Wednesday, March 14, 2012

life line - call a friend : )

Today was a very busy day for prosthetics. First of all I needed to make the TLSO for the patient with the unstable fracture. I was informed that we were out of plaster bandages, so it took awhile to find the supplies. Once we had the supplies we went and casted the patient for the brace in the ER- you need more than one to do this type of cast. It all went well but because of his injury and lack of supplies we couldn't do a bivalve casting technique (casting the front and then the back so you have two pieces that fit together). We had to do a clamshell casting for the tlso (leave a portion on the side open). This isn't a problem- it just takes a bit of art to sculpt the missing side. Good thing I enjoy an art project every now and then. : ) I did take some measurements so that I would know the circumferences. After this, FIVE prosthetics patients came up. One of the patients was a little girl who was having pain on the bottom of her residual limb. I took a look and even a small touch to the end was painful. It looked like her tibia had grown alittle and she had no distal padding on the end. The problem was that her limb was only 3 inches from the knee. I talked with Sidgu and we brainstormed everything we could. I kind of thought that she might need revision surgery so I went down to get the ortho surgeon. He took a look and said that he would do what I thought he should do but hadn't ever operated on a kid. He said let him know if he should operate....this put me in a cold sweat. If she had a longer residual limb i would think no problem but its so short as it is. Well...I decided this was a time to use the life line "call a friend:)" I went on the roof and called Todd at Shriners Childrens Hospital. He was super helpful and after discussing the situation we decided revision surgery was really the best option. I hope it goes well.
Next a casted 2 ladies for above knee prosthetics. There was another lady who wanted a prosthetic but she was really swollen so we gave her a shrinker and told her to come back.

Well sorry- that was alot of detailed prosthetic info....but I guess that was what was on my mind at the end of today. The good news is that - guess what, I have learned quite a bit the last couple years in school! : )

Tuesday, March 13, 2012

prosthetics in Haiti

Today was my first day in the Prosthetics Lab. It's on the roof and it's a legitimate lab- much better than many places in the US. Sedju. Emanuel, and Miguel are the three guys that work up there. They are really fun. They speak some English but alot of the time I am not sure exactly what is going on. Miguel is the captain of the amputee soccer team. They are pretty awesome- look up utubes of Medishare amputee soccer. I did alot of prosthetics today so I will just share some fun stories from the day. First, an engineer was down here a week ago who is designing an inexpensive prosthetic foot that can be manufactured with plastic in Haiti. Good idea...however...right now Ossur is one of the labs sponsors so all the people have 800 dollar or more carbon fiber feet (like the flex foot). Anyway, so while the engineer was here they switched out all the amputee soccer players feet to the plastic low cost foot. Oh side note- they don't where there prosthetics when they play soccer actually (they use forearm crutches). Anyway, so today the whole team was in the clinic making a bunch of commotion. I asked what was going on and they told me that the soccer players were saying that they couldn't walk with the other foot and they wanted their old feet back. I told him to tell them that they were athletes so they should be able to walk on anything (said as a joke). It was really funny. There was even more commotion as they tried to tell me that they could but still wanted there feet back. Anyway- so we switched their feet back to the dynamic response carbon fiber feet. Story two, one of the guys came back after lunch with a watermelon and gave me a big chunk. We stepped out of the lab to the back "porch" and as I ate.I started to spit the seeds out (there was a small gab between the fence and the hospital wall. All of a sudden I heard yelling and Sedju started laughing. I went to the edge of the porch and looked over and there was a whole line of people crammed between the wall and the fence taking a break from work- oops!! Story 3, I was cutting a cast off after I had filled it with plaster and let it harden and one of the techs came up to me and said "Do you like to cook?" I said "yes!" Then he said "really? Well cut it like you are killing a chicken!" I was confused- he just meant to use more strength but the analogy didn't work since I hadn't ever killed a chicken! ; ) Another excitement was getting called into the OR because of a spinal fracture. Casting the patient in the OR for an unstable burst fracture of L3 made me alittle I need to make a brace for the guy to keep it stable until they get someone down here to operate which could be a few WEEKS! Well, more from me tomorrow.

Day 4: being a PT for a day

Today I helped out with the PT. I did some exercises with a kid with low tone and some exercises with a hydrocephalus child. It was pretty self explanatory. You scan the patient logs and look for "PT." When you see that you look for the corresponding bed number and then assess the situation. For example the child with hydrocephalus needed to work on protraction and she had knee contractures. After peds, we went to ortho. One lady who had bilateral femoral fractures needed PT. We got her up and walking. Next we went to the spinal cord unit. This is where I spent most of my day. I learned how to do transfers- hard physical work. I got all the spinal cord patients into their wheel chairs. I played catch, talked and played connect four with some of the patients. It was good to get their spirits up. After that I got put to work organizing donations. We got all the suplies sorted and to the right department. I am excited to do prosthetics tomorrow. No prosthetics is done on Sunday (today). It was neat to see the pastor come and give a church service to the patients. It was a tough day. The problem is that there is no place to get away- except the roof which I learned this morning that we really aren't supposed to go so now I am alittle scared. It was nice to look down at the streets but also scary to see police standing by the gates with huge guns. So now I still go to the roof but I must sit between the generators just in case someone were to look up from the street and be unhapppy to see a "blanc" (white). It's pretty chaotic and everyone wants to chat in Creole if you are by a patient- It's good practice but it gets tiring. To be quiet honest- I'm already ready to go home. It might be a long week. I shouldn't speak yet though- I haven't done Prosthetics yet which is what I am trained to do. It's just tough to be on such a little complex in a "lock down" situation (no leaving), people screaming in pain...and for me- I can't do anything for someone in the ER. I crave solitude..a nice run to clear my's going to be awhile until I get that.

