Columbus Medical Mission Team

Tuesday Early AM

2012-02-14T06:00:00.001-06:00

I have been going on the early crew @ 6:20 I will send a few pictures. The first day got off to kind of a slow start with cautery and sterilizer glitches but once we got rolling we did around 20 cases total. I was doing ENT with Rich. We did two cleft lips and several tonsils. The other table did lots of hernia repairs among other things. I need to get the pictures on and eat so I will close. Lots of stories but not much time.
Dean

Sunday morning

2012-02-12T07:49:00.000-06:00

Good Morning, everyone. Dean & I are early birds this morning. Breakfast will be soon and then church services for 2 hours. Since we didn't want to worry anyone at this point, we did not tell you about the problems encountered by the team getting here. Other than some of our totes not arriving till Thurs. night, the NE people have had it easy compared to the California team. Part of their team flew separately from the rest of the team. The first group was rerouted but made it to Managua Friday night. Their totes ended up being confiscated going through customs. The 2nd group arrived and their totes went through. Suzie & RJ stayed with the totes as long as they could and then were thrown out and the totes were taken away and locked up for the night. Suzie's goal was not to be thrown in jail as well. Pastor Earl's brother, we think through devine intervention, happened to be at the right place at the right time and saw a person he knew that worked in customs and put her to work helping with their situation. To make a long story short, their totes were finally released Sat. morning and their team got here in Puerto Cabezas on 2 different flights. Now back to the NE team in PC with Keveta on Fri. evening, we were all waiting to hear news about them which changed with every phone call (and there were many from her to the people in Managua). We had to make a plan B as far as having our clinic on Sat. with NO doctors. We planned as best as we could and went to bed hoping for the best in the morning. We started our clinic with Dr. Taylor (Nicaragua dr.) helping fill Mark's (the general surgeon) spot and Jody assisting him. Sue & Sherilyn were the ENT docs, replacing Rich till his arrival. Dean, Melissa & I were at the scheduling (surgery) table. Dean & Melissa assessed patients, made the schedule and I did paperwork. (Yes, there's some paperwork in Nicaragua.) Since a lot of our clinic supplies were in the totes which hadn't arrived, we were working with a lot of makeshift forms, supplies, meds, etc. One by one, California people arrived after we had seen lots of patients and filled some days for Rich & Mark. The clinic was a HUGE success and we were done, packed and out of there before 4:00. WE DID IT!!!!!!! We had a team meeting, a great supper and able to get to bed early! We will have a very busy week and the doctors will be doing lots of surgeries and there will probably be some later evenings that we will be working. That should cover our happenings for now. By the way, if anyone at home is expecting to get e-mails from team members, you probably won't be receiving them for the time being. We are able to receive e-mails (the junk mail is coming through fine) but not send. Just continue to follow our blogs for updates. In spite of all the problems, everyone is upbeat and excited for the week. Keep us in your prayers as we proceed with our mission. Carolyn

In Puerto Cabezas

2012-02-10T20:16:00.000-06:00

Hello everyone! We are in Puerto Cabezas and Melissa is here as well. Dean & Karl went to the airport last night and got the rest of our totes. Great news!! Arrived in PC today at 12:15 and were picked up and brought to the compound which will be home now for 2 weeks. Hopefully the totes will arrive Saturday. Some of the California team is in Managua at this time and the rest of their team should arrive later this evening. We hope to conduct our clinic tomorrow. We have been busy this afternoon organizing the totes that Keveta keeps here at the compound. Time for bed. Everyone says "HI". More blogs to follow
Carolyn

In Nicaragua

2012-02-09T19:28:00.000-06:00

We are in Managua! Left Omaha on time this morning at 5:35 as we saw 4 of our totes going back to the terminal on a cart! So far, they have not arrived but are supposed to be on a 9:30 flight tonight. (We have a total of 12.) Good thing we are staying across the street from the airport. Dean & Karl will be going over to see if they have arrived.
We have had lots of challenges already. The man who was supposed to meet us with papers from the Ministry of Health allowing us to get through customs was not at the airport. We still managed to get through customs. Found out later that he has been tied up at the Ministry of Health waiting to get the papers. Needless to say all our plans have been changed somewhat and we are waiting on word of what to do next.
If you don't hear from us on a regular basis through these blogs, don't be alarmed since electricity could be a problem. It is sporadic to say the least.
We are all tired and hoping to get some of these issues resolved so we can get to bed. Has been a long day with very little sleep. Hope to keep you posted.
Carolyn & crew

11th Hour

2012-02-08T07:46:00.000-06:00

Well if appears we are down to the 11th hour. The totes are packed and ready to go. I was sure we would be taking 6 or 7 totes but the final count is 12. The Nicaraguan Ministry of Health decided to get very picky about who they allow to do medical missions in their country so last week was a whirl wind of emails back and forth with Keveta in Nicaragua and all the team here. We were finally able to satisfy their requests and got the official approval late last week. We thought this was done several months ago.
We leave for the airport at 2:30 AM tomorrow to catch our 5:30 plane. We will be in Managua by 12:30. Karl and Sue will meet us at Eppley and Melissa will leave from NY Friday. She will meet up with Suzie and the California Team in Managua and fly onto Puerto Cabezas with them.
We are all very excited to finally be leaving for this mission. I want to thank all of you for the many ways you have supported us as we have been preparing for this mission. Please continue to keep us and those we will be serving in your prayers.
We will try to blog as time and electrical service allow as we go through the next two weeks so keep checking back.
Dean

2012-01-14T10:42:00.000-06:00

Here is a reminder of why we make this trip. These are people waiting to be seen in our clinic, last year and there are 100 more inside the church.
Our schedule has changed a little for our trip this year due to the schedule of the surgeons. We will do surgery Monday through Saturday and then Sunday afternoon after worship services. The surgeons will be gone on Monday and we are planning a road trip to see another hospital up on the Rio Coco river. They are wanting us to consider a surgical mission there on a future trip. Carolyn and I have done a little research and it appears this is a small village in a remote area. It is only 50 or so miles from Puerto Cabezas but we are told it will take 3 to 4 hours to make the trip. Their roads make our minimum maintenance roads look like I-80. We will look over the facility to see if this is feasible. I am sure what they call a hospital will differ greatly from anything we have seen. Then we will pack up and prepare to come home. The team is getting very excited. Keep us in your prayers.
Dean

Thank you

2011-12-12T15:37:00.000-06:00

A big thank you to everyone who supported our spaghetti feed yesterday by your attendance, donations, & donations or purchases of baked goods. We had a great turnout and it was a BIG success!

Also, thank you to all the volunteers who so graciously gave us their time to help with preparations, serving, & cleanup. We couldn't have done it without you.

And thank you to Cargill for their generous donation of the hamburger and the Barilla pasta company for donating the spaghetti and spaghetti sauce. Thank you to Barb Olson for her donation of the delicious bread sticks. Everyone's generosity is so appreciated!

Again, keep us in your thoughts and prayers as we once again journey to Nicaragua in February!
Carolyn

Spaghetti Feed & Christmas Bake Sale

2011-12-04T17:30:00.000-06:00

The Columbus Medical Mission Team is sponsoring a spaghetti feed along with a Christmas bake sale on Sunday, December 11th from 11:00 AM to 1:30 PM. It will be held at the Eagles at 3205 12th St. in Columbus. This is a fundraiser for our medical mission trip to Puerto Cabezas, Nicaragua, in February 2012. After church, bring your family for a tasty meal and also pick up some Christmas goodies for your holiday enjoyment! It will be a free will donation.

We would like to thank Cargill for their generous donation of the hamburger as well as the Barilla pasta company for their donation of the spaghetti and sauce for our fundraiser. Please show your support of these companies by purchasing their products.

And thank you for your prayers and support of our mission.
Carolyn

Getting ready for Nicaragua 2012

2011-12-03T11:02:00.000-06:00

The Columbus Mission Team is returning to Puerto Cabezas, Nicaragua in Feb. 2012 for a 13 day mission trip. The team consists of Dean & Carolyn Athey, Karl & Sue Tillinghast, Jody Dreifurst, Sherilyn Haswell, and Melissa Shemek. We are again partnering with the team from California that we have teamed up with the last two trips. Their team consists of a general surgeon, an ENT surgeon, an anesthesiologist, several nurses, children's ministry people and other support people. Suzie Smith from California and Keveta Andersen from Puerto Cabezas will once again be our work and spiritual leaders. We have begun to assemble our supplies. Although we do not have a surgeon on the Columbus team this year we are still taking a lot of supplies, medications etc. Our team and the team from California have developed a very close relationship with the staff @ the hospital we work @ in Nicaragua. We actually hire some of their staff to work with us while we are there. Since we take over one of the hospital wards and an operating room some of these people would otherwise be unemployed while we are there. We ask that you keep us in your thoughts and prayers as we prepare for our next mission. Thanks. Dean

Antigua and Honduras

2011-10-11T18:21:00.001-05:00

We've spent the last 2 nights in Antigua, a historic tourist town. They had various tours we could sign up for so John and I took the one to Copan, Honduras which is an ancient Mayan city dating back to 400-700 AD. The ruins in the photo is the court where they played some form of soccer with a heavy rubber ball. They think the loser loses his head or something like that. It was a ritual ceremony and game. They don't know exactly the whole thing. We had an English speaking guide who was very interesting. It would have been a perfect day, except it took 5 1/2 hrs to get there. The scenery in Guatemala and Honduras is spectacular. We drove through the mountains with a driver working for the team. We got slowed down in traffic in Guatemala City and for mudslides. It rains at least a little every day.

