Our hearts go out to these children!

Please keep reading the blog! I am running behind on postings and there are some superb stories yet to be told! Keep reading for a few more days, please. Log on to facebook and join the open group Ecuador 2009.

This young woman of 38 went home on Thursday after a bilateral hip replacement. That´s Heather Perl on the left. Heather is the ¨jefe¨of the adult operating room nurses.

And now for a poignant story of a family in Ecuador.

Here´s Omar. He´s being distracted by Mathew Moreau since 41-2 yr olds don´t have a long attention span. Fern and I are speaking with mother, Olivia about her life. She has 5 children and Omar is the youngest. They lived in Quito until six months ago but her life was difficult. In Quito she would arise about 5 and give the 15 year old daughter her instructions for the day. The 15 yr old would have to get the younger children organized and out the door for the day while Mom went to her job as a houseworker by day and as a cook in a restaurant in the evening. Mom never got home until 10 at night and usually the children were in bed by then.

Recently Mom moved to Santo Domingo which is very near the jungle, East and North of Quito. In Santo Domingo she now earns about $8 per day. But the life style is better. The children can climb trees and pick oranges whenever they like. They help Mom on the farm. The farm offers a better lifestyle for the family and Mom sees a lot more of the children. But the work is hard! She has callused hands from the hard physical work. And work in Ecuador isn´t five days a week! She works six days per week.

But what about Omar?

Omar has returned this year to have his plates removed. This next photo is of Omar last year! Note his bow legs!!!!!! Omar had a surgical procedure at his knees to help straighten his legs and the result is great!

Omar is a cute little guy! Everybody loved playing with him. Mom told us his sister, who is 15 is deaf and non-verbal. The younger sister of 9 is the older sister´s sign language translator in school. For that reason the 15 year old and the 9 year old attend grade 4 in the country school near the 7 hectare farm on which Mom works.



After the surgery, here are Mathew and Pablo Valenzuela with Omar in the recovery room. Omar woke up hungry and we fed him some jello. He was only a day surgery patient because the procedure was minor. But then he got to horsing around afterwards and we had to re-tape his wounds after a piggy-back ride. No harm done! Mom and child headed back to Santo Domingo later in the afternoon since the other children were back on the farm alone.




Next is the story of Hugo. He´s a 4 year old with cerebral palsy and he came to us to lengthen his tendons. A year ago his father had a herniated disc and had to quit his work driving a truck. They started a small grocery store in the door of their home to make a living. Mom can´t work outside the home because Hugo is fully dependent. He can´t walk and he needs constant care. He is a bright kid though because he speaks very well. His twin brother walks but isn´t quite so bright. The two were born premature at about 28 weeks of age.
Now Dad is just back to work and Mom is still at home runing the store and caring for the child. She never gets out of the house except on Sunday becuase she is afraid that Hugo will catch a cold. He seems quite prone to colds.


Dad´s hours of work are very long! He´s gone at 6 AM and returns at 9:30 PM six days a week. He earns the typical wage of a few hundred dollars a month. I asked Mom what would have happened if she hadn´t learned of CAMTA. She responded that there was no way that they could have afforded the $4,000 cost of surgery at a private hospital. The loan would have taken years to repay.


Hugo is a bright boy -- He get´s very frustrated when he sees his hyperactive twin brother running about and he can´t. We have lengthened his tendons and he´ll have straighter legs. Mom is hopeful that he´ll walk. We´ll be happy if he can stand!


Here´s Hugo on the way home after surgery. We´ve run out of colourful cast material so he´s got plain white casts. The stick comes off in a few weeks but he keeps the casts for longer. The stick maintains abductio and that helps keep the tendons stretched.

Here´s another discharge shot. Maria and her family were headed home. That´s Asha Olmstead on the right. She came as a student but her Spanish language skills have blossomed this week.

And now for Bryan. This 13 year old has dysplastic hips. When he was 5 the first hip was operated on by Drs. Luis Piedrahita Jr and Sr. at the Hospital Metropolitano here in Quito. He walked much better after that but now the other hip requires surgery.

Bryan has pain and limp. He really wants to play football with his friends. Football is a passion here in Ecuador!

With Bryan are Bev Runka and Pablo Valenzuela. Below is a shot of Pediatric Anesthesiologist, Teresa Eliasson assessing Pablo before his surgery.

