Dr. Brian Parsley ’74 Donates Surgery for Young Guatemalan Woman
Reprinted from The University of Texas Health Science Center web site.
These days, Eva Nidia Carias’ smile is bigger than ever – thanks to a pair of Houston doctors, including an orthopaedic surgeon at The University of Texas Medical School at Houston.
Carias, now 22, was diagnosed seven years ago with a giant cell benign tumor inside her thigh bone. The tumor prevented full mobility. To make matters worse, the complex surgery she desperately needed is not available in Guatemala, where she lives.
Brian S. Parsley, M.D., assistant professor of orthopedic surgery at Baylor College of Medicine, first noticed Carias during a recent mission trip with “Faith In Practice,” a non-profit, interfaith mission organization that provides care to the poor in Guatemala through short-term surgical, medical and dental mission trips and health education programs.
Parsley wanted to help Carias, but he couldn’t do it alone.
“Dr. Parsley approached me about a case of a young woman from Guatemala with a giant cell tumor of the right distal femur, and asked me if I would help,” said Rex Marco, M.D., a visiting associate professor in the Department of Orthopaedic Surgery at the UT Medical School at Houston. “I had seen cases like this before, and sometimes the tumor is so big the leg needs to be amputated. We needed to bring her in for further examination.”
Marco worked with Parsley to review images of the tumor and find the best solution for Carias – which they determined would be to remove the tumor and replace Carias’ distal femur with a metal prosthetic. Now they had to find the prosthetic.
“We called Biomet, the company that supplies the prosthetic parts, and they agreed to supply the entire implant,” Marco said. “They donated a special implant that continuously compresses against the bone, which helps prevent loosening of the implant.”
With the help of the Houston surgeons, Faith In Practice, Consul General of Guatemala José Barillas-Trennert and Continental Airlines, Carias and her mother flew to Houston, where her surgery was performed free of charge this month at Foundation Surgical Hospital.
“Dr. Parsley brought Eva’s X-rays and information in to see if we could help,” said Ellen Peterson of Faith In Practice. “We had done charity like this in the past case-by-case through our affiliation with the medical community, but it’s not common that it involves taking the patient to another county.”
Carias was filled with emotion when she arrived in Houston. “I’ve always been happy. I’ve never cried – never felt sorry for myself, even when others made fun of me. I know God made me like this for a reason. It is a miracle that I was brought here to Houston,” Carias said in Spanish.
Eva’s mother has shared her daughter’s pain for many years. “For (the first) 15 years of her life she had not gone to see the doctor,” Carias’ mother, Rosalinda Garcia Castillo said in Spanish. “I was so happy to hear of this wonderful thing that was going to be done for my daughter. May God repay all of these wonderful people.”
“The surgery went very well. We were able to save the knee with her soft tissue,” Marco said. “Before the case, she had limited motion, and thankfully we were able to save the muscle and cover the implant. The operation didn’t need any additional plastic surgery.”
The implant from Biomet, Inc. valued at about $18,000, is expected to last 10 years or more, Marco said.
Carias will soon be able to put her full weight on the extremity, but her doctors plan to keep the area still or immobilized during the initial recovery process. When she leaves the hospital after a week, she next will begin rehabilitation.
Carias and her mother will be returning to Guatemala by the end of the month, where Eva will be able to live with full mobility and take a much more active role in the life of her own daughter.
“My daughter is so healthy – she is the greatest joy in my life. Miracles are possible,” Carias said. “My biggest dream is to see my daughter grow up. I’m so thankful, and may God repay these wonderful angels.”
Dr. Brian Parsley reports from Haiti
Well, is seems like yesterday that news of Haiti’s devastating earthquake was fresh in the news and pictures were plastered all over the airwaves. The devastation and death was overwhelming and the reality hard to believe. As I traveled to Haiti one year ago yesterday, I was heading into unknown territory with a hodge podge group of wonderful volunteers with hearts filled with hope to help those in need. We helped those that we could but we felt there was so much more that was needed. As I revisit this place, I see so much has changed while at the same time, so much is still the same. There is not the same sense of urgency but the needs are still overwhelming. As we arrived at the airport, there construction around us was evident and the rebuilding had begun. As we drove down the streets, it is encouraging to see themost areas were finally cleared of debris. There were positive signs all around that the country is moving forward and all the aid and support from around the world had indeed made a positive impact.
