Day Four Of Surgeries

Day four of surgeries went very well.  We performed 23 procedures on 16 patients.  Grand total for the four days was 65 patients and 82 joints.  The hospital beds were full!!  More patients are being discharged every day.  The unit is super busy with nurses providing patient care, physical therapists providing treatment, and physicians doing post-surgical rounding.  And of course the technical staff, moving and maintaining supply lines.
Last night was the team appreciation dinner.  We gathered at a beautiful local restaurant.  The Team from Operation Walk was joined by the Antigua Hospital team to share in the joy and the happiness of a wonderfully successful mission.  The meal began with a blessing from one of the Franciscan Friars, Ernesto Palma.  He blessed us and thanked us work our work and our kindness.  He blessed the people, both the Hospital staff and the Operation Walk Team.  He blessed our work, and he thanked us and reminded us that because we do this work for some of the poorest and neediest of God’s people, we therefore are doing the greatest good.  He blessed our skills, our dedication, and our generosity.  He also blessed the United States of America.  We were all very proud!!
Then he and the Hospital Administration called each of our names and we walked up to receive a certificate that the Hospital had prepared for each of us.  It was a small and simply token of their appreciation.  But everyone took great pride in hearing their own name called and the names of their teammates.  It helped remind us of all the different people and skills that come together to make the mission successful.
During the dinner, staff were treated to a video slide show of many of the moments from the week, captured on film and set to music.  Again it was another great opportunity to reflect on a wonderful mission.  After dinner, Kim Murray, thanked all of us for our efforts and for a wonder mission.


Day Three Of Surgeries

The day began with a necessary redesign of our work flow.  The Operating rooms were scheduled and ready to go.  However, there was major work flow redesign for the Nursing units.  After two full days of surgeries, and no discharges as of this morning, the nursing units were getting very full.  Two more rooms were converted into bed space to accommodate more patients.  Unfortunately, one of the rooms was the small area the staff were using as a central supply location.  The room could only accommodate 3 patients, but, combined with the other room, it would be enough.  After that we should begin to see discharges from the units that would make the necessary room to accommodate today’s patients from the Operating Room.  
The movement of the nursing unit supplies created an all hands on deck situation.  Folks worked to put supplies into boxes for transport.  Shelving space was created in a outdoor courtyard, with overhang, to receive the supplies.  This area was where some of the not yet used OR supplies were being staged for later today.  The OR staff took into the OR storage area what they could to make room for the nursing unit supplies.  The PACU staff took some supplies into their area as well, to help make room.  Then some of the nursing staff on the unit, along with the logistics team, began the process of re-stocking the Nursing unit supplies.  Once all those moves took place, staff adjusted to the new work flow, and the continued delivering of patient care.  Everything was a little tighter, but everything was back to fully functional.  This is the essence of Operation Walk.  And in particular the camaraderie of this team.  When faced with a challenge, the dialogue quickly moves to what are our options, and what are our best options, and what do we need to do to make it happen!
The rest of the day flowed very smoothly.  The operating room saw 17 patients and replaced 23 joints.
In total, we discharged 8 patients today!  These were patients that were operated on Sunday!
Tomorrow is a 4th and final day of surgery!


Day Two Of Surgeries

Today was the second day of surgeries.  Today the team operated on a total of 16 patients and replaced 20 joints.  All of the previous patients from yesterday did very well over night.  There were no patient discharges today.  The medical floor is very busy.  The patients are divided into 4 separate areas.  The smallest hold 5 patients and the largest holds 10.  All of the areas are ward style.  There a no private or semi-private  patient rooms.  
The patients who had surgery on the first day were very busy today with additional physical therapy.  Those patients continued with their stationary exercises, their walking exercises, as well as stair climbing.  All in preparation for their eventual discharge.
In addition to today’s scheduled activity, there was another opportunity to continue to screen more patients, to see if they are candidates for surgery.  Nine additional patients came in.  Five of them are candidates for surgery and will be woven into the schedule tomorrow or Wednesday.


The day began at 7:00 AM.  The first cases of the day were already in pre-op.  Our doctors and nurses joined the hospital staff there to continue the patient preparation.  Our surgical teams were busy in the operating room, making sure their rooms were ready for their first cases.  Meanwhile the floor nursing staff was busy making sure the beds and supplies would be ready to receive their first patients.
There are four operating rooms.  All day long, patients moved from pre-op, to surgery, to post-op, to the unit.  All of the cases went smoothly and the patients are doing very well.  Some of the first patients of the morning, were quickly alert and working with the physical therapists doing in-bed exercises.  Their enthusiasm and ability to listen to, and work with staff, is inspiring.  The first several patients of the day have already taken their first walks!
Each and every patient has their own unique story.  Today we had two patients with inter woven stories.  Two sisters, here on the same day, each needed both hip joints replaced.  Here they are seen holding hands in Pre-op, just prior to their surgeries.   And later, post-surgery they are shown here, lying side by side in the Recovery room.
At the end of the day,  some staff were busy making sure they were doing all they could for their patients, while other staff were busy preparing cases for the next day.
The total surgical activity for the day….the team performed surgery on 16 patients, and replaced 18 joints.