Sunday, March 11, 2012

Day 3 Haiti

(pardon typos- this key board is really sticky and no spell check :) We woke up at 5:45 and had some coffee and bread on the beach and then we were off to run. It was market day so there was alot to see- goats handing upside down on the back of a truck, all sorts of fruits. The run was fun but long and I don't think I was used to the heat. Good time though. Jeff and I showered quickly and then went down to the coartyard for breakfast (included). We had omelets, bread, and grapefruit juice. They also brought a glass of creme for the coffee which Jeff took a gulp off and said " hmm this must be goat milk or something." When I told him it was the creme we had a good laugh. We hurried to check out and grabbed a motto to take us to the glas station we were meeting Teresa at (doctor that used to work at Cloud Forest Clinic with Jeff and now works in Christianville). She had to check on some of the orphan kids in the orphanage so we went there. We then met someone she had a talk to about supplies for a project (busy lady!). We then went to Teresas home and had lunch with her, her husband, and her two little kiddos. Her home was clean and orgaanized and quiet- it was nice to have a little break from the chaos outside. After a quick stop for lunch she drove us down to medishare right before Jeff's shift started at 3PM. I met the Rehab director and he showed me the Prosthetics Lab. It's run by all Haitians but he said they speak good english. I had some dinner that was provided and then went to the roof to watch the hussle and bussle in the streets and watch the injured get carried in. This is going to be an intense week.

Saturday, March 10, 2012

Haiti Day 2

(day one will be posted when I find the paper I wrote it on :)
We woke up at 5Am and went out of security to wait for a man with Project Medishare who had a couple bags of medical supplies for us to check. We waited until 6:10 (we were supposed to see him at 5:30) and then started to get worried because our flight was at 7:30 and international. We checked in and started walking towards security and saw a guy with a Medishare shirt- oh no! We quick checked the 2 bags. He had 2 more bags but we didn't think we had time to go back to his car. I feel bad that we couldn't get the luggage (medical supplies). When we arrived in Port-au-prince we found the medishare ride right away. Medishare was very close to the airport. We dropped the luggage off and got a ride up the mountains alittle ways. We started walking up the mountains and all the kids followed us as they were going home from school. One little girl grabbed my hand and then they all held onto me. I kept getting behind Jeff because of the train of kids attached to me so I made up a game "i, 2, 3,run to Jeff (in Creole)." It was taking longer than we thought so we caught another motto (motorcycle). We took that motto as far as he could go until the road was so bad that he said he couldn't go any more. From there it was a grueling hike up the mountain on crushed rock. Many people were carrying goods on their heads= including hot coals!!!\ We again had a crew of children following us "Chree-stee-na- m gran gu! (I'm hungry). We didn't give them anything because we were told not to encourage bagging. We finally got to the top and through the clouds saw Clayton coming towards us. We both ran to meet him. From there we went to see the school they are building. It was super nice and the people there were so sweet. They remembered "Mr John" and were excited to learn he was my father. The view from the school was so beautiful. From there we drove down to Jacmel. It was Clayton's girlfriend Jeannie's birthday so they had gotten a hotel and some of her friends had come down. The place was nice. We checked in and had some barbeque chicken on the beach- it was a full moon and georgeous! I liked Jeannie and her friends. They had a big run planned and Jeff and I planned to join them the next morning for it.

Friday, March 9, 2012

To Miami

My day started out with a nice run with Marnie at 5:30 and then a big breakfast w/ J. Everything was going perfectly as planned- Sunshine and all. We walked the mile to the train that takes you from Portland to the airport. However, after waiting for awhile we found out that the train was broken and they were waiting for repair. Ugg- of all days! After waiting as long as we could we decided to take a cab. A nice lady gave us the number for the cab and told us to ask for the promo rate (which ended up saving us 20 dollars). We split the cab with a lady who was heading to SF. It as interesting to talk to her. She had been a chef for many years in Alaska and the last five years owned a wine bar on the Oregon Coast. We will have to check out her place. We made it on our flight on time even with Jeff getting searched in security. OUr flight to SF went smoothly and then we went straight to our flight to Miami- which made me sweat because we had to go in and out of security (I lost my pink Nelgene) because we switched airlines. I was wearing a Calvin shirt and a guy came up to us saying he went to Calvin as well. He was finishing an "earth ship" I hadn't heard of this but it's a sustainable home made of old tires. You always meet interesting people when wearing a Calvin shirt. He probably thought the same thing about me "met a girl going to Haiti to make arms and legs fr people." We arrived in LA around 9:30, had some dinner of packed PB&J's, checks mix, and banana- trying to travel cheap here...which brings us to the next point- setting up camp in the airport. We rolled out our sleeping bags in a corner- held onto our luggage and tried to sleep. Only problem was that I hadn't thought about the stupid announcements every 15 minutes "It is now 3AM...It is now 3:15AM....It is now 3:45AM....!!