Day 1 - Pre-operative clinic and our first OR cases

Day one at the Hospital General de la Plaza de la Salud started early and ended late, but it could not have gone any better.  With the help of our Dominican colleagues we saw over 40 patients in pre-operative clinic today and were able to perform eight joint replacement surgeries. 

Even though the patients were screened extensively prior to our arrival, we re-evaluated every one of them to ensure that we would be able to perform safe and effective surgeries.   Our team split into five groups – each one consisting of an attending surgeon, attending anesthesiologist, orthopedic surgery resident, physical therapist, nurse, and Dominican medical student – in order to more efficiently handle the volume of patients.

Christina Foley, RN (Orthopedic Nurse at Brigham and Women's Hospital in Boston) works with a Dominican medical student to verify a patient’s medical history and current medications, prior to her being seen by the surgical team.

 

Wolfgang Fitz, MD (Orthopedic Surgery Attending at Brigham and Women’s Hospital in Boston) discusses surgery with a patient in clinic with the help of a Dominican medical student. 

 

Once all the patients had been seen, our entire group met to discuss each case in detail.  We spent several hours reviewing the x-rays, physical examination findings, and past medical histories prior to determining a plan for each patient.  Although hip and knee replacement surgeries follow a predictable template, each procedure must be tailored to the specific person and disease pattern being treated.

 

Jeffrey Katz, MD (Rheumatology Attending at Brigham and Women's Hospital in Boston), Carl Harper, MD (Orthopedic Surgery Chief Resident), and Forrest Schwartz, MD (Orthopedic Surgery Resident) present the x-rays of a young man with bilateral hip arthritis.

 

This x-ray shows the knees of a young woman we will be operating on this week.  As a child she had multiple surgeries to correct a growth deformity, but unfortunately she is now essentially wheelchair bound.

 

After reaching a consensus on the patients we had seen in clinic, the team grabbed a quick lunch in the hospital cafeteria and then headed to the operating rooms. The patients we had just seen in clinic were already waiting in the pre-operative holding area, and with eight joint replacements slated for the afternoon, there was little time to spare. 

 

Lauren and TST operate.JPG

In this photograph Lauren Ehrlichman, MD (Chief Medical Officer and Orthopedic Surgery Resident at Brigham and Women's Hospital), Thomas Thornhill, MD (Chief Executive Officer of Operation Walk Boston and Chairman of the Department of Orthopedic Surgery at Brigham and Women’s Hospital), and William Sherman, MD (Attending Orthopedic Surgeon at Louisiana State University) prepare to cement an implant into a patient undergoing bilateral total knee replacements.

 

Performing so many surgeries in such a short period of time requires a tremendous amount of coordination and teamwork.  Adjustments to the schedule are made throughout the day in order to simultaneously ensure safe patient care while maximizing the number of joint replacements we can do.

 

Between cases, Roya Ghazinouri, DPT (Chief Operating Officer), Thomas Thornhill, MD (Chief Executive Officer of Operation Walk Boston and Chairman of the Department of Orthopedic Surgery at Brigham and Women’s Hospital), and Lauren Ehrlicman, MD (Chief Medical Officer) discuss the surgical schedule for the week.

 

Day two promises to be just as busy as today, and undoubtedly just as fun.  Tomorrow we will post updates from our follow-up clinics as well as the next round of surgeries.

 

Forrest H. Schwartz, MD (Orthopedic Surgery Resident)