Itigi: Day 5

Wednesday September 23, 2015

Our first case was to release burn contractures on a young woman. The patient had been burned in a motorcycle accident, and the scarred tissue at the neck kept the patient from looking up or side to side.

Other cases involve arms and leg burns that have healed and require a skin graph or z-plasty to release the scar so that the patient can move the joint—wrist, elbow, knee. The surgeon makes zig-zag, running incisions in the skin before suturing the area back together to increase mobility. In other cases, skin is grafted from the abdomen (full thickness skin graft) or the thighs and back (split thickness skin graft) and used to provide coverage for burns and contracted scars.


Posted in Volunteering | Tagged | Leave a comment

Itigi: Day 4 September 22, 2015

The boxes set off by van for the 11 hour trip to us from Dar es Salaam to Itigi (pronounced “Itiggy”). We delay the start of surgery for one day. The hospital uses different anesthetics and anesthesia machines, and in all of our team choices, patient safety is a priority.
The ReSurge team is here to provide training and education for the physicians who staff St. Gaspar’s Teaching and Referral Hospital. Five surgeons and one anesthesiologist from Tanzania have come here. The surgeons and anesthesiologists spend the day discussing cases with the physicians here. The intern, head nurse and I discuss the management of a girl who was recently diagnosed with diabetes.
The 8 missing boxes are delivered after dinner and we return to the operating room and post-operative area to inventory supplies and finish setting up. 


Posted in Volunteering | Tagged , | Leave a comment

Itigi: Day 3

Monday September 21, 2015

The team has an early breakfast before meeting the hospital staff. We tour St. Gaspar’s which has a CT machine. 

In clinic the surgeons examine the patients with anesthesia and pediatrics. The evaluation we do here is like the pre-operative history and physical patients have in the US before undergoing surgery. We want to know about the patient’s health, allergies, medications, and any medical problems. We have two volunteers who served in the Peace Corps in Tanzania translating for us. Nurses check temperature, pulse and oxygen saturation. We use a Hemocue machine identical to the one in my office to check the patient for anemia. The day is long, but the process efficient.

The Monday night flight from Amsterdam lands in Dar with our 8 boxes at 10 p.m. 



Posted in Volunteering | Leave a comment

Itigi: Day 2

Sunday September 20, 2015

Six a.m. breakfast had us in our bus and An extra van with our 15 boxes for the 600 km drive west through Dodoma to Itigi. There are towns and villages, farms and stores. The road was paved until the traffic circle where we turned off for Itigi. From there it was a short drive over a dirt road to the St. Gaspar Teaching and Referral Hospital. The hospital provides medical, surgical, obstetrical-gynecological and pediatric care to the town and central Itigi.

There are no flights into Dar es Salaam today. The missing boxes have gear we need. We cross our fingers and tumble into bed to wrestle with the jet lag.


Posted in Volunteering | Tagged | Leave a comment

Meningitis B Vaccine

Shot TimeMeningitis is a serious brain infection that strikes quickly causing disability and death.

In the United States we immunize teens for bacterial meningitis strains A, C, Y and W. The first immunization is given at age 11 years with a booster dose at 16 years. This immunization protects children and young adults for middle school, high school and college. Gathering together in groups, sharing food and drinks and close contact all increase the risk of meningitis transmission. It has long been known that close living quarters for military recruits and college students in dormitories can spread meningitis. This is why we immunize young adults.

Recently, the meningitis B strain which is not in the current immunization has caused infections and deaths in the United States. Some of these deaths have been on college campuses in California.

The meningitis B vaccine is licensed to give in the United States, however the American Council on Immunization Practices stopped short of recommending it for everyone. Part of this involves the relatively small number of infections and the cost of immunizing all young adults. Some college campuses are requiring the meningitis B vaccination; others recommend it. Some insurance companies cover it; some may not.

We believe it is important for all families to have information about meningitis B and consider immunizing their child/children against this infection. The vaccine is requires two doses given 4 weeks apart for ages 10 years and older.

The CDC has information about meningitis and the meningococcal vaccine.

The vaccine information sheet for the meningitis B vaccine is here.

Please call the office if you have questions or would like to make an appointment for the immunization.

Posted in 101, Immunization, Medicine, Teens, Wellness | Leave a comment

Car Seat Fitting

Home from Hospital



Buckle your baby up right!


Schedule a car seat fitting close to home.

Car Seat Fitting 2015




Posted in 101, Babies!, Children, DIY, Medicine, Pediatric Bits, Safety, Wellness | Tagged , | Leave a comment

Scars: What to Do

Very-minor-scarHow a wound heals depends on many things.

Here’s how to help the healing process.

