Code Blue....No Wait ..Code Milk

What The Mess...

So I am spending a quiet evening at home (finally) when I hear a tapping at the gate and someone calling my name (so goes that quiet night) the security guard  say that Madame  Lareche is calling for either Dr. Wise or myself and said it was and emergency ( we have a 27 week premature baby in the unit and so if Madame Lareche says it's and emergency it really is). So I quickly change into scrubs run to Joe and Anna's house telling them there is an emergency in NICU, and took off running to the hospital.

hmm... as I run through the hospital to get to the NICU, past the guard that warns me to stop running or  I will fall (it had rained earlier and hospital has tile floors), so I do what anyone would do at that point ...I ignore him and kept on running to NICU cause it's and emergency right??? I get to the NICU  where it is suspiciously quiet and madame Lareche is calmly walking away from the incubator... she opens her mouth and tells me "bebe a pa gen lèt" ....... WHAT THE MESS !!! she says that the baby does not have any milk,,, important but not an emergency.

Apparently the guard decided to add emergency to the message.

Soon after I arrive Joe and Anna get to the NICU to assist in the "code" but I had to break it to them that it was not a code Blue but a code Milk ... yeah we just had our exercise for the night .

Don't get me wrong I am happy that it was not a real emergency but dang it my heart can not take this kind of excitement.

Until next time

Blessings
'
Marc J  (S.A.L.T)

Gerilon's Miracle

For several months the Haiti Adventist Hospital team has been working to get a young man with a facial tumor some help.  One of our visiting orthopedic surgeon Dr. Bibiloni suggested bringing him to Puerto Rico for surgery.  A "get Gerilon to Puerto Rico  team was formed". Project Medishare made it possible for us to get the CT SCAN, Dr. Bibiloni arranged everything on the Puerto Rico end for Gerilon and his mother to get a visa and for his time in Puerto Rico during his recuperation from his surgery. 

With unfaltering devotion Marie Paul was able to call in some favors at the local television and radio stations to raise money for Gerilon.  With the aid of our CMO Dr. Geneus, Gerilon and his mom were able to get a passport in short ime frame.  Haitian citizens from all over called into the stations pledging their support of this young man.

Below is a copy of an e-mail Marie Paul sent me on Gerilon's first day of surgery

We were received like royalty, the First Lady of Puerto Rico, Lucé Vela and the Secretary of State Kenneth McClintock as well as Dr. Bibiloni, Dr. Carlos Mellado, other doctors and dignitaries were
at the airport to receive us. We were escorted throughout the trip by Homeland Security Officers, TSA, and afforded other privileges reserved for diplomats. All this for a young man from Haiti who lives in a small house without electricity, running water, and indoor plumbing. God is so good and He does things in a grand way. Our airline tickets were donated by a travel agency in Haiti and they sent us first class, Gerilon got to meet the pilots and sit in the cockpit of the plane. 

 Gerilon had his first procedure done today, a tracheostomy ( a hole in his throat to help him breath).. He is spending the night in Intensive Care and going back to his room tomorrow. The First lady of PR, Luce Vela, came to see him today after his surgery, she's awesome. I think she's going to have him on a talk show. The removal of the tumor is scheduled for next Thursday morning.

I am sending you a picture of Geri right after the tracheostomy, and one with his mom.

This young man has several months of surgery ahead of him if you would like to help financially please contact me at ahihaiti.programs@gmail.com and I will place you in contact with the appropriate people.  


Most of all please pray for this young man, his family and the doctors doing the surgery.  

P. Harley Davidson

Sabbath afternoon

On Wednesday we were given the one of the best news, his head ultra-sound exam came back clear.  Davidson is becoming more interactive, playful and aware of his surroundings. He eats like there is no tomorrow, at the physician's office he threw a fit because his food was finished...hmm that has to stop.

He is becoming a very spoiled little boy with all the attention he is getting from the staff and us (he has a lot of aunties and uncles). This child refuses to sleep unless I hold him and sing him a song.  

     

Ted and I went to the social services office today to inquire about the steps for adoption, They denied my request to be his guardian.  We were told that he had to go to an orphanage for at least 6 months before they would release him for adoption.  Because of some situations that have happened with child trafficking they have changed the laws, so I will not be able to take care of him while we are waiting for him to be adopted. 

