It might sound like an obscure sub-specialty, but interventional radiology is actually the standard of care in many institutions. Compared to traditional surgeries, these minimally invasive procedures guided by medical imaging are faster and less painful for the patient. They’re also less expensive for the health care system overall.

Interventional radiologists diagnose and treat renal disease and cardiac malformations, obtain tissue biopsies, place needles and catheters, and treat blocked blood vessels. However, these procedures require specialized equipment such as an ultrasound, X-ray fluoroscopy, computed tomography, and magnetic resonance.

And while interventional radiology for children is widely practiced, there are currently no procedural suites dedicated to their care in Puerto Rico. That means that a child who needs one of these procedures must transfer to an adult hospital or travel to the U.S. mainland. Both options are financially costly – and compromise the safety of these young patients.

A much-needed resource

Llorens trained at the Children’s Hospital of Pittsburgh of UPMC, intending to return home to Puerto Rico eventually. “When [the hospital] recruited me, I let them know of my interest in developing a pediatric interventional radiology service” in Puerto Rico, he said.

Today, when a child is determined to be a candidate for a procedure, Llorens first has to make sure that he has the right equipment and that the interventional suite at the adult hospital is available. These hurdles often mean delays in diagnosis and treatment.

Direct Relief provided a $1.6 million grant to the Pediatric Hospital Foundation to construct a Pediatric Interventional Radiology Unit. It will be the first one in Puerto Rico – and the Caribbean.

The new unit “will elevate patient care to national standards,” Llorens said.

HOPU, the only public children’s hospital on the island, will be home to the unit. The hospital serves 8,500 patients annually, from infancy to age 21. Most patients are from low-income households and qualify for Medicaid. Because it is the only medical institution on the island that can provide 24/7 sub-specialty care and houses a pediatric dialysis center, it receives patient referrals from all over Puerto Rico.

Treating pediatric patients in a unit dedicated to their care will dramatically reduce stressors that children and their families experience while receiving care in an adult hospital environment, such as being surrounded by strangers or needing nurses trained in pediatric care.

New opportunities

Puerto Rico doesn’t lack interventional radiologists. But none of them specialized in pediatrics before Lloren arrived. Now, a unit devoted to caring for children is a necessity.

“Being able to offer this service provides an added value to the health of pediatric patients in Puerto Rico,” said Dr. Francisco Arraiza, an interventional radiologist and board member of the Pediatric Hospital Foundation.” He explained that the unit would mean a faster recovery time for patients – and lower cost since children won’t have to stay as long in the hospital.

Rebeca Quiñones, executive director at the Pediatric Hospital Foundation, indicated that the new pediatric interventional radiology unit would position the hospital as a state-of-the-art medical facility with “world-class advanced medical technology.”

There’s more reason to be hopeful. HOPU serves as the pediatric teaching hospital for the University of Puerto Rico’s School of Medicine and trains physicians in several disciplines. Doctors are optimistic that the new unit will appeal to other pediatric interventional radiologists who might practice or train on the mainland but be interested in returning home.

The unit may also help Puerto Rico prevent more doctors and other health workers from leaving the island, as they have in significant numbers in recent years.

Arraiza also thinks the state-of-the-art new addition could elevate medical tourism in Puerto Rico, providing an economic boost. Due to the island’s geographical position, “we could become a medical hub, and provide treatment to neighboring islands” in the Caribbean, he said. “If you build it, they will come.”

The post For Children in Puerto Rico, Elevating the Standard of Care appeared first on Direct Relief.

The 35-year-old doctor moved back to the island 10 months ago, forgoing job offers that would have doubled her current salary.

“Job offers in the U.S. are very attractive, but I knew that I wanted to come back,” said Dr. López, who works as Director of the Imaging Center of the Medical Sciences Campus of the University of Puerto Rico and assistant professor at the UPR School of Medicine.

(Español)

At the time she moved back to the island, the public health system of Puerto Rico didn’t have a program for her to apply her expertise in breast imaging, which she had practiced at the Mayo Clinic. But Dr. López was determined to find ways to help.

Direct Relief funded the purchase of contrast-enhanced digital mammography technology to the center. Direct Relief is also replacing the hospital’s colonoscopy and laryngoscopy equipment that was damaged during Hurricane Maria, when voltage fluctuations made the equipment unusable.

About two-thirds of the patients served at the University Hospital lack insurance, have incomes below the poverty line, and are medically underserved. The imaging center sees between 250 to 300 patients monthly.

The newly equipped space will allow doctors to care for patients on the island who otherwise would lack access to the help they need.

“Women aren’t the only ones at risk of developing breast cancer; men are too, and there’s another population on the island that’s terribly neglected: the trans community. Men who are sexually transitioning are consuming hormones that predispose them to cancer, and women who are transitioning are at risk as well if they haven’t had their mastectomy. These are patients who face many obstacles to receiving screening tests,” she said.

