Just a quick note so people know we're alive since we've not been near a phone or computer since Monday!
We had a great trip to Mhingo lodge, it was quite a brief R&R, but well needed. We are all exhausted beyond words, but all in the same, we're so happy with the results of our week of surgery. Three kids are left in the ward at Mulago, one to go home tomorrow and the other two should go home after the weekend. Every year this trip gets more rewarding.
So we're scrambling around right now sorting and repacking our luggage getting ready to head over to the Samaritin's Purse Offices to get the kids we're bringing back to the US. There are 17 kids plus Mom's plus the translators. It will be quite a trip home!!
Off we go, arrival in the US in a few (24-30) hrs!
-Sister Lynda
(thanks Laura!)
Sunday, May 10, 2009
A few pictures
Saturday, May 2, 2009
Bitter Sweet Ending
So today was the final OR day in the "theater". All of us are excited and exhausted in the same breath. We were all saying that it is "last call for the theater" and "standing room only" in a hot, mosquito buzzing OR (a real realization of the state of medicine here in Africa and why we are here). All of the team members have hit the wall with fatigue and look forward to a celebration to finishing the last 2 cases. Dr.Sable proudly announces that we will be doing a pericardial tap on a child that will be going to Germany for a complex repair to bring the total to 12. Shortly after the start of the first case, the realization that another long day was before us with the discovery of unexpected defects in our first case. The past days have morphed into us all asking "what day of the week is it?" All of the patients have done well and are transitioning into the ward where they will have to transition from “muzanga” care to the familiar ward of nurses. Surprisingly the last OR case turned out to be the most complex post op care for the Uganda nurses and a reflection of our goal. Dr.Darren challenged the Uganda nurses with patience and a smile as dopamine and a pacemaker were utilized for the post op course. Although we are all experiencing fatigue, the Uganda nurses are being challenged both physically and mentally with all that we are teaching them. We are all are looking forward to getting a little free time off and our planned excursions. Regretfully several members of the team will be returning to their loved ones in the states both human and furry…(Dwayne) and we wish them a safe flight along with the benefits of KLM airlines. Special shouts to every team member that is a piece to this complex puzzle of care. Loud shouts to Dr.Starr and her skilled hands along with Dr.Sable aka “JaJa” and his vision for this program for without we would not have a mission. Special thanks to all of those that contributed man hours, supplies, and money for all of us to be here today. The final OR day and recovery for 12 Uganda kids not to mention the healing process for 17 kids that will be flying back with various team members throughout the world. We all hope that immigration doesn't question the large drain from her heart. All of the team members have been a blast and hopefully we will have a chance to work together again. The trip does not end here, but some well deserved rest and many celebrations along with fascinating stories about gorillas, 4 wheelers, the Nile…..not the drink, and safaris....... Mostly Amy and a bit Krista
Close call
So, Craig Dobson, Steph, and I thought we were the luckiest people yesterday because we got to take off in the late afternoon yesterday on Labor Day. We actually saw sunshine. We got down to the Craft Market by the National Theatre. The woodwork was amazing. Steph bought a "masterpiece" (we think he meant "one-of-a kind") for a total steal.
We even got to take a nap before heading to Le Chateau for dinner. The food was great. The ambiance was better, except for the obnoxious European man sitting across from us who would signal to the servers by clapping his hands or beckon them with one finger.
Doreka, our Good Samaritan representative, had called a cab for us, and told us that a man named Dennis was coming in a bit to pick us up. We waited for a while and a car finally pulls up in front of the restaurant. Each of us thought it odd that the windows were all tinted black. We asked if he was Dennis and he said yes. So we all got in.
We drove for a bit but something felt odd. Maybe it seemed we were going in circles. Anyways, Doreka calls to tell us that Dennis was waiting at the restaurant for us. Steph told her ta ht we were already in the car with Dennis. And soon it dawned on us that the driver was not sent by Doreka, but somehow he knew where we were to pick us up and he knew that we were working at Mulago Hospital. He finally dropped us off at home intact to our relief.
Steph and I think he intended to kidnap us. Craig D thinks he may have overheard that we needed a ride and came before Dennis to earn some extra cash. Either way, it was scary to think how vulnerable we are.
But alls well that ends well. We were in our PJs for some time before the poor OR team came home from the hospital at 11:30 PM.
Uyen
We even got to take a nap before heading to Le Chateau for dinner. The food was great. The ambiance was better, except for the obnoxious European man sitting across from us who would signal to the servers by clapping his hands or beckon them with one finger.
Doreka, our Good Samaritan representative, had called a cab for us, and told us that a man named Dennis was coming in a bit to pick us up. We waited for a while and a car finally pulls up in front of the restaurant. Each of us thought it odd that the windows were all tinted black. We asked if he was Dennis and he said yes. So we all got in.