The little blue car was a police car. They are everywhere in blue and red, not just the police. I bet they get good milage.
The green courtyard is outside our hotel door with rooms all around it.
Today we slept in and strolled around the city of Antigua. The Hotel Santo Domingo is wonderful and I highly recommend it. We ate in a great hotel resaurant last night when we got back, which included quail eggs and caviar in the appetizer. We walked through the market and along the cobblestone streets today learning to barter for every little thing.

Finished

2011-10-09T18:17:00.000-05:00

We have finished the medical mission and have moved on to R&R in Antigua. We did our last case at 6:30 Friday evening because the little girl had eaten. She had a mass on her nose (dermoid, it looked like) so it didn't take too long. We spent Saturday morning packing up..... and I mean PACKING UP EVERYTHING. HELPS Int'l keeps supplies in G. City, so they brought a truck. We inventoried everything and loaded up some stuff to go back to the US, and alot to go to G. City. That included OR tables, anesthesia machines, stirrups, suctions, suture, gloves, etc. etc. etc. They keep some for the next incoming missions and distribute some to outlying hospitals and villages. It's quite a well organized system.

Sat. afternoon we got to go to nearby Mayan ruin made into a park and had some fun climbing pyramids untill the rain started. The vendors like the rain, I think because their open air shops are covered so we took refuge under them and, naturally bought stuff. I'm going to make a Guatemala shadow box for my office so found some things for that.
We're standing in the photo w/ Dr. Imler, the General Surgeon who was the team leader. He was wonderful to work with.

Tomorrow we're taking a tour to Copan in Honduras to see Mayan ruins and hopefully we'll have a well informed tour guide. There are ruins scattered from the Yucatan on the Atlantic across Belize, Honduras and Guatemala. It's incredibly interesting, especially knowing we were treating the Mayan descendants.

More photos

2011-10-07T15:27:00.000-05:00

The Mayan descendants, the pharmacy, anesthesia, surgery. That's me in a Guatemalan surgery cap. They are selling them along with scarves, etc here on the army base. All hand weaved. They will barter for shoes, clothes, blankets, lotion, etc. I'm told.

More photos

2011-10-07T15:09:00.001-05:00

The surgery picture is the guy who thought he was ugly. He was extremely happy with the results. The others are pictures from surgery and people.

Friday

2011-10-07T14:56:00.000-05:00

We are now winding down. Our thyroid today got cancelled for very high blood pressure, so we did a needle biopsy and sent it away. She will be back for the team coming in January. A lady walked in with what looks like a melanoma on her brow, but left because her family talked her out of having it removed. We had some other small things and the dentist was doing some serious extractions of teeth of young children most of the morning. We're doing one more lesion on the nose yet and then wrap it up. NN

Photo of the physicians and P.A.'s

2011-10-07T09:28:00.002-05:00

Friday morning before we started our day, we took this photo of the providers of our trip to Huehuetenango. It is right outside of the hospital.

A Day Continued

2011-10-06T22:24:00.001-05:00

From 8 am till about 7 pm, give or take, insert photos from surgery and recovery. Today I had time to go to the comedor for lunch, but the last 3 days we had it brought over. The comedor (lunchroom) is about a block away. Today it was hot dogs and mac n cheese for lunch, fajitas (delicious) for supper with milk cake.

I'd done so well giving up caffeine the last couple days, but our OR started craving diet Pepsi/ Coke, etc and miraculously 2 coolers full of Coke and Pepsi on ice showed up, so I gave in yesterday and today, so I'm back on caffeine and IT'S GREAT!!! We've done 29 cases on our 2 cleft tables M-Th. We have non-clefts tomorrow, a thyroid and an arm lesion. (Yes, I know the arm and the face are not the same.) There's a strict rule about no food in the OR. Note the black tote in the corner of the OR brought in by our lead surgeon. The patients are extremely grateful and really wonderful people of Mayan descent. Their red striped pants and matching shirts are everywhere. The women wear traditional clothes too.

Back to the day. We finished surgery around 7. We've done more palates than lips and lots of revisions of scars and alveolar fistulas (holes from the roof of the mouth or dental arch into the nose). I got to pull a rotten tooth in a 3 year old. We had a 57 yo male who had a lip revision who said he's felt ugly his whole life and wants ot look good for his wife and kids.

I'll go to bed about 9:30 and be up by 5:45 to shower and start over. When we're done, we'll start packing up. Much of this stuff gets stored in a HELPS wearhouse in G. City and waits for the next team in January. This group is very organized and I love working with other Drs of my specialty. It's great having a resident, Jenning Boyette. He makes rounds and trouble shoots. I'm afraid they won't want me back because so much of the work of this trip has been done by the team leaders and I just get to show up and do cool surgery!!!

This blog will only let me post 5 pictures at a time. There is so much I want to show. I took pictures of all the clinic and depts today. Dentistry, clinic, eyes, etc.
NN

MacGyver wrap up

2011-10-06T16:32:00.003-05:00

I was anticipating my next posting, and not necessarily focused on what the post would be, and another MacGyver said what about just making a list of what we did for last few days. So I was making my list, and thought of all the people that have told me in the past that they would love to come on a trip like this, but didn't think they had any talents to offer. I decided to make two lists, one that I have been involved with (MacGyger stuff), and another with what this group calls "Helpers". After making the lists, I was further convinced that just about anyone can go on a trip like this and have a role. My lists are as follows:

MacGyvers:

-Serviced and fixed nearly every instrument sterilizer in the hospital
-Changed light bulbs and fixtures in many areas
-Unplugged clogged toilets (you are not supposed to flush toilet paper)
-Electrical wiring of many pieces of equipment
-Making IV hangers from bailing wire
-Help do the initial setup of the operating/recovery and other rooms
-Fixed many monitoring devices (mostly had those annoying error codes)
-Made old styled door keys from old printer parts
-Helped transfer patients from OR to recovery room
-Changed out many large oxygen tanks (those puppies are heavy)
-Fixed ceiling tiles that were falling down due to age/moisture
-Reglued pins on name badges
-Wired and set up room fans (no A/C on this trip)
-Connected many air/water tubes for patient recovery and OR
-Fixed/mended an vision tester
-Fixed stethescopes and blood pressure cuffs
-Altered protective arm splints for post op cleft children
-Glued, screwed and fastened many items that were loose, broken, etc.
-Monitored and serviced the drinking water supply in the hospital
-Trash disposal and bathroom and other cleanup and supply duty
-Replaced batteries or charged them in many medical units
-Answered the many calls of "can this be fixed?" (Always "yes")
-Answered the many calls of "how long to fix this?" (Always 5 minuets) :-)

Helpers: (Most people can do at least one of these)

-Be a one of the cooks for the team
-Be the team media/photographer
-Play with the children and be with the families of the patients
-Run the instrument sterilizers (oh yes you can!)
-Be a runner for "hey can someone get me a...................."
-Help with logistics
-Help with worship
-Just be a general helper

In the photo is Joe Leier who is the head MacGyver on this trip, who is from Canada, and now living in Guatemala. I have had the honor and pleasure to work with him. Joe is this team's version of a hummingbird on crack. (Joe, that's a compliment!)

A day in the life

2011-10-06T12:04:00.000-05:00

I thought I'd take pictures of my day. I'll start w/ bunks, the one w/ blue suitcases on top bunk is mine, the bathroom. It turns out that the water goes through a warming thingy on the shower head. If you check the water spouting out the side, it's electric so that proves there really is a God since I'm still alive after touching it. I take my Clorox wipes with me everywhere, they have toilet paper, but no towels. It turns out the glove packages make fairly good towels so I keep one in my back pocket all day and have become the soap fairy leaving little hotel soaps in the bathrooms to wash my hands. The General talked to us at breakfast today. We wash our hands before we eat, then rinse in 3 tubs. I'm not sure what's in the tubs, but the third one smells like Clorox. A picture is definitely worth a 1000 words.

I'm in between cases, so will try to put more on later. NN

More MacGyver stuff

2011-10-06T11:48:00.000-05:00

This is Thursday morning and "most" is going well. The usual problems of electricity going out from time to time, no money to buy more needed supples (like oxygen for surgery and recovery), etc. still exist. Late nights & early mornings, but I am sleeping well as long as I have my ear plugs in. Many of the men snore, even the some of the Dr.s brought c-pap......................for themselves, they snore too. :-)

Photos are me and a military officer outside the OR and a little down time with the kids.

More later

Juan

Wednesday Evening

2011-10-05T22:02:00.000-05:00

I'm done w/ surgery for the evening. We've operated till 7 each night, but the next two days aren't quite as busy I think. We're running out of clefts, but managed to fill up tomorrow plus a salivary gland. One of our palates from today is oozing, so we're pacing around, packing the mouth. He's pretty sleepy still, the last one we did tonight.

