Thankful morning

One might assume that this Army girl is great at camping, well you would be wrong in your assumption. You see when I was little Scott and I would ask Dad why don't we go camping like our friends? Dad's answer was invariably, "because I spent 23 years, camping, I don't need to camp anymore". I only understood that once I got into the Army, but only partially understood. 1) I was an officer, given a shelter half (one half of a tent) that was never used. 2) dad actually used the shelter half he was given. Slept on the ground, in war time. 3) When we slept in "the field" we slept in nice big tents, on cots, the backs of trucks, etc. 4) We were often fed out of mobile kitchens, so I have no idea how to cook while camping. Except if you give me an MRE (Meal Ready to Eat), that I know what to do with.
So thank goodness for Kelsey, Lee and Ian. Kelsey can throw down on one of those little bitty single burner camp stoves that she carries on her bike. On the first night we had rice and beans, with veggies cut up.  In the morning we had an awesome pot of oatmeal with peanut butter, dried cranberries, and bananas to get us going. And of course COFFEE! But I must admit I could use a nice hot vente Pike Place right now. Lee the engineer/Eagle Scout is is great for all kinds of things, like being kind enough to give me his Mountain Hardware jacket for the trip, because I forgot to bring one! Having a personal professional bike mechanic on the trip is never a bad think. So far he's only had to change his own flat though, but did so in impressive time.
As I wake up this morning I am thankful for three really awesome young folks that are putting up with this woman that is 52 years wise.  I am also thankful for the elements -
As I hear the owl hooting, the cows mooing (farm next to camp ground), the sound of the ocean, birds tweeting, I am truly thankful, for God's goodness. But I do miss Bob Goodwin because right now at 6:40 am as those young folks are still curled up in their fart sacks (sleeping bags), my Bob would be handing me a hot cup of coffee right now. Sigh. #thankful

Day 2 Wisdom and Determination will Out Live Youthful Exuberance

Today was rough, as soon as we took off we were immediately faced with a hill. My legs were just not ready for the hills. Kelsey, Lee and Ian are taking the hills with youthful ease, I just take them one pedal push at a time, they are usually way ahead of me. My sweet Ian though keeps looking out for his mama and waits at the top of the hills for me. We stopped in Charleston, Oregon for a quick break and as soon as we got back on the road, we were met with a giant hill. By now we were off of highway 101 and on the Pacific Coast bike route, which was nice, but that hill did me in, I had to get off and push my bike numerous times, that is until Ian looked at my bike chain and informed I was in the wrong gear! Ugh. It made all the difference in the world. We stopped in Bandon for lunch at the Bandon Fish Market. After a beer and fish and chips we set out for Cape Blanco. The problem with Cape Blanco was the camp sites were first come first serve, so the plan was for Lee and Ian to ride ahead and get us a camp site. But Ian got a flat tire on the way. He fixed it in about 15 minutes and Lee was bound and determined to stop at Langlois Market - Home of the world famous hot dog. So once back on the road a decision was made to turn off before Cape Blanco and try for another camp ground. We wound up tonight at Lake Floras State Park. A much nicer, quieter and friendly place than we stayed at last night, complete with showers, washer, dryer, WiFi and access to plugs. Speaking of which I have very few photos from today because my phone died. I bought a solar power charger but it seems to work on everyone's phone except for mine.
We did about 60 miles today, tomorrow will be a bit shorter and on day 4 we get to stay in a motel....yeah! I'm tired on day two, but determination will always win the day.

Day 1 Complete - 2017 Most Excellent Cycling Adventure

Well we finished day 1, stopping at the Spinreel Camping area outside of Lakeside. Today's take away? Hills are no joke! And it started immediately, we crossed the Siuslaw bridge and immediately hit our first hill and they just kept coming. We stopped in Reedsport for a long leisurely lunch at the Waterfront restaurant, recommended to us by a guy at a auto shop on 101. We asked for good food and beer and he said that was the place to go. It was good. Bud and Buy-in were the primary brews, but they had a local brew that we all went for. It's was good. So far the shoulder for us to ride on has not been too bad. The motor homes whizzing by are not bad, the log trucks are the worse. The young folks are beating me up the hills every time, but I haven't stopped just moving slow.

