Our lives are like the threads of a tapestry. We come in different weights and types and colors and we each provide variation to the picture of life. The threads of our lives may cross just once or may brush against one another only in passing. Sometimes, something very special happens and the threads of several lives intertwine, twisting and turning into new directions.
Galo Burbano, CRNA, chief nurse anesthetist at John T. Mather Memorial Hospital, Port Jefferson, N.Y., first helped to organize a medical mission to his native Ecuador in 2006. Twenty-six healthcare professionals from Mather donated their time and expertise. In 2007, word of mouth about the success of the first mission drew twice as many volunteers from Mather and five other institutions, as well as enough donated supplies and equipment to support five surgical tables in the small town of Guayaquil.
Nurses from all the hospitals were generous with their time and energy. Those who didnt have OR experience helped in the post-anesthesia area and with initial screening. The plan was to offer plastic surgery for cleft palate repair; gynecological procedures; ear, nose, and throat procedures; and general surgery. They expected to give their help and expertise to the local residents. They were not disappointed the group examined more than 400 people and performed more than 200 procedures during the week they were there. As sometimes happens, however, the trip was only the beginning of a larger, longer journey.
Thinking Outside the Box
Tatiana Franco-Rosero, a 27-year-old mother of two young boys, came to the volunteers for help because of a mass growing in the roof of her mouth. She was losing weight because she was unable to eat her normal diet.
The plastic surgeon saw the tumor and sent her to the ENT surgeon, says Burbano. They were hoping to debulk it and make her more comfortable. But, when the biopsy results came back, the diagnosis was papillary carcinoma. She really needed to have the entire tumor resected.
The procedure was far beyond the capabilities of the mission group, so Burbano began to think of ways to help. Upon returning to the U.S., he presented the situation to Mather Hospitals CEO, Kenneth Roberts, who offered the use of the surgical suite and support toward meeting the legal requirements for Franco-Roseros stay in the United States.
Getting Franco-Rosero to the U.S. presented obstacles that Burbano had to overcome. First, a visa had to be secured. Burbano petitioned the consulate in Ecuador and guaranteed Franco-Roseros support and care during her stay. Mather nurse Metzi Shea, RN, opened her home to Franco-Rosero when she arrived, and shepherded her through the necessary pre-admission testing and examinations.
The Big DayThe surgical team included (L-r): Sharon Watklevicz, RN; S. Coccaro, MD; Brian Healey, CRNA; Trudy Weeks-Roach, RN; S. Matar, MD; K. Sauer, MD; and Rebecca Griffitt, ORT (or Kim Azar). Other team members (not pictured) included Irma Rivera, RN, Linda Fransisco, RN, Jenn Whitfield, and Mike Watklevicz.
On the day of the surgery, the volunteer surgical team gathered for the eight-hour procedure. The circulating nurses, scrub nurses, and nurse anesthetist were all working on their day off, as were the three surgeons who led the team. One surgeon removed the tumor and another surgeon inserted a feeding tube. The third surgeon performed a temporalis muscle flap graft to repair the large hole left in the palate after the tumor was removed. In this rare procedure, the muscle is freed from the temporal bone and rotated down into the area and across the palate, covering the hole.
The procedure is unusual and the results are amazing, says Burbano.
Cosmetically, it was very successful it isnt at all obvious that she had the surgery.
In the PACU, the nurses were able to reassure Franco-Rosero that all was well. The ICU, however, posed another challenge. Burbano lauds the ICU nurses compassion as they coped with the language barrier.
The story didnt end with the surgery, and the support of the volunteers didnt end there either. Franco-Rosero was discharged to Sheas home, where she received the care and instruction needed to care for her mouth and administer the tube feedings that gave the surgical site a chance to heal. She has no sensation in the roof of her mouth and has had to learn about protecting the area from sharp and hot foods. Her last hurdle before going home is the radiation therapy that will be completed in a few weeks.
Helping her has enriched the lives of a long list of healthcare providers and has added deep colors of compassion, kindness, and satisfaction to the tapestry of life.