Screening Day

Screening Day begins our first encounter with the patients and their families.  The patients already have an established medical history with the medical personnel in Guatemala.  And although our team has already received some medical information in advance, this is our team’s first opportunity to meet with the patient personally.  The goal of the Screening Day is meet with patients, get an updated and complete history and physical, and decide if in fact the patients are medically cleared for surgery.
The Screening Day went very well.  The patients come to a general waiting area, wait unit their names are called, and then they meet with various members of the medical team.  It is a very busy day and a very busy process.  Lots of interpreter services needed, to help both the medical team and the patients understand what is happening.
While many on the team are busy with patient screening, some of the other members; OR staff, Physical Therapy and technical support, were busy all day refining the unpacking processing, and getting their areas ready for Day One of surgeries.
We screened over 80 patients.  Some patients were not able to make it to Screening Day today.  But fortunately, through a coordinated effort with the local hospital staff, arrangements were made to have them come on Sunday.  The medical staff will take the time at the end of Day One Surgeries to screen these additional patients.  If they are candidates for surgery, they will be woven into the schedule.  This is the nature and the essence of Operation Walk.  We leave Syracuse, with our team, our supplies and a plan, but then, adjustments are necessary along the way.  This is when the team is at its best.  Pulling together to make the best decision possible and making it work.
After the screening was completed, the medical team convened for medical conference to review each case and determine which patients will be scheduled for surgery, and the best way to arrange the schedule in order to maximize care.


Tomorrow is Screening Day

The day began at 8 AM for the team already in Antigua.  And even early for the rest of the team that was beginning their travel day from Syracuse to Atlanta to Antigua.  The rest of the team has arrived safely, and we were all able to meet at the hospital for a team photo and tour of the facility.
For the team already in Antigua our day was mostly unpacking our supplies and organizing them.  This hospital in mainly a mission hospital which means different teams from different cities come in at different times to perform needed surgery and provide care.
So all day long we unpacked and organized the different supplies into the various medical specialties; Orthopedic, Anesthesia, Pre-Op and Post-Op, Medical Nursing Unit, and Physical Therapy.  The supplies are many, and the storage space is tight.  We got very creative to make it all fit.  
At the end of the day, 4:00 PM our time, we met up with our traveling colleagues who were just making their way to the hospital.  Once together we took a Team Photo, and were treated to a tour of the facility.  We were given both instruction and orientation to the hospital operating room protocols, as well as being able to witness the care that the staff are able to provide to a very needy patient population.  Some of the patient population are small children and many of us were filled with emotion, both joy at greeting many of them and sharing a welcoming smile and “hola!”  and also sadness as we witnessed first hand some of their suffering.  We developed an even deeper appreciation for the care the staff provide on an ongoing basis.  And it made us even prouder to serve alongside them for the next several days.
Tonight is team dinner, breakouts into small work teams, and additional instruction and orientation about the days’ work ahead.

Arrived in Guatemala City

Yes we did arrive safe!!  We left Syracuse bright and early.  We were in the air by 6:00 and in Atlanta a little after 8:00.  A 2 hour lay over in Atlanta and then off to Guatemala City.  After a 3 hour flight and we landed in Guatemala City around 11:30 AM Guatemala time.  The pass through customs was nice and easy.  Then we boarded two mini buses for the 45 minute ride to Antigua.  It is election season in Guatemala.  Elections are early September.  The driver told us there are over 25 political parties, and the streets are covered with campaign posters and slogans.  
Once we arrived in downtown Antigua, it is easy to see the entire center city is a designated historic site.  Literally cobblestone roads.  Imagine the 1600's in Spain, Mexico or Texas.  Many of the buildings, including the Hotel and the Hospital are simply tall, stucco, windowless walls when viewed from the streets.  But once you enter inside, especially the Hotel, it is like an internal mall, with various rooms, restaurants, and sitting areas connected by a layout of covered walkways and open courtyards.  The view all around us in the distance is of various mountain tops.  It is very beautiful.
The crew is spending the day settling into their rooms and doing some preliminary exploring and sight-seeing.
Team dinner is tonight at 7:00.