***Patient Names are not used in order to provide some sort of privacy
Tuesday night 8 pm. Drank the bowel prep stuff for scheduled colonoscopy in the am. Watered plants on balcony. Wednesday early morning hours- up approximately every hour for bathroom fun. Possibly will not sleep at all tonight. 5:50 am alarm goes off. Up, shower, wash my hair for the FIRST TIME IN 5 days (total record!), grab laundry basket, change bathroom trash can. 6:07am. On pasola somehow holding laundry basket driving to clinic in dark.
6:10 am. Arrival to clinic, drop off laundry and head out to see patients. Hmmmm colostomy guy is still on oxygen but the gallbladder and thryoid ladies are stable and should be able to go home. Give instructions to sweet lil Dominican nurses to move colostomy guy to private room and head to preop to make up the beds and review charts for day. 6:30 Back to clinic, can’t eat breakfast- laundry started. Listen to end of devotions, make my announcements for the group (“it’s UNPACK Thursday!”.) and talk to doc about pending colonoscopy- I’d like to be first. Game on. 7:05ish Take my bactrim for the weird infection thing on my leg that is clearing up nicely. 7:10 Out to clinic. Cora puts IV in my arm, ahhhhhh IV fluid feels so good. I was so dehydrated. 250cc bolus. 7:30 Back to Guesthouse, flip laundry to dryer, open up Room 14 to grab some paperwork for the day and pocket some pain meds just in case I need it for my colonoscopy.
7:35 Out to clinic, push the nurses to get the colostomy patient moved before the incoming patient arrive. Begin calling the first 3 patients of the day. Cute 9 year old circumcision is first. He’s scared. But we hang- he’ll be alright. No IV for him. Ahhhhh dear 71 year old hernia comes next. Hugs/kisses/saludos. Just excited to be here. He can’t wait for surgery. Walking through the hallway, I am stopped at least 10 times for greetings and questions. Noted Gunshot-wound-to-the-foot guy who was here last night in the hallway. Review plan of care with him and and orthopedic surgeon. He will have his labs drawn, I will call cardiology and try to get him cleared for surgery. In a bit, I get a message from Dr. Canario- he’s on it. His wife will come in to clear the patient- we are good. Back to Pre-op now Nef-The-Mighty Translator is here. Great- he can run pre-op and call the patients. Quick review of charts to be sure everything is there. We are good in the hood. Small concern that 14 year old hernia has not shown up yet. Nef phones him- they don’t have the money for surgery. “No worries- come on in- we’ll work something out”. He’s on his way.
7:50 Bathroom enema fun. Yay.
7:55 In gastro room for my scope. Love these peeps- they are awesome. So blessed to have the greatest docs in the world come down here.
8:25 Goal achieved- this wasn’t bad. I’m off to Guesthouse to scarf down some food. I haven’t eaten any solid food since Monday night and it’s Thursday morning. Two pieces of salami and a small pancake. Huge cup of coffee with milk. Checking in with Kari- laughing about my scope. Coffee=Heaven. 8:35 Back to clinic. Check on Gunshot Wound- he’s got his labs drawn and waiting for cardiology. Good stuff. Hey, 14 year old hernia made it but oops- he ate some yucca this morning. No worries- we’re good! Quick conference with Dr. Valdez about family situation- Valdez handles everything. Yippeee- he’s off for his labs and will find me when they are drawn. Good stuff. Check in on colostomy guy. He’s good, in his room with his family there. AndryOmar, super nurse, has an oxygen tank in the room cuz he’s good like that and this guy can’t quite keep his oxygen levels up well. General surgeon at bedside, changes dressing, has pulled NG tube. We’re moving on up! Good times. Two post op ladies are up, bathed, ready to go. Discharged.
Patients come out of the OR. I bounce between OR and Pre-op and Post-op and Canario and Valdez and the consultation rooms. Look for some supplies for the OR, pray with the Gunshot wound guy in pre-op. Talk to his sister about how hard this is. Oh, here comes the 14 year old with a big fat grin. He got his labs drawn and he’s psyched for surgery today. I park him in a bed and hand him an IPOD so he can listen to some sweet music while he waits for a few hours for his surgery. Ah, there’s a 19 year old with a necrotic finger who needs to have surgery to debride it/possibly amputate. He’s devastated at the thought of losing some of his finger. Consult room. Prayer. Call in his Dad to discuss plan of care as well. They are sober, thinking, hurting. We pray. They agree to the surgery. I send him off to the lab and run to Valdez’s room to work out a plan of care. I bring lunch to Canario and we grin over the huge pumpkin that someone brought us to eat that Margo cooked up for the group. It’s at least 20 pounds. Check in on Colostomy guy. He really doesn’t keep his sats up well, needs to walk, needs to get out of bed. General surgeon at bedside. Lungs don’t sound the greatest. We talk to the family. They agree to help him walk around his room.
