Day 3 - Surgery

Day 2 - The Clinic

Who are the people of CAMTA?

Today was a big day for a CAMTA volunteer. Have you ever seen the Spanish language blog called http://www.camtaparaquitenos.com/? A year ago after Mission 2008, Pablo Montuahano Sosa who had received a hip from CAMTA wrote and offered to help. He's been posting to the blog for months. Pablo reported on the post-operative recuperation of the patients - his peers. But today was Pablos' turn to receive his second new hip. He is 45 years old and has suffered for years with early osteoarthritis caused by dyplastic hips from his childhood. Below is the story of the care this carpenter received in the operating room at the Tierra Nueva today.

Here below is Pablo with his leg being draped for surgery.

During the surgery I got this shot of the operating team and the instruments. It was different - being able to show a patient pictures during his own operation. Most wouldn't be interested but Pablo sure was!

Here's Pablo resting with his oxygen during the surgery. He received mild sedation but he also translated for Dr. Orlando of the Tierra Nueva who scrubbed on the case with Drs. Ed Masson and Greg O'Connor.


Meanwhile over in the pediatric theatre, Debbie Jaraway RN has been scrubbed on a long case of a teenager who needed his acetabulum adjusted so his femur would bear properly in the "socket". This took some hours but Debbie is a competent and happy opeating room nurse. In her "real" life she is the charge nurse in pediatric orthopedics at the Stollery Children's Hospital, Edmonton, Alberta.



On the left is Dr. Luis Piedrahita. He's showing Medical Student Sheena Sikora, pediatric orthopedics! She hasn't chosen a specialty yet but she soon will need to make some decisions. Sheena is attending the Faculty of Medicine and Dentistry at the University of Alberta.

And now for two students. Darcie Stein and Jenna Coulombe are attending as non-health care students. Jenna has just received her degree in Human Ecology from the University of Alberta. She has a Spanish course under her belt and she's being trying a little conversation during the day at the Tierra Nueva. Both she and Darcie who is a first year student at the U of A are experiencing a lot during this mission! Below are some shots as Eileen Guilfoyle shows them how to gown for a surgical procedure.

Here's how you get your sterile surgical glove on!




Here's Darcie learning that you have to keep those hands tucked!

And here's Jenna also getting gowned and gloved. Note that oversize surgical gown - it's just for trial purposes. We'll give her the right size tomorrow when she really gets to scrub! She won't operate -- just watch and we hope she'll learn a lot!

After every case there are a "ton" of instruments to wash in the "kitchen". The kitchen is really the CSS or Central Sterilization and Supply Room. It's about the size of your kitchen and it is where the instruments are washed, wrapped and re-sterilized. I was particularly pleased with this shot of a number of the team members after the last case was done for the day. Here they are from left to right: Dr. Marc Moreau, President, (it's 11:45PM and I'm going to bed, I'll finish tomorrow)

Here are Joanne Stein and Clare Gallant, who are both lay-participants "doing the dishes". It's a tough task in a hot room with bloody instruments. Koodoos to them for their on-going effort!

And finally to finish off -- here's a shot of Pablo Montohuano on the ward just 6 hours after his surgery! He's already been walking three times!!!! We sure wish our patients in Edmonton could do that on their first day! With him are from left to right: Dr. Greg O'Connor, Dr. Ed Masson and RN Mae Pascoe.

Mae is from Edmonton and she is a ward nurse with CAMTA. She's quiet but not afraid to work!

Thanks all and we'll have more for you tomorrow!

John Lilley, Secretary of CAMTA

Greetings from Anne Magee -- three time mission participant!

John:

I've been thinking about you all over the past few days, imagining what you are going through- the long trip down, getting your bearings on Saturday morning, the excitement of familiar surroundings, seeing what's changed at Tierra Neuva, Otavalo market for some!, the hectic Sunday clinic, unwinding with the Oscars late Sunday night, the joy of getting to work on Monday morning..... I'm missing being there!  Please give my greetings to everyone there and pass on my best wishes for another fantastic mission for all!  I look forward to following your adventures on the blogspot!

