Tuesday, July 29: Today is our second day of surgeries, and so far everything is going well. Drs. Janet Tomezsko and Jennifer Ozan from our team, and our local partners, Drs. Arebalo and Lara, have done five surgeries - two Novasure and three TVT bladder slings. While yesterday the Bolivian doctors were only observing, today they began to take turns with the scalpel, sling, or ablation wand under the close watch of Janet and Jennifer.
A social scientist is pretty useless in an O.R., so while the actual surgeries are happening I hang out in the waiting room. This has given me the opportunity to watch Marizol, the PuenteSol social worker. Marizol is so impressive and I’m struck by how absolutely pivotal her role is to an effort like this. She talks to the patients not only about their physical symptoms, but about everything that’s going on in their lives that may be relevant for their treatment - all of the stuff about finances and family and work that medical practice is often not so good at taking into account - and communicates it to the surgeons. I wish there could be a Marizol in every doctor’s office in the entire world!
Yesterday I also had the pleasure of meeting our second patient, Carolina*. Getting to see her before and after surgery was such a gratifying experience! She was such a sweetheart, and her husband was so attentive, running around making sure she had everything she needed. Carolina had been suffering from extremely heavy bleeding, and was recommended by Dr. Pati Lopez as a possible candidate for endometrial ablation. It’s not that no other effective treatment for this kind of heavy bleeding is currently available in Bolivia, but the alternative to Novasure is a hysterectomy.
Hysterectomies are pretty common in Bolivia, and are often covered under the country’s universal basic healthcare package. But even though it’s a routine operation, a hysterectomy is still major surgery, with all of the corresponding risks of bleeding, infection, and other complications. Even when everything goes perfectly, there’s a recovery period of about three months, and patients usually can’t return to work for several weeks - longer if their job involves carrying heavy loads, which is the case for many of the patients Solidarity Bridge sees. That recovery period, I should mention, can easily make a surgery, provided at no out-of-pocket cost, suddenly not so cheap anymore. In comparison, Novasure can treat heavy bleeding in a fifteen minute procedure with drastically lower risk of serious complications, and most patients can return to their normal routine the next day.
Carolina’s Novasure procedure went off without a hitch, and when she was ready to go home, she was positively beaming. On her way out, she stopped in the hallway to give the doctors and translators a big warm hug and a kiss on the cheek. She and her husband kept saying thank you and that just touched everyone on the team so much. We were so happy to have been able to make a difference in her life.
Today, in addition to the two surgeries, the team evaluated a few more possible patients. Some of them arrived for the first time, and others had come on Sunday but needed labs and other evaluations before being cleared for surgery. We scheduled three more increasingly complex cases for tomorrow. For now, time to do some quick souvenir shopping and maybe even get eight hours of sleep tonight!
* Patient name changed to protect confidentiality.