I'm backtracking and posting pics of the hotel where we stayed in Guatemala City. It was top notch with beautiful furnishings, wonderful breakfast buffet. We rode 8 hours in 2 tour buses to Huehue the next morning so had a nice night of orientation, etc when we first got here. The bus ride was long, much of

it 4 lane highways through rural areas. One of the bus stops included the lady making tortillas.
We haven't gotten outside the compound here and in fact they are quite ademant that we don't leave. The OB (high risk) w/ his crew went out to meet with the midwife equivalents. They are only trained by their own family and friends so have a lot to learn. 75% of babies are born at home so when they get to the hospital it's often an emergency. They have a 50% c-section rate. They made little backpack kits for the midwives to help them with deliveries.

Well, it's only 9, but I'm ready for bed. I've missed the chance for a shower, but I can do it in the am instead of boot camp workout!!! :) NN

Wednesday

2011-10-05T16:23:00.001-05:00

Before I forget you can look at some

other blogs from here if you are interested. We have real live media people here that are taking tons of pictures, most of which I haven't seen yet, but are extremely good. The various sites are: google mission_focused, joshnewton.com or Josh Newton Facebook. We did 15 clefts the first 2 days, today we've finished 5 cases, including a large venous malformation of the lower lip. I did an alveolar fistula alone. Dr. Rob Glade from OU and I are working at one table so trade off 1/2 of each case. He does the clefts in Oklahoma. Dr. Lisa Buckmiller, U of Arkansas is the lead surgeon and brought a resident. The General surgeon is doing about 10 hernias a day and a few other miscellaneous stuff, OBGYN is doing a variety of things and the clinic line is farther than I can see.

I need to get back so will post some pictures. I'll try the thyroid we DIDN'T do, before and after and some of the crowd. The red striped pants denote which tribe or village you are from I think.
Rest assured I did NOT go to exercise today. NN

MacGyvers

2011-10-05T10:29:00.003-05:00

It is now Wednesday morning, and finally getting past the inital glut of getting set up. The usual issues of electrical, plumbing and sterilizers are abundant. However, didn't have as much A/C problems, as they basically don't exist. We are at about 6,500 feet elevation, in a forest, a lot of mist and rain, so heat per se is not a big problem. We do have box fans that we have placed in the OR and other selected places, but many of them needed cords, knobs, and blades fixed, so I guess its kinda A/C problems.

We are working/staying at an active military base, protected by their army, so no safety problems here. The 6 (or so) hour drive to here from Guatemala City was escorted by the military as well. The base commander gave a talk, also had their troops perform a welcome with their band that played the both national anthems. We feel very welcome here.

Surgeries are going fine, I sorta go in/out of the OR during cases to help, which would never happen in the US. There are over 70 people on this trip whwhich is a lot larger than prior trips.

On this trip, I am one of four MacGyvers who's task is to "keep it running". :-) If you don't have parts, make them. The standard of living (it seems) is a bit better than Nicaragua, but since we are on a military base, its a little hard to know. There are long lines of people outside of the main gates, and they get let in as they are triaged. Many have come from great distances and have been staying for days for just the chance to get seen.

In the photos are the four MacGyver's in their "man cave" in the hospital, our dinning area (in a separate building), and me posting this blog.

Will blog more as I can.

Adios todos
(see you later everyone)

Monday

2011-10-04T09:37:00.000-05:00

We operated till 7 last night. My table did 3 palates. Today they are letting me staff a palate w/ the resident from Arkansas. They went very well. We've got a peds anesthesiologist and peds nurse anesthetist in our room running the two tables. IV's are difficult in the really little bambinos. It's damp all the time. We're up in the mountains in the cloud forest. They are beautiful, but misty clouds are there all the time. It's the end of the rainy season so sprinkles off and on much of the day and rains at times. I guess it rained alot last night, but didn't hear it. I got up for boot camp exercise class @ 5:15 (6:15 our time). It's run by a very physically fit young woman so put me to shame. I might just get up ant walk tomorrow. It's hard to sleep in with the army marching and pounding drums @ 5 am and again @ 6 am. They seem to practice marching a lot. They were mowing the grass today with machettes. Amazing how much lawn there is and how good it looks considering how labor intense it is. Our own people are our cooks, so we're eating gringo food. It's quite good, burgers, spaghetti, french toast, cereal, etc. When they said we'd have hot water 5-7am, 5-7pm and 11-1 they should have clarified that it's water, not always hot and don't expect it any other time. In other words, if you use the bathroom, don't expect to flush or wash your hands unless it's those hours. I've got my clorox wet wipes and water bottle w/ me all the time. The hospital has water all day, it seems so I may try to figure a way to shower here. Well, gotta go start surgery. The picture is mme w/ the other cleft surgeons. They are very good to work with. John is kept busy all the time, fixing stuff.

Guatemala

2011-10-03T14:32:00.000-05:00

I don't have much time to write, but will try to load some pictures. We made it here in one piece. We're working at an army barracks at the unused infirmary. There are hundreds of people lined up outside. People of Maya descent. We're staying in long dorm type rooms on cots and bunks. Peds ENT, ObGyn,and General Surgery in 3 ORs w/ 4 beds. 11 docs, whole team is 99 including interpreters. There are 77 from USA, from California, Oklahoma, Arkansas, Nebraska, Missouri, Texas, Michigan, and Washington maybe more? It's very well organized with a tight schedule, name tags, information, a greeting from the Guatemalan army w/ the national anthem by their band and all.

IAOMAI BLOG

2011-09-22T20:16:00.000-05:00

Iaomai has a blog if you are interested in following. I don't think we will have internet access the whole time. Go to http://iaomaimedical.org/blog

UPCOMING MISSION - GUATEMALA

2011-09-18T18:05:00.003-05:00

We're setting up to go on a new mission. This will be a Cleft Lip and Palate team along with a General Surgery Team and ancillary personel under the agency Iaomai. I was invited to join the Cleft team from Little Rock, Arkansas after doing some additional training there last year in anticipation of the Nicaragua trip. The training was immensely helpful and triggered and enthusiasm for doing clefts, perhaps because it's something I can't do in Columbus. At any rate I couldn't pass up the opportunity to join them. We are going to Huehuetenango, Guatemala in October. It looks like a large team, around 70 people with 4 cleft surgeons working together. I don't know all the working conditions, but it is up in the mountains, the Guatemala Highlands, so won't be as hot as Nicaragua. It is working with the impoverished indigenous people of Maya descent. There are Mayan ruins that we will get to visit at the end of the trip. They say we will be escorted in by the army with guns and all....... I'm not sure if that's good or bad. The organization seems to be well organized and we aren't responsible for all the instruments, medications, etc. We have to take sleeping bags, pillows and towels. There will be hot water 3 hrs in the morning and 3 hrs in the evening. They have sent a very specific itinerary and packing list including what to pack on top and bottom of your suitcase. They seem to have a lot of experience with this, so it's reassuring. Iaomai's website is http://domedicaloutreach.com if you are interested in finding out more about it. I don't think there will be much internet access, so we may not be able to blog from Huehue. John and I are the only ones from our Columbus team going as it's organized elsewhere and we are joining them. That doesn't preclude others from here going in the future. In the meantime, a portion of our team will join the California missionaries back in Puerto Cabezas again next February. They will update you as that gets closer.

Presentation

2011-02-28T21:16:00.000-06:00

We're planning a presentation Sunday, March 27th at 1:30 pm at Federated Church for anyone interested. There will be lots of pictures, stories and question and answer period for the community. This is to give a big "Thank you" to everyone who supported us!
Dean and Carolyn are presenting at the Methodist church for the missions committee, March 20 along with another presentation about a medical mission to Jamaica. NN

Team pictures

2011-02-20T17:08:00.000-06:00

Chana before 2010, After 2011

2011-02-20T16:34:00.002-06:00

I was very happy to see Chana, whose cleft I did last year. She came in for a picture.

Pictures

2011-02-20T16:27:00.002-06:00

I've spent the last few days flooded with thoughts about the mission to Puerto Cabezas. I appreciate all the followers and comments and am sorry about those who tried to comment, but couldn't. Somehow the blog makes it tricky to post comments, but some of you managed to make it through the mazes. We're all home, back to work and regrouping. I've spent many hours already looking through the pictures (about 3,000 combined). I thought I'd post a few of the clefts. They make the biggest visible lifechanging statement, although we did a lot of surgery that is of great benefit, but not so obvious on the surface. We worked 14 hrs a day on average and were all pushed to our limit. I don't believe they've ever had a team do as much surgery. All the members worked incredibly hard, each with their own gift. The surgical crew included Dean and Sandra (PC) with anesthesia, Sue T. and Connie M. scrubbing. Kevin (CA) and Keveta circulating, Dr. Morin and Ashley in clinic doing lumps, bumps and misc, Carolyn and Rene (CA) on instruments, John & Karl on handyman crew, Melissa, Sarah & Suzie (CA) in pre and post op, Peggy in pharmacy, Jerry, Linda and Tami in ministry. Dr. Taylor (PC) and Dr. Salas (PC) were on hand to help in many ways as well as the PC nursing staff, anesthesia and scrub techs. I can't thank them all enough. NN

Home to Columbus!

