What a wonderful week. God Blessed my son Sean and I with so much. We were able to help Dr Perdomo serve the people of the village and at least 30 of the children in the Malnutrition Program. We bought groceries for some of the poorer families. They were so appreciative (as always). The is a 2-1/2 year old boy named Angel that I had been concerned about because he clearly had a neurological disorder and seizures underlying his malnutrition. He was not able to talk a 2y old. On this trip he had been to the neurologist in Santa Domingo. He is now on Depakote. He is starting to talk and was all smiles. I was so happy to see him. His family is extremely poor. We brought supplies for his mother to learn to make soap and try and start her own small business. Ruth who is the receptionist; and "do everything person" at the clinic is going to teach her how to make the soap later next week and help her with buying new supplies. Tomas works in the pharmacy and also as a social worker for the families, he and my son had a great time. He made Sean (16years old) feel at ease quickly. The El Cercado clinic is so special to spend time at.
Then our last day we went out with Grace Bible Church to do a barrio clinic. What a fantastic group of people. The energy they had was wonderful. I felt right at home with them. They shareed their love of God with the people as much as the medicine we gave. I hope to join them again next year.
Sean said the only thing we didn't need were the roosters-like knowone has heard that story before!
God Bless
Valerie Whitney
Updates from Solid Rock Missions teams as they serve in San Juan de la Maguana, Dominican Republic
Friday, February 25, 2011
Thursday, February 24, 2011
Dr Mauldin/Greison/Locke Surgical Team (anesthesia post) 20Feb-25Feb 2011
This post is from the CRNA's of the surgical team (Terry Wellman, Jackie Barkley, Shira Friend, Sue Virgil and Jaime Parke)
We did approximately 75 surgical cases (primarily peds ENT) upon a semi-inventory of what we used, what will be needed, and what we had plently of is as follows:
Needs:
-5/10/20 ml syringes
-decadron, propofol, sevo (always need sevo), kids vitamins, junior tylenol, and claritin
-if you want to start IV's on the older kids emla cream, hurricane spray or ethyl chloride would speed the process
-dermabond
-peds pulse ox (the disposable are on their last leg)
-EKG pads
-filter for anesthesia circuits (humidivent)
-t-connectors for IV's
-oral airways (especially 8mm/9mm)
-4.0ETT
-drug labels
-soda sorb (round canisters)
-suction filters
NO MORE (at this time)
-tongue depressors, LMA's, anesthesia circuits, masks, laryngoscope blades/handles,
-paralytics (sux, vec), beta blockers, atropine, zofran, toradol
There is only one H cylinder in the PACU and 6 beds to share it another split connector would be nice
-A new suction machine would be FANTASTIC and the more the merrier (need one for PACU, anesthesia and surgery share the suction)
BE CAREFUL ABOUT BRINGING YOUR PHARMACEUTICALS WITHOUT PROPER DOCUMENTATION -we were unable to retrieve our meds (vitamins, tylenol, ointments....) during our stay after they were confiscated in customs. Contact Joe, Shannon, Dan, Carrie, or Nichole for information.
If you can bring any schedule II or III drugs it would be great as we did send surgical patients home with them.
We had a great, albeit VERY busy and successful week! We will pray for the upcoming teams as well! God Bless!
We did approximately 75 surgical cases (primarily peds ENT) upon a semi-inventory of what we used, what will be needed, and what we had plently of is as follows:
Needs:
-5/10/20 ml syringes
-decadron, propofol, sevo (always need sevo), kids vitamins, junior tylenol, and claritin
-if you want to start IV's on the older kids emla cream, hurricane spray or ethyl chloride would speed the process
-dermabond
-peds pulse ox (the disposable are on their last leg)
-EKG pads
-filter for anesthesia circuits (humidivent)
-t-connectors for IV's
-oral airways (especially 8mm/9mm)
-4.0ETT
-drug labels
-soda sorb (round canisters)
-suction filters
NO MORE (at this time)
-tongue depressors, LMA's, anesthesia circuits, masks, laryngoscope blades/handles,
-paralytics (sux, vec), beta blockers, atropine, zofran, toradol
There is only one H cylinder in the PACU and 6 beds to share it another split connector would be nice
-A new suction machine would be FANTASTIC and the more the merrier (need one for PACU, anesthesia and surgery share the suction)
BE CAREFUL ABOUT BRINGING YOUR PHARMACEUTICALS WITHOUT PROPER DOCUMENTATION -we were unable to retrieve our meds (vitamins, tylenol, ointments....) during our stay after they were confiscated in customs. Contact Joe, Shannon, Dan, Carrie, or Nichole for information.
