“One Day In The Life”… of the adult patients and their caregivers

Here's a photo from the roof of the Radisson Hotel!  According to Quitenos, a clear view of the Volcan Cotopaxi is a sign of good luck for the day!  The volcano was very very clear for the last few days of the CAMTA project!

Canna Lilies are common throughout the city of Quito.  Every park has great stands of these tropical plants.  Wish we could grow them in Edmonton in lush stands like this one!  But what about our patients….
Here's Leticia waiting for her surgery on her left hip in our pre-op holding area.

Leticia was seen preoperatively by Dr Gayle Heibert.  Gayle has participated in the project for three years.  The family doctors assess the patients pre-operatively and then care for them afterwards on the floor.  The care they give is similar to what happens here in Edmonton.  We have physician hospitalists who optimize the medical management of the patients.

Here's an x-ray showing osteoarthritis of the hip.  This is painful!  When bone rubs on bone instead of cartilage on cartilage there is inflammation, pain and limited movement.  If you need to work it is tough!

Here's Dr. Paul Moreau reviewing x-rays and the prosthesis inventory before the surgery.

Now compare the two photos!  The one below is from early in our first week of surgery.  The prosthesis storage room was filled in the shot below of Dr. Ed Masson.  But the photo above shows Paul Moreau is choosing from a limited supply as the two week project concludes!

First things first!  The patient needs a spinal anesthetic before she can have surgery.  Here's Dr. Saifee Rashiq performing a spinal.  Nurse Cori Kalven is supporting the patient and that's Glenn Day in the background.  Medical student Mike Metcalfe was up to lots during the second week.  He scrubbed and assisted with surgery as well as helping mobilize patients upstairs and learning about anesthesia.

There are many pans of instruments to prepare for surgery.  Here Nurse Robyn Staffen is “ready to go” with everything that Drs. Paul Moreau and Ron Henderson need to complete a total hip arthroplasty. 

And now the surgery is underway.  That's Paul on the left and Ron on the right. Saifee is in the background and Robyn is in the foreground.

RN Heather Perl is preparing a prosthesis.  She's attached it to the implantation device, ready for insertion into the prepared femur (lower bone) of the hip.

Meanwhile, translator and student Adam Petriw drops in for a picture.  He`s down here in Ecuador for his second experience.  Adam worked very hard on the floor helping to mobilize whilst translating.

After the spinal anesthetic, the patients rest comfortably with mild sedation while the surgery continues.  At home the patients WORRY about whether they will hear noises!  In Ecuador they are simply overjoyed to be receiving a new hip.

With the surgery complete there are many, many pans of instruments to be thoroughly soaked, scrubbed, dried and wrapped before re-sterilization for the next case.  Here are Geoffrey Moreau and Betty MacRae doing their duty!  These two were tireless workers.  They work under the direction of the RN`s and they meet all the standards for surgical instrument processing that we use in Edmonton.  The steam autoclave at the Tierra Nueva is an excellent Italian model.

The reward after surgery is up on the second floor where the patients recover.  They learn to walk with crutches.  They are so very grateful!  Here`s Drs. Paul, Saifee and Ron with a very happy Clarita!ASDF

Where would we be without local staff!  Here`s Lca. Hilda.  She kept our surgical suite organized, tidy and full of supplies!  Hilda truly understands what we are doing.  She works with 8 or 9 surgical brigades each year.

After the last case on Friday afternoon the staff of the surgical operating room poised for pictures.L-R:  Cori, Robyn, Paul, Scott Wiens, Ron, Heather, Saifee and Barb.I`m not sure if Scott was identified in another photo.  He`s an R4 resident in orthopedics at the University of Alberta.

Back on the floor we watch the SHORTEST hip patient that either Ron or Paul have ever operated on ambulate with her crutches.  Lorena is about 4 feet 8 inches, I think.L to R:  Deb Chalupa, Linda Ushkowski, Ron Henderson, Robyn Goplen.

Here`s another Tierra Nueva nurse.  Blanchita was invaluable.  When we needed blood we got the blood fast.  Every patient has two units available upstairs in the blood fridge.

Here`s a nice shot of Mike and Cori.  Both week one and week two had very compatible teams.

Dr. Orlando observed and scrubbed in several times this week.  He`s a Tierra Nueva Traumatologo!  That actually means Orthopod!

To close I thought I would show you a beautiful view of the hills of Quito.  It is such a beautiful city.  Verdant green interspersed with communities of pastel buildings.  The city is dominated by the Volcan Pichincha which is apparent from everywhere in the city.  If you lose direction:  just look for Pichincha to get your bearings.
And that concludes CAMTA Mission 2009.  We`ll blog some statistics soon about our patient volumes.  But let me know what you think!!!!Comments_for_John@shaw.ca