Hiorger's family heard about Rotaplast from a friend. Hiorger was born with an extra toe and came to Rotaplast to have it removed. The family has been very happy with Rotaplast.
Joangelys' father heard about the Rotaplast Clinic through his local hospital. Joangelys was born with two fingers fused together on one hand and an extra finger on the other. She was sent to the Rotaplast Clinic so that her surgery could be done by doctors experienced in this procedure. The family has been very happy with Rotaplast.
Two-year-old Miguel is a return patient to our Rotaplast Clinic. Miguel has a cleft lip and palate and had more work done on his cleft lip. Miguel will be returning next year to our Rotaplast Clinic for his palate repair. His mother commented that "everyone has been very nice".
Day 5 and 6 were generally uneventful. The surgery schedule was in its usual state of flux during the day. There were no shows, walk-ins and cancellations due to colds and coughs. In other words, things had settled into a reasonable routine for us.
We are consuming much of the supplies we brought with us, so the store room is starting to look empty. Dr. David Low, Medical Director and Jaime Chavez can be seen removing supplies and equipment at the start of the day. Jaime is the go-to guy for everything associated with logistics and making things work and run smoothly.
We completed 13 surgeries on both days. The majority were associated with cleft palates and lips. We always leave the hospital wishing we could have done more as there are always patients waiting on the list.
Tomorrow is Surgery Day 7, our last day of surgery:-( It will be a longer than usual day as we try to get as many patients done as feasible.
His name is Christian Hernandez Malave. He is 13 years old and has already had 4 cleft surgeries. He and his mom drove 5 hours from their home in San-Felix near the Brazilian border to hopefully have another revision surgery on his lip. His mother, Jacklin, said it was his idea to come to Cumana.
He has such a great attitude and is so happy to be having the surgery the nurses and volunteers fell in love with him.
His Mom said, he does not want to be different from his friends any longer and is willing to undergo the surgery to make it happen. She is hopeful he will be happier and his interest in education will improve. He is in the 2nd grade of middle school and is just doing fair.
After arriving the day before the clinic and waiting for almost a week, Hernandez had his surgery on Day 5. The surgery was a success with no complications. He was discharged to return home the day after surgery.
One of the hopeful girls on Clinic Day had gotten the bear when she was 10 years old prior to surgery and was inseparable from the bear and slept with it every night. Five years later later, she was selected for surgery on the 1st day of the Mission in the morning. As part of the pre-op process volunteers give the kids small toys or games to occupy their time. Cyndie George gave this girl a stuffed puppy. Her eyes lit up with joy and her mom had a huge smile on her face. She clung to the new puppy the whole time including the post-op process.
Her surgery was a success and she found a new friend all in one day:-)
We leave the hotel about 6:45 am every morning and arrive at the hotel about 20 minutes later. Today is Saturday so traffic was much lighter and fewer people out and about. One of the reasons probably is the late night celebrations of the Bolivar Holiday celebrations last night.
Everyone hits the ground running when we enter the hospital.
People are checking the schedule to verify timing, patients, OR staffing.
OR's have been cleaned the night before so the surgical staff can start getting ready. In this case anesthesiologist Jennifer Krupp and nurse David Sparks were prepping OR#3.
The mission team is meeting the hospital staff members who will be assisting in the surgery.
The sponsor and local Rotary volunteers are being assigned to specific duties and in many cases trained as many are being rotated into the mission.
The first patients are being prepared for surgery by volunteers. In this case Lynn Devou is having to trim a surgical gown to match the patients height. The kids are starting to figure out this is not going to be an ordinary day and getting anxious. It becomes pretty normal to hear kids crying.
At roughly 8:00 am the first patients are taken to the OR's and the day is under way. Surgeries will continue until 7:00 pm.
The start up on Saturday was uneventful. This changed fairly quickly as a couple patients dropped out of the surgery schedule quickly for different reasons. Ultimately 11 surgeries were completed. We all gather in the hall to go out to the waiting bus as a group when surgery is complete. This usually takes a bit of time to round everyone up..
As we head out of the hospital to the bus everyone is talking about plans for Sunday our day of rest which is sorely needed.
Every morning starts with the pediatricians examining the patients from the previous day and hopefully being able to discharge them to go home. It is amazing how much improved the kids are less than a day later.
During the discharge process, you can tell just how much the kids are loved. You can certainly see this in the face Dr. Len Leonard Friedland, the head pediatrician.
We plan for a smooth surgical schedule every day but things do not always go as planned. Sometimes surgeries have to be cancelled. When these things happen Kim Capps, the head nurse, makes schedule adjustments on the fly to minimize the loss of OR time. Sometimes she actually finds a bit of time to help with surgery.
In some cases dental work is required as part of the procedure, which is why Rosie Mayro is an important member of the mission team. She determines what dental work is required in consultation with the doctors. She has to coordinate the dental work within the other surgery schedules and make sure the dental information is being included by Shishir Doctor who maintains all the medical records. The required dental work is performed by local Venezuelan dentists under Rosie's guidance. Doing it this way helps insure there will be dental follow up after the team leaves. Rosie is very happy with the dentists that are associated with a new clinic near the hospital.
