Today’s schedule for the mission team was very busy.  Eight surgeries were performed and there were no cancellations for the first time this week.  There were two cleft palate surgeries, three cleft lip surgeries, one scar revision, one frenulectomy (tongue tie release) and an excision (removal) of a cyst.  All patients recovered successfully and discharged to the inpatient unit.  Dr. Goudy was also able to see Josie today.  Josie’s family brought her to the hospital so that Dr. Goudy could see her before he left Guatemala.  Josie’s condition continues to improve and her family is very pleased and thankful for the care she received from Children’s Hospital physicians and nurses.  The team will visit El Nino Jesus one more time tomorrow morning to ensure that all patients are doing well and can be under the care of the local pediatricians. 

The last thing on our agenda at the hospital was to pack up the supplies for transportation back to Children’s Hospital.  Many hands made work light and we were able to secure all instrumentation, etc. for the plane ride back to the United States. 

Every team member was proud of their contribution to the work that was done at El Nino Jesus this week.  27 cases were completed successfully.  Good relationships were formed with the pediatricians as well as the nursing staff.  Several El Nino Jesus staff members requested that Children’s Hospital mission groups come back to Guatemala and hopefully very soon.  All of us will never forget the beautiful children that we were allowed to participate in the care of.  The staff who didn’t necessarily know each other very well were able to come together as a team under some very difficult conditions.  They were able to many surgeries and even perform a successful resuscitation.  Congratulations to everyone who participated and many thanks.  Many thanks also to the administrative staff who arranged this blog on the Children’s Hospital website.  I am hopeful that this blog helped every staff member’s family.  One picture says a thousand words!  Adios amigos and hasta la vista…baby!

We were able to complete six surgeries. Three surgeries involved repairing cleft lips, and the other three were oronasal and plate fistulas.  All patients were discharged successfully to the nursing unit on the third floor. 

The team was finished a little early today and decided to get some R and R.  Some members of the team (all of the girls) decided to walk a couple of blocks from the hotel to explore a Guatemalan shopping mall.  They were surprised at the sheer size of the facility.  It was four stories and had lots of American type stores.  There was even a McDonald’s at the mall!  It struck the team as odd that there was such a modern facility in the midst of the extreme poverty that we have seen around the rest of the city.

There are eight cases scheduled for tomorrow.  We are hoping that the illness that seems to be prevalent among some of the children doesn’t affect any more patients.  Stay tuned….

The ENT mission team started the second day of surgeries without one of the surgeons.  Dr. Cofer developed a viral illness and had to stay in bed for the day.  Drs. Goudy and Wittkopf stepped up to this challenge and worked with Dr. LeMelle to coordinate a schedule that would accomodate all of the patients who had been originally scheduled.  As the team began preparing the O.R. we were informed by the El Nino Jesus staff that two of the patients would not be coming that day because they had fever.  Later in the day two more patients failed to show- also because of fever.  Another patient showed up at the hospital and we were able to operate on him.  In total, five cases were done- three cleft lips and two cleft palates.  One of the cleft lip patients had been discharged from the PACU to the floor and developed a complication requiring emergency resuscitation by the team.  The Guatemalan physicians ran with the baby from the floor to the PACU where the baby was successfully resuscitated.  The hospital physicians were uncomfortable leaving the baby on an unmonitored bed for the night, so they transferred the baby to a government hospital by ambulance.  There are nine cases scheduled for Wednesday.  The team hopes to be able to complete all of these surgeries without as many changes to the schedule!  Stay tuned….

filed by Lori Graves, R.N.

The surgeons on the ENT team performed eight surgeries today.  Three palate surgeries, two cleft lip surgeries, one hemangioma (benign blood vessel tumor) removal and two frenulectomies (releasing “tongue tie”) were completed.  One surgery was cancelled because the patient had fever. 

The team was able to function smoothly and really didn’t encounter any major obstacles.  Two of the patients were able to go home the same day, with the rest of the kids spending the night in the hospital.  The children are monitored very carefully by the mission staff as well as the hospital staff when they are transferred to the floors for care. 

The Guatemalan pediatricians are very careful not to discharge patients prematurely as the family could encounter great difficulty when attempting to return to the hospital.  Most of the patients come to the hospital by city bus and that is not always the safest and most reliable transportation. 