We drove for a bit but something felt odd. Maybe it seemed we were going in circles. Anyways, Doreka calls to tell us that Dennis was waiting at the restaurant for us. Steph told her ta ht we were already in the car with Dennis. And soon it dawned on us that the driver was not sent by Doreka, but somehow he knew where we were to pick us up and he knew that we were working at Mulago Hospital. He finally dropped us off at home intact to our relief.
Steph and I think he intended to kidnap us. Craig D thinks he may have overheard that we needed a ride and came before Dennis to earn some extra cash. Either way, it was scary to think how vulnerable we are.
But alls well that ends well. We were in our PJs for some time before the poor OR team came home from the hospital at 11:30 PM.
Uyen
You don't know tough
Obviously this experience has shown and taught me a whole lot. One of the most notable is the strength and resiliency of people who do not have much. While the care we give is certainly somewhat different than we are used to in the U.S., one marked difference is the kids. They are tough, sweet, and incredibly eager to listen to instructions...the same goes for the families.
The most notable story is the 1 1/2 year old with a terrible cleft lip and palate who was extubated day 1 following a VSD repair and soon thereafter eating toast, porridge and milk - all with a massive cleft lip/palate. No special nipples, no gentle feeding - take the toast, and eat it. Darwin's law...the strong survive.
I clearly am not so strong. I am exhausted - days start at 7:30, and we are not home until nearly midnight....day after day. Resources limited, culture different, and we are all beat...not so tough, sweet, or eager as the patients we are treating...but we already knew that.
Klugs
The most notable story is the 1 1/2 year old with a terrible cleft lip and palate who was extubated day 1 following a VSD repair and soon thereafter eating toast, porridge and milk - all with a massive cleft lip/palate. No special nipples, no gentle feeding - take the toast, and eat it. Darwin's law...the strong survive.
I clearly am not so strong. I am exhausted - days start at 7:30, and we are not home until nearly midnight....day after day. Resources limited, culture different, and we are all beat...not so tough, sweet, or eager as the patients we are treating...but we already knew that.
Klugs
Thursday, April 30, 2009
More Adapt and Overcome
I am starting to feel like a 24 hour convenience store are hours are 7-11. Mosquitoes are out in full force. I started carrying a pair of tweezers in my pocket I figure that a man that can catch a mosquito with a pair of tweezers can do anything. The operating room or the theater is very interesting voltage stabilizers, step down transformers and 17 million power cords that spark and sizzle and none of it works, gas connections that do not hook up to anything, transport oxygen cylinders that weight more than I do.Things that work on 110 volts 220 volts and when things are connected to the wrong power source spark and smoke starts to fly. We have manage to create a small computer network and stream live video of the heart surgery from the operating room to several computer in different locations and quite frankly it better than anything we have at home. It has been a challenge to orchestrate all this stuff. In spite of all of this it has been rewarding even if what we do is just making a small dent in the grand scheme.
Ozzie
Ozzie
Adapt and Overcome...
It is HOT here today, woke up to a bright steamy day. I’m generally not a night shift admirer; however night shift here, is really Day shift time back home so it makes it easier to acclimate (there is a method to my madness). But, the downside is trying to sleep during the day in
THEM: “Yes, ma’am, no pro-blem ma’am” as they bow away nodding.
Oh no, they ring the room looking for their coworkers, and are in and out of the apartment, all afternoon.
The upside is waking up at 5:30p, having a coffee (Instant)(Nescafe) while you hear these birds, and watch the kids across the way playing kick ball.
Apparently in times past, people worried about, say, enough oats for their horses, or enough ice blocks for their frig. Nowadays people can have entire meltdowns (Me) because they left the cell phone charger behind. Camera’s, PDA’s, phones, and computers; they all need a cord to keep them charged, and combine that with the electricity being 220 DC (the smell of electrical burning has been a common smell in our apartment-TAMMY) and the outlet looks like absolutely nothing we have in the states (and remembering to bring THAT adapter and stepdown unit)….it’s not a pretty site. “Oooh can I borrow that cord, I forgot mine..” becomes a familiar phrase.
The honeymoon is over people, the excitement of arrival has worn off and the reality has set in. We have a full ICU, we’re running out of supplies, people are getting tired, even the Ugandan Nurses look beat. We have a ton of oh, blue clamps and plastic yellow stethoscopes for instance, but, one more set of blood tubing and NO sxn catheters (for the non-medical people, both are not good). But I learned from my misson mentor the great Betsy Tirado, to “adapt and overcome”, as we always do, we get creative. And we are.
Happy day all!
-Lynda
P.S. no pictures from me, I forgot my cord.