2011-02-14T01:26:00.002-06:00

Yes, as Dean said earlier, we are home! After many days of cold showers, boy, did a hot bath feel good!! Again, what a trip! Lots of sadness in Nicaragua. So heartbreaking to see all those people and especially the children, in such miserable conditions. You'll never see any more beautiful children (except for my grandkids!!!) anywhere and it just breaks your heart knowing that their future holds very little promise of anything better than what they have now. We saw newborn babies born during the week with birth defects, one that needed immediate recusitation after birth, another 2 month old who, up till now, had only been fed Kool-Aid and rice water and still looked like a preemie and was probably going to die soon without better nourishment, and on and on and on. Friday evening when we were finished at the hospital and were packing totes to leave the hospital, we saw a group of young men bringing a casket in to pick up a body of a young man who had just died from AIDS. Earlier in the day, we saw a newborn baby delivered by C-section. As Sue said this afternoon at the airport in Houston, we saw the full circle of life that day. As was the case last year, there are soooo many stories. It's a very humbling experience to work down there and see how people live in other parts of the world. It truly makes a person recognize how much we have and how lucky we are to live where we do. It was a pleasure to work with all the people on our team as well as the members of the California team. Here's hoping for safe travels for the rest of our team as well as the California group. Thank you to all who have followed our blogs and for your prayers.

Made it home

2011-02-13T22:40:00.002-06:00

I am happy to report that the Atheys and the Tillinghasts have returned to the great state of Nebraska however the totes with the surgical instruments have not. I am sorry that I have not blogged more. The surgical schedule left me exausted and I chose sleep over blogging. We spent last night at the hotel across from the airport in Managua with Karl and Sue. It was great to spend some time relaxing after a very long week. The hotel is nice and the showers were hot. I am still quite tired but I feel our time was well spent and we were able to provide care to a large number of people that otherwise would not have received it. I want to thank all of you for your thoughts and prayers during our time in Nicaragua. The need in this area is just huge.
Dean Athey

Finished

2011-02-13T21:41:00.002-06:00

We are all exhausted, but finished with a very busy week. I don´t have any pictures I can post right now because internet is limited, but thought I´d put in some statistics.
Surgery with General Anesthetics- 53, includes 4 cleft lips, 2 cleft palates, 17 tonsils, thyroids, nasal masses, etc, etc, etc.
Local Anesthetic procedures by Dr. Morin - 50
Clinic patients on the first Saturday - 87 (NMN), 130 (PM)
Clinic patients during the week in Dr. Morin´s clinic -75
We figured we averaged 14 hr days.
The last day is always bittersweet since we all go our ways and we say goodbye to the missionary´s in Puerto Cabezas and the California team members that we worked with.
No words or even pictures can truly describe all we did and saw, the people we met, the trials, heat and many struggles we went through. We appreciate all your prayers and interest and will be glad to tell all the stories you care to listen to when we see you at home. NN

worm

2011-02-11T07:21:00.002-06:00

Our lady with the trach threw up a 8-10 INCH WORM!! Will try to send picture! Mike, you will understand when I say "There are NO words!" to describe this experience! I got to scrub on a 6 hour neck case with a Nicaraguan doctor and both of our doctors--amazing!! Connie
Pictures- Suzie holding the worm. Cleft bath. NN

Greetings from Nicaragua

2011-02-11T07:15:00.002-06:00

Hello to all my family and friends-can not believe we are starting our last day of surgery. It has been hot!!! It has been really hard work! But oh my how rewarding. Thanks for all your thoughts and prayers they have lifted us up. XOX to M and J, K,L, and OT. SUE

Post op cleft, Washing our clothes for us

2011-02-10T07:25:00.002-06:00

Wednesday surgery

2011-02-10T07:19:00.001-06:00

Late night

2011-02-10T07:09:00.003-06:00

There is an adventure at every turn.
We had a difficult thyroid, neck dissection, 6 hours that we started at 6 pm and needed a tracheotomy at the end. I had good help with Dr. Salas and Dr. Morin. It's really interesting to operate w/ another surgeon, especially from another country. We ended up putting in a tracheotomy and Dean rigged up an oxygen system in the ICU. The nurses there looked worried that we weren't all staying the night. By 2 am we were out by the ER entrance looking for a taxi to get home and the ER nurse saw us, so called the Ambulancia to take us home for free. It's only a few minutes away. Dr. Morin has been doing all kinds of interesting ditzels, scar revisions, etc. and we are both working with the med students who are enthusiastic and very interested in everything.
We have more to do today once again than we can possibly do, so I'm going to offer some to Dr. Salas. Dr. Morin offered to open, take a look and decide it's inoperable, then close and give the bad news to the family.
The cleft child from last year showed up hoping to get her palate done and looked as good as I could ever have dreamed (considering I spent the last year worrying that her lip got infected, fell apart or healed badly).
Dean is the best anestetist you could want and Connie and Sue are the best scrubs I could have. Lionell is teaching me instrument names in Spanish. We are all healthy, but tired.
Everyone is working their heads off. NN

Sink

2011-02-09T07:15:00.002-06:00

I put the scrub sink on to point out the two faucets on the sink on the right. The silver faucet is from the hospital tank. When the tank is empty for the day, the water is done. The red faucet is the sterile (?) water from condensation off the AC. There's a little stash of that. Yesterday it was all gone by the end of the day. I brought my own soap and left it by the sink. Today I'm bringing more. John and Karl got a toilet seat for us and put in lights in the hallway. Among many other fixit things from their 'honey do' list in the recovery room. NN

Pictures

2011-02-09T07:11:00.001-06:00

Tuesday

2011-02-09T07:05:00.002-06:00

I was all reaady to admit that it wasn't as hot as I claimed after John and Karl fixed the AC in the OR on Monday. Something happened to the condenser and there were actual flames outside apparently. All we noticed was a smell that I hoped was freon going to work, but was actually the condenser blowing up. Somehow Dean came up with a temperature around 100F, then add in gowns and overhead lights and a 2 hour cleft. I got a wet hand towel around my neck, then later this special cooler padded wrap Karl brought from Linweld. It worked reasonable well and soaked my shirt, but still......
We had more to do yesterday than we could get done. An 89 yo w/ a malignant melanoma. I'm bringing a bit back because pathology has to go to Managua and won't be back for a month. Tell Dr. Lacey. Today are 2 thyroids. Don't tell Sandy, but I'm not going to mark the site. So far I haven't written and op note or clinic note or any note of any kind except for my own cleft notes. It might catch up with me, but so far it doesn't seem like anyone has noticed. NN

The long day

2011-02-09T06:27:00.001-06:00

Sorry I hit enter rather than tab. Those killer weekends on call at home don't seem quite as long now. They have a new Dept. of Health regulation that there is to be two anesthesia providers in the OR at all times so no sitting in the Recovery Room getting fanned by our Pharmacy Tech. Peggy. When I get back I want to here no whining about how hot the OR is. This makes the summer temps in the old hospital OR seem down right frigid. We were able to serve a lot of people and that is what this is all about and now we know we can do it in what ever conditions we find. No trouble sleeping last night and now back to work. We hope all is well at home. Stay warm, we are.
Dean Athey

BUSY Day!!!

2011-02-08T21:13:00.002-06:00

Hi, friends & family!
What a long day. I was in the first crew to come back at 7:30. The rest just got back a little bit ago just before 9:00. Lots of surgeries. AC off all day and there were a few rain showers during the day. Hot & humid! (Not complaining though!!!) Had a short tour through the hospital and saw several departments we hadn't seen last year. Lots of sadness but fortunately we also have seen several improvements. One big improvement that was very noticeable was that there was a lot less garbage strewn around the grounds. I didn't see the buckskin horse yet from last year but the vultures are still circling! Have a good night and there will be other posts to follow. We're doing great!! Carolyn

Karl - Feb. 8

2011-02-08T19:54:00.004-06:00

It is 8:00 and there are still 6 or 8 at the hospital. John and I had a great day - we didnt get sick and are having an exhausting time at the hospital. We are having trouble with the air conditioner at the hospital in the OR. It is old rusty and is not set up right in the first place and no one can find the breaker so we unhook the live wires at the air conditioner. Safe!!!! The opeating room is 80 or 90 and is wearing the OR staff out. We have been busy with fans- doors - suction machines - water faucets - washing machines - lights - and what ever else they ask us to look at plus being the gophers for the team.
This trip and team is so good. We are getting alot of good work done with more to come. We have a plan for the AC tomorrow so wish us well.
Thank you all for all your kind thoughts and prayers.
Have seen alot of the town on our supply runs around town and it is an eye opener but everyone is so appreciative and helpful even with the language barrier.
Thanks again for all your support. Love Karl

Cleft, forehead

2011-02-08T06:58:00.003-06:00

The mole was too big to take off completely, but I got about 3/4 of it. The child is 3.

Monday, Surgery

2011-02-08T06:29:00.003-06:00

We rode to the hospital, about 10 minutes, in the back of the truck. It reminds me of my days on the farm. We had a wild first day in surgery. 6 tonsils, a cleft, a gigantic forehead mole, 1 tonsil bleed. It turns out the cleft had already been repaired by Operation Smile in Granada last Oct, but got infected and fell apart, but mom didn't tell us because she was afraid they would get turned away. I kept commenting he looked like he had surgical scars, but I was reassured it hadn't. At any rate enough tissue had been removed so things didn't match up as well as they should have, but I did my best and now we all have to prey it doesn't get infected and fall apart again. If it could happen to Operation Smile, it could happen to me. A girl showed up, 16 with a wide... very wide open cleft palate and waited all day hoping we could do it yesterday, but we couldn't, so she is coming back today. I don't thing I can get the whole thing closed, but again will do my best.
We are giving away our sewing kits the 4-H kids made.
They are a real hit. The gowns the Federated women made are perfect. The mother of the cleft baby had the shirt on her back, no place to stay, no money and no food. We're keeping the baby (and mom) in the hospital so they have food and a place to stay. We've got bags of rice, beans and powdered milk to give her when they leave.
They have a rule to feed babys by cup at 2 months of age since they don't wash the nipples on bottles, but they they feed them Kool Aid and rice milk so the little ones can be extremely malnourished.

