Sunday, September 4, 2011

Appleton and NC Teams Are Great Blessings to HAH!

Aug 10
There are several runners in these two teams and they wanted to go out with me so we headed up the hill a bit after 6 am.   It wasn’t long before they all were ahead of me when I stopped to get a breather and walk.  Jerry King and Robert waited for me to catch up and then we ran back down the hill together.  It’s nice to have some company on the runs.

The clinic was really big since it included many of the patients from Monday.  Two more patients with hip fractures came in today.  They both need blood so we will have to put them off until the family is able to get that arranged.  There is a third hip fracture that the family was able to get the blood for and we will need to work into the schedule.  Since we have a lot of horsepower with both of these teams, we were able to start with surgery also before noon.  I did the TSF and Jay and Errol helped me.  It went well.

Aug 11
Having two full rooms to run all day meant we were able to get a lot done.  Dave gave anesthesia for Jerry and Adam, the resident.  They did 7 cases including the revision of the BK amputation.  Jay and Errol worked together on several cases in the second room with Steve giving anesthesia.  We finished with the cases around 8 pm and decided to celebrate with pizza at the Auberge.  The tap tap lights   
Errol Springer and Jay Minorik operate in room 2
weren’t working so we used another hospital vehicle.  I lost count but there were about a dozen of us crammed in the Montero.   I took it slowly up the bumpy road to the hotel.  We were disappointed that the restaurant only had one small pizza left.  It took them a while to get our table since the tables on the balcony were mostly taken already.  The service was even slower than their already legendary slowness.  We didn’t get our food until well after 10 pm.  A couple of us were able to get in a bit of nap time.

Aug 12
Steve was down for the count today with a serious dizzy problem.  He couldn’t sit or stand without getting extremely dizzy.  He stayed in bed and we tried to get medications that might help but it lasted the entire day.  Dave discovered an oxygen leak in the anesthesia machine in room one and couldn’t use that room anyway.  We did all of our cases in room 2.  The clinic was again very manageable with so many providers seeing patients.  Francel left yesterday for a CURE clubfoot seminar but even without him we worked through the clinic and finished by early afternoon.

Aug 13
Most of the members of both teams wanted to go on an outing so Manuel arranged for the same driver that took us to Kenscoff.   Steve Dungar had already started feeling better last night and was feeling well enough to go on the outing.  Dr Brannon and Robert stayed with Jeannie and me.  They didn’t go as far as we did but stopped at the Baptist mission in the little community above Petionville.  There is also a historical fort nearby that I managed to overlook when we went to that area.  Fort Jacques was built by Alexander Petion in 1804.  It was restored in 1992.  They all enjoyed the scenery and the cooler temperatures.  On the return, they went to Franz’ orphanage and left the children several bags of clothes.  The new team of Ron Anderson and his family arrived this morning.  Ron has been here before.  He and I took care of the American fellow with the open tibia fracture several months ago.  He was unable to bring an anesthesiologist with him.  He did bring his wife for the specific purpose of exposing her to the situation her to see if perhaps she might be interested in coming and staying for a longer period of time.  His college aged daughter and son-in-law and his high school daughter are also with him.  Ron will be here through Thursday then will be joining the staff of the hospital ship for a two week stint out in the bay.  His church sponsors several people who are staff on the ship.

Jeannie and I went to the English speaking church at the University up the hill.  Dave also attended.  After lunch, we did the lady with the femoral neck fracture.  It was clearly a month old fracture if not more.  It went well.   The rest of the crew got back as I was finishing.  We brought down the patient with the external fixator that Scott had placed for her dislocated hip.  Scott had recommended fusion with a cancellous screw and continuing the fixator.  We found the proximal pins all loose so took the fixator off.  We used the C-arm and studied the hip and found that the acetabulum appeared intact, including the posterior wall.  The head had a shear fracture.  We all agreed at her age, 43, that a hemiarthroplasty might work better for her.  We might even wait until we can do total joints and then do a total hip.  She and her husband were in agreement with the recommendations.  It wasn’t my ideal way to spend the Sabbath but we needed to do both of those cases.

Aug 14
Both teams left before 6 am.  It has been a really good week with them here.  Ashley is an excellent scrub tech.  She has such a positive attitude and is a joy to work with.  Robert really was able to make things happen in the OR.  He took ownership and moved things along.  It didn’t take him much time at all to get familiar with the OR and where things were located.  I hope they will come back again.  It goes without saying that Jerry and David are a huge help.  Having been here before means a great deal.  They are familiar with how the clinics and the OR work and can go to work with no orientation.  Jerry has a very good understanding of how to manage cases that are out of our capability for whatever reason.  David continues to provide very high quality anesthesia.  He refuses to compromise in any way which I thoroughly appreciate.

The Appleton team was really great.  They all adapted quickly to the situation and were a big help.  Being able to run two rooms and get a lot of cases done is so important.  It allows us to schedule a lot more elective cases.  It was a lot of fun watching and listening to them “rip” each other with put down after putdown.  They would go after each other as well as the anesthesiologist.  He was actually their biggest target.  They even got me to throw in a little bit of my own sarcasm and a couple of putdowns.  Their nurse, Eric Bowen, especially has a heart for the Haitian people and this work.  I certainly would like for this team to come back.  Steve is planning to encourage his partners to come.  We really have a big need for anesthesiology here.

I went for my morning run after they left.  Going up the hill is still a negative experience but coming down is even getting to be somewhat pleasurable.  I then spent a couple of hours with a jackhammer making holes in the roof over the balconies of the four rooms on our side of the hospital.  The air conditioners that have been installed in our rooms for about a year can now be connected to the condensers on the roof.  Randy says we might even be able to have them connected by tomorrow.  Sleeping the last couple of months has been somewhat less than refreshing many nights because of the humidity combined with higher evening and night temperatures.

Tonight we had one of the most incredible lightning storms yet.  The thunder and lightning were almost simultaneous as the storm passed immediately overhead.  The rain started to flood into our room from the balcony.  Fortunately, Jeannie noticed it and we put several of our towels in the doorway to keep the water on the balcony.  The balconies all have drains but they aren’t leveled properly and tend to direct the rain water towards the door rather than the drain.  The break room next door got totally flooded with water more than an inch deep even out into the hallway.  The electricity stayed on through the whole storm and then when it passed the lights, water and fans went off.  They were off for several hours and then finally came back on in time to take a shower before falling asleep.   

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