If you can bring any schedule II or III drugs it would be great as we did send surgical patients home with them.
We had a great, albeit VERY busy and successful week! We will pray for the upcoming teams as well! God Bless!
Friday, February 18, 2011
First Pres. Spartanburg 2/12-2/19
This week we saw many many patients in the clinic as well as with a barrio dental team. In surgery we did about 25 cases, including an amputation, lap gaulbladders, lypomas, hernias, etc. The surgery equipment was old, but working and all of the surgeries were very successful! Dr. Woolen, Dr. Jakub, Dr. Wheeler, and Dr. DeVore and surgical residents Dr. Stephen Phillips and Dr. Erica Clark all helped with these procedures.
Dr. Ridgell led the barrio dental team to four different locations throughout the week. Around 100 patients or more were seen each day and were treated for many different dental ailments. Alongside the dental team one day, volunteers helped in the construction of a church in San Juan. Although the construction made it very dusty and loud, it was very encouraging to see so much service inside one building!
Staying at the guesthouse was very very enjoyable for all on our team, Joe and Shannon made us feel right at home! Meals were delicious and the stay was very comfortable!
As a team, we all noted how fortunate we are all in our lives and how much God has blessed each of us This trip will be something that we remember forever!
Dr. Ridgell led the barrio dental team to four different locations throughout the week. Around 100 patients or more were seen each day and were treated for many different dental ailments. Alongside the dental team one day, volunteers helped in the construction of a church in San Juan. Although the construction made it very dusty and loud, it was very encouraging to see so much service inside one building!
Staying at the guesthouse was very very enjoyable for all on our team, Joe and Shannon made us feel right at home! Meals were delicious and the stay was very comfortable!
As a team, we all noted how fortunate we are all in our lives and how much God has blessed each of us This trip will be something that we remember forever!
Friday, February 11, 2011
Medications for groups to bring.
Just went through the med room with Nicole and Canario. We need Adult Ibuprofen, Adult Tylenol
Please bring Ca Channel Blockers. People here in the DR don't respond as well to Ace inhibitors.
Antibiotics sulfas quinalones, also can bring third generation cephalosporins
For gyne ... we don't have any oral contraceptives or any Provera for menorrhagia
we also have nothing for urge incontinence
For urology we have no meds for BPH
We need Children's vitamins and we need Iron
Could also use some triple antibiotic cream
Thanks so much for bringing this stuff down
Cora
Please bring Ca Channel Blockers. People here in the DR don't respond as well to Ace inhibitors.
Antibiotics sulfas quinalones, also can bring third generation cephalosporins
For gyne ... we don't have any oral contraceptives or any Provera for menorrhagia
we also have nothing for urge incontinence
For urology we have no meds for BPH
We need Children's vitamins and we need Iron
Could also use some triple antibiotic cream
Thanks so much for bringing this stuff down
Cora
Addendum to Yesterday's Post
Joe Clark thought of a couple additional notes to add to the anesthesia list posted yesterday
Need
-8.0/9.0 oral airways
Note
*Meds are refrigerated and in date
Need
-8.0/9.0 oral airways
Note
*Meds are refrigerated and in date
Thursday, February 10, 2011
Second Presbyterian- Roanoke, VA group February 5-12
For those mobile teams going out to the surrounding countryside (the Campos teams)
This week we saw approximately 400 patients- we handed out vitamins & albendizole to many other children that were there without a health complaint.