I am both sad and relieved; I will miss him when he goes but we have to get him out of the hospital, he is getting sick again and there are several kids in the peds department that have meningitis.  We are looking into several orphanages to see who will take good care of him, so far the only one that I have found is about 2 hours away from me.  :(

HAH's First EMT Graduates

Hôpital Adventiste EMT Graduates 

The Adventist Hospital in Diquine has four new EMT's as of Friday.  Today I feel like a proud mom x 4.  For eight weeks our students left their jobs, their families, and their comfort to attend the EMT program, an 8 week course provided by EMPACT-Northwest.   Our students left their homes before 5am in order to reach school by 8 am, missed meals, reaching home sometimes after 7pm.  Even on days where there were demonstration and people were cautioned to not travel on the roads, our students refused to miss a day of school.  Out of the several weeks of demonstrations our students only missed 1 day, that's it.

They took motorcycle taxis in the rain, endured injuries and still made it to class without complaint.
To explain how proud I am of Exume, Josette,  Pierre, and Rutza, I do not think I can begin to put it into words.  Every Sunday they would come of their own accord to the hospital for tutoring, often staying 5 to 8 hours in order to grasp the concept.   Every week they made a pact among themselves not to give up, to finish what they started in order to help change our ED and to make a difference in Haiti.

We often speak of how difficult it may be when we try to change an existing system, and how EMT's are not yet known in Haiti.  We often speak of the challenges that they will face, but more so we speak of their desire, their determination to help things change.

I am so proud of our EMT's, If they are Haiti's future, we are on the right tract.  

Mòn Dèyè Mòn-->Mountains Beyond Mountains

One of my favorite books is "Mountains Beyond Mountains" written about Paul Farmer and the work that he has done in Haiti, by Tracy Kidder.  After living here in Haiti for almost two years I finally understand what that means.  In Creole we say  Mòn Dèyè Mòn, meaning that behind every obstacle there is another one. I have learned to celebrate the success of overcoming a challenge but also to be prepared for the next one to come.

Matthew 17:20   And Jesus said unto them, Because of your unbelief: for verily I say unto you, If you have faith as a grain of mustard seed, you shall say unto this mountain, Remove from here to yonder place; and it shall remove; and nothing shall be impossible unto you. 

I see a lot of celebrating in my future :)

MAMMA MIA!

I am a mommy!!! well sort of... About two weeks ago a baby boy was abandoned at the hospital, the nurse who was on that night ran to where my room use to be in the hospital to tell me about him and to ask me what to do...???? 

1. WHAAAAT !!! I don't know. 
2. Thank goodness we moved and I no longer live in the hospital

The next morning she found me and ask to take a look at him (sucker). Yup that is what I am, he is too cute. Immediately they began trying to get me to adopt him, it's like the hospital banded together and formed a get Marc to adopt this baby, they even put my name on his medical paper work.

We have been worried about him because the "father" said that he was a year old but he appears to be 7-8 months old and has some developmental delays. For the past week I have been taking him home with me for a few hours to give him bonding time and play therapy.

When he first came to us he did not respond to anything at all. He did not cry when left, or made any facial expressions or even move from the spot we put him. PT has been working with him (thank you Emily) and we have been giving him lots of good loving (thank you Nadine, Sirko, Amy and the awesome peds nurses). So today he laugh, turned over on his own several times, babbled, played with is toes, and sat up for a while on his own. I know that this seems like a simple thing, but for a baby that was not reactive and displayed behaviors that are consistent with being abandoned emotionally long before he was abandoned physically, for me it is a big thing and I rejoice.

The nurses are still on the "get Marc to adopt wagon" God will provide some parents for him but for now I am happy to be is temporary mommy.

So what does this mean? It means I get the phone calls when he is out of diapers , water or food, it means that I get the calls when a new prescription or lab test is ordered. It means that I get the phone calls when he does something new and amazing like, roll over, laugh, drinks his whole bottle, or starts to play with his toys. It means that I am get the pleasure of being his mommy.... well for now.

Marc

I Have Learned

I have to learn, when the first words out of a doctors mouth when asked to do a transport is "the patient is stable" QUESTION that statement. At 10 am Saturday morning I was asked to get ready to go on a transport, at 1pm one of the docs called me out of church for the "stable" patient transport.... HAH, when you walk into the room and they are bagging the patient SHE IS NOT STABLE. 

[I have to say that I am very proud of our soon to graduate EMT students (they are the 3rd group of EMT students to graduate in all of Haiti). As we were walking into the ER she immediately went to the patient's bedside to assist.]

We bagged the patient all during the transport to General Hospital. I have to thank our driver Michael who was awesome, almost killed us several times but he made a 2 to 3 hour trip (because of traffic) in 1 hour.

When we arrived she coded twice, Every time we stabilized her our (awesome) doc tried to leave. I was like heck no, you are not leaving me with this patient, ( I think the man was trying to kill me).
We continued to bag the patient for 2 hours after we arrived at General , finally we stabilized her enough to get her on dialysis.