Necrotic finger guy has his labs drawn and I park him in a bed. Oh- here comes hernia guy that I called last week to come on in for a consult after he was seen in one of our barrio clinics. He doesn’t understand the system. I explain how to meet with Canario or Valdez to be prepared well for surgery next week. He’s excited. He’ll do whatever they ask of him. 
IV started on the 14 year old. He’s a trooper- “it didn’t hurt”. Grin.
Lunch. Fabulous cooked mashed pumpkin with Margo’s beef gravy. Molasses cookies that Kari made about 5 minutes ago still warm in the middle. This might be the greatest food I’ve ever eaten.
I check in on the post ops, write down some vitals, change out a monitor, look for my portable pulse ox for the colostomy guy, talk to family members waiting. Wait, here’s another patient sent from Caceres, a 13 year old circircusion. The docs are still in surgery or eating. I park him in a bed and review the labs. They are thrilled to make the surgery schedule cut. Necrotic finger guy is really quiet. We promise again to try as hard as we can to leave as much finger as we can. I’m wishing wishing wishing for him but not feeling so great about the possibility of it. Gunshot wound guy is nervous and has lots of questions. We talk a lot about the surgery. His son comes in and would like to hear everything from the beginning.
Surgeons come in and check out the 13 year old. We can do his surgery! yay. Consents, gown, and an IV. He’s also a trooper. Big grin.
14 year old hernia kid’s time for surgery has come. I tell him I’m coming to surgery with him and we grin and take the IPOD with us. He’s quiet as a mouse on the OR table while we get him settled. His eyes stay with me until he’s out like a light. I take the IPOD out to the 13 year old and he lights up like a Christmas tree.
Post op- sweet 9 year old circ is outta there. He’s not quite as happy as he was when he arrived this morning but he’s prepared to leave and his doting family members walk him out to their waiting car. The other two dear little old hernia men are both in post op hanging out and hanging on. Today was definitely the hernia special.
I head into the office to type up a surgical report for the week. I give Livida a copy and the surgical team a copy as well. Check a few emails. Sigh. Lots to return. I’ll write them later.
Back to clinic. Colostomy guy is doing better, up, sitting in a chair. I touch base with Valdez about a follow up care plan for the Gunshot Wound guy. We’re good.
I hang in post op with Nef for a while checking out the recoveries. 14 year old is serious and quiet but says he’s not in pain, he just “feels weird”. He takes the IPOD again and puts it up against his cheek to listen to the music. His Grandma makes me cry as she hugs me and says “this was our only chance….thank you- thank you-thank you!”. I wipe my eyes and head back to OR 2 to see how the 13 year old circ is going. All good in the hood.
Post op remains chill. Everyone comes out of anesthesia well. The dentists need their instruments run in the autoclave. I put them in and start the autoclave. Lily and AndryOmar are buzzing around helping everyone. 14 year old leaves with a big hug and they promise to come back and visit. Gunshot Wound guy keeps thanking us over and over and over again. 13 year old circ has tears. I head off to find anesthesia for more pain meds and we fix that all up.
Lily and AndryOmar are good to go so we bail on Post op. 2 quick meetings with Dan and some of the translators. Nice- nice. Dan and I head out at 5:55 for the Guesthouse. I catch up with Laura, Jeff, Kamanda, Kari and Dan in the kitchen while dinner is being prepared. Ahhh asopao- my favorite dinner. Soup with rice and chicken- delish! Total feast. Dinner, catching up with the crew. Take my second Bactrim- leg looks even better.
6:40- off to apartment to shower, etc. Oops- don’t forget the laundry. It’s finished. Again, squashed laundry basket on the pasola is a joke. But I can pull it off. Back at apartment, water plants again. Put laundry away. Shower. Check emails. Start this blog. 7:20 Head over to CCED to support Student Sponsorship Meeting. Wow- lots of folks. Really cool. But there are plenty of translators and I can skate outta here. 8:15 I skate with Monch. We head over to his mom’s house to visit. 9:40 Head back to apartment,, hang out and relax while he plans for his journey to the capital. I doze off. 11:00 Drive M home on the pasola. It’s COLD. 11:15 Home again. Check in with Laura and catch up on the last couple days and what’s been going on with this current group.
8:15 I skate with Monch. We head over to his mom’s house to visit. 9:40 Head back to apartment,, hang out and relax while he plans for his journey to the capital. I doze off. 11:00 Drive M home on the pasola. It’s COLD. 11:15 Home again. Check in with Laura and catch up on the last couple days and what’s been going on with this current group.
12:58 Finish this blog. Lay thinking of how good God is. The patients feel great- they felt loved. They were prayed for. The Americans worked so well with the Dominicans. I personally was loved on and prayed for. The surgeons seem pleased with their surgeries. Dr. Canario and Dr. Valdez seem pleased as well. This team has done amazing things but I’ve SEEN even more amazing things that God is working out- bringing folks in and showing them Who He Is. Showing ME more Who He Is. And now sleepytime. PEACE BE WITH YOU- May the God of our crazy days remind you more and more that He alone controls your every minute.