February 8th

2011-02-08T06:23:00.002-06:00

Buenos Dias de Nicaragua! This trip has been amazing, just like we experienced last year. Yesterday we mainly worked with children, so I was in heaven. Working with all of these lovely spirits that want help and are willing to do anything for it, blows me away. Yesterday I believe Nila was able to do 10 or 11 surguries....it was a loooong day. It's wonderful to decompress in the evenings. The hospitality at Pastor Earl's is top notch! We are eating breakfast now and headed out for another long, wonderful day. Thanks to all of you who are thinking and praying for us!

Adios!
Melissa

Clinic

2011-02-07T07:00:00.000-06:00

Today's cleft, forehead, hauling stuff to hospital

2011-02-07T06:47:00.003-06:00

Ready to go

2011-02-07T06:39:00.002-06:00

We organized at the hospital and are as prepared as we can be.
Today I have 6 tonsils, a large black forehead hairy nevus to partially remove, a nasal mass and a cleft in a child 1 1/2. I'll see if I can get pictures on.
The "uprising" was a local political party (?) who shut down the ferry about 1 1/2 hrs toward Managua from here. The truck with our totes couldn't cross so guys in dugout canoes (who belong to the ferry blockers) can then carry your stuff across in many trips and make some money. We sent a truck from our side with John and Karl so they brought it back. The totes got here a few hours late, but that's all. They are protesting the government.
We all smell strangely of bug spray. The heat hasn't been as bad as I remember, but they OR air conditioner wasn't working yesterday. John and Karl are on that detail and putting a window in the OR door, and on the hunt for a toilet seat for the OR bathroom. :) Can't wait! NN

Monday AM

2011-02-07T06:18:00.002-06:00

Up early to see the first group off to the hospital (Carolyn is in the first crew). We spent time at the hospital yesterday to prepare for today. I feel much more organized than last trip. We will be much busier than last year. We have about twice as many cases scheduled and that is before WALK-INS. Either I am getting used to them or the airways we saw in clinic are not near as scary as last year. The weather is great. We have been getting good sleep and are very well fed. Pray for us as we start to do our surgical procedures. The uprising is of a peaceful nature and does not affect us at all. It is more of a strike than uprising so do not worry.
Dean Athey

2011-02-06T13:47:00.003-06:00

Hello, faamily & friends back home! We have a little down time till we start packing up to take totes to the hospital. Nice to be back and recognize people from last year. We have been very busy since we arrived. The visit to the dump in Managua was undescribable. You can't imagine thousnds of people live in such conditions in a community. Pictures will surely follow for you to see.

In just a year, we have seen so many improvements here at Pastor Earl's compound where we are staying. From our houses to the orphanage. That is truly a blessing for them.

Clinic yesterday was interesting. I joined the ranks of "pharmacist" in the Athey family now. Move over Dave & Paul!!! Hundreds of people came through yesterday and there will be lots of work this week at the hospital. Medical students were at the clinic observing all day. I was so happy to see several girls as students. They obviously have goals and will have such an improved lifestyle compared to most of the women we see here.

Hope the weather has improved for everyone from when we left. It certainly improved for us once we arrived. Time to go! Keep us in your prayers.
Carolyn Athey

Getting the totes across country

2011-02-06T13:37:00.005-06:00

There was a local uprising along the road from Managua to Puerto Cabezas, and at a point in the road, there is a ferry. The ferry was shut down by the locals, so the totes had to be canoed across the river. This was on Friday/Saturday. Karl and I went with some locals from Puerto Cabezas to get them on Saturday.

Showing totes at Omaha airport and then after they made them over the river. Continental Airlines does not check them all the way, for obvious reasons. :-)

Doing fine otherwise, everything actually made it, and we are getting ready for surgery tomorrow.

John

Clinic pictures

2011-02-05T19:30:00.003-06:00

Clinic

2011-02-05T19:21:00.002-06:00

It was an incredibly busy day. Melissa finally got here!!! Woo Hoo!!! We put her right to work. We (Dr. Morin and I) saw 200+ patients in the clinic and turned away I don't know how many. We don't have an exact count, but we've amazing nurses and others helping. There were 100 in line at 6:30 am for good reason. Those last in line were too late to get surgery so they are on the waiting list and can come to the hospital to check on Wed or Thursday OR they can take a paper to be first in line next year. There were only a few of the worried well. Clefts, huge thyroids, nasal masses, ear deformities, lots of tonsils for me. I'm not sure what all Dr. Morin saw, but also not many worried well. The food is delicious, the weather hot, but not unbearable and it rained on us on our way home, so could almost be called cool now at 7:30 pm. I used more Spanish than I've ever known and had some good medical students who taught me how to say sneeze, lymph not and hyperthyroid. I'll post some pictures of clinic, etc. NN

La Chureka in Managua

2011-02-04T16:19:00.002-06:00

Puerto Cabezas, Day 1, Friday

2011-02-04T16:11:00.005-06:00

We made it to PC after getting up at 4 am. We took the 6 am flight and got here w/o any trouble. We had a GREAT breakfast w/ the usual fresh fruit, then later lunch after getting our rooms organized. Rice and beans w/ plantains. We went to Jeff & Chris' new home across the street for delicious ice cream and to cool off a little. We're totally pitted out now after spending the afternoon sorting through all the supplies they have stored here. Our own supplies are supposed to arrive by pickup early in the morning. We sorted out stuff for our clinic in the morning. We expect 100-200 patients. That's a wild guess only.
Yesterday afternoon in Managua we toured La Chureka (the dump). I will try to post pictures, but even that doesn't really explain it. You can only get the full effect w/ the smoke wafting by continuously. There was a guy w/ a fractured femur and an external fixation device on in one of the homes in the dump. Dr. Cimple will have to look at the picture. If I can't load pictures now, we will later. We have limited access to the internet, but will try to blog every day.
Keep in mind .... it is HOT HOT HOT. But not hot enough to wish we were back home just yet. NN

Arrival

2011-02-03T20:20:00.001-06:00

We arrived on time in Managua and sailed through customs. The only problem is that Melissa´s flight got cancelled and we don´t know when she will arrive in Managua. We toured La Chureka and Villa Esperanza. We had a great supper tonight and are really tired, so going to bed soon. NN

Travel

2011-02-02T21:30:00.001-06:00

We are leaving early Thursday morning from Omaha. Since there is a raging blizzard across the midwest Melissa's flight was cancelled from NYC to meet us in Omaha. She is now headed straight to Managua and will get there about 6 hours later than us, but will still travel with us to Puerto Cabezas. There are patients there who have already been waiting 2-3 weeks. NN

Packing Day

2011-01-12T21:30:00.000-06:00

We spent Sat. Jan. 8 packing in our garage. Mike took on the task of doing inventory for us. The supplies are coming together fairly well. We found out the microscope in Nicaragua is missing it's light source, so John has improvised and we're taking 2 and a cord to use as a replacement if possible. There is word that there are 4-6 clefts to do.

The Team, but without Melissa Dec. 2010

2010-12-31T18:27:00.000-06:00

The Spaghetti Feed

2010-12-31T18:19:00.001-06:00

Dr. Peter Morin - Family Practice

2010-11-30T21:30:00.000-06:00

John Novotny - Ancillary Staff

2010-11-30T21:29:00.000-06:00

Dr. Nila Novotny - ENT

2010-11-30T21:28:00.000-06:00

Karl Tillinghast - Ancillary Staff

2010-11-30T21:27:00.000-06:00

Sue Tillinghast, LPN

2010-11-30T21:26:00.001-06:00

Melissa Shemek, BSN

2010-11-30T21:20:00.000-06:00

Radio

2010-11-30T08:17:00.000-06:00

I heard about our team on the radio this morning on the newscast. They said to send donations via the blog. Our team is #802. They need that number for donors. Our location is Puerta Cabezas, Nicaragua.

Ashley Carstens, BSN

2010-11-29T22:26:00.000-06:00

Connie Mohatt, BSN

2010-11-29T22:13:00.000-06:00

Dean Athey, CRNA

2010-11-29T22:12:00.000-06:00

Carolyn Athey - Ancillary Staff

2010-11-29T22:05:00.001-06:00

Planning Meeting

2010-11-29T21:58:00.000-06:00

We had our 2nd planning meeting for our next trip to Nicaragua at Sue and Karl Tillinghast's in Lincoln. The team has changed a little because we are joining the California team. Our team now consists of Dr. Nila and John Novotny, Dr. Peter Morin, Dean and Carolyn Athey, Sue and Karl Tillinghast, Connie Mohatt and Melissa Shemek. Dr. Morin is a Family Doctor from Lincoln who works with Sue. He's done other missions, but none like this.