With the help of Juan Ernesto, the pastor on site that travels with us, and the other translators we have found an effective way to manage the crowds of children. It is hard to separate the children there that have complaints from the ones who are just showing up for candy or vitamins or albendizole treatment. It seems that some think that they have to have a separate complaint in order to receive the albendizole & vitamins. If you clear a different room (classroom etc.) and get them together and sing (heads shoulders knees & toes etc.) for a bit then do a mini-lesson on how to take the vitamins (once daily and they aren't candy), they will all take the vitamins & albendizole. This will prevent clogging the triage line, and assure that the ones who are truly sick or need to be seen by a doctor will be seen first because they stick around. Juan Ernesto is especially helpful with crowd control & separating out the kids who need to be seen first from the ones who need a check up if time allows after the ones in need of treatment are seen.
List for Campos mobile pharmacy
Do NOT need
cephalexin (500mg caps)
ibuprofen (200mg tabs)
acetaminophen (500mg tabs)
topical antifungal
topical steroids (prescription or 1%)
vaginal antifungal cream
DO need
childrens multivitamins (chewables better than gummies, they think gummies are candy)
infant liquid vitamins (WITH iron)
antifungal medication (griseofulvin)
antifungal shampoo
acne cream
3" ace wraps
bengay/ topical muscle rub
gloves, esp. large sizes
kit of wound care supplies (ie. burn kit in a tackle box)
kling wrap
medical tape
reconstitutable liquid antibiotics
albuterol MDI
skin moisterizers
If you need to contact anyone from the team for questions or further information you may contact Mary Chandler Pruette at marychandler1@gmail.com or 540-520-6255.
To Anesthesia providers:
Our team is completing a week in which we've done ~ 40 ortho, general, and gyn procedures. We've spent some time trying to inventory disposable supplies and have found a massive collection of certain items. It has really come to the point that continued accumulation will be detrimental.
-- very large supply of adult circuits. A few Mapleson D circuits, but no pedicatric circles
-- huge supply of needles and syringes with the exception of 20cc
-- huge accumulation of LMA's: 5/4/3/2/1.5/1. (the local anesthetists apparently use them very infrequently). Adequate supply of ET tubes
-- each room has a good set of laryngoscopes and blades
-- Sevo is in short supply but can be purchased down here
-- soda lime is always needed
-- bring IV tubing, especially mini-drips for kids. Although there are large numbers of IV catheters, we brought down our particular favorites and made use of 24 gauge.
-- the machines are in good shape,each with a new monitor and a good selection of BP cuffs. The third Drager machine is being evaluated by a local technician
-- huge collection of Propofol, Anectine, and Rocuronium. Adequate supply of Toradol, Zofran, Decadron, Robinul, Neostigmine, etc. Might want to bring and local anesthetics you would want to use for blocks
In short, DON'T bring Propofol, Anectine, Zemuron, LMA's, syringes except 20's, circuits. Bring Soda Lime, Sevo, Local anesthetics, IV tubing.
Give me or Judy Gustafson a call or email: jsjkc@msn.com jgustafson58@gmail.com
Nicole Eby on site is a tremendous resource and knows where all the anesthesia equipment is located.
Joe Clark
This week we saw approximately 400 patients- we handed out vitamins & albendizole to many other children that were there without a health complaint.
With the help of Juan Ernesto, the pastor on site that travels with us, and the other translators we have found an effective way to manage the crowds of children. It is hard to separate the children there that have complaints from the ones who are just showing up for candy or vitamins or albendizole treatment. It seems that some think that they have to have a separate complaint in order to receive the albendizole & vitamins. If you clear a different room (classroom etc.) and get them together and sing (heads shoulders knees & toes etc.) for a bit then do a mini-lesson on how to take the vitamins (once daily and they aren't candy), they will all take the vitamins & albendizole. This will prevent clogging the triage line, and assure that the ones who are truly sick or need to be seen by a doctor will be seen first because they stick around. Juan Ernesto is especially helpful with crowd control & separating out the kids who need to be seen first from the ones who need a check up if time allows after the ones in need of treatment are seen.
List for Campos mobile pharmacy
Do NOT need
cephalexin (500mg caps)
ibuprofen (200mg tabs)
acetaminophen (500mg tabs)
topical antifungal
topical steroids (prescription or 1%)
vaginal antifungal cream
DO need
childrens multivitamins (chewables better than gummies, they think gummies are candy)
infant liquid vitamins (WITH iron)
antifungal medication (griseofulvin)
antifungal shampoo
acne cream
3" ace wraps
bengay/ topical muscle rub
gloves, esp. large sizes
kit of wound care supplies (ie. burn kit in a tackle box)
kling wrap
medical tape
reconstitutable liquid antibiotics
albuterol MDI
skin moisterizers
If you need to contact anyone from the team for questions or further information you may contact Mary Chandler Pruette at marychandler1@gmail.com or 540-520-6255.