This is the first medical team that the upstart Houston Haiti Recovery Initiative (HHRI) organization has put together inpartnership with Project Medishare out of Miami. We have six dedicated volunteers from Houston and we are working at Bernard Mavs Hospital in Port-au-Prince alongside Haitian doctors and nurses and staff. The integrated cooperation and partnership with the local Haitians allows us to be a part of the community of care and help each other help those in need. While touring the facility and checking out with the volunteer team that was departing, the harsh reality of why we are here was still present. A little baby has died shortly after our arrival and the families were wailing. This touched the hearts of the entire team.We are here to do God’s work but He is in charge and has full control. We are only servants to do what we can. Life seems more precious when death is at our door step. It is always humbling.
We are no longer in the crisis mode that we experienced a year ago, but in a repair and reconstructive mode that requires our long term assistance. Working for Haiti with Haitians will ultimately help Haiti in more ways than we can imagine at this time. You can give a Man a fish and feed his hunger but it is better to teach a Man to fish and he will feed the others. We all hope that Haitican rise above the ashes and the debris to be a better place than it was before. This is a possibility. The international spotlight has dimmed but the needs continue. Thank you for all the support and the love to help those in need. It may be through others but giving of your time, your talent and/or your treasures certainly has an impact. I send you a picture of the Moon rise tonight over the city and Bernard Mavs Hospital. — Thank you and God Bless. -Brian
Well the week has begun and as we settled into the routine of the week, we became familiar with the patients currently admitted to the hospital and their dispositions. We are working at a two operating room, 52-bed hospital that has a make shift ICU with 4beds, a spinal cord injury unit, a pediatric unit and an emergency room. We are in such close quarters that the ER, ICU, Med/Surgical beds and the OR are all within a 20 foot radius of each other. This hospital reminds me a lot of the Obras Socialialisd el Santo Hermano Pedro in Guatemala when we first began traveling down there. Hospital Bernard Mavs is one of the very few acute case hospitals in all of Haiti. Most hospitals here take care of the sick and not the acutely injured.
The supplies here are very limited. The OR’s are very small and deficient, the equipment is either not available, antiquated or nonfunctional. The x-ray machine is broken and the only x-ray wecan use is the C-arm in the operating room when available. Foran orthopedist, not having x-rays is like only having one eye and limits what we can do—getting back to the basics of orthopedics.The majority of what we have seen are hand injuries with infections. I think everything is dirty here.
Today was filled with lots of excitement and a wide variety to boot. We started the day with a young man who fell 3 stories off a roof. It felt like old Hermann Hospital trauma days, head injury, forearm fracture, rib fractures, collapsed lung, and facial lacerations. We all went to work. My young colleague and chief orthopedic resident Lanny Rudner, MD was even learning new skills and was seen sewing up the patient’s deep eyelid lacerations with great expertise (see picture). I am proud of him and his adaptability and willingness to do whatever to get the job done. The day was even more interesting when a woman dropped into the ER with her baby crowning and ready to deliver. No, Lanny didn’t deliver the baby too but the rest of the team went to work. Her successful delivery was a nice change from the life we lost on the first day and smiles were all around the place, especially Mom and Dad. (See attached pictures) The day ended with a very fascinating and disgusting case of a 3-year-old girl with terrible abdominal pain and suspected appendicitis. Off they went to the OR for an emergency operation only to be surprised by the presence of tape worms. Eight to be exact. Sorry I didn’t attach that picture!! This definitely stirred up a reaction from the team. Well we cannot wait to see what tomorrow brings. I certainly hope for some more Orthopedic cases.
