Sunday, May 20, 2018

Celebrating 20 Years of Medical Missions

From Bruce Lehnert

It is hard to believe 20 years of medical missions have come to pass. When I started this journey in 1998, the dream was to have exactly this outcome. It has been a very rewarding journey that ties my life to so many of our patients.  When I see them return for follow up their smiles live in me forever!  

Twenty years in we have published our techniques in peer-reviewed journals and have nailed down the bottom-up approach to making a medical mission work smoothly and effectively.

Flecher Fleudujon's 20th anniversary IEP short film captures it all.  Please watch.

A big thanks to all past and present IEP members! And a gracious hug to all IEP supporters.

Monday, March 5, 2018

Countdown to Namibia: John T. Kao, MD

The IEP team is getting ready for our next mission to Namibia in August. Today's post is from Dr. John Kao, who will be joining IEP for his first mission.
As I begin my 25th year in sports orthopedic surgery -- caring for the weekend warrior as well as the professional athlete -- I have thoroughly enjoyed my career in medicine. I have gained great pleasure in helping others get back to athletic competition or their chosen activities. Most importantly, I appreciate the trust that my patients have had in me and my abilities over the many years.  

Still, as my last child sets off to college and my wife and I ready to become empty nesters, I started growing concerned about the routine nature of my practice. So, when Dr. Bruce Lehnert approached me regarding an opportunity to participate with the International Extremity Project, I accepted. Looking forward to this summer, I feel a renewed excitement and energy as I learn more about this great organization and its cause.  

Now, as I prepare to embark on my first medical mission, I look forward to helping others in the fundamental manner that I originally led me to choose a career in medicine over 35 years ago.  I truly appreciate any support that you may have to offer, and I look forward to sharing my great experiences with all of you when I get back!

Saturday, February 24, 2018

Up Next, Namibia!

Barely home a month and we're getting ready for our next trip! A smaller group of us will be heading back to Windhoek, Namibia in August for our second full mission. While there, the team will perform surgeries as well as lecture at the University of Namibia to help train the new generation of surgeons to treat lower-extremity deformities.

I'm always honored to have Drs. Lehnert and Spanko invite me to participate -- and grateful that I have the opportunity to travel with the team and help make a difference in the communities we visit. I've already applied for my visa and submitted my vacation notice for work.

Stay tuned as we prepare for our journey!

Thursday, February 1, 2018

Medical Mission: Thanks to Our Supporters

The International Extremity Project (IEP) team arrived in Can Tho, Vietnam, after over 25 hours of air and bus travel. With 22 boxes of medical supplies and equipment, plus our team of 25 people, it took two buses to get everything and everyone to our final destination!

The IEP team began screening patients for surgery the next morning and started surgeries the day after screening. After multiple surgical days, the team treated 47 surgical patients, most with multiple procedures.

Monday, January 29, 2018

Medical Mission: Communicating with Patients

Jesse Hsiao, RN shares his thoughts after his first mission with the IEP team. 

It’s difficult to name a most memorable moment since many were new learning opportunities, unforgettable, and inspirational. I particularly enjoyed going on rounds with the residents and translators.

Side note: Our teamwork and communication were impeccable. For those of you who watch basketball, it was like the fluidity of all five players clicking — think the current Golden State Warriors and San Antonio Spurs offense at their best. 

During this time, I did post-operative teaching with patients and their families. What I love about this is that I was able to talk to patients and their families. After surgery, there’s still some anxiety, especially with the duration and process of recovery. In particular, all of them were concerned about managing pain, when they could walk again, and when they could return to their routine or in some cases have a dramatically new life.

Tuesday, January 9, 2018

Medical Mission, Day 5: Final Surgeries

Our final day at the hospital was another busy day in the operating rooms with 14 patients. Outside of the OR, we had to pack up our all supplies for the journey home and visit patients who had surgeries in the days prior.

There's always one particularly memorable case in each mission. Two years ago it was a little girl with tibial agenesis, this year it was a young man with bilateral macrodactyly.

Friday, January 5, 2018

Medical Mission, Day 4: Full Day of Surgery

Because we were in Vietnam for less time than some of our previous missions, it was important that we were very efficient in the operating rooms. Wednesday was our biggest day -- 15 patients.

Our morning was made a bit more challenging with scheduling changes between the two teams. We knew what patients we'd see, but the Vietnamese doctors needed to make changes to the order in which we'd see them. I spent the first part of my morning matching up our patient records with the hospital records to make sure everyone had the information they needed in the operating rooms.

Communication across departments is a challenge in any organization or business. Here we get to add in the challenge of being a team with another country trying to align with the local doctors, anesthesiology teams, and nursing staff. But it always works out.

Wednesday, January 3, 2018

Medical Mission, Day 3: Surgery Time!

Once we've identified the patients we can help and the procedures the team will do, it's time to get started on the work of changing lives. Maybe it sounds dramatic, but just giving someone the ability to walk more normally or even wear shoes for the first time is a significant life change for most.

Wing Ip and Bruce Lehnert review
x-rays before a procedure.

The Art & Science of Scheduling

Because we're here for a relatively short time, we're utilizing three operating rooms so we can do as many procedures as possible. We alternate between soft tissue and bony cases to allow time for sterilization of the powered instruments between bony procedures. At the same time, we try to do most of the youngest patients earlier in the day to minimize their discomfort from hunger and anxiety. It's quite a balancing act that Wing Ip manages, then works with Dr. Em, the head of orthopedics at Can Tho General Hospital, to confirm and arrange the local team for anesthesiology, nursing, and operating room support.

Teamwork in Patient Care

Surgery days take coordination of the full medical team as well as most of the support team. Our translators are invaluable in communicating with the medical staff and the patients, especially in delivering post-surgical care information and medication.

2018 Vietnam Mission Team

A medical mission like ours takes a complement of people to fill the various roles. It's important not only that everyone has specific skills, but that people work well within the team and with the local medical staff. We intentionally keep the group small to minimize costs so that the funds we raise go to patient care. We're together all day, nearly every day for two weeks and -- most importantly -- we're responsible for the medical care of dozens of people.

The work begins long before we ever pack our gear to travel. Henry arranges air and ground travel for the team as well as our hotel accommodations. Meanwhile, Jenni takes the lead in identifying the supplies we'll need, collecting supplies, and identifying the people in each role. (It takes months!) While we're in Vietnam, our days are busy with everyone playing a part -- whether their primary role or doing other tasks as needed to support the medical team. My main role may be managing patient information, but you'll find me hopping down the hall to gather supplies or even supporting the team in the operating room. 

Medical Team

Tuesday, January 2, 2018

Medical Mission, Days 1-2: Patient Screening

Dr. Bruce Lehnert and resident Aziz Razooli
evaluate a boy for possible surgery.
The day after we arrive in Vietnam, we immediately start work by evaluating patients for the first two days.The hospital pre-screens many of the patients so that our team is evaluating the most likely surgical candidates.

The patient evaluations follow a three-step process:
  1. We start by doing a short interview with each patient to identify what they'd like our team to evaluate, some basic history on the condition and previous treatment, and basic demographic details.