It has been a very busy past few days, sorry I haven't updated! So Monday morning/afternoon was great! I got to sleep in all the way until 8am. What a great feeling that was LoL. I spent my day reading on the deck in the sun, shopping, and visiting with two other team members. It was exactly what we needed. I had been getting frustrated with some of the politics of the mission and a morning off to do what I wanted was both relaxing and theraputic for my 2 group members and I. We finished off our little day sipping coffee at this great till French Bistro we had found which faces the montesary and the mountains. Mount Misty was in full form. We went into the hospital around 7pm that night when they were finishing up surgery.
The patient turned out to be a very sick man who initially did very well with surgery but than we started to have some bleeding problems. We brought him back to the OR (always interesting to watch open heart surgery!) and didn't get home till 3:30am. The next morning I was up again at 7:30am. No wonder I feel so worn out all the time! Yesterday the rest of our pediatric team arrived and we did our first pediatric patient surgery which was the first bypass ever done at this hospital. A 4 year old boy with a VSD. Turned out great.
I was bummed last night. The adult team ended up leaving a day early due to a flight change. They are a great group and I'm going to really miss them!! We all worked well as a team and the patients got great care. Hopefully I can end up at their hospital for a few months on assignment! I'm really happy that I was able to join them for their going away dinner. Zev convinced me to try a bite of Cuy at dinner. It is a local specialty, otherwise known to us as Guina Pig. Tastes a lot like chicken but one bite was enough! Alright I better get working again.
Wednesday, April 9, 2008
Sunday, April 6, 2008
La Joya
Yesterday was a crazy day with my going back and forth between the two hospitals, but things were accomplished which is always good! Last night a group of us went to a place called Zig Zag for dinner. It was amazing! I was brave and tried the trio of meats... I had Ostrich, Alpaca and Steak. Didn't care much for the Alpaca but everything else was great. Than we headed out to the disco, what a blast!! Our doc's, translators, nurses and I were all out in full form. Nonstop dancing for two hours straight. Zev, the surgeon, was a bit sore this morning from getting jiggy with it (LoL) and our cardiologist Phil gave us instruction on how to properly do the funky chicken. Pictures will be interesting to see :)
Today I went to La Joya. To get there it was about an hour drive through mountains, mines and the desert. I did not expect the desert to be so beautiful. The sand and mountains were multi colored from the copper and volcanic rock. Than suddenly in the midst of the desert we'd come across a patch of green lush farm land that was watered via irrigation systems. Apparently their water comes from the mountains (20 kilometers away) and requires much cleaning before drinking. It made me worry about the poor. We went to the La Joya hospital, last year this little tiny hospital treated over 40,000 patients. A doctor informed me that on a normal 12 hour shift he sees at least 40 patients. The hospital doesn't have proper supplies, drugs or equipment. They can't afford it. The equipment they do have is locked up and only the director has the key... he's rather rude and is rarely there meaning the life saving equipment (including respiratory equipment) is never accessible. The town seems so destitute. People make homes out of branches, cardboard, wood, brick or whatever they can find. One room huts, no plumbing or electricity of course. In the middle of all this is a beautiful resort with step horses, pools, and a green lush landscape. The difference between the poor and rich is outstanding. This is definitely a new experience, one that is unforgettable.
Today I went to La Joya. To get there it was about an hour drive through mountains, mines and the desert. I did not expect the desert to be so beautiful. The sand and mountains were multi colored from the copper and volcanic rock. Than suddenly in the midst of the desert we'd come across a patch of green lush farm land that was watered via irrigation systems. Apparently their water comes from the mountains (20 kilometers away) and requires much cleaning before drinking. It made me worry about the poor. We went to the La Joya hospital, last year this little tiny hospital treated over 40,000 patients. A doctor informed me that on a normal 12 hour shift he sees at least 40 patients. The hospital doesn't have proper supplies, drugs or equipment. They can't afford it. The equipment they do have is locked up and only the director has the key... he's rather rude and is rarely there meaning the life saving equipment (including respiratory equipment) is never accessible. The town seems so destitute. People make homes out of branches, cardboard, wood, brick or whatever they can find. One room huts, no plumbing or electricity of course. In the middle of all this is a beautiful resort with step horses, pools, and a green lush landscape. The difference between the poor and rich is outstanding. This is definitely a new experience, one that is unforgettable.
Friday, April 4, 2008
A better day.