To Anesthesia providers:
Our team is completing a week in which we've done ~ 40 ortho, general, and gyn procedures. We've spent some time trying to inventory disposable supplies and have found a massive collection of certain items. It has really come to the point that continued accumulation will be detrimental.
-- very large supply of adult circuits. A few Mapleson D circuits, but no pedicatric circles
-- huge supply of needles and syringes with the exception of 20cc
-- huge accumulation of LMA's: 5/4/3/2/1.5/1. (the local anesthetists apparently use them very infrequently). Adequate supply of ET tubes
-- each room has a good set of laryngoscopes and blades
-- Sevo is in short supply but can be purchased down here
-- soda lime is always needed
-- bring IV tubing, especially mini-drips for kids. Although there are large numbers of IV catheters, we brought down our particular favorites and made use of 24 gauge.
-- the machines are in good shape,each with a new monitor and a good selection of BP cuffs. The third Drager machine is being evaluated by a local technician
-- huge collection of Propofol, Anectine, and Rocuronium. Adequate supply of Toradol, Zofran, Decadron, Robinul, Neostigmine, etc. Might want to bring and local anesthetics you would want to use for blocks
In short, DON'T bring Propofol, Anectine, Zemuron, LMA's, syringes except 20's, circuits. Bring Soda Lime, Sevo, Local anesthetics, IV tubing.
Give me or Judy Gustafson a call or email: jsjkc@msn.com jgustafson58@gmail.com
Nicole Eby on site is a tremendous resource and knows where all the anesthesia equipment is located.
Joe Clark
Monday, February 7, 2011
NEEDED
After finishing up some consults this morning, it was determined that we are in need of a wheelchair for a 17 year old patient. The suggestion is for a pediatric reclinable wheelchair 18 inches width with pneumatic tires and anti-tip with offset wheels. Any takers? Hey future teams- let us know if you can help us with this patient!
Thanks so much-it's neat to see how God is working through the teams this week!
nik
Thanks so much-it's neat to see how God is working through the teams this week!
nik
Friday, February 4, 2011
Supplies for the Clinic
Just did some updating in the med room. Thanks for the posts from the Northwoods team.
We don't need any Marcaine or Lidocaine.. we have lots.
Of course we always need pediatric Tylenol, Motrin, childrens vitamins, triple antibiotic cream,
in addition to those things already mentioned. I also did not see a lot of Albendazole or Mebendazole
Thanks Cora
We don't need any Marcaine or Lidocaine.. we have lots.
Of course we always need pediatric Tylenol, Motrin, childrens vitamins, triple antibiotic cream,
in addition to those things already mentioned. I also did not see a lot of Albendazole or Mebendazole
Thanks Cora
Thursday, February 3, 2011
Update from the Barrio Clinics 1/31/2011-2/3/2011
We had a great week in the Barrio clinics. We saw 366 patients, in addition to another 200 children or so that were briefly seen and given parasite treatment with Albendazole. Our team included folks from Northwoods in Peoria, as well as Ingrid Watkins, MD from Rochester, NY, Victor Perdomo, the Dominican doctor, and a great team of translators organized by Juan Ernesto. We tried to determine when we arrived at each of the campo (countryside) sites who the sickest patients were such that we could be sure to see them, as MANY people wanted to be seen every day for gripe (URI) and dolor (pain) and we really wanted to make sure the sickest were all seen. We did multiple joint injections, drained a HUGE breast abscess, and did some other small procedures in the clinics, as well as rx'ing many meds for hypertension, pain, URIs, headaches, etc.
