By Jean Bedell
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There are not only objective criteria involved in whom we treat. There are also subjective and ethical considerations. As of this morning, eyes had only 10 slots open for Friday. Within a short time, there were only 6 slots left. Yesterday, 297 patients were screened in the one day. Considerations when triaging patients include 1) bilateral cataracts, 2) age, with a focus on mothers caring for young children or young men working to support a family and 3) diabetic complications. For example, 50yo Hector is a tractor driver and is blind. Will cataract surgery allow him to return to work, or is there retinal damage which, because of diabetes, will not provide vision even with surgery? Andres, 43yo was given one of the last slots so he can return to work selling papers and sweeping streets.
The indirect retinoscope can’t be used. The week started well, but power surges burned out each of the bulbs needed. What a loss for effective diagnosing.
A huge THANKS to BAUSCH AND LOMB for donating essential equipment. It was back-ordered, and the company even went to other reps to collect supplies. When an incision is made to remove a cataract and insert a lens, this viscous material maintains the pressure and keeps the capsule open.
And, on a different level, thanks go to Yolanda, housekeeper in the clinic for the past 8 years. . She has adopted Brusiella, the green parakeet found yesterday. No paperwork was involved except for the paper on the floor of her new cage.
PT has now ‘seen everything.’ A man with Parkinson’s came for help. A 32 yo man is a complete quadriplegic from a car accident. He came by ambulance hoping there might be some new surgical procedure. With excellent care from his wife, his skin was perfect. The only help was to reinforce the exercises for tenodesis (tendon contracture). When he pulls up his wrist, the hand automatically forms a grip position to help grab and lift items.
“Con todo respecto…” the note began. It continued asking for Laurel to consider developing a relationship with the man in the red shirt. Her cheeks were the color of his shirt. Also, she taught an excellent class in Drug Toxicity to student nurses. They were totally attentive…then asked questions including her age (thinking she was 15) and admiring that a woman can aspire to be a pharmacist.
Almost all of the beds in PACU were occupied after a full day’s surgery yesterday and a very efficient morning. Four yo Yatziri cut her hand when she was very young causing two of her fingers to permanently curve. Dr. Michael reattached tendons in her hand and she can now straighten her fingers without pain. Rodrigo, a 14 yo boy who recently lost his father in a car accident in Houston and returned to live with his grandmother in Mante, came to the hospital to receive reconstructive surgery. A bone graft from is iliac crest was taken to fix his maxilla. Also from PACU, Hipolito a 8 yo boy recovering from a tonsillectomy particularly appreciated the attention from the blond haired nurses.
Three years ago Jose and his father came to the mission to have their hernias repaired. This year he wanted to give back and is one of the much valued translators at the mission.
NB: Fiesta Friday…invitations delivered Thursday….dress fancy…come and have fun…..with Abby and Jean