Tuesday, July 19, 2011

Needs Continue to Abound at HAH

June 1 - 16
What a good last 2 weeks this has been. I left the Herzenberg team with Francel to cover for me while Jeannie and I returned to Appleton. I was able to work taking call for my partners and do elective surgery.  It was beautiful spring weather.  I was also able to spend time doing spring cleanup in our yard.  Golf and tennis were also on the agenda.  The best part was seeing the first edition of the coffee table book.  I stayed in contact with HAH via email.  John had arranged for Jeff Young to come and follow the post op patients for at least one week along with Francel.  Jeff recently finished a pediatric orthopedic fellowship and is moving to Stanford to teach.  I really appreciate his willingness to come and help with this program.  I hope he will be interested in returning and perhaps bringing residents.

June 19
 The trip back was very interesting.  We had a flight delay in Miami.  It gave me an opportunity to talk to several people wearing t – shirts that indicated they were volunteering in Haiti.  I showed them the coffee table book and they were all interested in having one.  A Haitian sitting nearby seemed very interested as well.  I showed him the book and we began to talk.  He lives in Boston and has a home in Haiti.  He has many connections with the Haitian American community in Boston including two Haitian radio stations.  He also gave me the telephone numbers of two people that he says are very close friends of Mickey Martelly, the new Haitian president.

Brock Cummings team arrived here yesterday.  He practices orthopedics in Northern California.  He was in Port au Prince several weeks after the earthquake.  He was deeply impressed with the Haitian people.  He brought his 16 y/o daughter on this trip.  He also brought an OR nurse and an anesthesiologist, Dr Brad Tym.  Dr Adeel Hussain is also here.  He is a third year orthopedic resident from Loma Linda.  Johnathan Mills is a second year medical student from Loma Linda.  He will be here for several weeks.  Eric Bauer is a premed student from Wisconsin.  His mother is one of my partners in Thedacare.  Eric and his dad Rick are here for about 10 days.  With a team like this we should be able to get a lot done.

Jeannie and I are both happy to be back.  We really are enjoying the experience here.  Our room was a bit stuffy so we got it aired out.  Our daughter, Summer, and her husband , Tim, will be arriving this Friday.  We have several things we would like to do including putting up some shelves.

There are several challenging inpatients that require special management.  The most difficult is a 19 y/o boy with a tumor in his proximal humerus.  Francel admitted him and sent his xrays to John Herzenberg and others.  The consensus is that it is a malignant tumor and he will need a forequarter amputation.  I have never done one before but I am sure that we should be able to manage it.  We will certainly need to have blood available.  Four patients with hip fractures were transferred from MSF (Médecins Sans Frontières/Doctors Without Borders) Belgium when they closed last week.  Lynn had emailed me about them and I told her to go ahead and accept them if there were beds.  Two are intertrochanteric  and two are femoral neck fractures.  One of the femoral necks is basilar.  We can fix three of them with compression screws and the other put in a hemiarthroplasty.  All of them need blood typed and cross matched and Lynn is already working on that.  We’ll do at least one hip fracture tomorrow after getting a good start on the clinic.  We also have some smaller cases to do.

June 20

The clinic was really big.  Brock and Adeel and I dove in and started seeing patients.  We made good progress by 11 oclock so Brock went to the OR and we set up the fracture table and got the hip going.  It is so great to have the C-arm working reliably.  Since Scott got it running in March, it has worked perfectly.  The second identical machine should be coming down when the next container comes.  A specific date has not been set but it should be in the next couple of months.  Brock did a nice job  on the hip compression screw.  The Stryker Omega 3 system that the Vitale team brought down in January has been working very well.  Whenever I use it, I think of the Vitales, Aldo, Mark and Mike as well as Tom Lyon and the other members of their team.  All of the teams that have come here have been a big help.  The Vitale team was a special one.  I look forward to working with them again.  Both Aldo and Mark have talked of coming again this fall.  The fracture table is working very nicely.  That is certainly a valuable addition to our armamentarium here at HAH.  THANK YOU Ed Miller!!!  We were able to finish the clinic at a reasonable time and wound up doing 5 cases.  Brad Tym, the anesthesiologist from northern California, is very efficient.  He is comfortable doing regional blocks and running more than one room with the medical student or a nurse watching the patients as he supervises.  I am very impressed with him.  The OR nurse, Stacy, that came with Brock is also very comfortable and is very much at home in the OR here.  It turns out that she went to school in Riverside, California with Jeannie’s brother, Bob.  She lived just down the street from Jeannie’s family.  Brock’s daughter, Chloe, is very mature for a high school student.  Brock has taught her to scrub and she has no qualms about setting up the OR and scrubbing on ortho cases.  I am really impressed with her.

June 21

Today was another major test for the whole team.  We had a lot of cases scheduled and made it through all of them except for the child that had an upper respiratory infection that we cancelled.  Brock did another of the hip fractures.  I did a couple of biopsies with Adeel and the students.  Everybody is working very well together.  The family of the boy with the shoulder tumor has decided to transfer him to the Medishare hospital and possibly to the US.  We made all of the arrangements for that.  Our load will be less stressful now.

I had a nice long talk with Nathan today.  The Florida Hospital people were here while I was gone.  They did a thorough cleaning of the whole place.  The administrators and engineers also came.  Nathan filled me in on the progress.  I hope they will be interested in helping get the coffee table book more widely publicized.  There has been progress in getting the two duplexes emptied of their current nonhospital affiliated occupants so that they can be utilized for volunteers.

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