Starting on Tuesday I asked Juan Ernesto to ask the people in the pueblo if there were ill patients that could not make it to the schools (where we set up the clinic daily) and 2 days a few of us accompanied a person from the pueblo who brought us to older, more frail patients' homes and sometimes to the homes of quite ill people. One day on a home visit, I encountered a 72 yo man who had had an AKA 12 days prior, who had a large wound dehiscence and infection, and we brought him back to San Juan with us on the bus and the surgeon who was with us (my husband) revised his AKA. 2 days later we brought him back to his home in the pueblo and he was feeling much better and seemed quite a bit stronger. Dr.. Perdomo is going to be checking on him weekly. The patient and his family were very grateful for our care.
Each night we packed up the pharmacy box for the next day, which took some time, but was well worth it to have everything organized for the next AM. There are meds/supplies that are needed for the barrio clinics, which include:
Lisinopril
yeast vaginitis treatment
Children's Vitamins (MANY MANY ARE NEEDED)
Lotrisone cream
Phenergan (po and/or supp)
Amolidipine
Terazosin or Doxazosin (we saw many men with BPH sxs and had no meds for BPH)
Kenalog or Depo Medrol for joint injections
Lidocaine or Marcane for joint injections and for local anesthesia for abscess drainage, etc.
syringes for joint injections
gauze (4x4s or larger)
paper tape and bandage tape
disposable scalpels
ear curettes and Debrox
BRING and otoscope and opthalmoscope if possible
Things that are NOT needed currently:
bandaids
expensive samples of BP meds
expensive samples of any meds
Nicole, the RN who is here from Dec 2010-April 2011 is very knowledgable about what is and is not needed, and she can be contacted through the guest house. She is great and very helpful.
It is a fascinating and very rewarding experience! I can't wait to come back again next year. Feel free to contact me via email or phone with any questions.
And THANK YOU to all the wonderful people with whom I got to spend this week. It was such a privilege and a pleasure to work with and get to know all of you. Lastly, I'd like to thank Shannon and Joe and all the others who were on this trip for putting up with our sons (who are 5 and 9) and my niece (13) who acted as our nanny for the week. We could not have come down to the D.R. without bringing our kids and this was such a wonderful experience for them as well. You are all such loving, amazing people. And a very special thanks to Steve Shaffer from Northwoods, and to Sandy Nofziger for their help in setting us up to join the Northwoods group this week. We hope to come down next year with your group again!
Ingrid Watkins
Rochester, NY
ingrid_watkins@urmc.rochester.edu
(585) 709-9176
Starting on Tuesday I asked Juan Ernesto to ask the people in the pueblo if there were ill patients that could not make it to the schools (where we set up the clinic daily) and 2 days a few of us accompanied a person from the pueblo who brought us to older, more frail patients' homes and sometimes to the homes of quite ill people. One day on a home visit, I encountered a 72 yo man who had had an AKA 12 days prior, who had a large wound dehiscence and infection, and we brought him back to San Juan with us on the bus and the surgeon who was with us (my husband) revised his AKA. 2 days later we brought him back to his home in the pueblo and he was feeling much better and seemed quite a bit stronger. Dr.. Perdomo is going to be checking on him weekly. The patient and his family were very grateful for our care.
Each night we packed up the pharmacy box for the next day, which took some time, but was well worth it to have everything organized for the next AM. There are meds/supplies that are needed for the barrio clinics, which include:
Lisinopril
yeast vaginitis treatment
Children's Vitamins (MANY MANY ARE NEEDED)
Lotrisone cream
Phenergan (po and/or supp)
Amolidipine
Terazosin or Doxazosin (we saw many men with BPH sxs and had no meds for BPH)
Kenalog or Depo Medrol for joint injections
Lidocaine or Marcane for joint injections and for local anesthesia for abscess drainage, etc.
syringes for joint injections
gauze (4x4s or larger)
paper tape and bandage tape
disposable scalpels
ear curettes and Debrox
BRING and otoscope and opthalmoscope if possible
Things that are NOT needed currently:
bandaids
expensive samples of BP meds
expensive samples of any meds
Nicole, the RN who is here from Dec 2010-April 2011 is very knowledgable about what is and is not needed, and she can be contacted through the guest house. She is great and very helpful.
It is a fascinating and very rewarding experience! I can't wait to come back again next year. Feel free to contact me via email or phone with any questions.
