Sunday, November 22, 2009

H.A.N.D.S. Recap and Mirsa's Story

Today marked the end of an extremely successful surgical mission with 72 surgeries completed.  On the first day of the mission, only 45 patients were scheduled of the 60 some originally confirmed.  Partner for Surgery had originally booked plenty of patients, but many did not show up on the day they were to travel to San Juan, Sacatep√©quez for surgery.  Many of the no-shows don't come simply because of fear.  They do not understand the specifics of an operation and are unnerved by such invasive procedures.  Additionally, coming to San Juan for a week often means several hours of transportation to get here, and a week off of work (a week less of pay).  Many people just can't afford to give up that much work and still put food on the table.  Furthermore, who is going to take care of the 12 children at home?  Excuse my exaggeration, but I'm not exaggerating.  It is common to find women who have 8 or more children.  Therefore, with all this extra room in the schedule, we were able to find several patients in the area who were able to receive surgery.

One particular walk-in was a family that included a mother with two children, ages 2 and 4mo., and a grandmother.  They patiently waited for their turn to be evaluated, and after the surgeon was able to screen them, they left with two surgeries scheduled and antibiotics.  The grandmother was scheduled to have a lump removed from her breast.  Mirsa, the two-year-old girl was scheduled for a hernia operation.  Oscar, the four-month-old received antibiotics for a lung infection.  Good thing they decided to stop by.  Mirsa was scheduled to be operated on the next day.  She came in with her mother scared and hungry from not having eaten.  She quickly forgot about her woes while she was distracted with bubbles and crayons.  Everyone immediately fell in love with Mirsa and her family.  They were incredibly cooperative with all the photos being taken of them.

Mirsa's mother entered the O.R. with her when it was time for her surgery.  She was asked to be there to keep her calm until the anesthesia took effect.  I passed by her as she was taken out to the waiting area.  I can't imagine the stress on a mother when her child is in the operating room.  I was surprised to find out that her son received the same operation at age four.  I guess one can never really get used to such a thing.

The surgery started at 9am.  Initially, the surgeon could only find lymph nodes and the hernia was not obvious.  As he was pulling away at the lymph nodes and excising them, he accidentally cut a vein that connects to the main artery of Mirsa's leg.  The wound quickly filled with blood and the atmosphere in the room became tense, but the surgeon reacted with a calmness that only a veteran could display in this situation.  He asked for a smaller size suture that we didn't have at hand, so the circulating nurse and I ran into the next room to find the appropriate size stitch stashed away in one of the boxes while he managed the bleeding.  We found the suture, quickly ran it into the O.R. and the surgeon patched up with tear with ease.  Once this crisis was averted, the overall mood lightened to its usual pleasantness.  The hernia was repaired swiftly and Mirsa was out of there in no time.

While in post-op recovery, Mirsa started to feel panicked as the anesthesia started to wear off and she found herself in a strange place with foreigners.  Her mother was quickly called in to console her and she was soon comforted in her mother's arms, tears streaming down both their faces.

Mirsa recovered quite quickly, and the family was able to go home that afternoon.  It is amazing how quickly children are able to recover after an operation.  Within no time, she was smiling and playing in her bed, enjoying the oreos the nurses gave her.  Mirsa's mother was incredibly grateful that the surgical team was able to do away with her daughter's pain.

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