Friday, December 20, 2013

Surgery Team & Miriam Center

In October I had the privilege of working alongside the orthopedic surgery team. Dr. Dell is a wonderful orthopedic surgeon who volunteers every October on the surgery team and performs life changing surgeries. I had ~15 children/adults between the Miriam Home and FJS Outreach Program evaluated for surgery. Dr. Dell was so patient answering all my questions and the parents questions. 9 of them received surgery over the week. The surgeries I observed Dr. Dell explained what he was doing as he worked which was so educational for me. It was a very exciting/busy week. These surgeries have the potential of bringing life change for these children and their families. The ability to stand better & walk with less assistance for others the ability to walk! What freedom this brings.

I had the wonderful opportunity to walk alongside my outreach families through this week. I was able to be there for pre-op and post-op supporting them, praying for them, loving on them and growing in relationship with them. I also had the privilege of watching 3 of their surgeries.

HELPING WITH SURGERIES
Ever since I started going to Haiti I have wanted to be there for a surgery team and observe/help. Unfortunately at the end of May I was sick when the surgery team was in Haiti and unable to participate. I was very excited to be healthy and able to observe some surgeries this past October. It was even more interesting as the surgeries I watched were some of my children and Dr. Dell explained the surgeries to me as he performed them.





WILDENS
Wilden's was the first to have surgery. His mother adores him and is so good with him.  He was evaluated a year ago but was to little for surgery. The doctor informed mom last year that he did not have knee caps & down the road as he got bigger would require surgery to bend the knees so he could sit in a chair. It was unlikely he would ever walk. This year when Wilden's was seen by the doctor he was diagnosed with Arthrogryposis and the doctor believes both hips may be dislocated (will get x-rays before next October to confirm) but does have knee caps. They are just rotated and on the inside of his knees instead of front. The doctor performed double foot surgery. Wilden's surgery went smoothly. He had a few minor breathing issues with Asthma for the few days following but has been recovering well. His mother did not leave his side the entire 3 days he was in recovery. He just got his first set of casts off 3 weeks ago and his pins removed. He is now in short legged casts for  6 more weeks but is able to start working on standing again. 



THAMERA
Thamera is one of the Miriam Home Children. She had major bilateral leg surgery performed that will allow her the ability to walk after LOTS of INTENSIVE therapy. She had  1 major club foot repair, bilateral tendon releases at the knees and 1 tendon release at her hip. Her surgery went smoothly & she was placed in bilateral casts up to her hips. She has a little bit of rough time coming out of anesthesia and until they got the pain controlled but she was surrounded by so many staff who loved her. Part of her agitation was being in a new place. The same day after surgery we moved her back to the Miriam Center where she quickly calmed down as she knew she was home. We had 1 Miriam Center Momma "Vernicia" stay with her everyday for the first 7 weeks after surgery. She had a few complications with infection & skin breakdown but we are blessed with an amazing set of nurses & doctor who took great care of her. Days after surgery we started working on standing and walking with a walker. She was not a fan of either but it is very important to a full-recovery and gaining skills. We were blessed with receiving an adult size stander which has been great for working on standing with Thamera. Thamera is so strong that it takes 2-3 people to work on standing outside the stander. She is currently not very motivated to work on standing and/or walking but with lots of encouragement and help she is daily regaining strength in her legs, building muscle and able to stand longer. She will be my special project over the next few months doing intensive therapy with her. 






Den-Den
Den-Den is another Miriam Home Child. He had a very minor surgery to have a cyst removed from behind his ear. He actually reminded me the day of surgery evaluations that he needed to go see the doctor to look at his cyst. He has grown into being such a pleasant young man. His surgery was performed first thing in the morning and by lunch time he was out playing soccer. He made sure to come back to surgery in the afternoon and check on his sister Thamera. 