Anne Magee

 

Twas a busy day and a late evening...

For Orthopod Dr. Ed Masson the day begins with templating the films for the cases that he and Dr. Greg O'Connor have booked. They are adult surgeons -- and today they did a 32 year old woman. She got BILATERAL hip replacements. Her legs were so stiff from advanced arthritis they could barely move apart. How can a woman of that age with children expect to work and raise her kids with such severe arthritis? Sonya did very well -- and she was very stable under the anesthetic for Dr. Sam Stetsko. Nurses Pauline Vatcher, Bernie Johnston, Ann Osinboyejo and Katrina Crnogorac scrubbed and circulated.

Here Charlette Opper RN and Erin Nikolic B.Sc.N admit Maria into our little surgical suite at the Tierra Nueva. Maria's only 12 but she needed a Chiari osteotomy on the second side of her pelvis. CAMTA did the first side last year but thought it better if she grew a year before we did the second side.

This is a great shot of Maria as she is prepared to receive her anesthetic.


On the x-ray box in the pediatric OR are Maria's films. Dr. Jay Jarvis of Ottawa indicates the side that received surgery today. You can see the pins in the side we operated on last year.



Before the surgery began, Eileen Guilfoyle and Patricia Cortes "ham" it up for the camera. Note all those surgical instruments which the team washes and re-sterilizes after each case.




Up on the ward we have from left to right: Nurse Joanne Brown from Winnipeg. Next to her are Dad and daughter. Lesly is 13 and she had a pin adjusted in her ankle. She was a natural to use her crutches. On the right are nurse practioner, Betty Anne Thibodeau and Mom.

Now isn't this a bright cast! What's the story here!

Little David is only 11 months old. Another team operated on his clubfoot a few months ago. But there was a residual deformity that needed correction. Otherwise he wouldn't be able to run and play soccer like the other boys. Here Mom and babe wait because they didn't make it into the OR until about noon time.

I took a quick shot of his feet so you can see the residual deformity for yourself. Note how his left foot turns into towards the other foot.

Surgeons Dr. Luis Piedrihita and Darcy Durand released the contractures and straightened the foot.

The anesthetic consisted of local and caudal blocks plus a general. Dr. Andriy Rodyniuk has been down in Ecuador many times.

Later in the afternoon, baby David was nursing and Mom kindly permitted me to take a picture of the little tyke. He should be home tomorrow.

I couldn't resist adding this great shot of an Ecuadorean child. Vanessa had surgery yesterday on both sides of her pelvis and her left hip. She's doing fine.

Some stories from our first day of surgery!

Everyone was on the bus bright and early at 0700h. We arrived after a journey through the old town of Quito to a quiet hospital since the "Carnival" long holiday weekend is underway.

Here above is little 2 year old Vanessa being prepared for surgery by nurse Erin Nikolic. She's a sweet little thing with the sad misfortune of having bilateral dysplastic hips. She needed pelvic osteotomies to correct the deformity and an open reduction of the left hip.

She needs to grow up walking without a limp!

Below, you see her at the start of her anesthetic as the staff prepare her for surgery. That's Blair Gallant, Anesthetic Technician on the right and Eileen Guilfoyle RN in the background. The long arm of anesthesiologist Andriy Rodyniuk holds the mask!

Meanwhile in the next theatre, Dr. Sam Stetsko is inserting the spinal on the first adult patient of the day. She's a little woman of 54 years of age with severe osteoarthritis and she needs a total hip.


When little Vanessa's surgery was finished she got a nice green cast from chest to toes and here is the x-ray to show a nice reduction of her hips.



Dr. Ed Masson is very careful about selecting the right prostheses for each patient. We've brought down a large supply at no cost courtesy of Smith and Nephew.

Have you been watching those videos? I thought you would like to see the man behind the camera! This is Mr. Steve Van Deist. He's here as an interpreter but his real profession is at Global Television in Edmonton. He leads a mean group workout too!

