Santiago, a.k.a. Freddy is a good looking, buff, thirty year old from Cuenca.  He came to our clinic day this past Friday with his wife, daughter, mother, and two sisters.  His father passed away over a decade ago.  Freddy was on crutches and we could see that there was something wrong with his right lower leg.  He tells us that he fell three meters out of a tree almost two and a half years ago.  Since then, he has undergone forty eight surgical procedures trying to salvage his leg.  He has been fighting infection and has been on long courses of antibiotics as well as pain killers.  Forty eight is a huge number of surgeries.  Freddy jokes, in his good English that he should be in the Guinness World Book of Records!  He has not been able to work and earn an income.  Before the accident, he was supervisor at a large yogurt and milk factory.  Now he and his wife, who has a job part time and 7 year old Julian and 1 year old Maria Pac live at his mother’s house.  They receive help from Freddie’s mother and sisters.
Reviewing the x-rays and the status of the leg, it was felt that further attempts at reconstruction would be futile. Modern prosthesis would offer him reduced pain, improved function and improved quality of life. He could go back to work, be mobile, be pain free and not worry about bone infection compromising his health.

So this afternoon, Freddie had a below the knee amputation of his right leg.  We know he must have had mixed feelings, but before the surgery, he was very brave.   His wife and sisters were there in his room and his mother, whom he honors as “my angel” waited downstairs.   The procedure went well, but he was in pain in the recovery room.  Our recovery room nurses, Judy and Deb were so comforting as they tried to reassure him.  They were willing to stay all night until Freddy was comfortable enough to be taken to the ward. They even brought Freddy’s wife down to the recovery room to reassure him.  It is very difficult for all of us to see another person suffer but it is important to keep the goal for Freddie and his family in mind.  Despite his pain and discomfort tonight, as a result of the amputation, Freddy and his family will be in a better position and he will be on his path to leading a normal life.  This will include fittings of prosthesis as well as rehab in order to gain his full mobility.  From his big smile, we know they have a great chance that it will be a very happy normal life.

There were 8 other surgeries today, in addition to Freddy’s surgery.  One man did not bring his blood because the Red Cross blood bank was completely out of O negative blood.  One of our nurses, Michelle was a match in her blood type and generously offered to donate her blood.   A flurry of activity ensued.  Another patient’s husband offered to drive Michelle to the Red Cross blood bank for donation accompanied by the patient,  patient’s son and a bilingual medical student.   As it turned out, donated blood has to be bussed or flown to Quito for testing and that takes 3 days.  Undeterred, Michelle proceeded to a public hospital to see if she could donate O negative blood and receive an equal amount of O negative blood or buy the O negative blood.  Santa Ines is a private hospital and TNM is donated time on the ward and OR .  The  public hospital refused to give any blood to a patient in any private hospital.

It is truly incredible how committed the TNM team members are and how far they are willing to go to help and facilitate superb treatment for the patients.  In the end, the elderly patient received the surgery and is doing well. Today was an extremely busy.  Same time again tomorrow for the team. 6:30 am!