Luis is a 4 year old who was born with several problems. He had a hole in his heart as well as a cleft of his lip and palate. When he was less than a year old he had his heart defect repaired in Lima. Last year he came to us to have his lip repaired. Normally, we do not do children with multiple problems as the risk of complications after surgery is higher. Last year our pediatrician was also a heart specialist and he felt there was no reason not to do the lip repair. The day of surgery, Luis had a cold so we had to cancel him. This year he came again, but I did not remember him right away and the rest of the team was concerned. After hard work by our anesthesia resident who found the local cardiologist and had the studies interpreted, we all agreed that he was not at any higher risk than any other child and today he had his surgery.
Jose is a 12 year old who was born with both ears only partially formed. One of the procedures that plastic surgeons do is to take cartiledge from the rib and form it into the framework of the ear. We were able to do this for Jose today.
His left ear before the operation.
The rib after forming it into the framework.
At the finish of this stage. It will take two more operations to complete the reconstruction.
Well after doing cases on Weds., we have been back on hold. Not being given an arrival time for the disposable supplies, we had to keep putting families off. When nothing arrived by Thurs. AM, we took a trip to a sacrificial site a bit south of the city.
Part of the complex
Collection of skulls.
Friday was no better. Back to the hospital to tell the families that they would have to wait another day. Figuring that if some thing happened today, we would be working hard for the rest of the trip to catch up, we went to the beach, stopping along the way for a nice lunch.
Today we were able to do 4 cases, but only because I have a really great team that was will to be inventive. All of the patients required skin grafts that we do not like to do late in a trip because of the need for dressing changes before we leave. One patient is Yajaira who was burned while helping her mother cook over an open fire. She has had many operations, but could still not close mouth completely. This makes eating difficult. We were able to improve that situation today. The Mother showed us a picture of her at age 4 when she won a beauty contest.
This is her current condition.
After releasing the tissue and putting in skin from her abdomen.
Due to issues that we can not get good answers to our disposable supplies which were sent a month ago have not been able to be released from customs. As we did not want to lose another day of doing surgery,the team agreed that we would try to obtain what we needed from the hospital. There were also some items left from last year. We had great cooperation from the head nurse in the OR and have enough to do 4 burn cases tomorrow. Who knows what the next day will bring.
I'm searching the cabinet to see what we can use to do the cases planned for tomorrow.
To console ourselves we had dinner at a local culinary school. I think we gave the students a real test as they had to deal with 16 people at one time. The food was some of the best I have had.
The students working on our dinners
One of our meals. Ceviche, which is various seafoods marinated in lemon juice.