Muscle Fitness Advice

Sharon French is a quality coordinator for Regency Hospital in Cincinnati. She used to practice in pre-hospital/trauma care and worked as an EMT with the City of Edgewood. She was also a part of the medical assistance team with the Red Cross for several years. her latest blog entries from Haiti are posted at the top of this page.March 2It’s a beautiful day here in Haiti. the temperature is about 80+ degrees and there is a steady wind blowing. the clouds have left us, so the humidity is low. Ahhhh.Today, my partner was sick, so I spent the day in the clinic where vaccinations are an ongoing effort. One of the greatest health care efforts has been to prevent illness among the poor here in Haiti through vaccination programs. We saw numerous babies — little ones, big ones, quiet ones and loud ones. They all had one thing in common — they were updated on all vaccines while there.the standard immunizations are given here in Haiti when compared to the U.S. — diphtheria, pertussis, tetanus, measles and rubella. One vaccine is given here that is no longer given in the U.S. — BCG. the BCG vaccine is still given in third world countries as a preventive for tuberculosis. it is not always effective and can lead to a false positive skin test for exposure to TB. These are problematic in that you do not know if the vaccine is working or if the patient was exposed to active TB. Either way, medication to prevent the activation of TB must be given.Programs to vaccinate are not only targeting the children but the mothers as well. many of them were also in line for tetanus and diphtheria booster injections. I do not know who cried more — infants or their mothers!I spent a lot of time in the malnutrition center playing with babies. There is one young boy who is about 9 months old who had been distant from the staff. He is not meeting his developmental milestones of sitting up, engaging to play, vocalization, reaching, etc. it was time for ‘bubble therapy.’ I brought about 100 bottles of bubble solution (the type you get at weddings) to use for play. so I propped this little one up and started blowing bubbles at him. it took about 10 minutes before I noticed he was tracking the bubbles with his eyes. After about 30 minutes we took a break for a bottle (the baby, not me!) and then started again. I hope to work with him again tomorrow.this is the outcome of starvation. not only are these infants malnourished, which makes for poor development of brain tissue, but the mothers also sense their child is dying and begin to detach. Once this occurs they no longer take the effort to nurse, to play or engage their babies — they are getting ready for the baby’s death and pull away. unfortunately, this leaves the baby socially malnourished as well. because health care workers are spread so thin, the ability to provide stimulating play is limited. Child Life Specialists would have a field day here. I noticed the toys in the malnutrition center are pretty sparse — something I will correct once I get home. Toys that can stimulate attention and be sanitized daily are in great need in a setting like this.Other than a great day with the children and infants of Love A Child, it was a pretty quiet day. We heard that the USNS Comfort has pulled out of port which signifies the end of treatments for the severely injured of Haiti — this is truly a good sign!A quiet and lovely day!March 1I am going to start this entry with a 3-word statement: I AM OK!things here in Haiti are so unsettled and we are starting to see gangs reorganize following the earthquake. this is not good because everyone is still so distracted that they are not paying attention to their surroundings. We received word late yesterday that a carload of missionaries — who had stopped at Love A Child — were kidnapped in Port-au-Prince. We have not heard about the request for ransom nor about U.S. involvement in this. We are still waiting.our security here on the mission compound has been beefed up. We are all indoors by dark and I am staying close to the big dog on campus — Bo. Bo is the size of a great dane and has a bark that will startle anyone! When he is not pretending to be intimidating, he carries around his blanket that he sucks on. the big baby! As I get more information I will keep you apprised of any changes involving those who were kidnapped. Apparently this is not as big a deal here as elsewhere — you pay what they are asking and they let you go.Work started a little later this morning, closer to sun up but I was glad about that. our role here in Haiti is changing quite a bit. We have received so many shipments of medications and medical supplies that we are now acting as a supply hub for other hospitals in the area. our warehouse is bursting at the seams, and we have several hospitals coming today and tomorrow to pick up pallets of items from gloves to OB packs. Everything is needed here. no one is getting anything from the government at this point. When I ask people what the government is doing the common answer is, “What government?”Oh, I have not told you about the new ambulance received by Love A Child from Canada. this is a beauty and looks more like the combat medic vehicles than the ambulances we are accustomed to. it will hold five stretcher patients, travels on all terrains and can pull its own generator. Today, the mechanics from Canada are here