And THANK YOU to all the wonderful people with whom I got to spend this week. It was such a privilege and a pleasure to work with and get to know all of you. Lastly, I'd like to thank Shannon and Joe and all the others who were on this trip for putting up with our sons (who are 5 and 9) and my niece (13) who acted as our nanny for the week. We could not have come down to the D.R. without bringing our kids and this was such a wonderful experience for them as well. You are all such loving, amazing people. And a very special thanks to Steve Shaffer from Northwoods, and to Sandy Nofziger for their help in setting us up to join the Northwoods group this week. We hope to come down next year with your group again!
Ingrid Watkins
Rochester, NY
ingrid_watkins@urmc.rochester.edu
(585) 709-9176
Hola from San Juan de la Manguana- what's up in the OR
Operating Room update for the week of 1/31-2/3....Brian Watkins, MD, MS, general and laparoscopic surgeon here from Rochester, NY with Ed Bosch, CRNA from Mobile, AL. We had a great week in the operating room! Busy and productive. I did not bring staff with me from NY and the RNs and staff that came from Peoria were great and helpful. We did 16 cases including a lot of hernias and hydroceles (adult and infant), a tonsillar bleed, lumps and bumps, thyroid lobectomy, revision of an AKA, and a lap chole.
There are many supplies here, and we tried to organize them as they were somewhat disorganized at the start. Helping to continue the organizational efforts would be greatly appreciated. Nicole, visiting RN (here until April) is helpful, awesome and willing to do whatever it takes to make things work. As for laparoscopy, they have plenty of trocars and some working instruments. The limiting factor will be the availability of CO2. I had to use parts of 2 towers but had a picture almost as good as in the U.S. There are plenty of bovies, bovie tips of all sorts, TONS of suture of all varieties. The instruments are adequate but if there is a specific instrument you MUST have, bring it. The lighting is poor. I would recommend bringing a headlight if you think you will need it. There is mesh of all varieties, both standard hernia mesh as well as composite mesh. As there are many children I would recommend bringing loupes if you have them.
There is an 11 month old with possible anal stenosis and small anal dilators would be helpful. There is a 77 yo gentleman who I saw and is coming back next week for a L inguinal hernia and it may be recurrent. He was getting labs and an ECG today (2/3). In addition there is a 75 yo with thyromegaly but he is entirely asymptomatic and he is euthyroid. I didn't think he needed surgery. As of now, these are the only remaining general surgery cases. As I got through the entire list and some emergencies as well this week.
This was my first experience operating outside of the U.S., it reminded me of the reasons for which I went into surgery. The patients are gracious and thankful, the hard part is sending them back to less than ideal situations in the post-op period and not seeing them in follow up.
Feel free to contact me with any questions via email or phone: watty1@rochester.rr.com (585) 831-7656
Brian Watkins
There are many supplies here, and we tried to organize them as they were somewhat disorganized at the start. Helping to continue the organizational efforts would be greatly appreciated. Nicole, visiting RN (here until April) is helpful, awesome and willing to do whatever it takes to make things work. As for laparoscopy, they have plenty of trocars and some working instruments. The limiting factor will be the availability of CO2. I had to use parts of 2 towers but had a picture almost as good as in the U.S. There are plenty of bovies, bovie tips of all sorts, TONS of suture of all varieties. The instruments are adequate but if there is a specific instrument you MUST have, bring it. The lighting is poor. I would recommend bringing a headlight if you think you will need it. There is mesh of all varieties, both standard hernia mesh as well as composite mesh. As there are many children I would recommend bringing loupes if you have them.
There is an 11 month old with possible anal stenosis and small anal dilators would be helpful. There is a 77 yo gentleman who I saw and is coming back next week for a L inguinal hernia and it may be recurrent. He was getting labs and an ECG today (2/3). In addition there is a 75 yo with thyromegaly but he is entirely asymptomatic and he is euthyroid. I didn't think he needed surgery. As of now, these are the only remaining general surgery cases. As I got through the entire list and some emergencies as well this week.
This was my first experience operating outside of the U.S., it reminded me of the reasons for which I went into surgery. The patients are gracious and thankful, the hard part is sending them back to less than ideal situations in the post-op period and not seeing them in follow up.
Feel free to contact me with any questions via email or phone: watty1@rochester.rr.com (585) 831-7656
Brian Watkins
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