“Having the best technology in the best place makes the sacrifices worth it because you know that you’re making difference,” said Dr. López, who sometimes works 24-hour shifts.

“Doctors in Puerto Rico work more. There’s no way to sugarcoat it. We have to meet standards with less staff. We cover administrative needs that would typically be handled by specialists… Which in Puerto Rico, don’t exist,” she said. The doctor acknowledged that these tasks are time-consuming efforts that extend her work shifts and prevent her from seeing more patients.

Despite this, she looks to the future with a strong desire to serve.

“I obtained all my college education at the University of Puerto Rico, and I think that, if it’s possible, one has to give back. It’s a way to help future generations have the same opportunities that I had,” she said.

– Alejandra Rosa Morales is a journalist based in Puerto Rico.

The post Puerto Rican Doctor Moves Back to Give Back appeared first on Direct Relief.

La radióloga de 35 años regresó hace diez meses a Puerto Rico para proveer atención médica a poblaciones femeninas, dejando atrás ofertas laborales en Estados Unidos cuya paga duplica su salario actual.

“Las ofertas de trabajo en Estados Unidos son bien atractivas, pero yo sabía que quería regresar. Este es el sitio en donde se hace patria”, aseguró la boricua, directora del Centro de Imágenes del Recinto de Ciencias Médicas (RCM) de la Universidad de Puerto Rico (UPR) y catedrática auxiliar de la Escuela de Medicina de la UPR.

(English)

En en ese entonces el sistema de salud pública de Puerto Rico no contaba con un taller en donde pudiera poner en práctica su especialización en imágenes de la mujer, preparación que adquirió en Mayo Clinic, entidad médica reconocida a nivel estadounidense por su gran vanguardia y prestigio.

La doctora López dicta notas mientras examina placas de pacientes. Equipo más avanzado permitirá que los pacientes tengan acceso a la tecnología de mayor vanguardia.

El donativo otorgado por Direct Relief posibilitará la llegada de una tecnología conocida como Mamografía Espectral Mejorada con Contraste al Centro de Imágenes de la Escuela de Medicina de la UPR.

Direct Relief está también reemplazando el equipo de colonoscopia y laringoscopia del centro, que se deterioró durante el Huracán María, cuando fluctuaciones de voltaje lo volvieron inusable.

Cerca de dos tercios de los pacientes que atiende el hospital universitario no tienen seguro médico, viven con un ingreso por debajo de la línea de pobreza, y están médicamente desatendidos. El centro atiende un promedio de 250 a 300 al mes.

El nuevo espacio le permitirá a López atender a pacientes en la isla que, de otro modo, carecerían del acceso a la ayuda que necesitan.

“No solamente a las mujeres les da cáncer de seno, a los hombres también y, de hecho, hay una población que en Puerto Rico está sumamente desatendida, que es la comunidad trans. La comunidad trans está a riesgo real de cáncer”, explicó la puertorriqueña, para quien estas realidades reivindican la importancia del taller radiológico.

“Tener la mejor tecnología en el mejor sitio hace que algunos de los sacrificios que uno quizás tenga que hacer sean más llevaderos, porque uno sabe que uno está haciendo una diferencia”, reflexionó la doctora, que a veces trabaja turnos de 24 horas.

“Los médicos en Puerto Rico trabajamos más. No hay forma de decirlo de otra manera. Tenemos que cubrir unas exigencias con menos personal. Cubrimos unas necesidades administrativas que típicamente [en otros países] recaerían en un especialista en asistencia de médicos — que en Puerto Rico no existe”, dijo López Álvarez.

La doctora reconoce estas tareas como esfuerzos que le consumen tiempo adicional, lo cual extiende sus turnos de trabajo y le impide atender más pacientes de lo que quisiera.

A pesar de eso, mira al futuro con un fuerte deseo de servir. Mientras el taller comienza a operar, se concentra en supervisar residentes, y en trabajar desde el Recinto de Ciencias Médicas de la UPR pos de la creación de más espacios para proveer servicios médicos a distintas poblaciones.

“Toda mi educación universitaria fue en la Universidad de Puerto Rico, y yo pienso que en la medida de lo posible uno tiene que repagar una deuda. Es la forma de uno asegurarles a las futuras generaciones que van a tener las mismas oportunidades que tú tuviste”, apalabró la egresada del Recinto Universitario de Mayagüez de la UPR y de la Escuela de Medicina de la UPR.

– Alejandra Rosa-Morales es una periodista independiente radicada en Puerto Rico.

The post La Doctora Que Regresó a Puerto Rico Para Servir appeared first on Direct Relief.