We had a phone conference call with Suzie Smith from Redding, CA and got a lot of questions answered. Since we're combining we may not have to take as much equipment and supplies as we did last year. We learned alot.
We'll be having a spaghetti feed Thursday evening Dec. 9 and I'll be on the radio along with Connie Mohatt at 7 am, KLIR on Dec. 7th. Stay tuned! NN

Presentation

2010-03-18T16:12:00.000-05:00

Our presentation will be Sunday, March 28th from 2-4 pm at the Federated Church Social Hall. There will be LOTS of pictures and souveniers and momentos from our trip.

2010-03-03T14:58:00.000-06:00

For those of you who are still checking in on this website, please keep checking from time to time as there will be an announcement regarding our presentation which will be open to the public. It is tentatively scheduled for the afternoon of Palm Sunday. Everyone is anxious to share our many stories and pictures. See you there! Carolyn

Home

2010-02-28T15:45:00.000-06:00

WE ARE HOME!! We took the plane from PC to Managua, waited for 2 more flights for the rest of our luggage, then made the plane from Managua to Houston. HELLO GOOD BATHROOMS!!! We beat some of our luggage back, but got the rest this morning. Now we have to sort through things to get the hospital equipment back, and everything sorted out. We took down 32 tubs and brought back 4 along with a lifetime of memories. Boris the Blue Bus driven by Denny V. was a great site to our weary eyes after a long day of traveling.
We're planning to have a community presentation. Tentatively set for March 28th, but not decided for sure when and where. Stay tuned for that for anyone interested. We'll show lots of pictures and tell stories. Pete and Tam are slated to talk at a United Way (?) luncheon on March 16th. I'm speaking at Federated Church to the Women's Fellowship this coming Saturday, March 6. Anyone can come. If you want breakfast you need a reservation for 9:30 am. Otherwise you can just come to hear the talk and see more pictures at 10:15.
The crew needed the last day to regroup before coming back. We're really glad we didn't have to do the bus ride 400 miles, 1/4 paved, 3/4 dirt in a hot school bus. Really glad.
I may post some more pictures as we sort through them. There are lots I haven't even seen yet. NN

02/26/10 - Karl

2010-02-26T17:34:00.000-06:00

We just got back from a tour of the city and some shopping. We are back in the heat and humidity and a few sun burns. We also stopped for ice cream and got to go and see the ocean and the beach (couldn't get in the water).

This has been an amazing experience and the hand of God touches us every minute of every day. Thanks for all of your comments - it is great to hear from all of you. It looks like we are leaving the compound at around 6 or 6;30 in the a.m. get into Managua around 9 leave at noon to Houston then to Omaha.

We also got to tour the orphanage today - they were not in school today so they were doing their delousing - stripping their beds - washing hair - airing out shoes and beds it was kind of interesting. It is about time for supper and if it is anything like the rest of our meals they have been fantastic. Thanks for all of your support and followers. Love Karl

Market etc.

2010-02-26T13:43:00.000-06:00

Pete found a nice eye clinic. The guy on the motorcycle is the health inspector of the market we think. ........ Well, gotta' go on the city tour. It is swealtering hot. NN

Plan C

2010-02-26T13:30:00.000-06:00

OK, the wind is down enough so we can fly out tomorrow morning, unless the wind comes back up. We took a tour of the grounds where we are staying today. There is a school and orphanage. Tam and I did come finish up clinic so we didn't go, but caught up with them at the Clinica, then saw the Oasis, their church's resaurant and their water drilling mission. This is the girls, Melissa, Sue and Katrina relaxing on the steps of our lodge, and a picture of the lodge where we're staying. The kids are'nt in school. It is de-lousing day for them so they are checking hair, and dragging their mattresses out onto the grass to get rid of lice. We toured the Miskito market today. Very 3rd world. I'll include some pictures. Pete found and eye clinic. There was lots of big bags of rice and beans to be bought by the scoop, as well as fresh fish. Caught today we figure. Vegetables clothes, well see the pictures.

We're going to the beach this afternoon. We can't swim there (too dangerous). Then a drive through the city for a tour and by the medical school and swing by the ice cream shop. The ice cream lady likes the missionaries so brought us frozen bubble gum flavored coconut milk slushies in baggies to the hospital the other day. You bite off a corner and suck it out. A bubble gum lovers dream!!! NN

Flexibility is the keyword

2010-02-26T08:42:00.000-06:00

Once again, our plans may change. There is very little wind today so we MAY stay today and go back to our previous schedule. The bus ride across country would have been interesting but also I think would have been very difficult. We might get to see more of PC now and also visit the ocean. I personally hope that is the way it works but will just have to wait. Since I don't have a job to return to on Monday, I guess I could wait out the wind situation and stay as long as necessary! But where ever Dean goes, I will follow! What a week. I can't wait to see the hundreds (or maybe thousands) of pictures. Many of us have cameras so we take pictures of whatever we choose. Some of us have been in different areas of the hospital so will have completely different pictures than others. A few of us sat on a porch this morning and talked about the week. Janet told some stories of what she has seen this week that those of us in surgery didn't even know about so I know there will be many many stories for even us to hear. We are about ready to go to town and see the Moskito (sp?) market and other sites. If we stay today we will also get to see the ocean. We will know more by lunch. Our bags are packed and ready, should we be leaving later. I will be happy to unpack a few things if necessary. Hello to everyone following this site. Carolyn

Dean - 02-25-2010

2010-02-25T20:04:00.000-06:00

Well I have now spent a week in Nicaragua and have seen two of the most difficult airways I have seen in years. Today it was a beautiful young girl that had a tumor in her throat that after I had her asleep and went to place her breathing tube I found that her vocal cords were nearly covered by the tumor. With the help of the Lord and the team again all turned out for the best. Tomorrow brings a long bus ride to Managua and a plane ride home. I am ready to go but I also could gladly stay and help out longer. There is so much need. It has been a very gratifing week. We have been blessed far in excess in what we have been able to bless. Carolyn says HI. Dean

Mother

2010-02-25T19:57:00.001-06:00

This is me with Quillermo's mother. The pictures below are the tracheotomy, us in Recovery Room, and leaving by the Emergency room. Also Carolyn doing what we all have agreed is the worst job, but look at the great smile on that face!!!! NN

Checking out

2010-02-25T19:30:00.000-06:00

The word(s) of the day was lo ultimo (the last). It was our last day of surgery. We have follow up clinic in the morning, taking out stitches, packs, drains, checking wounds, etc. The breeze was nice today. It is the first day I didn't sweat all day, but the down side is the wind is too strong for planes to land and it's predicted to last 3 days. Since we're due to leave on Saturday we probably won't make it Managua by plane that day so we made an executive decision to drive. We'll leave after lunch on Friday. It's a 14 hour drive when the conditions are good. And I think they are good??? They left today with of the California team that stayed with us till today. The driver will be extremely tired. The Oregon team will travel with us on the church school bus. They told us to take toilet paper with us and snacks. It looks like there won't be any really good rest stops. They say it is really bumpy. We need to make the plane in Managua before noon on Saturday so we have almost 24 hours to get there. Pray for us.

Today I did an otoplasty to fix a deformed ear and some smaller cases. I took more packing out of Quillermo's nose so he can breath out of one side now. He seemed really happy about it. His mother looks a little like the lady in the video photo. She was wandering around saying goodbye to us all and wondering if he needed more medicine, etc. We gave her a package with rice beans and powdered milk. He has to hang around next week to get the rest of his packing out. I'm afraid to remove it so Dr. Taylor will start advancing the pack next week slowly. I gave him a bottle of the illegal vitamins with iron the government didn't allow us to bring, but slipped through customs anyway. He seemed glad and so did his mom. We'll let him out of the hospital until Tuesday but he can't go home. Home is a 2 hour drive (bus), then 2 hour horseback ride so it might be hard to get right back if he started to bleed again.

We are spending this evening sorting all our packed stuff. We're finding things we didn't know we had and couldn't find all week. We found lots of nasal packing in a leftover California tote. Hmmm that could've come in handy the other day.............

We may not blog much tomorrow unless we get to Managua in really good time and will go to the hotel and shower before we get on the plane. We should be home Saterday evening to Omaha about 8 pm.

We all enjoy your comments. It's fun to see who is following us so please leave a comment.

FE field reps

2010-02-25T11:00:00.000-06:00

We don't want to forget the support we have received by the folks that met us down here once we arrived. Those connections are critical and appriciated.

Jeff and Kris Thompson are the field reps for Forward Edge in Puerto Cabezas that have been like "our parents" or "house parents" to us, taking care of all the non-medical logistics details once here.

Keveta Andersen is the resident nurse who also lives in Puerto Cabazes who has many of the contacts with the local hospital and other medical professionals here.

Suzie Smith is a flight nurse with the California team that stay behind to be with us this week, her team left last Saturday.

Pastor Earl and his wife Damaris have been kind hosts and provide the facilities where we are staying. There are many other support people as well.

The conditions these support people have chosen to live in, and still serve, are nothing short of amazing. The extreme limited resources the local medical's have to work with are horrific. It's hard to explain (even with photos) the degree of poverty, but we will try as the days go on.

One thing that is excellent here, is the food. Not a place to lose weight. Some of the best food we've ever had, prepared by some of the most loving and caring people you could ever meet.