So this morning I woke up feeling a little iffy... not sure if I drank some water or what. That's a BIG no no! By mid morning I felt well enough to get back to work, slowly of course. I started stocking my pediatric unit and than headed over to see if they needed help with today's adult post-op patient. Everything is a tug of war still with the nurses at the adult hops ital but its getting better after a long hard talk with the director. All in all things were laid back today which was great. Than over dinner my new adoptive family (a group of people working with me who are all from the same hospital have adopted me) discussed all of the problems so hopefully we can work out the kinks and make a bigger impact here. We want to leave it better than when we came without hurting anyone's feelings. Dinner as usual was amazing and was followed by sangria and chocolate! The Sangria (wine with fruit and juice) led to some crazy antics... I've been informed what happens in Peru stays in Peru!! LoL we're not allowed to get TO crazy with the body guard and 2 SWAT guys following us! Oh yeah, apparently I'm a hot commodity in Peru. One the of the SWAT team guys passed his phone number along to me via the interpreter. To funny. Off to bed for another busy day!
Thursday, April 3, 2008
I've had better days.
So today was a success and a failure both. A success because our patient survived his surgery and is currently recovering in the ICU. It was a failure because every step along the way we have been fighting with nursing staff. The administration wants us here, but the charge nurse of the ICU clearly does not want us to be here. I will state again that we were asked to come here to educate the hospital on open heart surgeries and heart valve replacements.
Every thing that I have done this week this charge nurse has disagreed with me. I try to explain things but the language barrier makes it difficult even with a translator. Tonight she did not like how our ventilator was working so instead of working with me to come to an agreement, she took another SICK patient off a ventilator so she could use it on the open heart surgery patient. When I left the ICU tonight, that other patient was not doing well off the ventilator. By doing this she gained control over the ventilator. She discussed nothing about a ventilator change with me or my team. She put the patient on settings that research has shown to be inappropriate. It is so frustrating because we are trying to help her but she has this complex that she is right. In no way are we saying that what she does is wrong, because it is not, but we just want to show her a better ways to do things. Safer ways, more effective ways and ways that are more comfortable for the patient. I won't get into how horrible today was for me, because it was pretty bad. Unless things are changed, and nursing and administration decide together that they want help, I can honestly say that I will be spending the rest of this trip helping people who want help at the pediatric hospital.
Highlights of my day included the amazing views of the volcano's this morning and that I got an arterial line in our patient to measure blood pressure during surgery that the anesthesia doctor and resident couldn't get. They called me in as a last ditch effort before they took more invasive measure, I don't think anyone expected me to get it. Off to bed so I can get up early so I can not teach nurses who don't want help.
Every thing that I have done this week this charge nurse has disagreed with me. I try to explain things but the language barrier makes it difficult even with a translator. Tonight she did not like how our ventilator was working so instead of working with me to come to an agreement, she took another SICK patient off a ventilator so she could use it on the open heart surgery patient. When I left the ICU tonight, that other patient was not doing well off the ventilator. By doing this she gained control over the ventilator. She discussed nothing about a ventilator change with me or my team. She put the patient on settings that research has shown to be inappropriate. It is so frustrating because we are trying to help her but she has this complex that she is right. In no way are we saying that what she does is wrong, because it is not, but we just want to show her a better ways to do things. Safer ways, more effective ways and ways that are more comfortable for the patient. I won't get into how horrible today was for me, because it was pretty bad. Unless things are changed, and nursing and administration decide together that they want help, I can honestly say that I will be spending the rest of this trip helping people who want help at the pediatric hospital.
Highlights of my day included the amazing views of the volcano's this morning and that I got an arterial line in our patient to measure blood pressure during surgery that the anesthesia doctor and resident couldn't get. They called me in as a last ditch effort before they took more invasive measure, I don't think anyone expected me to get it. Off to bed so I can get up early so I can not teach nurses who don't want help.
Wednesday, April 2, 2008
The set backs grow...
So at first I thought that this trip was going to be a piece of cake for me. I had almost nothing to do with the adult hospital, nursing staff is pretty well educated and prepared. Things that need to be changed won't be changed due to the staff being so set in there ways. Those situations are delicate because you can't be pushy and be all "My way is better than your way". So I pretty much helped where possible and went exploring in all the spare time. Easy breezy! This afternoon I was brought to the 2nd hospitals pediatric ICU for the first time. We are supposed to interview patients on Saturday and start surgeries on Monday. Key word SUPPOSED to. Well I have my work cut out for me. I may have to pull some all nighters trying to get things together. The ped's ICU has nothing I need, I mean NOTHING. They have two vents. One is broken and is so old I wouldn't use it on a kid even if it worked, the other vent is probably older than I am but is still functional. I haven't tested it yet to make sure it doesn't blow out the kids lungs. That is all the ICU has. No supplies... nothing!! So I along with only ONE nurse have to sit down and pretty much build a pediatric ICU from the ground up. We have till Monday. I need to write out everything I need and send it to the appropriate people hopefully by tomorrow so they can send me supplies from Lima. If we get our crate (still in customs) I may find much of what I need, if we don't get it we may cancel the surgeries and focus on ICU growth and education. Thats why we are at this 2nd hospital... to help build an ICU, educate and hopefully do a few surgeries to teach. I must admit its a bit of a load but I'm here so I'll do what I can. The ICU here is brand new which is nice... just not set up.
