Saturday, March 23, 2013

Delia and Daisy

These ladies are Delia and Daisy.

Delia was hit by a car 13 years ago. She is about 34 years old. Her left leg was severely broken in the accident. For the last 12+ yrs Delia was in an external fixator.

For those non-medical people, a fixator is a cage used for complicated fractures when a cast or screws and plates won't do.

While fixators are great and work wonders for many people, the patients are prone to infection. AND 10 yrs is just a touch long for someone to be such an apparatus; nursing along a non-functional leg.

9mos. ago Delia's bone became infected with osteomyelitis and her leg needed to be amputated.

She is walking for the 1st time in 13yrs.
Funny, not knowing the ramifications of not walking for 13 yrs; weakness, atrophy, instability...she made a comment shortly after being fit. "Why do limp?". ;-).

She'll come around, I have no doubt.

Daisy is 52 years old. She was struck by a car 2 yrs ago. She could not help it. She was saving her son, preventing him from being struck by the car.

Daisy's right leg was amputated above the knee. Her residual limb required many large skin grafts to be preserved, yet still had severe scarring and was told by local healthcare workers that she could not be fit with a prosthesis.

She walked into the airport today, pretty darn well.

I am not sure who was happier, these ladies or the people that had the privilege to help them.

Pablo
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Fw: A crazy thing happened

I don't quite know how to begin the ending of this blog, but the story below is a good start. It details Lena, and Kate the Nurses leaving the airport with Esther and her fiance, Caesar after seeing us off.
PDA

----- Original Message -----
From: Lena [mailto:lenafotiadis@gmail.com]
Sent: Saturday, March 23, 2013 12:20 PM
To: Paul Armstrong
Subject: A crazy thing happened

The four of us- Kate, Caesar, Esther and I were trying to hail a cab to bring us back to their apartment from the airport. But with two full packs on our backs no one would take us for less than 40 soles- the tourist price.

We about decided that we wouldn't find anything inside the airport parking lot when out of nowhere appeared a man wearing a hangar shirt! And he wanted to give us a ride!

I don't remember his name but he was one of the last ones on this years' list? he was supposed to get a new leg next year and you guys made time for him this year instead.

He drove three hours to come to the airport and halfway there his car broke down. He got it to start and kept going only to be stopped at the parking gates at the airport because his paperwork expired (WEIRD) but when he told them he had to see his friends because they made this new leg for him the guards said, "WOW, does it move?!" And he said "yes" and they let him through.

He missed the pictures and he didn't get to see you and Al in person but I don't think it was just a coincidence that he kept on coming after his car broke down. And not even a coincidence that we found him in the parking lot in a moment of need.

I think someone above is telling us we did a great job!

Have a safe flight!

Lena :)

Ps he says thank you for his new life
Pps thanks for being such a patient teacher. You da bomb



Sent from my iPhone

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It's not over yet.  37 limbs fit with new prostheses.  41+ patients seen.  But the story does not end there.

Please stay tuned.

Buenos noches
Pablo

Thursday, March 21, 2013

So....I assume you noticed the lack of pictures, today.  I am so sorry.  There was no time. Did I tell you that the boxes arrived?  ;-)   Yes, there were many memorable and touching moments, but too many others were patiently waiting to be seen.  We do not currently have an accurate count, but approximately 35 legs, sockets and arm, later....And the day was over.  We left the hotel at 6:30AM and returned at 9:30pm.

Our crew was outstanding.  Every individual tested the meaning of yeoman, pushing on tirelessly.

Tomorrow, hopefully our efforts will prove out as we fit and align our patients and they get some introductory fit and gait training.

Hasta manana
Pablo

Wednesday, March 20, 2013


Boxes, Boxes, Boxes

Boxes! Ain't nobody got time fo'dat!!

Cesar, Loves boxes too

Esteban molding Yuli, Muy Bueno


Hector, Kids are kids


Hectors Shoes


It is too late and too tired to make a long story.  Al, Mani and Dr. Mary played the "get the boxes" game, while the made the best use of our time seeing the patients that we could actually get things done for.

In the end, the boxes arrived around 6pm.  We fit everyone with their liners.  Taught a couple group classes on liner use.

We fit 1 patient with part of his prosthesis in order to 1) asses his fit, but 2) to train Abby, Steve and Taber on our protocol and come up with a game plan for tomorrow.

It's go time.  We are more than ready.

Buenos noches
Pablo

Tuesday, March 19, 2013

My friends, I am having trouble with that last post.  Perhaps I rambled on too long.  The pictures of Hector tell this story all by themselves.  He is perfect the way he his.

Buenos noches
Pablo
Ummmmm......the boxes have not arrived.  Dr. Wakefield refers to Peru as the land of Manana.  People are never in a rush.  No one ever seems let down or disappointed.  They simply pray for the best.  There is no actual reasonable explanation, from the stories I am told.  We simply needed longer; needed the boxes here earlier so that we could accommodate all of the new rules that apparently no one knew. 

Al, Mani and Dr. Mary left early this morning to go try to see what wonders they could work, trying to resolve the customs issue.  Clearly, it was to no avail.  Apparently, Peru has been recieving so many donations for non-profits that they needed to change some of their intake requirements.  As many of you know, dissemination of these kinds of materials and information is many times less than efficient.

