Team Leader: Dr. E. David Shaw, M.D.
Team Type: Children’s Orthopedics, Prosthetics, Orthotics, Physical Therapy, and Occupational Therapy
Campaign Summary: There were 150 patients triaged and 39 surgical procedures performed. There were 17 ankle/foot braces, a knee brace, six custom hip braces, and two prosthetic lower limbs provided. Several walkers and crutches were also provided.
The Campaign was Financed by Team Members and their Supporters. Some Supplies, Services, and/or Funds were Donated by the Following:
Americares — Stamford, Connecticut
Friends of Dr. E. David Shaw, M.D. — Salem, Oregon
Friends of Guy and Missy Farris — Lake Oswego, Oregon
MAP International — Brunswick, Georgia
Northbank Surgery Center — Salem, Oregon
Roger and Janet Olson — Salem, Oregon
Salem Health — Salem, Oregon
Bill and Margaret Walsh — Troutdale, Oregon
Team Members:
Dr. Nathan Bay, M.D., Anesthesiologist
Stephanie Brenden, R.N.
Val Daberkow, R.N.
Guy Farris, Prosthetist and Orthotist
Missy Farris, Administration
Sherri Furch, Sterile Supply
Nicole Garcia, R.N.
Dr. Kim Geelan, M.D., Anesthesiologist
Andrea Hughes, R.N.
Terryl Lee, R.N., Nurse
Dr. Luis Lucero, M.D., Traumatologist
Eric Miller, Administration
Dr. David Noall, M.D., Orthopedic Surgeon
Rachel Nolan, R.N.
Samantha Schmit, R.N.
Tabor Scrabeck, R.N.
Dr. E. David Shaw, M.D., Orthopedic Surgeon
Trent Tompkins, Physical Therapist
Note: Audio starts at 16 seconds:
A Beautiful Blanket Provided by Roger and Janet Olson Being Used by a Patient
Antony Being Fitted for a Prosthesis by Guy Farris
Dr. Nathan Bay Taking a Patient to Recovery after Surgery
Guy Farris Fitting a Patient in a Hip Abductor Brace
Team Members Jokingly Getting Ready for Open Heart Surgery on Trent Tompkins
Nadia Viaz Quispa and Her New Glasses
The Surgical Team
Dr. Shaw Examining a Couple of X-rays
Patients Waiting to be Seen – More were Waiting Outside
Guy Farris, Trent Tompkins, and Patient Standing in a Hip Abductor Brace
Drs. David Noall, M.D., David Shaw, M.D., and Nathan Bay, M.D. Performing Surgery
Antony Using His Walker to Stand for the First Time
Nicole Garcia Behind Bars – at the Team’s Hotel
Cast Change Schedule
Narrative:
Inter-Team Cooperation
On Dr. Paul Schultz’s 2016 Campaign he had a patient named Nadia Viaz Quispa who needed special glasses to correct a severe nearsightedness in each eye. There was not a known place where these glasses could be made and even if there was, they would likely not be affordable. He was able to get the glasses made in the United States and our team was able to transport them down to Coya. The patient went from being able to only sense light and blurriness to being able to see details and letters. She will now be able to learn to read.
On Dr. Mark Hershey’s 2016 campaign, there were several patients from one small village, and largely from one family that suffered from severe and acutely thrombosed hemorrhoids. They needed nifidipine ointment with lidocaine that was not available in Peru. Dr. Hershey was able to secure the medicine for Dr. Shaw’s team to bring with them to Peru on this trip. Dr. Hershey’s team will follow-up with its 2017 campaign and try to bring a colo-rectal specialist who will be able to treat the disease in a more permanent fashion.
C-arm X-ray Machine
One of our patients had a significant dislocation of the left hip. Using the C-arm machine, Dr. Shaw was able to see where the hip and femur were at the beginning of the case and decided whether an open or closed procedure would be necessary. During the case he was able to monitor the progression of reinserting the hip into the socket and verify the correct angles of the bones’ positions. He assessed that the patient needed a femoral osteotomy as well and a rearrangement to place the hip into the acetabulum. He placed a plate on the bone and secured it with screws. After checking the placement of the plate, despite his best efforts, the C-arm revealed that the correction was off. He replaced the hardware, and achieved a much better result. The analysis of the placement of the plate with the C-arm saved this young lady longer surgery and possibly additional surgeries.
Another patient benefited from the use of the C-arm. He was an 8 years old who presented with a femoral shaft non-union fracture caused by a fall. He didn’t seek help until three months after the fracture. To place the bone in the correct position to heal naturally, Dr. Bay used a neuro-muscular blocking agent to loosen the muscles. Then Drs. Shaw and Noall reset the bone using traction. The C-arm was a huge help by allowing the doctors to see the exact position of the fractured segments. X-rays were repeatedly taken until the bone segments were positioned correctly. At that point, a special cast was applied to secure the bones in position. After the cast was applied, a final X-ray was taken in two planes to make sure the bone segments were correctly aligned. The C-arm allowed X-rays to be taken seconds apart, rather than taking 10-15 minutes to develop a film during which time the bone may have changed position. Also, the increased resolution from the C-arm versus X-ray film allowed for small pieces of the fracture to be positioned correctly. The ability to see the bone fragment positions in real time saved hours of surgery and assured there was no movement between the X-ray and the placement of the cast. Further, the time the patient was under anesthesia was significantly reduced.
Pucallpa Prosthetic Workshop
Pucallpa is a city of around 300,000 people on the Amazon side of the country. In fact, the Amazon flows right by the city. During this trip, Guy Farris and Eric Miller checked on the status of the workshop Capitol City Medical Teams helped start with Jennifer and Mark Morris, and Milton Neyra.
To get to Pucallpa, Guy and Eric took a taxi from Coya to Cusco, then flew from Cusco to Lima and then to Pucallpa. (There was no time efficient way to get there directly from Coya.) They expected warmer weather because of its location, but were not prepared for going from 50 degrees and rain in Coya, to 100 degrees and 90 % humidity with blazing sunshine. At least there were delicious cold fruit juices (from fruit they didn’t have in the United States) provided to them to keep them refreshed. (Later that evening Eric recognized he shouldn’t have drank so much of the delicious juices because it created another set of problems during the night.)
The visit was a great chance to be involved in an expansion of orthopedic services into a previously unserved market. We saw the current workshop, met Milton Neyra and his wife, met with Mark and Jennifer Morris, and saw what they were able to accomplish. With additional funding we hope to provide a larger and improved space as well as more equipment and supplies. The costs of these items will be “repaid” by free or reduced services to those in need. It was now time for them to return to Coya and head home.