to do a little buffing and glossing of the vehicle, which will include installation of a GPS system for the mountains of Haiti. this way, the missionaries can track and be tracked when they are off the compound. They have also installed a system to create medical records on line. this will allow the nurses working in the villages to email a medical record to the mission clinic; follow up will take place on the mission compound in the clinic. Pretty neat, huh?Elvis was back last night, and he brought Priscilla with him. the two of them were running around the house until 10 p.m., when they were escorted out of the building. There was a whole lotta lizard love goin’ on last night! They are still on the deck this morning, lounging in the sun. must be nice to be cold blooded!Well, I think that this is all for today. Remember us in your thoughts and prayers for protection. Feb. 27Other than the riot at the gate today it has been a pretty quiet weekend.Saturday started with another early morning at the warehouse/pharmacy. Late in the morning we met with MAP personnel (Mission assistance Partnership) from Georgia. They are a great group that networks businesses with missions in the field to provide materials and support. We were able to show the need for ongoing supply management to support the rescue effort; they have committed to sending a significant donation of pharmaceuticals (already sorted, Praise God!) and manpower every three months to better organize the warehouse/pharmacy. what a blessing this will be for the mission staff at Love A Child in the future. the relief effort and needs grow daily, and it is difficult to keep up with the demand.Saturday afternoon we loaded up a truck and headed into a small village near Port-au-Prince with an orphanage. They have about 30 children in residence and have been unable to obtain food for several days. We delivered enough food for several weeks in the form of ‘Manna Packets.’ These boxes contain a rice that is high in protein, legumes and dried milk. One box can feed a family of four for about a month. now that the mission knows of the need, this orphanage will be on their regular distribution list.On the way back we stopped at ‘Craig’s mission compound.’ now this is someone with an interesting vision of how to help his Haitian people. On his compound he has built a church, a store, an orphanage, a hospital and a hotel. your basic one-stop-shop center. He is getting on in years, and cannot maintain this property much longer — he has no pastor, nurses, doctor or help. but he is there for the people and they love him for it.Sunday started later — we were up at 7:00 a.m. it felt good to sleep in a bit. After a light breakfast came the walk to the hospital and church. There is really a sense of community there — everyone singing the same song but in different languages. I wonder if this was what Pentecost was like? I met health care workers who arrived from Tunisia today, unpacking medications that will be sent directly to the two hospitals still standing in Port-au-Prince. this has become a fascinating place where people of all ages, all races, all nations are gathering together to reach out to the people of Haiti — what an incredible event.Hospital visiting hours are being cut as of today. We have been preparing meals for the patients, staff, etc., and only recently found out that people from the local villages have been getting in as visitors and staying in as patients to get a hot meal. the gates to the compound — and visiting hours — are being cut to prevent us from having to prepare and serve more meals than necessary.Well, the folks at the gate were pretty angry and vocal about the reduction in time (meals). There was a lot of shouting and threatening, but the gates were closed anyway and people just had to go home or wait until the gates were reopened. the mission staff has decided that with the steady flow of injured we simply cannot prepare and give out meals on the property to those who can — and should — help themselves. it also presents a significant security problem. so, meal packets are prepared and delivered to outlying villages through the local churches.I think the people of Haiti are simply getting tired of waiting for help and of needing help. very little is coming from their own government and communication is significantly lacking on what to do and where to go, etc. I am concerned that after I leave the political situation will become more unstable with time. On our way into the small village yesterday we passed a truck of individuals waving tree branches and shouting political slogans. “There goes another cause,” was the comment by the mission nurse driving us.I spent time this afternoon just walking around and talking with the children. I visited the Love A Child orphanage and spoke with several of the older girls. They are afraid all the men of Haiti were killed and they will have no husbands when they come of age. I told them not to worry; there were plenty of men left! They just giggled. I also met a little girl whose mother works at the orphanage. She ran up to me and gave me a big hug, and then touched my breast asking if they were as white as the rest of me. the little girl’s mother grabbed her hand and told her, “Non!.” I told the mother it was OK, and explained to the little girl that all of me was white, and not a pretty dark color of