Wednesday, April 29, 2009
Where's my ASCOM
Call room Mulago styleI just completed my first call night. I have some news for all of you back home. Strangely enough - life goes on without the ASCOM. I actually was able to take call and communicate with the nurses without a pager or a phone - weird. Other random things I discovered last night:
- I kinda dig blogging, but don't know if I am cool enough to Twitter
- No ice in the Mulago hospital
- Colola means cough in Lugandan
- Malaria preps here come back quicker than RSV swabs
- blood gas results can take less than 2 minutes
- Ugandan Mountain Dew is delicious
All is not perfect in Uganda though - I slept (~2 hours) in a top bunk designed for someone 5 feet tall with a mosquito net....no flat screen TV's, and no private bathrooms.
Rollin' on
Klugs
Mosquitoes are overrated
Carrying on Dobson's tradition of bloggin on or soon after ones call night...I present you with my call night blog. I am on call tonigh for our "biggest OR day" of the trip. We did an 11y girl with a mod secundum ASD and a 7kg 2yo with a large VSD and larger cleft lip and palate. 2 cases and out of the OR at 9:50 pm. Crazy - the OR team is working like dogs. Again - seniority carries with it no priviledges. Nearing the 5th year of my fellowship I still don't get pick of calls - even in Uganda. It is a busy night by the standards here - 4 CICU patients and one stepdown.
While I am sure all can tell the CICU aspects of this work are pretty straight forward (except figuring what drugs we actually have, and whether or not they have expired yet), the echo part is grueling and amazing. I think we did upwards of 30-40 echoes today and saw everything from normal (which is actually an anomaly here) to a 26y unrepaired ebsteins to AP window to truncus to a large DORV canal with TGA and interrupted arch. Fortunately, my clinic has prepared me well. The weird thing is none of my patients have asked me if I am a model. One; however, did tell me "I am going to beat you" while I was doing her echo...this all with a smile on here face (jack ass Klugman thought she liked me).
I think the hardest thing about my call night tonight will be not having my 3 Niles before bed. Oh well, I can have 6 tomorrow.
Last of my random thoughts and loose associations....while the mosquitoes here carry the threat of malaria (which would obviousy suck) they certainly are not as nasty and aggressive as the asian tigers in my backyard back home. Also, no swine flu.
Pics to follow.
Klugs
While I am sure all can tell the CICU aspects of this work are pretty straight forward (except figuring what drugs we actually have, and whether or not they have expired yet), the echo part is grueling and amazing. I think we did upwards of 30-40 echoes today and saw everything from normal (which is actually an anomaly here) to a 26y unrepaired ebsteins to AP window to truncus to a large DORV canal with TGA and interrupted arch. Fortunately, my clinic has prepared me well. The weird thing is none of my patients have asked me if I am a model. One; however, did tell me "I am going to beat you" while I was doing her echo...this all with a smile on here face (jack ass Klugman thought she liked me).
I think the hardest thing about my call night tonight will be not having my 3 Niles before bed. Oh well, I can have 6 tomorrow.
Last of my random thoughts and loose associations....while the mosquitoes here carry the threat of malaria (which would obviousy suck) they certainly are not as nasty and aggressive as the asian tigers in my backyard back home. Also, no swine flu.
Pics to follow.
Klugs
Cultural Adjustment and Our New Driver
Hello All,
Last night was my first night on in the CICU in Uganda. It was the first time I have ever had to remember to pack insect repellent for a call night...but I digress. Tammy and Lynda (go night team!) were on with me. I stayed up until 1AM talking with Tom, one of the Ugandan CV surgeons. We discussed pre- and post-op management here versus the U.S. But most of all we discussed his experiences in the theater. Actually, that is a cultural difference. Here the OR is known as "The Theater." Incidently, when the head nurse told me she would like to leave our clinic yesterday to go to the theater. I thought it odd, but I figured there was a movie she really wanted to see. I understand now.
On an unrelated note, one important factoid about Craig Sable that none of you ever knew. His greatest aspiration (beyond perhaps being a member of the Steelers) is to be a bus driver in Kampala. He keeps saying things like, "I now know my way around here... I think I am going to drive next time...I think I could drive this bus better, don't you?"
Luv,
Craig
Last night was my first night on in the CICU in Uganda. It was the first time I have ever had to remember to pack insect repellent for a call night...but I digress. Tammy and Lynda (go night team!) were on with me. I stayed up until 1AM talking with Tom, one of the Ugandan CV surgeons. We discussed pre- and post-op management here versus the U.S. But most of all we discussed his experiences in the theater. Actually, that is a cultural difference. Here the OR is known as "The Theater." Incidently, when the head nurse told me she would like to leave our clinic yesterday to go to the theater. I thought it odd, but I figured there was a movie she really wanted to see. I understand now.
On an unrelated note, one important factoid about Craig Sable that none of you ever knew. His greatest aspiration (beyond perhaps being a member of the Steelers) is to be a bus driver in Kampala. He keeps saying things like, "I now know my way around here... I think I am going to drive next time...I think I could drive this bus better, don't you?"
Luv,
Craig
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