Pablo did just fine after surgery. He´s gone home to be with his family. There is a sister of 15. They live with the two parents plus the two grandparents. This extended family is quite typical of the family situation in Ecudor. Dad is an accountant and the mom is a cashier. The aunt and uncle live with them and they are a mechanic and an assistant to an accountant. With all these wage-earners in the family they could afford to pay $200 to the Tierra Nueva for the surgery.

Watch for more in the blog. It´s been too busy to get it all posted. Tomorrow it´ll be a story about adult hip surgery.

Thanks.

Hi Again - from Henrietta Goplen

I am really enjoying your blog.  I am sending it to as many people I can think of who might enjoy seeing it and  as well donating.
Enjoy your warm weather.  We are back in the midst of a blizzard in Saskatoon.  The news at home is Obama leads the headlines. The federal government trying to help the recession.  Saskatchewan now a have province, you should all come home.  Lots of terrible court cases and nasty accidents across Western Canada.  Team Camada won the Scotty and the Men's Brier starts.  The Olympics are a year away.  But your team is doing the most important work.  Take care Henrietta Goplen.

It´s not all about surgery! There´s care on the ward too!

The ward delivers the superb care that gets the patients back on their feet and gives them the skills they need with their crutches to return safely home. Here´s Sarah Southon, Nurse Practioner in Pediatric Orthopedics, Family Doc Doris Kent with Marta at the nursing desk. Marta is a long time Tierra Nueva staff nurse who has worked with us for years. I´m sorry I don´t know the name of the other Tierra Nueva nurse. This year we also have some Tierra Nueva nursing students working on the floor.

Graduate Nurse Robyn Goplen is with Yolanda who had her total hip this very day! Watch for video to be posted of her taking her first steps with her new hip!

Linda Ushkowski, Adela Sandigo RN´s both with Dr. Doris Kent in the charting-medication-storage room.

Julianna´s clubfoot needed a little more work

Julianna is 10. She had her clubfoot operated on when she was about 2. But there is some residual inturning of her right foot. Julianna came with her older sister who is 26. The parents are working in a small town and they sent the kids to Quito to live with their grandparents. In Quito they should get better schooling.

Julianna hopes to wear normal shoes and to play some sports. She hopes to run better.

That´s Fern Cannon on the left and Glenn Day on the right.

Below, Fern stays with Julianna for her anesthetic induction by Teresa Eliasson in the background.

Scott Wiens, R4 Orthopedic Resident, Glenn Day RRT, Cori Kalven B.Sc.N. and Eileen Guilfoyle RN were part of Julianna´s surgical team.

Here´s the surgery underway.


Here´s Julianna´s x'ray.



And finally we have Julianna in recovery room with Bev Runka RN and Student Nurse Rebecca Latimer.

Miguel gets his tendons lengthened!

Miguel has cerebral palsy. Here´s Miguel with his grandmother and aunt, Maria. He was abandoned by his mother and now he lives with his sibs, aunt and their grandmother. The only income is from Maria´s husband´s work as a chauffeur of a bus. Miguel smiles lots and he loved the balloon animals that Anesthesia Tech Glenn Day made for him. Miguel needs flat feet if he´s to walk better and that´s what we did for him today.

Here Fern Cannon helps Miguel onto the operating room table. Fern has been part of CAMTA as a translator since our inception and worked with some of us in Cuenca before CAMTA was formed. She´s an Ecuadorean and now lives with her husband and three girls (9, 7, 5) in Texas.

Here´s the surgical team for Miguel. It´s the end of surgery and he´s got some nice cylinder casts! That´s Robyn Goplen, Surgeon Marc Moreau, Anesthesiologist Teresa Eliasson, Surgeon John McIvor and medical student, Mike Metcalfe.



And finally here is a smiling Miguel on the ward after surgery!

Clinic Day for Team Two - Sunday March 1st

The bus transported Team Two to the hospital at 0800h on Sunday. Some Team One members came in too since there were patients to care for on the ward. And it´s important to brief everyone about the events of the week and where the medication and the equipment is located. Here´s a little girl with the Canadian flag:

Here Robyn Goplen, Graduate Nurse assesses a young woman who needs a total hip arthroplasty. Sonya has had dysplastic hips since childhood. She walks with a terrible limp and has a hard time sleeping. We only had about three surgical slots left after the first clinic. There were 60 patients to see and the majority were follow-up patient exams. It was great to see last year´s patients. There were lots of hugs and kisses.

These two tykes received hip surgery last year. Aren´t they cute!


Here´s their extended family. Mom, Dad, sister and grandpa.