John

ps: In the photos, vultures in the hospital courtyard, a horse in the hospital courtyard, off to work each day in the back of a pickup, and Tamra with a patient.

More Hospital

2010-02-24T23:22:00.001-06:00

This is the hospital lab, the coal storage outside the kitchen door and the best bathroom in the hospital. I know it's pretty gross, but it's reality. This is the one right by the OR. You don't want to see the bad public restrooms.

The rat ran too fast for Tam to get a good picture. NN

Post op

2010-02-24T22:53:00.000-06:00

Pictured is the finished cleft. There are two of PED in surgery.

There are guards at the hospital with real guns!!! Makes me feel really safe. PED is w/ a child with an eyelid tumor he removed. Dean's mother made some pediatric hospital gowns that are a big hit. PED is closing a thyroid with Jody, Lionel and Dean. He's stepped out of his usual zone here. He might just give up that eye thing he does.

We had tour of the hospital kitchen. Mrs. Rigsby led us around. She is on the video we showed everybody, a nurse at the hospital and can speak English, Spanish and Miskito, the native language. She's a lifesaver!!! She's showing us the bags of coal for the kitchen which is the next door on the right of the picture. NN

Update

2010-02-24T20:56:00.000-06:00

This is the hospital kitchen. They use coal in a fire to cook with.

This is Melissa with Dr. Taylor at the hyperbaric oxygen chamber. He has quite a story to tell about his life. Too long to go into here, but a wonderful man. There are lots of divers here parilyzed from the waist down from the benz. The chamber helps.

I'm including some random pictures. Janet L. and Katrina S. have been working nonstop in recovery and doing a splendid job. They are pictured with Peggy, a pharmacy tech from the California team who stayed and did pharmacy for us. No problems..... awesome. We gave some Spanish medical books to a couple of Drs. Dr. Taylor is doing the preop assessments and looking after our hospitalized patients for us. He got 2 and seemed thrilled to get them.

I'm spending most of my energy on the patients. Today was the first day I became a complainer and made them get me a drink of water while I was doing surgery and asked if they could aim the a/c toward me. Keveta gave me grief for whining so I bucked it up and quit whining. I must admit it's nice to go to work every day in flip flops and shorts. We change into scrubs at the hospital and are so hot and sweaty and dirty we wear them home to shower before changing back. I've used my scrub pants as a towel after washing my hands in the undrinkable water at the scrub sink. The wrench handle so far has always had water. There is no soap there, but we have Avegard. I did a couple of big thyroids today. I was frustrated because there is no pathology readily available. Where is Dr. Lacey when you need him? I took out a small portion of the gigantic pack in the guy that bled from his nasal tumor.

Our cleft baby went home, eating and smiling. She's already learned to look at the pictures after you take one.

The rat in the recovery room, heading for Carolyn's sterilizing area and the flock of vultures out back are the talk of the team today.
Dr. Cespedes (of the fish bone) helped in surgery today. He's full of jokes and stories in Spanglish. Then we have Lionel who is a scrub tech and has a very interesting fold job he does on the drapes. He gives you exactly the corners he wants you to have and makes you open it in a way I'd never have dreamed of. He's also taken the liberty of telling Sue & Jody how to arrange their trays (which hasn't gone over the best).

Pete, Tam and Melissa gave talks tonight to some of the local medical folks, Drs, Nurses, etc.

at the Oasis restaurant across the street. We gave out our stethescopes and various medical gifts.

2010-02-24T19:58:00.000-06:00

Tamra was the lucky one to be the first to see one of the hospital's resident rats today. Glad it was her and not me! The thing that is the hardest for me to get used to is the unsanitary conditions. Maybe that's because I'm cleaning most of the surgical instruments and the area is in a dark little corner with a sink where the water comes from a big barrel that sits next to the sink. I never feel like I'm getting things clean but at least they have a sterilizer that works well. There isn't any area in surgery where you can wash well and dry your hands. Nothing like any of us are used to! Thank goodness for hand sanitizer and wet wipes. Our meals have been very good here at the compound and we've tasted some excellent Nicaraguan dishes. The Nicaraguan people are very appreciative of our help and continually offer us their blessings for what we are doing here. Time is going fast and tomorrow might be our last day in surgery. We all have accomplished a lot and have worked well together as a team. We have also met a lot of neat people from the other teams who were helpful to us in the beginning to get us rolling. We are thankful to them for all their help. The last of the California team is leaving tomorrow and we wish them well. It was a pleasure meeting them and working along side them. Thank you to everyone who has shown an interest in our mission. Carolyn & Dean

2010-02-24T19:45:00.000-06:00

Think of the very hottest most humid day in Nebraska x 24 hours!!! But, it is hard to complain too much while you realize people live in this all the time. I switch from my heart breaking at witnessing the suffering here to being filled with joy at being part of this wonderful experience. Today we finally hit our groove with surgery--things went really well. Looking forward to tomorrow. God bless you all at home, thanks for all the prayers and good thoughts we feel them lift us up. SUE

Cleft

2010-02-24T06:13:00.000-06:00

Well, the cleft went very well. PED was an awesome first asst who helped me map out all the little flaps, measure, etc. In the end I thought it wasn't symmetrical enough, etc. but looking at my references afterword to see what I should have done different I saw that all their post op results had the same asymmetry as mine did so I was reassured. The mom looked really happy and Channa was eating an up right away. Melissa was in her glory with that baby, helping with the IV. We put in an IO (like a bone IV in the leg). Sorry about the picture. I have plans to get a good one. Please tell Deb Curry. She was interested in the cleft, but I don't think she does much internet.

I put in a picture of John and Karl with their OR table adventure.

Our thyroid was totally routine, but for lack of most of the key instruments I'm used to. The ear drum perforation made history as the first ear surgery ever done here. The local nurses were all taking pictures.

I took out the trach. The guy was happy.

Our nasal tumor 'Quillermo" is in ICU still with all the packing. OK, I didn't do my math right and he really only lost 1 1/2 liters of blood instead of 6 units. I'm going to start unpacking it today.

I befriended a new med student, Jassinia, pictured above. She's been in med school 3 weeks and just finished high school. They go 5 years combining college and med school compared to our 8 so she's just now taking triginometry and has zero experience. I gave her a scrub suit from my office. She's living in the orphanage with her brother. Her mom was shot by her stepfather and is paralysed from the waist down so can't take care of her or her siblings.

We're learning a Spanish word of the day (my idea). I think tengo (I have) will be for today. Yesterday was entiendo (I understand).

John and Karl regaled us with a story about the dog with the bloody guaze in it's mouth in the hospital compound being followed by a vulture. There are dogs everywhere sitting outside patient rooms and the nursing stations. There was a horse there the other day. I think Carolyn wanted to ride it. The fish the used guaze out of the trash and wash it and refold and use it. It turns out beautiful and give jobs to people.

Janet and Katrina have totally hit their stride in the Recovery Room. The TV station came with video cameras and interviewed Janet. I guess we made the local news, but we don't have a TV to watch it. They say she looked lovely on camera, swetting and all.

I have so many stories I could write all day. I can't imagine anything more exciting can happen than the emergency trach, bleeding and cleft so the rest of the week will be a piece of cake. NN

Melissa February 23, 2010

2010-02-23T22:05:00.000-06:00

Today was another great day.....still long and hot, but great. These people appreciate every little thing that we can do for them. The pictures that I am including are those of me and "Doctor Pete" doing a procedure from yesterday. Also, a photo of me and some kids on the streets in front of the hospital. The most exciting part of my day was that we couldn't get an IV started on a dehydrated baby that was sweating buckets pre op! We did an Intra-osseous needle on the surgery table on the cleft lip baby......cool stuff here. Melissa :)
Tell Deb Curry that NN did a cleft!

2-23-2010 John

2010-02-23T17:14:00.000-06:00

Well, our day is nearly over for Karl Tillinghast and me. We fixed an OR table, converting it from electric to manual. Many items just get so rusted from humidity, and they don't get maintenance routinely. We turned the OR table on it side to work on it, and mouse dropping, left over used medical supplies, oil, broken glass and dead bugs fell off onto the floor. Amainingly, the OR table would work electrically when the table was on its side, but not in the upright position. So Karl and I greased and worked to get the table to work manually. Nila was having a big day with the cleft palate surgery, tympanoplasty, thyroid, etc. It is about 5:30 pm and the rest of the team is not home yet. Don't expect them for a while.

Karl and I also worked on many air conditioner units, some lab equipment and tried to get an old x-ray machine to work that had been donated about 6 months ago. Kinda the attitude down here is that if it does not work for a few months, they give up. Partly due to no money, and partly due to lack of technical ability. Some of the items donated are high tech, and after a mission group leaves, the locals just don't know how to run the item. For instance, the lab machine was in Spanish for the software, but the working manual was in German. You get real good at sign language.

This was an especially hot day here, and we just have to make some re-arranging of our sleeping situations. Some of our accomodations have A/C and some don't. The one's that don't are just brutal. So, we are probably going to go Camp, or Boy Scout/Girl Scout with separating the couples so everyone gets A/C, but we will have 4 to a small bedroom, which is a very tolerable tradeoff from the heat.

Did someone say below zero up in NE? Send some down.

The trip is amazing, the support from all the folks that helped to send us here is so appreciated by the team.