her skin. She told me she was sorry, gave me another hug and then ran off to play. the curiosity and candor of these children will be one of the stronger things to survive here in Haiti.I am pleased to see children more relaxed around people of another color. When I was here last year, I was the first white person many of the Haitian children had seen. They had been told that the white people captured Haitian children and ate them. now, I am not a small woman and I am sure they must have thought I had eaten my fair share of poor Haitian children!Daily the weather is changing, with storm clouds growing throughout the day with a little rain at night. this is a warning that the rainy season is coming. While this season is needed for the annual crops, it will bring about many problems for the people who are now living outdoors. some of the tents donated do not have bottoms, nor are they waterproof. this means that everything — living quarters, tents, belongings, people — will be soaked for days on end. Everyone is hurrying to get ready for the rainy season, but it is upon us.Feb. 26TEARS OF SADNESS – TEARS OF JOY … the day started early in the warehouse pharmacy. with a steady breeze at 4 a.m. it was time to go to work! We got so much accomplished with checking on new shipments, identifying overstock that we could send on to other hospitals in the area and restocking the shelves. it is amazing how the heat affects your ability to work. the hotter it got the slower we got. try as we wanted, we had difficulty concentrating and just lifting another case of band-aids seemed an insurmountable task. by 7:30 a.m. we were done for. but we were in for a special treat!the woman I am working with found a large pedestal fan in the back of the warehouse. We scrounged around until we found a cord — Praise God! As I remembered an elderly lady say one time, “Lift your arms! Here comes a breeze!” We were able to work well until 10:00 a.m. when we left for Port-au-Prince for grocery shopping.the trip to Port-au-Prince was long and dusty, but was far better than driving through Port-au-Prince (PAP) itself. Once you reach the city limits the chaos becomes apparent. Trucks from different countries are delivering supplies, Tap-Taps (the only local public transportation), people in cars, people walking, people on motor bikes, etc., are all on the same road moving in different directions!. There is no traffic plan — just plan to move through the traffic. An inch is as good as a mile — my dad used to say. but here they come even closer!As we made our way to the shopping area, the damage of the earthquake became apparent on every street. Pancaked buildings and those that seem to have lost their center of gravity, leaning precariously over the road, dotted the landscape. you could tell which building might give someone a chance at life in a small crevice. Other buildings were not so merciful. Small, hand-painted signs that read “Help Us” in English, French, Creole and Spanish dotted some buildings.the business of Haiti has moved outdoors. Slowing traffic means that vendors could sell their wares directly at your car. We bought several bags of fresh veggies and fruit from the local vendors. the mandarin oranges here are in season and are HUGE.We arrived at the store and began our quest. Prices in PAP are extremely high — a packet of sweetened, flavored drink mix is $5 a packet. I bought a bottle of coke for $7.50 (American money). the prices are continuing to rise about 4% each day. it is no wonder the people are starving here.A young man was assigned to help me find things. While we shopped he asked me why I was here. I told him I was here to help. He then asked how I was so calm. He said they were all scared, him especially since he lost his family in the quake. He began to cry as I spoke to him about his loss. He said he knew his family was in heaven, but that he missed them here at this time. We prayed for a brief moment and then it was time for me to leave. While in the checkout lane, the missionary nurse I was with suddenly began sobbing. She recognized three grocery workers at the store that had worked in a store that had collapsed. She thought they were killed. She turned to me and said, “I am falling to pieces.”That seems to describe the whole of Haiti — in pieces. Pieces of concrete and rebar. Pieces of joy and of grief. Pieces of recovery and hope. Pieces of horror and of history. it will take a long time to put all these pieces back together again.Feb. 25GO YE, THEREFORE AND MULTIPLY… And boy, did they ever! Today was all about babies. I started the day checking on two of the set of triplets born here on Monday evening right after I arrived. We were expecting twins, but not triplets. One of the triplets did not survive. We attempted to resuscitate the little boy, but he could not maintain his heart beat. After several rounds of CPR we decided to let him go. There is no neonatal intensive care unit in Haiti. it is little comfort to a momma to have two other babies in her arms when she knows that another one has died. She had no idea she was expecting triplets; of course, she had no pre-natal care. the two babies who survived are doing well as they are being kept in the clinic for 24/7 observation by the nurses and a doctor. They weight about 4 pounds each, which is good for triplets in Haiti, and are nursing vigorously.Early in