Its been a long day! It started at 3:30am when the city's sirens started blaring. My group all opened the doors and were questioning what the sirens meant... Earthquake? Attack? Fire? Who knew!?!? We found out at breakfast over our morning cup of coca tea that it is a fire alarm calling the firemen into work. So we all freaked out and lost sleep over nothing! I spent the morning at the adult hospital and sat in on some consults with potential surgery candidates. I decided to stop sitting in the consults when one patient broke my heart. She is a single mother with 2 small children, she cannot afford surgery on her own and there is no one to care for her children when she dies meaning they'd probably end up in an orphanage. When she learned that she was a good candidate and that we'd fix her heart she broke down crying. I, along with a few others, were trying hard to not let her see the tears run. She couldn't thank us all enough. These surgeries that are somewhat common place for me are impossible here leading these people to certain death. For every person we save (hopefully the surgery saves her) there are thousands that die. The town I visit on Sunday is a 15 bed hospital that serves 40,000 people. How lucky are we in the States? Its not that they don't work hard or don't deserve the care, its just the way things are here. Its impossibly sad.
Tuesday, April 1, 2008
Set Back
So we are having a bit of a set back for surgeries. Cardiostart sent over a crate full of equipment necessary for the surgeries and its not been released by the Peruvian Customs people. We can not perform pediatric surgeries without it and its making our adult surgeries more difficult. So that along with the set back of our Cardiologist stuck in Lima has definitely changed this trip. Our cardiac surgeon Zev is doing his best to make a difference here by assisting in surgeries with local doctors to help with education. Everyone in our group is doing what we can with what we have and providing education. Hopefully we get our crate soon!
With all these set backs we have found ourselves with more free time. Today we went to the Sainta Catalina Convent (Monastery), it is by far the most magnificent thing I have ever seen. Its a paradise surrounded by white volcanic rock walls. My mom and cousin Britta would never leave! It is called a city within a city and it truly is, its huge. It was built in 1579 and has had many reconstructions after earthquakes. The gardens are a paradise and the building has such amazing architecture and history. It was originally for nuns coming from wealthy families and they were each given their own 'house' with servants. I will try to post pictures but it is literally indescribable. We went at night when they light the candles and all the character comes out. because of this my pics may not come out well. Being its only across the street I plan on going back a second time during the day. Its worth every penny. If it weren't for the self mutilation and all the solitude I'd probably consider becoming a nun myself! Some still live there in a closed off section (no more mutilation of course).
Today I met my match... I discovered the worlds best hot cocoa. It was absolutely perfect and this is coming from a chocolate connoisseur!! I wanted to learn how they made it but once again the language barrier got in the way. The nurse who often translates for me became the first one of the group to get ill and be subjected to IV fluids. So far so good in my case, which is surprising cuz I've eaten everything! You only live once. :)
Buenas noches!
With all these set backs we have found ourselves with more free time. Today we went to the Sainta Catalina Convent (Monastery), it is by far the most magnificent thing I have ever seen. Its a paradise surrounded by white volcanic rock walls. My mom and cousin Britta would never leave! It is called a city within a city and it truly is, its huge. It was built in 1579 and has had many reconstructions after earthquakes. The gardens are a paradise and the building has such amazing architecture and history. It was originally for nuns coming from wealthy families and they were each given their own 'house' with servants. I will try to post pictures but it is literally indescribable. We went at night when they light the candles and all the character comes out. because of this my pics may not come out well. Being its only across the street I plan on going back a second time during the day. Its worth every penny. If it weren't for the self mutilation and all the solitude I'd probably consider becoming a nun myself! Some still live there in a closed off section (no more mutilation of course).
Today I met my match... I discovered the worlds best hot cocoa. It was absolutely perfect and this is coming from a chocolate connoisseur!! I wanted to learn how they made it but once again the language barrier got in the way. The nurse who often translates for me became the first one of the group to get ill and be subjected to IV fluids. So far so good in my case, which is surprising cuz I've eaten everything! You only live once. :)
Buenas noches!
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