Here´s another family. Everybody wears their Sunday best to the clinic!



There was time for a picture of some of the 40 team two members in scrubs. From left to right is Barb, Marc, Cori, Pauline (star of the CBC 2006 documentary) Ron, Heather, Paul and Robin.

Pedipod Marc Moreau watches the gait of a child with cerebral palsy. We´ll help him to walk a little better with tenotomies to let his feet be flat on the floor!

Here´s Dorothy, Bev and Rebecca with Omar. He´s enjoying all the attention!

Dan Ducholke is fixing the label printer. Everybody loves the labels that our database, designed by Mark Fedorak, produces. Dan is a mechanical engineer who is our data man for week two.

If you think we are doing good work in Ecuador then join our FACEBOOK group at www. facebook.com. Search for the group called ECUADOR 2009.

Team One hands off care to Team Two

On Friday evening, Team Two arrived after their long trip from Edmonton, Bonnyville, Kelowna, Vancouver and Texas. On Saturday evening everybody enjoyed dinner together and we continued the tradition of a picture of each team. About 12 of our members from both teams enjoyed a game of soccer. For Ecuadoreans (and most of the world) this is known as FOOTBALL. FOOTBALL is a national passion in Ecuador and six games were played in Quito on Saturday. Each and every CAMTA member except Sam Stetsko arrived at the dinner in football shirts. Sam couldn´t because there wasn´t one large enough for this former football player.

Team One of CAMTA Mission 2009

Team Two of CAMTA Mission 2009

Find your friends and relatives! They are all there!

Second Sunday Clinic -- Patiénts return for a one year follow'up

Dorothy Latimer, Bev Runka and Rebecca Latimer with little Omar. He´s smiling cause he loves the attention! Last year he had surgery so he could walk better. Now he´s walking just fine and we all know that soccer is in his future!

Our patients are recovering

Here´s Eileen, Jose and his Mom just before Jose entered the operating room for his surgery. Jose was another of the many many children we have seen this year with dysplastic hips! These kids walk with a limp and then grow up to have very very early osteoarthritis which when it becomes severe limits their ability to work and feed their families.

Dr. Orlando scrubbed in with Ed Masson and Greg O´Connor again. Earlier he scrubbed in on Pablo´s hip surgery and Pablo translated for him while Pablo himself had surgery! Amazing!

Jenna Coulombe has just finished her Human Ecology degree and applied to come as a lay student with CAMTA, two years ago. Here she is learning about what anesthesiology might mean as a career. This type of exposure is done only under the direct and continuous control of anesthesiologist Dr. Andriy Rodyniuk.



Meanwhile in recovery room Charlette Opper and Erin Nikolic care for a little tyke after surgery.



Consuelo has had an amazing experience this week. She volunteered as a translator. Consuelo moved from Colombia to Edmonton many years ago and raised her children single handedly. She has never had an experience with such emotional power as her experience this week. She is a CAMTA translator. She says she will participate as a translator for as many years as she can. Consuelo has been in tears. She is a very compassionate woman.

The child Consuelo is with has cerebral palsy. He´s 13 years old. When parents have such a kid in Ecuador there isn´t much support like at home in Edmonton. This little guy has some contractures in his tendons and a seizure disorder. His mental ability is about age 2. He needed tendon releases so that his parents can get him up in a chair or help him to stand.

Jenna Coulombe carried this tiny little 13 year old into the operating room for his surgery.

Meanwhile next door in the adult theatre, medical student Sheena Sikora is pictured here making the incision for a hip arthroplasty. She is under the direction of Drs. Greg O´Connor and Ed Masson. Sheena is thinking of orthopedic surgery or plastics as a career. We want her in orthopedics!

On the right is RN Debbie Jaraway. She´s a pediatric OR nurse but for fun she did an adult hip today.

In the pediatric room with the Pedro - the boy with CP asleep, Darcie scrubbed in. Eileen taught her about sterile surgical technique on Wednesday. Now was her turn to scrub and observe.

Then the surgery progressed back in the adult room. Loreno is getting her femoral prosthesis implanted here.

Pedro now has his tendons released and two cylinder casts applied. He´ll keep these casts for six weeks. Left to right we have Dr. Andriy Rodyniuk, RN Eileen Guilfoyle, Dr. Marc Moreau, Ms. Darcie Stein and Dr. Jay Jarvis. Jay is from Ottawa. Everyone else is from Edmonton, Alberta, Canada.

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