2017 Most Excellent Cycling Adventure

San Francisco or bust! Me and three 20 something's will be riding from Florence, Oregon to San Francisco. Follow our adventures here.

The Team

I have mentioned a few of the folks that I am working with mostly in passing.  I've really focused on the kids because they are the reason we are here.  But let me tell you something....26 people have been thrown together to work as a team, for two weeks and I have never seen anything like it! 

team·work/ˈtēmˌwərk/

Noun:

The combined action of a group of people, esp. when effective and efficient. That pretty much sums up the group of people that I have been fortunate enough to work with for the past two weeks. But allow me to add a few words to effective and efficient.  How about talented, caring, humble, compassionate, brilliant, steady, congenial, generous, warmhearted, social, thoughtful, accomplished, skilled and how about just plain "Cool".  For some like me this is their first ROTAPLAST trip for others this is trip number 16.  For one this is the 3rd ROTAPLAST this year.  We range in age from 26 to 72, the majority of us are from the West Coast but we've got one from Texas, one from Massachusetts, one from Florida and one from Canada.  We are doctors, nurses, lawyers, retirees, Realtors and the list goes on. I am working next to Stanford grads, UCLA and believe it or not we have two Huskies in the group (Washington Huskies that is) and you know they just aren't all that bad :).  I'm nobodies fool I know that not every mission can run this smooth, but I tell you what - God has blessed me with awesome teammates..."shout-out to Melanie the best roommate a girl could ask for!".  These plastic surgeons are some of the best in the country (maybe the world?) yet there is no "high and mighty" attitude.  They are real caring people.  I have watched approximately 8 surgeries this week and every single one of them is willing to teach and explain what it is they are doing and why they are doing it.

Dr. David and Dr. Ron "fight" over who will have local "Dr. Ebel" to assist

Dr. David, Head Nurse Diane, Chief surgeon Dr. Janet, look at the days schedule

Recovery room staff - Nurse Melanie, Nurse James, Pediatrician Dr. Amie and PACU Assistant Garon

Ward Coordinator gets Anderson ready for surgery

Surgeons and friends Dr. Janet and Dr. Ron

Pediatrician Dr. Collin enjoys one of our delicious Peruvian lunches

our tallest and shortest team members Nurse Melonie and Garon

Nurse James, Interpreter Siuna, Dr. Colin, Anesthesiologists Dr. Sal & Dr. Zak

Local surgeon Dr. Margaret & anesthegiolgist Dr. Brad

Surgeon Dr. Tom

Equipment sterilizer Bill with Mission Director Tom & and surgeon Dr. Tom

Speech Pathologist Dianne & Ward Coordinator Ellen

Team Photo Journalist Darlene

Medical Records manager Laile

Sunday a Day off

So Sunday was the teams day off, but the doctors still had to make their rounds on Sunday morning.  And although I didn't get in until 3:00 AM I was bound and determined to get up and go see the kids and so I did.  Poor kids as soon as they saw the Americans come in they wanted to run and hide.  It had been a nice peaceful morning but by the time the doctors got done poking and prodding them they were all screaming their fool heads off.  My buddy Anderson was up and smiling, that is until the doctor touched him.  I took some photos of him and then showed him the pictures on the view finder.  He was completely enthralled with it.  So I held the camera and let him point at the subject and I punched the button -

Dr. Tom, Anderson's mom, nurse Lourdis, Me & Anderson

Shots by Anderson

He had a great time with the camera

Perhaps one day with his new hands he can take pictures on his own

After we left the hospital we headed back to the hotel to pick up the rest of the group that slept in....then we headed off to the museum Museo Nacional de Arqueología, Antropología e Historia del Perú. www.arqueotur.org But the condition I was in was not the best for taking in a museum, I was miserably tired, falling a sleep standing up, so I completely missed my Inca history lesson. After the museum we went to lunch at a really cool restaurant who's name I can't remember, but I do remember this, they were cooking beef heart on skewers over an open fire as we walked in the door. We had wonderful wonderful food and drinks.  After lunch we went to an "arts and crafts" market.  It was wonderful because our Rotary hosts accompanied us so that they could help us barter and get some good deals on souvenirs.  All in all it was a great day off, we went back to our hotel and crashed completely exhausted, by 8:00 PM. 

