Saturday, November 12, 2011

New Renovations to Take Place at HAH!

Oct 18
Cam and Chris left early this morning.  It is exciting and very
gratifying for me to see them so interested and with such good ideas
for fundraising for this project.  I went for a run after they left
and had my best time ever by 5 seconds.  I continue to detest the
uphill part but the fairly level part in the middle gets easier and
less somewhat less detestable.  Then the downhill is even kind of
“fun.”  Having a nice set route gives me the opportunity to time
myself and makes it a game and new challenge each time I do it.
We had surgery all day.   We started with 8 plates on a 3 year old.
Mimi had never seen one done so I helped her with it.  It went fine.
Then we had a couple of smaller cases and a delayed ORIF of a wrist
fracture that Frank and Mimi did very nicely together.  Our last case
was actually two procedures.  A large teenager had a genu varum and
painful knee that he and his family said began when a wall fell on his
leg in the earthquake.  There were some mechanical symptoms in his
knee as well. He had an expensive looking knee brace and was well
dressed.  His xrays showed the nearly 15 degrees of varus that was all
in the femur.  There was no apparent old healed fracture.  His
epiphyses were closed.  Frank first did an arthroscopy and found some
unstable chondromalacia on his medial femoral condyle.  He did a nice
job and trimmed it.  We then switched to the radiolucent table and
Mimi and I put on an LRS femoral fixator and osteotomized his distal
femur and corrected his femoral deformity.  I really enjoyed the case
as did Mimi.  I continue to be amazed at all of the equipment we have
here for doing this type of surgery.  Virtually all of it is because
of the earthquake and Scott’s unbelievable hard work and vision.  That
this type of work is being done in post earthquake Haiti is pretty
mind boggling.  After the case I talked with Frank for quite a while
about how Jeannie and I made the decision to volunteer here for a
year, how it has been such a tremendous experience for us and how we
would like to stay longer if it weren’t for my contract back in
Wisconsin.  I am hoping that the circumstances with my work will allow
me enough flexibility in the next year to return(if I am needed) from
time to time.  If the practice in New London is able to attract a
younger orthopedist who would like to work full time, then I might be
able to reduce my time there significantly and be able to come here
for longer periods as necessary.

The internet finally came on here at the hospital.  I have a ton of
emails to answer and many others to send.  I have seen about a half
dozen patients that I need to run by Scott.

Jeannie made soup and salad and we ate dinner together with Frank and
Kaye.  We had a good time talking about our experiences with our
orthopedic practices through the years.  He was in solo practice in
Sonora, California until a year ago.  He had a same day surgery center
that he really enjoyed working in.  It was very efficient.  He sold it
to the hospital in town and “retired.”  He has been doing locum tenens
about half time since in the community where Scott grew up and where
his parents still live.  Steve Mulder gives anesthesia for him

Oct 19
Very busy day today.  Jeannie and I took Frank and Kaye out and showed
them the duplex that we want to upgrade for living quarters for the
orthopedic director.  The large clinic went well with the three of us
steadily working.  Several more patients with frames came in today for
adjustments and strut changes.  Franz, our xray tech here at HAH had a
motorcycle accident last night and injured the top of his left
hand/wrist badly.  He “sandpapered” off a large area of skin and two
tendons down to bone.  The tendons go to his thumb and index finger.
The wound was highly contaminated and required extensive debridement.
The tendons are missing a segment each and will require specialty care
and probable tendon grafts.  He may also need a pedicle flap to get
skin coverage over the area.

The Mulder/Whitney team provided an excellent meal of “haystacks” for
dinner.  They brought all of the ingredients with them.  It was
terrific.  All of the long and short term volunteers enjoyed it

Oct 20
We had a good sized surgery schedule today including an 8 y/o boy with
moderate Blounts for a TSF.  Frank helped me and it went nicely.  We
finished in well under 2 hours.  Passing the Gigli saw was
uncomplicated.  I helped Mimi do an ORIF of a proximal femur fracture
with a SIGN nail.  She hadn’t done one before.  The patient has
osteogenesis imperfecta and didn’t know for sure when she had
fractured her femur.  The fracture had begun to unite with the
proximal fragment flexed about 30 degrees or more.  We eventually got
it reduced after shortening it a bit and then the rod down and locked.
I spent time emailing to see if we can get a hand surgeon down to
work on Franz.  I sent out about a dozen emails.  I continue to apply
subtle(and occasionally not so subtle pressure) on both Frank and
Kaye.  They haven’t given us any indication of which way they are

Nathan announced today that funding is now available for building a
new kitchen that will apparently be a sit down facility as well as a
commercial laundry.  Both could be revenue centers for the hospital.
Jeannie made a tasty chili and salad dinner tonight for the two
medical students who are leaving in the morning.  It has been great
having Andy and Josh here the last three weeks.  Andy is totally
commited to orthopedic surgery at this point.  Josh really likes ortho
also but is going to wait to make his decision.  One of their
classmates arrives this weekend for a three week rotation.  Andy is
planning to arrange with his school for Jeannie and me to give them a
presentation about the work here and mission work in general.

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