Always clean wounds with lots of running water right after the injury. An infected wound doesn’t heal well.

Cuts that are deep and gape open will heal faster and with less scarring if they are sutured, glued or stapled.

Keep sutured or stapled wounds clean until it’s time to have the sutures or staples taken out. Get the sutures and staples removed when recommended.

Healing wounds should be kept out of the sun for 6 months. Cover up with a hat or clothing. Once the wound has healed, use sunscreen with a high concentration of zinc oxide or titanium dioxide (some extra strength diaper creams are 40% zinc).
Silicone sheets are available over the counter to cover new scars as the body heals. These may be effective, however they are difficult to keep on children and parts of the body that move a lot.

Some specialists recommend liquid silicone like Scarguard.

Mederma is sold over the counter, but the research on its effectiveness is very limited.

It can take a full six months for the body to heal and remodel the injured area. At that time the result of scarring can be evaluated.





Posted in 101, Children, DIY, Health Care, Pediatric Bits, Safety, Wellness | Tagged , , , , , , , , , , | Leave a comment

Eliminating Foods in Food Allergy


Food Allergy Research and Education has the information you need if you want to better understand the difference between food allergies and intolerance, or if your child has been diagnosed with a food allergy and you need to eliminate specific foods from their diet. The FARE homepage is here.


Click the food allergens below for the link to eliminating specific foods from the diet:






Tree Nuts


Posted in 101, Children, Health Care, Medicine, Nutrition, Wellness | Tagged , , , , , , , , , , , , , , , , , , | Leave a comment

Flu Vaccines

Shot TimeFlu Vaccines 2015-2016 Season


UPDATE: September 14, 2015.

Call for appointments

  • Flumist nasal spray flu vaccine for 2 years and older: in stock
  • Flu injection for 6 months to 3 years: in stock
  • Flu injection for 3 years and older: in stock

Please check back for updates.

We stock only preservative-free vaccines

Sign up for vaccine stock updates @casaverdepeds

Read why to get a flu vaccine HERE


Vaccines for Children Program

Children with Blue Cross through Children’s First Medical Group receive their shots through the Vaccines for Children (VFC) program.

VFC Flu Vaccines 2014-2015 Season

  • Flumist nasal spray for 2 years and older
  • Flu injection for 6 months and older
Posted in 101, Babies!, Children, Flumist. nasal flu vaccine, Health Care, Immunization, Medicine, Pediatric Bits, Wellness | Tagged , , , , , | Leave a comment

Baby Now and Zen: Medicine Cabinet

Dr. Spock

What should I have in the medicine chest circa 1940s?

rectal thermometer
absorbent cotton: one pound and toothpicks or toothpick swabs
zinc ointment
baby oil and cod liver oil

These were suggested by Dr. Benjamin Spock in his classic baby care book. The cotton and toothpicks were to make cotton swabs to clean nose and ears. The cod liver oil was given as a vitamin D supplement.

What should I have in the medicine chest circa 2015?

Stocking the newborn medicine chest is easy–all you really need is a digital thermometer.   Rectal temperatures are preferred in infants, but in a pinch you can take an axillary (underarm) temperature. Ear thermometers are best for children over one year old. We no longer recommend old-fashioned glass thermometers because if they break, the mercury is hazardous.

Another essential piece of equipment is the bulb syringe. The hospital will provide the one that was used to clear your baby’s mouth and nose at delivery. Hang onto it because the ones sold in the store tend not to be as good as the hospital model. When used with or without salt-water nose drops, the bulb syringe is good for suctioning mucus from your baby’s nose during colds.  Cool mist humidifiers may also help when baby’s nose is congested. Cool mist machines are preferred because they pose less of a risk for burns.

A trip down the children’s medication aisle is enough to give any parent an ulcer, but for now remember one thing: Never give any medicine to your newborn without first checking with the pediatrician. Always measure medicines with droppers that are calibrated; you’ll need a one medicine dropper that measures 5 milliliters. Metric (milliliters) is more accurate than conventional teaspoons.

If you want to plan ahead, reasonable things to purchase include infant acetaminophen, salt-water drops for nasal congestion, a zinc-based diaper cream and an oral rehydration solution like Pedialyte. Check the expiration date on anything before you buy it, because chances are you won’t need any of these for the first months. Don’t store medications in the bathroom medicine cabinet. Children are excellent climbers and explorers. Keep all medications and hazardous material securely stored away.

Take the time to put the Poison Control number in your phone now: (800)222-1222.

Posted in 101, Babies!, DIY, Health Care, Medicine, Pediatric Bits, Safety, Simply Safe, Wellness | Tagged , , , , , , , , , , | Leave a comment