruments are different than Anthony is used to but he dealt well with it and got a nice stable knee.