07 April 2025 – Monday – Day 1 in the Operating Room

Breakfast service in our hotel starts at 4 am. Our bus pick up was schedule for 7 am. It took a little prodding to get everyone on board by 7:20 for the hour ride to the hospital. Traffic during the week is much more than on the weekends. Luckily one of our surgeons connected her phone to the bus WiFi so we had music for our journey. She had even set up an AI generated song about the mission. FUN. 

The first day is always a slow start. We needed to get narcotics from the hospital personnel. We can’t bring our own narcotics internationally. We also needed intravenous fluids since they are easy to get locally and heavy to transport. All this takes time. Then the patients come to pre-op to get checked in and we insert IVs. Once the surgeons finish marking the patient, we walk them into the operating room and hook up our monitors with them lying on the OR table. We induce anesthesia with intravenous drugs and secure the airway. But…each room has a different monitor and a different anesthesia machine. Each nurse anesthetist has done a full machine check before the patient arrives. In my room, one of the connections had cracked as we connected it to the patient. We taped it quickly but when we connected the whole circuit we had a leak of anesthetic gas that was a prominent odor. We removed the cracked piece and replaced the breathing tube in case that was a problem. Finally, everything was working. 

As the day has progressed, each room has had a monitor or anesthesia machine issue. This equipment is old and probably not maintained as closely as in the US. We first need to determine if there is an issue with patient safety and then we try to fix the equipment if we can. The bottom line is that the patient has stable vitals and adequate ventilation. It’s back to the old fashioned way of doing things. Both Nancy and I have experience without the fancy monitors that exist at home. We will make it work. Luckily, there is a local anesthesiologist in one of the other ORs. We asked him to help with a machine alarm. He called an anesthesia tech who solved the problem. It didn’t require any Spanish fluency. We just pointed to the alarm. 

It was a challenging day trying to feed everyone in 90 minutes because the cafeteria has limited hours. In order to move from one area of the hospital to another, we need a key card to open doors. If one person leaves with the key card going to lunch, the next person can’t leave until the first person comes back. We solved the problem for tomorrow by getting another key card. Hope it works. 

The day finally ended at 6pm. A bus was supposed to be waiting for us but a few of us wanted to leave when the bus wasn’t there. We hopped in a taxi with a driver who clearly didn’t want to take us. So we went back to the hospital and got on our bus which had arrived late. We are on our way back to the hotel where we will grab dinner and go to bed. We are leaving tomorrow morning for the hospital at 6:30 a. Yikes. Sorry no photos today. Just too busy.