the morning I went to the malnutrition center to see the babies there. the malnutrition center was started by Love A Child in response to the number of children starving to death here in Haiti. their work has been significant in not only saving lives, but also working with mothers regarding the health of their children. Of all their outreaches to the people of Haiti, this one captures my heart.Case in point: Baby Regina was admitted to the malnutrition center months ago. She was a full term infant, but shortly after birth a voodoo doctor told the mother that her milk contained salt. if she continued to nurse her baby, she would poison the baby to death. not wanting to harm the infant the mother stopped nursing her little one. When admitted at the malnutrition center the baby weighed less than 3 pounds and her liver was failing. several scary days were ahead before Regina turned the corner. not all babies are so lucky.Two little ones in the malnutrition center really caught my eye. A little girl who came in five weeks ago at age 6 months. She was not trying to sit up and did not engage with the staff when admitted. Today, she sat up against a pillow and giggled when I played peek-a-boo with her. her hair is dark brown, and she has dimples — the nurses said she was so thin at admission they did not know she had dimples when she was admitted.the other baby is a little boy who is 8 months old and weighs only 10 pounds. He lies quietly in his crib, his little legs about the size of one of my fingers. His hair is brittle and red and his eyes are sunken into his head. because he will suck from a bottle, a feeding tube is not necessary for this little one.the Haitian nurses at the malnutrition center are truly angels and save lives. not only do they provide for the physical needs of these babies, they provide counseling for the mothers, encouragement to continue breastfeeding and stimulation for these babies. the clinic nurse tells me that many of the malnourished babies they see will take years to catch up on development — some may never because of the effects of poor nutrition during the first few weeks to months of their lives.Later in the afternoon a baby was rushed into the hospital. International health care workers thought the baby was in renal failure because its little feet and abdomen were so swollen. Arrangements were quickly made to airlift the baby to the USNS Comfort for a renal work up and possibly dialysis. but one look at the baby by the Haitian nurses told another story: kwashiorkor. this results when a baby does not receive the nutrients it needs to grow, primarily protein. These infants develop an enlarged liver that gives it a swollen belly look. their little feet swell tremendously and their skin breaks down, allowing precious body fluid to escape. the baby’s mother explained that for 6 weeks no milk was available and she could no longer nurse the baby. As the baby got weaker and weaker, it could not suckle from the mother stimulating more milk to form. this is becoming a common problem among nursing mothers as the stress of the earthquake, lack of food and water and aftershocks are relentless. this mother would boil rice and give the baby rice-water. this was all she had to give.During this past year, I have really been driven to do what I could for the malnutrition center at Love A Child. several companies — Union Bead Boutique for one — donated a hospital grade breast pump and the supplies to make sure mothers who could not nurse their babies would be able to pump and store their breast milk for their infants to be fed by inserting a feeding tube. A feeding pump and supplies were also sent to the malnutrition center. Prior to this time the nurses would sit by the infants’ beds and squirt a few milliliters of formula into the feeding tube with a syringe every few minutes. having a feeding pump to automatically deliver the formula will ensure adequate/accurate amounts are given to the babies until they can begin to suck enough to support their life.the word ‘life’ is taking on such a different meaning for me these last few days. Seeing life begin — and end so abruptly — is a sobering experience. Am I discouraged? yes. it is discouraging to see such a lovely people consistently struggle and then lose what little they have. Am I giving up? no way! every time I see those little ones overcome hardship and their dimples bloom with a big smile I am reminded that there is hope in life, and there is life in hope.Continue to pray for us.Feb. 24The Academy Awards has nothing on me here in Haiti. We finished sorting TONS of supplies and medications, and finally opened our stock pharmacy. many thanks to the pharmacists at Regency Hospital in Cincinnati who encouraged me to ‘keep it simple.’ all items are sorted according to the alphabet, which means we must keep a close eye on the types of drugs by name that we are distributing. someone mixed albuterol tabs with atenalol tabs yesterday — it could have been a nightmare! We now have a system of three checks by three different people before meds are turned over.Late yesterday, a Haitian nurse came to the pharmacy and needed a large amount of drugs for a regional clinic. the only problem was that she did not know English, and my French is pretty bad. Everyone is so busy with patients and other things that I do not have an interpreter. My colleagues would have died laughing as I demonstrated the use of Lovenox (a blood clot preventive) by having a clot in my arm and then throwing it, leaving me gasping for air. the nurse put on a good show as well as she acted out the need for urinary catheters. We are now requesting that the regional clinics and the hospital write down the name of the drugs so that the ’show’ will not go on and we can be assured of providing them with the correct drug.We received another two semis with drugs last evening. One of the missionaries unloaded the pallets in our area with a forklift. looks like tomorrow will be another busy day of unpacking boxes.Night time came early as the heat is really wearing us down. even the veteran missionaries are beginning to show the effects — headaches, severe fatigue, etc. unfortunately, as soon as you lie down another aftershock occurs. They are small, but annoying at times. I can see where the last 5-6 weeks of this wears on the soul.We received many wounded yesterday by helicopter. I counted 10 patients in 45 minutes. They came from the small hospital in Jimini. the doctor got tired of the aftershocks and left. He simply left everything — packed up and gone! unfortunately, he was the only doctor at this hospital. so the nurses called the United Nations and they made arrangements to have the wounded transferred here.let me explain how the wounded are transitioned through the hospital: when someone is severely wounded (critically), they are taken to the USNS Comfort. the ICU is there and the staff can care for the patients much better than the hospital here. Once the patient is ready to come out of ICU, he/she is airlifted to the field hospital at Fond Paresien (the Love A Child compound). the patient is triaged and then sent to a specific tent (orthopedics, head injury, pediatric, etc.). After the medical needs have been met (i.e. the patient no longer needs IV fluids or antibiotics), they are then given a tent in the refugee camp, Camp Hope.the triage and hospital is led by a group initiative from Harvard and they are exceptional. They are attentive to sanitation, patient needs, cultural influences, etc. We have physicians from St. Petersburg, Fla., Columbia University and the University of California. We have ENT surgeons, plastic surgeons, orthopedists — we have a standing joke that if you want the best medical care you need to come to Haiti! Today the plastic surgeons will begin working to reconstruct a serious facial injury on a young girl. She was struck by falling debris in the earthquake and lost facial structures to one side of her face. They told her she will once again have a pretty smile — they are confident they will be able to reconstruct her face successfully.I heard one of the missionaries speaking to an amputee yesterday. He was very despondent about losing his leg. the missionary took a $20 bill and ask what it was worth — of course it was worth $20. Then she crumpled it into her hand and asked what it was worth — again the patient responded it was work $20. She told him that currently he was a bit ‘crumpled,’ but that his worth and value was still intact. I think that example of how to face a dark time in your life will always remain with me.take care, all. Continue to pray for us and the work we are doing.Before the TripI worked in Haiti last spring and, as a nurse, saw things (and did things) that I could hardly believe possible. the people of Haiti are so willing to do better, but their circumstances keep them at a level of poverty that would take generations to overcome. Although I was only there a week, Haiti captured my heart. since that time I have been in close contact with the missions nurse. the services that the mission has been able to provide the people of Haiti are remarkable: they have started 11 schools in the mountains around Fond Paresien that provide food for the children attending school, a general service clinic, a malnutrition center and hope to open a maternity lying-in hospital and burn center. in addition they opened a carpentry school and are planning to open an electrical and plumbing school. the people working on this compound are truly remarkable. I feel blessed to know them.since the earthquake there have been many changes on the mission compound. the Dominican Republic has established a hospital on the grounds (they did not want all the Haitians coming into the DR for medical care) as well as a refugee camp that will house 400. the USNS Comfort is bringing patients in daily who are discharged from acute care to the hospital on the grounds. Once patients no longer need hospital services (i.e. intravenous antibiotics or more surgery) they are moved to Camp Hope (the refugee camp). I will be arriving in Santo Domingo on Feb. 21 and leave for Haiti on Feb. 22. We will be traveling by truck over the mountains into Haiti; this is also the one road for refugees. I am not sure what I will be doing upon arrival. There is critical need everywhere right now. Although the acuity of the situation is dying down, they are STILL getting injured people walking to the mission for help. the food situation is still precarious as shipments are being delayed at the Haitian border due to red tape. During my stay in Haiti, I hope to get to two areas: La Tant (a mud hut village that was destroyed by the earthquake in 2008) and Port au Prince.

Blog: Local Nurse Travels To Haiti