Speaking of team, it is always so wonderful to get to know all the new friends and find out who they are and what brought them to this place. Many have been to Haiti more than once and others are making their first trip. They all have big hearts and share their skills with those in need. We have Canadians, Californians, Boston and New Jersey, but the largest group is from Houston and HHRI. We feel like we are making a difference and we appreciate your support and prayer (and your donations help as well). All for now. -Brian
What a difference a day makes! Like the weather in Houston, that is subject to change at any moment. This was also true here at the hospital in Haiti. The flood gates opened and the patients were endless the past three days (see picture). We operated all day and into the night and are finally getting a break this evening. The acutely ill in need of the general surgeon, the trauma victimsin need of surgical care, both young and old and some evenancient hit the doors and were in need of care. Off to work we all went. We were all pushed to a new limit and a little soul searching was common. There is no relief because we are it. We cannot pass it on to the next shift because the faces will be the same. We become dependent on each other to work as a team because without it the mission breaks down. Every step can be challenging when you come to a foreign country that’s medical system is lacking and that’s work ethic and sense of urgency is significantly different. We are reminded that we are guests of their country and not in ours and that we are here to help by working with the Haitians who are here and not separate or apart.There is a delicate balance as we try to work as efficiently as possible in a place that has little. Even the simple procedures are hard and require lots of time and patience and compromises incare. Every step which seems simple in the US is an ordeal here.
Yesterday, a patient came in who had his foot run over by a truck and had significant injuries. Multiple fractures of the toes, footand ankle and major soft tissue injuries as well. Half of the padon the bottom of his foot was sheared loose by the injury. Off to the operating room. Lanny, David Robertson, RN and I went along with Tom our anesthesiologist went for 5 1/2 hours worth of surgery finishing at 12:30 in the morning.
At every turn there were challenges and compromises.Everything took extra time. Not enough pins to hold the fractures,the batteries for our drill that was critical for our repairs couldn’thold a charge so we resorted to the use of a hand drill that wasat best, inadequate. Plates and screws that didn’t have the right length, requiring us to use a bolt cutter to custom fit each one. All these are things that we take for granted back home. The hard work and frustrations though were rewarded by the sight of his pink toes this morning thru his dressing.
Speaking of upgrades, boy have we made improvements. The sleeping accommodations are just below the Ritz (see the picture of my beauty rest). Four bunk beds per room, but AC and running water. Yahoo. Two meals a day and rice and beans still prevail. Tonight we worked late again and missed the ride to the UN bar& restaurant, “The Deck,” so my surgical team enjoyed our freeze dried meals on the roof of the hospital (see picture). That beef stew was delicious and a nice change from the beans and rice.
The hospital is making upgrades as well (see picture ). New scrub sinks were being placed through the rubble, but the water still comes out through the wall pipe. A new CT scanner contained within an trailer is coming but no x-ray machine is in sight. Anew space for the Amputee clinic for their prosthetics (artificiallimb) program was going in and should help the high number of amputees that resulted from the earthquake.
Well I gotta sign off and grab some sleep in my beauty rest bed because I never know what tomorrow brings. –Brian
As I travel back to the States and to the comforts of my world with running water that you can drink and a sanitation system that doesn’t harm you, it gives me time to pause and reflect on this past week. What a special week it has been as all these medical mission trips seem to be. Each is unique in the experiences and the people you come to meet. Each is filled with the anxiety of preparation and unforeseen challenges and this trip was no PIC8 different. Our HHRI team was prepared to provide significant support for Project Medishare Hospital Bernard Mavs and hadgrown to a group of 14. Two weeks before our departure our teamhad shrunk to 6. Panic and concern was felt as we reached out to others and were able to grow back to 12 only to shrink back to 6 members the night before we left. I was terribly concerned that we had failed in our mission and put undo burdens on others to provide the needed care and services. I know that PM was depending on us to fill those spaces and provide for those in need. In the end, that is just what we did and the overall team did it well.