The rest of us travelled to the hospital with the intent to make the best of it. Steve and Taber set straight to work making pads for some of our BK (patients people missing their legs below the knee)

I was very excited when Roberto Carpio returned to our clinic.  We had fit Roberto with an arm prosthesis last year.  At the time Roberto did not feel he wanted a leg prosthesis, nor did we have the extra supplies to attempt it with him.  Roberto is missing his right arm below the elbow and above the knee on the same side.  until we fit him with an arm prosthesis, Roberto had to squeeze a crutch into his armpit in order to ambulate.  The prosthesis and Roberto's limb both seemed in excellent condition.  We did a few maintenance adjustments to his prosthesis and further assessed his leg for a prothesis.

Using one prosthesis is tough enough.  Making successful use of one and taking on another is quite a challenge, and I welcome and am excited to help Roberto take it on.  I honestly feel that he could easily get down to 1 crutch with ease....we'll see. ;-)

After Roberto, we did a follow up with Rosa.  I had mentioned Rosa earlier in the blog.

  We fit her last year and she has done really really well.  Today, Rosa prepared lunch for our team.  The best Ceviche I have had was part of this lunch. Muy deliciosos!!!

After lunch and Al, Mani and Mary's sad return we evaluated a few new patients and called it a day.  2 patients stood out as remarkable...but I have a hard time calling them patients, for in the end we really felt that we could do no better for them than they were already doing.

The 1st patient, Juan, was missing both arms above the elbow as well as his Right leg above the knee from the explosion of a land mine..  You can see him with Al in the picture.  His prosthesis was made many years ago.  There is no knee joint.  It does not bend.  Juan spends a lot of time standing.  He walks and moves remarkably well.  

Having no arms, Juan's wife puts his prosthesis on every day.  After that, Juan is nearly independent.  Anything Al or I would try to do for Juan at this point would feel like a hinderance.   We took some picture and notes of his upper extremities, trying to make a plan for what we might be able to plan for Juan for next year.  My greatest hope is that we can provide him ONE arm prosthesis that he finds beneficial.

In a remarkable way, Juan does not find his amputations to be a disability.  Through the translator Juan commented that he is grateful the the Lord spared him.  In his own way, Juan was commenting that The Lord must not be done with him yet.  He felt that there was much work to be down...and further that his amputations were going to help and enable him to be even more successful.

In the end we took some pictures and measurements so that we could plan and prepare for seeing Roberto next year; hoping at a minimum to fit Juan with at least one arm prosthesis.

The next fellow was Hector.  A delightful 6 yr old boy that was born without arms.  There is nothing we can do for Hector.  He will most likely never be our patient.  There is nothing the we could provide Hector that would make everything seem alright.  Hector, like many kids his age, like to play soccer.

Mis amigo, my head s really dropping.  I'll nee to finish this 

Monday, March 18, 2013

Tres

Today, was a bit of a mixed bag.  We gained, but how far we moved forward remains to be seen.  The photos already loaded tell the brief story, but from a purely prosthetic standpoint, the boxes that we shipped to Peru; that arrived over a week ago; are still suck in customs.  The story is far from clear, but the boxes we shipped down are here in Lima.  They are simply stuck in customs, supposedly due to proper documentation and verbage not being what is required for its release.

We made the best of it.

The day began with the president of the hospital welcoming us to Carrion Hospital.  The pictures below show the president as well as Dr. Wakefield doing the inventory of the medicines and supplies that he is bringing in and donating to the hospital.

After the presidential welcome we enjoyed breakfast and then set to work.  As a group we worked both together and separately as teams to set up what tools and supplies we had, as well as evaluate 20 of the 35 patients we came to fit with new prostheses.

Steve Charry (Esteban) and I worked together all morning getting to know our new friends.  These Peruvian patients are amazing.  Patient after patient told us that they had prayed that we would come...as if that were a question.  ;-)  The oldest prosthesis we saw, we were told was 40yrs old.  The lady had been an amputee since she was 7.  Hit by a car.  You could see how the prosthesis had been repaired multiple times, both due to normal wear and tear as well as simply keeping up with a childs growth.  

We did a somewhat normal physical examination; making sure that any information we had been provided was correct; as well as attempt to glean any information that might help us make a better device for them.  We assessed measurements, abilities, areas of pain or discomfort.

The highlight of my day came at about 2pm and lasted for 60 sec.  It was seeing Jorge.  Similar to Rosa from yesterday, Al and I had fit Jorge last year.  He excelled and moved extremely well with his prosthesis.  His English is about as good as my Spanish.  Enough to say hello, how are you and where is the bathroom.  Still, we hugged and he nearly lifted me off the ground.  Jorge and I have exchanged maybe 4 emails since last year....simply to say hello and how are you, in broken tongues.  It is just great to see for certain that he is indeed as good as he said he was.

The pictures posted are a glimmer of some of today's work.  PT, Kevin Connellan playing McGuyver, making a large washer out of either a small diameter washer or a Soles (1$) that I had given him and McGuyver II, Taber Hammond repurposing a strap from a misused back brace to a leg brace that a patient badly needed.

