No. of Recommendations: 31
I just returned from a medical mission trip to Nicaragua Saturday. Was gone for a week. Here are my thoughts and comments in no particular order.

-- we did 27 total knee replacements and 2 hip replacements in 4 OR days. We were busy. Typical day was 8-6. Seems like something happened everyday to bump one room back an hour or so either emergency c-section or autoclave failure. But we managed.

-- it was pretty much the same cast of characters as last year, just a couple new additions. Always interesting to see a "rookie's" response to a foreign country.

-- just when you think you've seen the worst of poverty, you always find a lower level. Part of our group went to the dump. There is a small city living at the local dump. Picking through the trash to find plastics, glass, and metals that can be recycled. They then store this collection in their home waiting for the once a month visit from the recycling truck. They get maybe $30 for their troubles. Our group passed out bags of rice and beans to these people.

-- a good salary in Nicaragua is $300/month and not too many people make that. The orthopedic surgeon we work with makes maybe $500/month.

-- as a joke, I wear a "Survivor - Nicaragua" t-shirt from the TV show on the return trip home. Some one always asks if I was on the show. I guess I need to trim up the beard some at the end of the trip.

-- people still ask why I go and help the poor in Nicaragua, aren't there enough poor to help here in the USA. Big, big, big difference. The poor here have help plus something better, opportunity. There, there is very little to no opportunity.

-- one evening while sitting on the beach watching the kids play, one surgeon and I had the same idea/feelings about the trip. The trip is like going to the gym and working out. You might not particularly like it while you're doing it but you're glad you did after its done.

-- had to cancel one case and felt bad but in the bigger picture, it was the right thing to do. This man had normal pre-operative work up the week before. While in the holding room doing the femoral nerve block for post-op pain control, everything normal. Get in the OR ready for spinal anesthesia, atrial fibrillation. Probably is something he goes in and out of all the time, but as far as we could prove, its new. Couldn't take the risk. So for him, it was like winning the lottery (being chosen for surgery) and then getting his ticket invalidated when he went to collect.

-- I'm working on putting together a video, still combing through everyone's photos. I hope to have it posted by week's end.

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