Let me tell you about our fabulous team of Volunteers from Houston (see HHRI Team photo). We had Lanny Rudner, MDwho is a chief resident in Orthopaedics at Baylor and who immediately contacted me last year when he heard that I was going to Haiti for the first time right after the earthquake and he wanted to go. Despite my efforts, a seat was not available on the plane. This year he was ready and willing to help and what a great help he was. He did it all. Tirelessly and without complaint even with me watching over him (see photo Oh MyGod). He was a major glue for the team and a reliable confidant.I enjoyed watching him grow in many ways as the week wenton. Becky Urech, RN an ER nurse at Hermann who agreed to goat the last minute on her first mission trip ever despite the fears of Haiti and the fact that several of her colleagues has canceled. She was terrific. She ran the ER with efficiency and a wonderful smile. She shared that smile with all the patients she touched. Mindy Jaros, RN a floor nurse at Hermann who not only had never been on a mission trip but had never been on an airplane. Like Becky, she had a calling and overcame the obstacles to say yes and put her faith in a Higher Power. She was the leader ofour 9 bed patient ward and kept it moving and ensured that the patients were cared for. She was on duty until the last minute aswe loaded the cars to head to the airport. Alexandra Attie, RN.A Haitian born nurse and friend of Janet Wheeler who was avaluable resource who knew the country and the language and worked diligently in the pediatric ward for hours on end. This was her fourth trip back since the quake. And David Robertson,RN an OR circulator nurse at Methodist Hospital who returned for his second trip to Haiti and was an invaluable asset. Here organized the OR supply system, educated the nursing staff but more importantly he entertained the team with his light hearted comments and off the wall humor. He was also the team photographer.
Everyone on the team was touched by someone or something on this trip. I share with you Marie (see happy patient with femur fix); a pleasant lady who fractured (broke) her right thigh bone last year when a wall fell on her during the earthquake. Thankfully she was not killed. She had an attempted repair at the time but the bone did not heal. She has been walking with her leg flopping around on crutches for the past year. We were able to operate on her and insert a new rod inside her thigh bone to stabilize the break and hopefully get her to heal. She was working hard and her pain was improved. The second patient I want to share with you is the gentleman who fell from the 3rd floor roof top with multiple injuries. Due to his injuries and swollen face, he could only look out of one eye and smile with half his face but we we’re all smiling when we finally got his arm surgically repaired and his chest tube out as he took his first steps. The smiles say it all and that one eye was smiling too! (See photo another happy patient). His grit and determination was inspiring. His trust in us was motivating.
In addition to all the stories, there was lots of networking going on this week. As a result of one of my daughter’s boyfriend, I was able to make contact with a US Embassy Assistant Army Attaché. We had a chance to share a beer together and I Shared the Mission. He was gracious enough to come to the hospital to review the project directly and meet and greet the leadership and assess the needs. This may open doors for additional support in the future and our fingers are crossed. I also meet with the Batar brothers who are twins and both general surgeons who run the hospital and we discussed ways to map out the future for the program and the hospital. (See photo.) They are very open and interested in our continued support. Dr. Hans Larsen, the President of the Haitian Orthopaedic Association joined mein the operating room for surgery on Thursday and we had an opportunity to discuss orthopaedic care and residency training needs. In addition, he invited me to join him for dinner on Friday evening with the speakers from the first US Orthopaedic Trauma Association and University of Maryland Ortho Dept sponsored course. My friend Andy Pollok, MD was heading the conference with the Notre Dame Medical School in PAP. Notre Dame isa private catholic medical school and they are partnering with Project Medishare Hospital Bernard Mavs for part of the training and education. This is exciting news for both.
As I said at the start of this journey, their appears to be hope for Haiti. As I drove around the city, areas are getting cleaned up and streets are clearing. There still is much to do. As I spoke with Dr. Larsen at dinner and during our drive home, he shared with me his story of his life in Haiti growing up within a familyof seven and sharing a life as a family. He stated that Haiti wasmuch different then from now and people could prosper. PAP had 150,000 residents compared to 2.5-3 million today. He talked about how all of his siblings have remained in Haiti. His brother is also a physician and the current Minister a Health. He told me of his own family of three adult children who all left the country for the US and how much he misses the chance to spend timewith them and share as a family. As a father of four wonderful and beautiful daughters, I could feel his pain. He has hope that Haiti can become a better place again and become a place that his family and others would have the desire to return.
There is hope for Haiti but the Mission continues. With your help and continued support and prayer we might see noticeable changes. As you forward these emails, I invite and encourage you to go to our website www.houstonhaitirelief.org and Facebook page at Houston Haiti Recovery Initiative and consider making a donation to help make it happen. All for now. God Bless. -Brian
Brian S. Parsley, MD
Dr. Parsley was part of Haiti Earthquake relief efforts organized by AAHKS 2nd Vice President Carlos Lavernia, MD
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