Wikenson
Wikenson is in my outreach program. Prior to surgery he was able to walk holding onto furniture but in a crouched position. He had just started school across the street at the mission school and everyday walked in with a HUGE smile announcing He was going to school! Wilkenson had bilateral tendon releases that will enable him stand and walk upright and once he gains balance without holding on to anything :-) His surgery went smoothly but he had a rough time coming out of Anesthesia. Once his pain was controlled all he wanted was to go home. The next week we started therapy. His family did not have time to do therapy at home and so Wikenson came 3x a week for stretching and to practice walking. By the end of his 6 weeks in casts he was walking all over in his casts not holding on. He was beyond happy to get his casts off and even more excited to receive new shoes & braces. He is a such a FUN kid to work with and his smile just melts your heart.

Waiting to go in for surgery
Snoozing right after coming out of surgery
His cute little casts
He was not too happy about stretching....
Showing off his awsome walking independently not holding on....
Working on standing with Erin during outreach

Les Katie
Les Katie is one of my outreach girls. She has the best smile, giggle, and snort. She has been coming to outreach for 2-3 years. Her dad usually brings her but occasionally mom does. I love watching her family love on her. What really melts my heart is watching dad get on the floor and play with her to encourage her to participate in therapy. Les Katie has been working on standing while holding onto something above her head and help straightening her legs. She had bilateral tendon releases to increase her ability to independently straighten her legs to stand up. The last picture at the bottum shows her independently standing holding on to the gate this was taken the day she got her casts off. Her surgery sent smoothly and she was placed in bilateral casts up to her thighs for 6 weeks. When her casts came off she was placed into bilateral AFO's.


Waiting with Mom morning of Surgery
Waiting with Dad for surgery


Just Chillin after surgery
Look who is standing right after getting casts off :-)

KATIANA
Katiana started coming to outreach about a year ago. The only problem she has in a club foot. She is able to walk with hands held but her foot turned sideways and made it awkward and hard to walk. Her surgery went smoothly and was a success. She recently got her long cast off and pins out of her foot and now has a short leg cast on for another 6 weeks. She is able to start working on standing and walking now.





NERLANDE
Nerlande started coming to outreach a little over a year ago. She comes all the way from PdP. She has a smile that just lights up a room. She is always happy and smiling. I have rarely seen her without a smile on her face. Prior to surgery she was able to walk with both hands held and had learned to use a walker to walk. She walked crouched low to the ground as her muscles prevented her from standing all the way up. She just started her first year of school in a regular school near her home. She had bilateral tendon releases to allow her stand straighter and walk better. Her surgery went smoothly. A week after surgery she was already independently standing and walking around with her casts up to her hips. She is one of the most determined little girls I know. She actually walked so much she wore the bottoms right out of her casts. We had to remove her cast and recast. This led to a few other problems that results in me making her a leg splint to hold her leg in the appropriate position secondary to skin breakdown and not being able to recast. I have definitely learned to tap into my creative side in Haiti. She is in short leg casts currently till I return to Haiti with AFO's and shoes that fit her. Mom was so concerned when she was placed in short leg casts as she went from being able to walk to not. I had to explain to mom that her legs were supported by the high casts before and being in them for 6 weeks her muscles deteriorated and with practice she will be able to restrengthen those muscles and will walk. 

Waiting to go in for surgery
The Doctor took extra time to make bows for her casts

Practicing standing in front of the ball
Standing during prayer at the end of outreach

The Makeshift cast I made that could be removed for wound care


I had the privilege of helping remove the kids casts, pull out their pins and recast the ones that needed recast. It was very hard to leave at the beginning of December just as many of the casts came off and the ones in short casts got the clear to begin weight-bearing and doing therapy. Just when I am most needed and it is time for me to leave. I kept thinking...man I did not plan this well. BUT I am so blessed to have an amazing therapy team Presidue and Nicholson who I was able to go through some PT resource books that had wonderful pictures in them and train them on specific treatment plans for each child with pictures of exercises. I am also so thankful for facebook and voxer which allows Presidue and Nicholson to Message me with any questions or concerns they have.

The children still have a long ways to go with therapy but the updates I have received from Haiti have been overall good that the children are regaining strength and skills. That follow through is beginning to happen at home with some of the families and that overall the surgeries have been a success. 


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