Lesson for the day
1. Always assume a patient is unstable until you have verified for yourself
2. Make sure the your spare oxygen tank is not locked (forgot to tell you they placed a locked O2 tank in the truck).
3. An awesome team can make or break a code
4. NEVER let the doctor leave the room after he says "she is stable now" !!!!
5. Take a candy or granola bar (I was so hungry).

Question: How many people do you think it takes to assess a patient?

Answer: 3 

Had a patient that came into the ER today with severe diarrhea and vomiting (simple assessment right, NO) The problem, the patient only spoke Portuguese and the doctor speaks French or Creole (see the problem). We needed three people to assess this patient; The doctor, speaking French/Creole, me, translating to a friend in English, Her, translating to the patient in Portuguese and repeating the process in reverse. That was the longest assessment ever.

SO you want to know the kicker, as she leaves to get somethings to admit him to the hospital, I was left with Him to do his admission paper work, problemmmmm, or so I thought. I asked him is he understood any Spanish so I could fill out the paper work, he responds to me "oh, I rather speak English. WHAT THE MESS, that bugger spoke English the whole time.

Sunday ...

Sunday: spent 8 hours teaching (to some awesome students) with one 15 minute break 

Monday: woke up at 5:30 -worked till 11, no breakfast, a quick lunch and a Bagel with 

hummus for dinner

Tuesday: woke up at 5:am, but dreamt about work all night long...quick Bagel for breakfast, I did eat lunch, no time for dinner...wait does a Bagel count? and spending the rest of the night on call for a post-op patient... In all of this I ask one question...

 WHAT THE MESS IS TAKING FRIDAY SO LONG!!!

The End is What Really Matters

You know when you start the day and you have a feeling it's going to be one of those days where you never stop moving... well welcome to my Thursday... it all started with a 6:20 am call. Here are the highlights.

Challenges at the start of the day 
1. abdominal pain that ended up being appendicitis, that ended up perforating (one of the volunteers), 
2. convincing a physician to doing a CT scan for us for a cancer patient,
3. and looking for O- blood for a patient with a hemoglobin of 4 (impossible)

Results at the end of the day

1. Successful appendectomy, just finished recovering the pt,
2. batting eyelids successful, patient had the CT Scan
3. got a call to go pick up the blood to day at 4 pm after we were told it was not going to happen.

No breakfast, no lunch, no dinner, but still full
Finally getting to bed...I wonder what tomorrow will bring... ehh scratch that .... Whatever tomorrow brings, with God I know we can handle it.

Update: Houston... We Have A Problem--> Haiti we have a problem

Dang it, seriously... Ok guys this is to crazy for me to make it up... I finally got to Florida for my connecting flight back to Haiti.  I took a 6 am American Airlines to Haiti, was bumped up to first class (well actually I paid for an upgrade so I could get the extra bags of supplies on the fight, it was cheaper than paying for the bags).  Back to the crazy story, I am in the first class cabin, just finished drinking my pre-breakfast orange juice served on a tray in a glass, closed my eyes to take a rest (actually I was praying for knowledge and a steady hand for the pilot) when what do you think I hear....

YEP... "is there a doctor, nurse, or paramedic on board, please press your call light" umm hummm third flight in a row.  So I do what any medical professional would do, I crack open an eye to see if someone else responded, nope... here I go again.  I head to the back of the plane where an elderly lady was passed out cold, pulse weak, could not find a blood pressure cuff (they had a new complicated one that you would need a rocket scientist to figure it out).  We asked the family members if she had any medical condition..no help there... they didn't know. So I figured that at that time of the morning she probably did not have a chance to eat and her blood sugar was low.  I asked the flight attendant to get the glucose paste, she said that they did not have it so I told her to go to the black pocket of the emergency bag... sad to say I knew what was in each the emergency pockets because of very recent experiences.

Thank God the lady responded after we place the paste in her mouth followed by a peanut butter sandwich and OJ.

Lesson learned:

1.  Carry and emergency kit in my carry on
2. Never ask "whats next"
3. Always travel on American Air... they were the only ones that gave me frequent flyer miles (United and Continental just lost my business) LOL.  
4.  Take a later flight in the day.

Update: Houston... We Have A Problem

Update: No not another medical emergency... my plane has mechanical problems so they made us deboard after 40 min on the plane, now we are stuck in the airport in Houston. Next update 15: min. I love life it is so full of adventures.

Houston...We Have A Problem

On my flight to Houston the flight attendant started having palpitation mid flight, Three of us responded to the call. Ended up placing an AED on him to monitor his rhythm,giving him a IV bolus of NS and one dose of aspirin. On my flight to Cali we had a guy with seizures that bit his tongue bleed on me all before the flight took. 
Hmm. Seizures and cardiac issues. I wonder what will happen next on this next flight.