    
Postop patients

After the final hospital rounds were made by the surgeons and the anesthesiologists the ENT mission team were given a special dinner sponsored by the Pediatric Foundation of Guatemala at Los Cebellos.  The team was greeted by the Shalom Foundation Medical Director and two physicians employed by the Shalom Foundation.  The food was very good and included the best guacamole that we have had yet on our trip.  

One of our team members was surprised by the restaurant staff singing Happy Birthday to him and placing a large sombrero on his head.  The only problem was that it wasn’t his birthday and therefore he was quite surprised.  The restaurant staff are very enthusiastic about birthdays and gave Dr. Watkins a very nice photo of this event.  Maria Jose (Shalom Foundation staff member and interpreter) explained to Dr. Watkins that this was his welcome to Guatemala!  Tomorrow there are eight scheduled surgeries.  These will be similar to the cases done today.  The team will continue to work with the El Nino Hospital staff to continue to ensure the success of the mission.

 
A very tired crew!

The ENT Guatemalan mission team split up today.  Surgeons and anesthesiologists along with the PACU staff went to work at the clinic offices of the Pediatric Foundation of Guatemala.  Many patients were screened today for several types of surgery.  32 patients were found to have problems that could be repaired surgically.  The surgeries for the upcoming week will include cleft palate repairs, cleft lip repairs, frenulectomies, and scar revisions.  The O.R. staff along with the CRNA’s worked at El Nino Jesus today.  They worked with the staff of the hospital to organize 3 O.R.’s.  They located and arranged the necessary supplies so that surgery can start promptly Monday morning. 

After work was completed for the day, the team was taken to the Shalom School and Church complex.  This facility is located in a section of Guatemala City known as Zona 18.  This is a very impoverished area of Guatemala.  The team was impressed at the great ongoing work that the Shalom Foundation has undertaken at the school and church.  There have been several improvements to the facility that were noted by team members who had previously visited the church/school.  After the tour of Shalom the team headed back for a little R and R.  We anticipate a busy work day tomorrow and plan to “keep it a go!” no matter what situations come up throughout the week. Stayed tuned throughout the week for more updates!

To see more photos from the team’s first day, click here or on the photo below.

Filed by Lori Graves, R.N.

The ENT team wasted no time in getting to work after their arrival in Guatemala City.  Our first stop was to visit the hospital where we will be working for the next week.  The team took a quick tour of El Nino Jesus Hospital and made an assessment of the necessary equipment and supplies.  We put together a plan for throughput that will help maximize our efficiency as a team.  After the hospital visit, the team was taken to the new Shalom Surgery Center that is currently being remodeled.  The team agreed that the new hospital has a great potential but needs some more renovation work before a surgical team can be sent to work there.  We will be watching the ongoing work there with great anticipation!  Speaking of great anticipation…

The team is excited about tomorrow’s work.  We will send several team members to clinic to screen patients for surgery.  The operating room nursing staff and CRNA’s will be working at the hospital to ensure that all equipment is ready for business on Monday morning.  The team plans to work in 3 O.R.’s in order to maximize the number of patients that they are able to treat.  Stay tuned for more updates!

The Monroe Carell Jr. Children’s Children’s Hospital at Vanderbilt Operating Room staff has packed up once again for another surgical mission trip to Guatemala City, Guatemala.  The team will leave on Saturday, September 27 and perform mostly cleft lip and palate surgeries at El Nino Jesus hospital during the week of September 29.  The team will be led by Drs. LeMelle and Goudy.  Other participating team members include: Dr. Shelagh Cofer, Dr. Maria Wittkopf, Dr. Scott Watkins, Dr. Rachel Cambray, Jill Moore CRNA, Roni Nylander CRNA, Brenda Sandlin, Lori Graves, Jacque Lee, Glenda Sullivan, Kate Rafferty, LaDonna Reyka, Sandra Tidwell, Allison Newton, Tommy Sanders and Cindy Bhavsar.  The team plans to run a very busy clinic on Sunday, September 28 and screen children for surgery.  Hopefully we will be very busy during the week, helping as many children as possible.  Also on the itinerary are plans to visit the new Shalom hospital that Vanderbilt is partnering with for future trips.  Wish us luck!