And finally I thought I would show you a sequence of how a patient gets up to the ward on the second floor above the operating room. It's a long trip for Vanessa! It's up the ramp and around the corner. Then after the elevator is unlocked by Pablo, Kathy Angus and Charlette Opper move her into the elevator. Then it's down the ramp and onto the ward. Each patient gets manoevered into their room and transferred to their bed.

On the left, Nurse Mae Pascoe consults with the local Tierra Nueva nurse about the care of the patient.

I hope you're enjoying the blog! Let us know what you think!

Thanks, John

CAMTA sees 140 patients at the Tierra Nueva!

Today we arrived at the Tierra Nueva bright and early for our clinic. The OR staff set up the theatres while surgeons and translators got to work in the clinic. We saw our first patient at 0930h but it wasn't an facile morning. We worked hard to get more efficient with the flow of patients. By the afternoon we had a great rhythm although we were a little short of translators since the local school kids had to leave at about noon. By the time the day was over we saw ONE HUNDRED AND FORTY PATIENTS! This is the most patients we've ever seen in one clinic. We didn't wrap our clinic until about 2100h Sunday evening.

The pediatric surgeons are so very pleased to have two FULL weeks of pediatric surgery all organized. The first child tomorrow is having a bilateral pelvic osteotomy and a left femoral osteotomy as well. That's a big case!!

Sammy Ruiz had brought some amazing steel tie wraps to the warehouse. Here's Greg O'Connor using a surgical instrument (pediatric pin cutter) to remove them from the prostheses boxes.

During the clinic Eileen ran around and got pictures of the kids and their parents. Someone kindly took a picture of her with this little monkey. He introduced himself to Eileen with a very English "HELLO". Then he kept bringing his friends for more pictures.

This poor little thing got so upset later in the day. Here her Mom, who wasn't much happier trys to comfort her.

The scrubs are all lined up ready for Monday morning. Watch the blog for more pictures and video of the patients! The kids are so so cute. The adults are so so very grateful.

The applause this morning as we entered the Tierra Nueva waiting area was quite emotional for some of the new CAMTA team members.

CAMTA IS ENROUTE - Departure from Edmonton

Hi Everyone!
We had a great trip down although it was tiring. Enjoy the video of an excited team embarking from the warehouse!
Today is a day of rest and then tomorrow the clinic to select our patients will begin!
Watch for more!
John

Good luck wishes from Erin Ennis -- 2008 participant in CAMTA's mission to Ecuador!

HI Erin,

Nice to hear from you!!!!!

Thanks for the best wishes.

John

2009/2/19 Erin Ennis <ennis.erin@gmail.com>

Hi John & Eileen!

 

Best of luck to you guys and the rest of the team this year in Quito!! I'll miss you guys and will be following the blog!

 

Talk to you soon,

 

Erin E.

CAMTA is PACKED and ready for Mission 2009!!!!

The Adult OR nurses receive the Smith and Nephew Prostheses for packing at the Warehouse

Smith and Nephew are a company with philanthropic beliefs.  Here Mr. Bill Wilkins, the Edmonton area sales manager for the company is delivering the prostheses and instruments for the total hip arthroplasties that we will perform in Quito, Ecuador from Feb 20th to Mar 7th.

It has been very busy at the warehouse.  We now have 84 bags packed!  We have 3000 pounds of materials to transport to the Tierra Nueva Hospital for our surgical project. 

Here, Marc Moreau sweeps up the dust.

It really is so exciting!  The last general meeting had a big BUZZ in the air because departure is so close.  We have students like Asha Olmstead and nurses like Mae Pascoe who will be having their first experience helping out in the developing world.  They are so ready to experience new things and to help people improve their health.  

 Follow the mission over the next almost three weeks.  You'll see pictures of our patients and our staff getting to work at the Tierra Nueva Hospital in Quito, Ecuador.

  Here Betty, Rocio and Asha work hard at entering the hockey bag lists into laptops.  This year we must have our supplies pre-approved for import into Ecuador.