Today was a different day for the team. There were a wide variety of types of surgeries. We had planned for 15 but were only able to do 10.
Two of the surgeries involved reconstruction of ears. One was a new new ear and one was of an revision of an ear created last year. These take hours to do with the new ear involving removal rib cartilage from which the new ear structure is created. Happily both were successful today and overshadowed the earlier issues in the day.
Things got going fairly smoothly on Day 2. Everyone knew their job and just started doing it. We had a full day scheduled but as typically happens we have 2 no-shows so the schedule quickly was revised to effectively utilize the OR's.
After being examined several day 1 patients were discharged, so all the Day 1 patients have gone home. We are ready for the new patient influx to begin.
There are many tasks performed by the Rotaplast non-medical volunteers. One very important task is the production of sterile instruments and tools for the surgeries. This task is performed by Colleen Wynn using an autoclave which basically steams the instruments. Colleen then packages them into groups of instrument needed for the different types of surgeries.
I finally found out where all the boxes went. They were locked up in a store room. Happily only about 20 of the boxes will return to SFO with us.
So a bit more about the overall process. Many of the patients spend the night before surgery at the hospital so we don't have worry where they are when they are scheduled for surgery. A couple hours before their surgery the patients begin their preparation by changing in to their gown. There is typically a waiting period for an OR to come available. They gather in a lobby area with their parents for the wait. Larel Bondi watches over and entertains them.
Once an OR is ready for them they are taken in and prepared for surgery. The anesthesiologist prepares them for the surgery which can take anywhere from 30 minutes to 1 hour. The surgeries can take from 30 minutes up to 2 hours.
By the end of the day we had completed 13 surgeries mostly involving infants. Everyone felt very satisfied with the accomplishments on Day 2. This can be easily seen in the happy faces of the Toyota volunteers as they were leaving.
Whenever you see a patient in a bed, on a gurney or being carried in someone's arms, you will see them with a colorful quilt. These are given to each patient as a gift from Rotaplast. The quilts serve several functions: they are a means to cheer them up; give them a bit of security; and most importantly keep them warm.They will also be a lasting memory of a day in their lives that they were made better in many ways by a group of strangers.
This quilt program is not unique to the Cumana mission but is done for all the Rotaplast missions around the world. The quilts are made by volunteers via the "Wrap A Smile" organization: Wrap-A-Smile. Over 400 quilts have been given away so far in 2015.
The day started like any other day: early breakfast and a bus ride to the hospital. Once we got to the hospital things turned into controlled chaos as everyone found their place and got set up. The 1st surgeries began at roughly 10:00 am.
The schedule was for 13 surgeries as we only had 2 OR's. We scheduled the easier, simpler patients first so all the Docs and volunteers could make sure all the systems and procedures worked and were appropriate. The medical team also went over various emergency scenarios with the entire team before the surgeries begin.
Like all surgeries everywhere the day starts for the patient putting on the gown that opens in the back. Some of them had to be cut shorter to fit the younger patients.
When the surgeries are completed they are brought to post-op for observation prior to going to the recovery room where most will spend the night and be discharged the following day.
The whole Rotaplast team is well cared for by the Rotary Cumanagoto Club and the Sponsor organizations (Toyota and Chevron) at the hospital. We all get a terrific lunch every day.
The schedule was for the surgeries to be completed so most of the team could be on the bus to the hotel by 7:00 pm. We all made it except for a few post-op nurses and pediatricians that were taking care of the final patients.
The purpose of the clinic is to register and examine all the potential patients. At the end of the day lucky patients will be selected for surgery.
The day starts early again with breakfast at 6:00 am followed by a bus ride to the clinic hospital which is a different hospital from the one where we will do the surgeries. We were greeted by the staff and numerous volunteers upon arrival. Again more carrying boxes:-(
Many of the families wanting to register their children were already waiting. Many were bussed in the day before from the countryside surrounding Cumana.
The 1st hour or so was spent getting organized and figuring out the patient flow in the hospital. This would not be at all possible without the many local Rotarians and sponsor volunteers that support the mission.
For the potential patients the day begins with registration, i.e. filling out lots of forms and getting pictures taken. Each patient has a folder with their number and all the forms which follow them everywhere. The number is also written on their arms.
The next stop is the measurement of their vital signs including lab work.
Throughout the day the kids and the adults were entertained to help break up the long long day.
Vitals are followed by an examination by a surgeon to determine the type of surgery required and if it is feasible with the resources available. The surgeons were assisted by Mission nurses and volunteer translators.
To assure the overall health is adequate the children are next examined by a pediatrician.
Finally they receive a dental exam to determine if a cleaning, devices or other dental services are necessary. If needed this will be done before any surgery.
Decisions are made throughout this process in which patients can or cannot be treated by the Rotaplast team. Each folder is given a colored sticker indicating the final outcome: green for acceptable and red for not acceptable.
The final patient was seen at roughly 7:00 pm and we left the hospital at 8:30 pm. It had been a very successful day. We registered and examined 246 potential patients. Of those 13 lucky patients were selected for surgery the next day. A simple preliminary schedule was created that evening and converted to a computer spreadsheet the following day.
The Team all felt it was as very successful Clinic and which will lead into a very successful surgical program beginning Wednesday.