The vessels that the Pisco is fermented in

The Pisco still

All Work and No Play......

We actually have gotten a day off since we've been here.  Sunday was our day off, therefore I did not blog on Saturday night because we spent the night out on the town.  We got back from the hospital at 8:00PM, and a group of us planned to meet for dinner at 9:00.  We met in the lobby of our hotel and took off towards the beach where there is a mall filled with great restaurants, bars, clubs and of course shopping.  When we go to the restaurant we were informed that there was a 40 minute wait.  It just didn't dawn on me that 40 minutes meant we were going to eat after 10 PM.  So we sat in a bar near the restaurant and drank Pisco Sours.
The national origin of the pisco sour is debated. Both Chile and Peru lay claim to the drink.^[3] In both countries, the variety of lime used is what North Americans would call Persian lime but Peruvians call simply "lemons". In the United States, the drink is usually made with commonly available Lisbon or Eureka lemons. With the increased availability of Pisco and regional bitters outside South America, the Pisco Sour, like the Mojito and Caipirinha, has increased in popularity in the United States.
Since 2003, Peru has a National Pisco Sour Day which is celebrated on the first weekend of February. ^(Wikipedia) 

Melanie, Joelle, Collin & Maureen with our DOUBLE Pisco Sours

Here is a Pisco Sour recipe -
4 cups ice cubes
     1 cup pisco

1/3 cup lemon juice

1/3 cup white sugar

1 egg white

aromatic bitters

Place ice cubes, pisco, lemon juice, sugar, egg white, and bitters in the bowl of a blender. Blend on high speed until finely pureed. Pour into two glasses and garnish with an additional dash of bitters.

And then there was dinner -

Most of us had not eaten much that day so the double Pisco Sour was probably a bit of overkill.  I don't remember the name of the bar nor do I remember the name of the restaurant.  But I must say that a good time was had by all. We didn't finish dinner until after midnight!

Ceviche

A beef dish with fries and rice

This was mine - Rice with seafood Yumm

After dinner someone had the bright idea to go dancing and so we did - a place called "Ohm". A few turns around the dance floor another Pisco Sour and me, my roommate Melonie and our friend James decided to call it a night. But before we returned to the hotel we stopped by one of the numerous elaborate casinos found about town. I let Melonie drop some change into the roulette machine she lost, then I drug Melonie and James back to the hotel. We got in at about 3:00 AM. I can't remember the last time I stayed out that late. 

Aimee, Melanie, Collin, James

Lima Day 5 - Anderson Gets Thumbs

Nurse Lourdis keeps Anderson occupied

After a bit of drama and lots of discussion, the decision was made this morning to proceed with the surgery to separate Anderson's thumbs from his webbed hands.  The hope is that once separated and with some physical therapy, he will be able to pick up his own fork, and pen among other things.  Right now his mother does most everything for him.  Surgery began at 9:00AM, with two surgeons, both with some background in hand surgery.  Dr. David was the lead surgeon and Dr. Tom was there with the assist.  They began by marking with a pen the area of the hand in which they would make the incisions.

The area to be cut is marked with pen

And then slowly but surely and carefully, began separating the thumbs, going through all the layers of skin, fat, muscle etc. It was fascinating to watch. Once the left hand had been successfully separated, the decision was made to go ahead and operated on the right hand also.

The left Thumb is separated

While Dr. David moved to the right hand, Dr. Tom began the skin graft, once again making pen markings very low on the stomach. Then carefully cutting around and separating the skin from the body.

Skin from the stomach will be used on the thumb

Once separated the Dr. Tom carefully scraped off the little bit of fat that was still connected to the tissue then the it was placed in a a small bowl of saline water to keep until the second thumb was successfully separated and the area where the skin was taken from was closed up.

The area is sewn up

Human Skin.  Awesome!

A blood pressure cuff was used as a tourniquet, to slow the blood flow to the hands, this way the surgeon is not trying to cut through a pool of blood. One fear was that the fused fingers may not have enough blood flow and they would die, but it looks as if Anderson has good blood flow to the fingers.