There will be more blogging as the team gets back in shifts.

In the photos are hospital ladies folding gauze that was rewashed from yesterday's patients. Yes, they recycle gauze here. Also, our laundry service is done by hand, and by some of the most carring people you would ever meet. The last photo is a child who lives in the area.

John

Monday 22

2010-02-22T22:05:00.000-06:00

Well, I'm both tired and wound up. Everyone else is asleep or at least in bed, but I'm up like I was last night thinking about things tomorrow. Carolyn and Tam (I think) had my camera today. I put in a couple pictures from the OR. You can see Pete, Eye Dr. turned dermatologist operating with Lionel. Then there is Keveta, Sue and Jody. They are exhaused tonight. And, last but not least proof positive that they have a fly swatter in the OR. Notice the shoe holder behind Jody. It's the perfect way to organize suture, gloves, blades, etc. The California team dreamed it up and kept it for us.

It panned out that my worry about today was correctly placed about how to deal with a man with a large nasal tumor. He came advertised as a polyp (no big deal). Let's see, didn't I think that before??? Well I scoped him last Friday and knew it wasn't just any old polyp. He had a biopsy done in Managua months ago that said inflammation, but it wasn't just that. There is no CT scan to be had here so I pondered what it was, etc, etc, etc. He was 2nd to last of 12 cases today. The day was going incredibly smoothly up until the tumor was found to be attached quite tightly in more places than I expected, but I was at a point of no return. 3 units of bleeding later I got the tumor out. It was about the size of a golf ball, way, way, way in the back. Then it started REALLY BLEEDING. Finally 3 more units of bleeding later, I had in the most heavy duty pack I could make and we had it well controlled. Sue scrubbed, but pretty soon Jody and Tam were retracting on posterior pack sutures. Never mind that I accidently hit Sue pretty hard when one broke. I'm hoping she will forgive me. I still don't know exactly what the tumor is. I've cut a deal with our pathologist to look at any unusual specimens I bring back so there is a little piece of it that will find it's way into my suitcase so the patient won't have to wait the usual month for a report........

By the way, the emergency tracheotomy patient was up and talking to me today. I should be able to take it out tomorrow. Tonight I'm going to worry about the 11 month old cleft I'm doing tomorrow..............

The team is working together so well it's unbelievable. They are making it look easy inspite of the conditions. The best bathroom in the hospital is right by the OR. There is no toilet seat or paper or flushing handle. You have to pour water in to kinda' flush it. There is a big tub of water beside it with a big scoop floating in it to get the water to pour from. The floor is wet, it's just gross, then there is no sink to wash your hands.
Around the corner is the scrub sink with city water (undrinkable) till noon and a PVC pipe with a wrench type handle with other water that was collected from somewhere else??? I don't really know. I have TP in my backpach at all times and use lots of hand sanitizer. Later.... NN

1st day is over!

2010-02-22T21:06:00.000-06:00

We're finally done with our first day of surgery! Some of us went to work at 6:30 am and we got back after 8:00 tonight. Long day but pretty amazing. I worked in surgery and cleaned and sterilized surgery instruments. The conditions are NOTHING like any of us are used to. Pretty unbelieveable, to say the least.

We Americans are spoiled. Yesterday we spent some time with children from the orphanage. It's amazing to see how little it takes to make them happy. Giving them one little "smartie" will make them smile from ear to ear. They are very loving children and so well behaved. It can make you sad to think that their future will more than likely be very bleak.

Others are in line to blog. Time to shower and go to bed with no blankets necessary!
Carolyn Athey

Monday 2-22-2010

2010-02-22T20:28:00.000-06:00

I visited with Scott Boettcher tonight by skpe, I am still amazed that the technology exists to do audo/visual over the internet from such a remote place like we are in.

Today was our first official day of scheduled surgery, about 11 cases in the OR, and Dr. Diedrichsen had many skin lesions in a minor procedure room.

We are having fading memories of snow and cold, with each day being upper 80's with about that much humidity.

Other team members will be blogging later, limited time right now as we are all just getting back from the hospital (8:00pm or so).

Later

John

2010-02-21T21:33:00.001-06:00

Good evening all...we have had a relaxing day which is good. We need to be well rested as tomorrow is the start of a crazy week. We went to church as a group and it was extremely hot and humid. We were served lobster tail for lunch...for those of us hoping to lose weight this trip, not a chance! We then got into our swimsuits and loaded up the kids from the orphanage and headed to the river to swim. That was a blast! We are now just hoping that those of us who swam won't be getting sick from the water. Pete, John and I jumped from a 20 foot cliff into the water because we could and as Dean says...he can say he didn't because he didn't want to! The kids are warming our hearts and are so happy, respectful and kind. They fell asleep in our laps on the ride home, wanted us to play with their hair and of course loved the candy we shared with them today. When we got "home" we packed some things and took them to the hospital in preparation for tomorrow. Pete and I are going to do some lesion removals while Nila does her surgeries. Carl and John were trying to fix a fan in the room that we are going to be using and spotted...a bone on the floor. The bone is a human bone, probably from a previous orthopedic surgery? It looks like part of a leg bone. We haven't seen the rats yet, but have been told they will be running through the rooms that we will be working in. I am NOT excited about that, especially if the lights go out, come back on and some beady eyes are staring at me-you will hear me scream in Nebraska.

For those of you who have read about our excitement last night. The man that had the emergency surgery is doing bueno!!!! He is stable and comfortable. He has no family, it is very sad.

Well, it is going to be a short night - thanks for the thoughts, prayers and blog responses. We love hearing from you all. In His service, Tamra

2010-02-21T07:42:00.000-06:00

Uh,.....what they all said. There is a class clown in every group, and they are paying me big bucks to perform that role. Now where is that scalpal? John

Other thoughts

2010-02-21T06:58:00.000-06:00

You know that God is with you when the the worst airway you have seen in years is 'after hours' in a third world country and everything turns out for the best. The challenges are great but so are the rewards. Great to have a full change of clothes. Dean Athey

Despite the obvious poverty you don't hear any complaints. The mornings are beautiful. Pete

The roosters start crowing around 4:00 to 5:00 but are still able to sleep our room is one of the lucky ones that has air conditioning when the electricity is on. I know the experience is just beginning but is and will be one that will last a lifetime.
The list of lives that we have touched is growing and growing. Today breakfast is @ 8:00 - church at 9:00 - river in the P.M. with the children from the orphanage.- two school bus loads. Karl Tillinghast-

So far this trip has been amazing. I could not have asked for a better team to travel with.....at the last minute. The people that we saw at the clinic yesterday were awesome! It's neat to know that by taking off a mole, here they call it "ditzels" can really change their lives. It could be cancer. It could be cosmetic, but whatever the reason, they came to us with so much hope. The hardest thing yesterday was knowing that we had to turn people away. There are so many wonderful things that we are about to experience and do this week. We are all so enthusiastic that we are here to help them. These people are strong and they are tough and it's going to be good! Thank you for all of your prayers and thoughts! We NEED THEM and so do all the people of Nicaragua...... Melissa

Emergency

2010-02-20T23:18:00.000-06:00

We we were all settling in for our evening team meeting around 7:30 pm when a General Surgeon from the Hospital, Dr. Cespedes showed up looking for the "Otorino" (that's me). He had a patient about 40 years old who thought he got a fish bone stuck in his throat about 8 hours ago. He wanted me to come and help get it out. "Fish bone", I thought, "no big deal. " I've seen lots of foreign bodies including many fish bones. I'd get to show them how easy foreign bodies are. They are one of my favorite things. Quick, easy cure. So we gathered up a few instruments and my headlight, a fiberoptic scope and scrubs. It turns out Dr. Cespedes came in the Ambulance to get me and was a little anxious. I went along with Dr. Diedrichsen (next to me) as assistant, Tam Boettcher to photograph our first emergency and Dean Athey (at the head) in case we needed to put him to sleep to get it out. Suzie and Keveta (green print hat), the nurses here who know the system well, came along to keep track of us. When we got to the ER there was a man with a neck as swollen as any I've ever seen. A little guy with a NFL linebacker thick neck, in obvious distress. I won't give all the details, but the option was to 1) put him to sleep, do a tracheotomy to secure an airway and then see what was in his throat, or 2) let him die. We decided we would go with #1. Dean gets the big award for putting him to sleep with much finesse and securing the airway with me standing by with a knife in hand and neck scrubbed. Once we had an airway Dr. Cespedes (across with no headlight) and Dr. Diedrichsen (next to me) assisted me (black headlight) in the tracheotomy which went without a hitch. We then had time to look at the massively swollen throat. There was no foreign body, no abcess, no obvious infection and no real explanation for the problem. There is no CT scanner here so we couldn't get one of those. I kept asking if we could get a white blood cell count to check for infection. They didn't seem to know at first, but finally decided they could. I have to confess they never did draw any blood, but they said they would. We couldn't just leave a breathing tube in through his mouth because there is no ventilator and he would have to be kept asleep if he had one, or he would thrash around so much it would come out and lose his airway. We left him in the ICU on antibiotics and steroids with a tracheotomy tube stitched in and no family anywhere. The ICU nurse had to hunt awhile to find some suction and oxygen, but we left him there stable for the night with oxygen and suction. We got home about 11 pm. NN