Honduras: Day Two

Source: Blog Post

Today we began our first day of operative cases at La Providencia.  Energy and excitement filled our bus as we returned to La Clinica.  A little anxiety occurred as well, as operating in a foreign country requires a lot of flexibility and ingenuity.  As it was our first day in the OR, we chose straightforward cases in terms of equipment and case complexity. 


We arrived shortly before 8:00 a.m. with patients waiting for us.  Our cases ranged from the simple to the complex and included a pediatric trigger thumb, ring/small syndactyly reconstruction, and tendon transfers for a patient with hemiplegia.  One procedure was hardware removal on a child with a lateral condyle nonunion that we fixed last year.  This child returned with no pain, full elbow flexion and extension and restoration of function.


In the pre-op area, all children receive a handmade donated blanket from the United States, a stuffed animal and an activity pack containing crayons, stickers and assorted toys.  The children are delighted and the families are incredibly grateful.  These blankets are taken into the operating room with the child to keep them warm during the case. 


Our first patient was a 10 month old with a ring/small syndactyly.  He traveled over 2 hours to see us on Saturday and stayed in a nearby town overnight for his surgery today.  He underwent a pre-operative electrocardiogram to rule out cardiac arrhythmia and long QT interval.  After an uneventful induction by anesthesia, his surgical procedure took 3 hours.  Hand surgeon Apurva Shah and fellow Jonathan Katz performed a separation of his ring and small fingers and used full-thickness skin graft from his antecubital fossa.  All equipment, supplies, and sutures are donated by various organizations through the efforts of team leader and retired nurse, Mary Dowling.  We utilized many of the same instruments and equipment that we do in the United States, making adjustments when necessary. 


Postoperatively, our 10 month old had a green cast placed per family preference and he will stay overnight in recovery.  His mother will be by his side all night while nursing care is provided by the nurses at La Providencia.  A local orthopedist and physician at La Providencia will facilitate his post-operative care.  He will return in 5 weeks for cast removal and a splint that was fabricated for his webspace by Occupational Therapist Meagan Pehnke. 


Our great OR nursing team (Paula Woods, Michelle Friday, Lynn Gregorwicz, Lynn Burleson, and Linda Wilson) wears many hats including taking on the thankless work of instrument cleaning and processing at the end of the day.  The entire team reviews the cases for the next day and makes plans for instrumentation and surgical timing.   Additionally we make rounds on patients who are staying overnight before heading home for the day.  Overall it was an exciting and rewarding day.  The enthusiasm and energy from the morning carried over through the day and into dinner where talk of the patients, families and troubleshooting that occurs each day at La Providencia.  We are looking forward to another great day tomorrow.


“Volunteers do not necessarily have the time; they just have the heart.” Elizabeth Andrew