The skin from the stomach is sutured to the hand

The finished look

After he was all sewn up, the hands and much of his arms were wrapped up in sterile gauze and bandages. Upon waking up from the anesthesia, Anderson was not a happy boy. Something that I learned earlier in the day was that Anderson cannot talk and he can only hear you if you yell at him very loud, so he expressed his pain and frustration at having the bandages on his hands by yelling. He immediately tried to remove the bandage with his mouth. He is such a smart and resourceful kid. Nothing was going to make him happy. Except for moments of fascination when he would stop and look at his hands and the small amount of blood coming from the top of the bandages. He tried to pull the blood pressure cuff of of his leg and wanted to pull the needle and line to his IV bag out. He will have to keep the bandages on his hands for 10 days (or at least try to). I think that what we did to help Anderson will better his quality of life. I would love to be able to see him 3 months down the road.

Anderson and his mom getting wheeled back to his hospital bed

The other fascinating operation that I saw today was a bone graft for a left aveolar cleft on Jorge who is 8 1/2 years old.  It must be good to be the last surgery of the day.  Jorge had four surgeons working on him.  While Dr. David and Dr. Margaret took a 1 inch canoe shaped piece of bone from Jorge's hip, with what looked to be a hammer and a chisel.  Drs. Janet and Tom opened up Jorge's gums to place the piece of bone in -

The bone is removed from the hip

And sewn into the gums

The bone is then taken and sewn into the gum line in hopes that it will grow and attache to the bone that is already there. All in all it was a fascinating day and the end of a fascinating week. As tired as we were we went out Saturday night for a night on the town, dinner, dancing and the casino. We stayed out until 3 AM, and though I had an awesome time, I am exhausted. Sunday was a day off, after rounds at the hospital to see how the kids were doing. Then it was lunch, a visit to a museum and shopping. Tomorrow, more surgeries.

I felt My Heart Breaking

Anderson gives me a big Oregon "O"

He has touched my heart
I had no idea I would react this way to the kids coming in for treatment.  I knew when Anderson came in on Tuesday that he was special, he is just a big goofy kid that likes to give a show, he has boundless energy and an infectious smile, he doesn't talk but you know when he is happy.  Dr, David was very sure that he could improve Anderson's quality of life by taking his fused hands and giving him thumbs.  We had to remember that we are not in the United States and sometimes getting what we need is not always possible.  It took two days to get the correct x-rays of Anderson's hands to see if the surgery was possible and then once we got them it still wasn't clear as to what we were looking at.  It was assessed that the hospital may or may no

t have all of the instruments that are needed to conduct the the right and left thumb syndactle release...a certain sort of saw, wire and all kinds of other things that I can't remember or pronounce.  The decision was made to NOT do Anderson's surgery.  My heart sank, I wanted to cry and I did.  I couldn't even bring myself to go onto the ward to say goodbye to Anderson as I left for the day, but in the end I did.  He clowned around for me like he always does and I gave him a rubber duck.  While there the doctors were conferring about the case.  All is not lost they may still attempt the surgery tomorrow.  I am praying that they can get everything that they need to perform the surgery.

 

Sebastian 24 hours after surgery
Sebastian had a cleft lip and palate surgery therefore must remain in the hospital for one more day.  He appeared to be in quite a bit of pain but I did get a very small smile from him.  I am sure he will be up and about tomorrow.

Veronica Celebrates her 74th birthday

Yesterday Veronica at 73 years old had cleft lip surgery, today she turned 74. Many of the ROTAPLAST Team went to see her and sing happy birthday to her. Ellen one of our ward coordinators gathered up a small bag of gifts to give to her, a scarf, a key chain among other things, she didn't smile, in fact she gave no expression at all. But we are told that she was very happy with the gifts and the recognition. Apparently she rarely shows emotion. After five kids all conceived from being raped, I suppose I might be farely emotionless also. Who knows once her surgery scars have healed she will find something to smile about. All of our surgeries from Wednesday went home except for Sebastian. Cleft lip surgeries stay for one day, cleft palate surgeries stay for two. Its a long night for the team. Tonight I came back to our hotel early to set up for a class to be given by two of our plastic surgeons to a group of our local medical hosts. While the rest of the team stayed behind at the hotel to finish up two more surgeries. There seemed to be quite a few babies today, but also some four 20 somethings. Tomorrow is Saturday, another full day of surgery. Tonight is the earliest I will have gone to bed. I think I need this sleep desperately.