At the end of the day, we made our way to a typical Peruvian eatery....during facetime with my family tonight, my daughter Anna was taken aback when in response to her dinner question, I said that I hoped to have some heart-on-a-stick.  I think Steve and I together had 3 ...;-)  Muy Delicsioso.

In the picture from the eatery are nurses, Kate and Lena, prothestist Abby and P&O student Esteban Charry.

Cross your fingers for us for tomorrow.  Pray that our boxes get out of customs and we can begin to finish what we have started.

Buenos noches, mis amigos
Pablo


Sunday, March 17, 2013

Dos

St. Patrick's Day in Peru was quite interesting.  We were not allowed to buy beer.  Apparently, the city of Lima is having an election.  They do not permit alcohol sales for days previous to and day of the election.  It is a crime, to say the least.

Since it was Sunday, there was not going to be any seeing of patients on this day.  Dr. Mary, the physiatrist that helps coordinate our trip had arranged a gathering of sorts.

Dr. Mary had arranged a presentation.  We were brought to Carrion Hospital, where Dr. Mary, 2 of our previous prosthetic patients, Rosa and Luis, as well as some other volunteers had gathered to provide us a light lunch and show us what they had been working on.

Dr. Mary is a saint.  The blog should end there, but you need to know more.  The presentation detailed clinic after clinic, village after village, of places that are not just poor, but poorer than poor....and somehow Dr. Mary and her crew have found a way to provide services and relief that would otherwise go unprovided.  The services may have encompassed physical therapy to the disabled, but they may have just easily included psychiatric support to single and/or battered mothers, or provided a carnival and games to under served children and communities.  The presentation seemed endless.  To bring the the experience full circle, two patients Rosa and Luis, now participate with Dr. Mary, in assisting in the aide offered to these communities.

Rosa and Luis were patients that Al and I had made prostheses for just last year.  When I saw Rosa, I had to check her prosthesis to verify for myself that it was the same prosthesis that we had provided....It was.!!   To me it was amazing.  These people were overcoming many many obstacles.  They were helping Dr. Mary to show other communities that life is not over simply because of these issues.  Show them that they are not alone.  There is a way to live, to carry on and survive and to not only exist but to contribute and help shape their world into the community that they want their world to be.

I cannot express how impressed I am with Dr. Mary and how inspiring it is to me, to try and do everything I can...to simply help.

After the presentation we traveled to Callo, for dinner.  As you can see from the pictures, we dined on some most delicious Ceviche, white fish and fantastical butterscotch icecream.

Mary had arragned for some dancers to perform a couple traditional Peruvian dances.  Afterwards, we could not resist walking down to the water to simply dip our toes in.  It was a touch chilly ;-)

Closing the day, we made a stop at Lima's answer to Home Depot to stock up on supplies.  Tomorrow begins our first true patient day, and we have much to do.  1st and foremost we are praying that the supplies that we shipped down get out of customs in time for us to actually begin the very work we came here to do.

Buenos noches, mis amigos
Pablo

Buenos dias, amigos
Welcome to Peru.

I will never understand why sitting on a plane for hours, waiting around for others and then riding in a van, can make you so tired and wiped out.  Still, we arrived early this AM. No daylight savings here.  It is 7:45AM.   Happy St. Patty's Day, everyone.  Whiskey, beer, chicha and Shamrock shakes for all!!

In the airport we finally met up with Andy Wakefield as well as the two nurses, Kate and Lena.

It was dark when we arrived so I could not easily see, but the hotel appears to be something designed by a Peruvian Dr. Suess.  My room is on the 2nd floor, but to get to it I first needed to go down, around, across, up and over.  In nearly every nook is either what appears to be a secret door or staircase that you didn't know about.

The rooms are small, simple, yet efficient.  I haven't seen them yet but from the noise, "cooing", the doves or pigeons native to here are fairly boisterous.

I'll try to get some pics...later when I finally expore out of my nook.

Not much happens on Sundays, though I have heard that today is some sort of Election Day in Lima.

Dad.....they say that the beans you speak of do not actually come from here, but I will keep looking.

More later.
Adios
Pablo


Saturday, March 16, 2013

Lunch tends to knock King All (his given Peruvian-name) out cold...we haven't even taken off yet.

Lunch at JFK

Friday, March 15, 2013

Uno

The trip begins manana, and the real work doesn't really begin till Monday.  Tomorrow is a big travel day.  Sunday, will clearly bring a new experience; St. Patty's Day in Peru.  Chicha for everyone!!

This year the foundation held it's first fundraiser.  Hooker Brewery was the definite place to be that night.  We extend a hearty cheers and thanks to the brewery for hosting us, and an even bigger thanks to many of you.  We raised a lot of money for the foundation and it will go a long way toward helping us sustain these kind of efforts beyond this week.  Who knows, we might have just found an annual thing.

Below is a picture of our beloved founder, Hernando with some of his co-workers; social workers from Hartford Hospital.

After tomorrow, we should be able to introduce you to the rest of the crew...haven't met them all myself, yet.