The next day, we went to the hospital one last time to round on our patients before taking the bus to Entebbe, where many of us began the trip back home. Priscilla (our scoliosis patient who had surgery Wednesday) is recovering well and standing up straight. The pain tolerance and determination of many of our patients in Uganda has been astounding. None of them have had any IV pain medications post-operatively, yet most are up and about the first day after surgery. On the bus ride back to Entebbe, we took a scenic shortcut to avoid “jam” (which is what they call traffic in Uganda). Not only did we shave an hour or so off of the 6-hour drive, we also were treated to some nice views of the countryside. Megan: “Are there any liquor stores around here?” We stopped by the equator line on the way to Entebbe for coffee and pictures. They have an interesting set up at the equator line with three bowls: one in the northern hemisphere, one on the equator line, and one in the southern hemisphere – all three no more than 10 feet away from one another. When water is allowed to drain from each of the bowls, the resulting water funnel twists in opposite directions on the north vs. the south side, while the water draining from the bowl directly on the equator line doesn’t seem to spin at all. A bit hard to believe at first, but we saw it with our own eyes, and even switched the bowls around to be sure it wasn’t a trick.
With that, the trip – and the blog - have come to an end. This mission has been a unique and transformative experience for me in many ways, and I have taken from Uganda many lessons and memories that will surely stay with me for the rest of my life. As a special sign off, we leave you with a fantastic video that Michelle has put together to chronicle the July 2016 Mission. Wishing everyone in Uganda and elsewhere a safe and happy year. Thank you to the many people who came together to make this trip possible. https://www.youtube.com/watch?v=262wUxLGBeI&feature=youtu.be
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Today is the final operative day of the mission, and we intend to sprint through the finish line. The hospital graciously allowed us to use two O.R. rooms today, as we have 5 operative cases that we hope to finish before we leave. Everyone buckled down and really came together to get things done today. The surgeries for the day included: two anterior cervical discectomies and fusions (one for degenerative disease and radiculopathy and the other for trauma) and three lumbar decompressions and fusions for adult degenerative spine disease. Much of the equipment had to be run back and forth between the rooms during the cases, as we didn’t have enough C-arms, bovies and drills to run both rooms simultaneously. After the operative cases were done, we still had to pack most of our equipment back into tubs to take with us to the warehouse for storage or back to the states to the companies and individuals from whom we had borrow them. Luckily, Lance is a beast, and had cleaned and packed most of the instruments and other equipment before we were even done operating. Our last night in the Mbarara O.R.
Exhausted, we made it back to the hotel in time for dinner and packing up our luggage. The big operative case of the day was a young lady named Priscilla who had idiopathic scoliosis. Priscilla is a nursing student in her final few months of nursing school. She has been trying for years to visit our mission and have surgery, but because of issues with timing, she has never had the opportunity to have her deformity corrected. This year, the stars aligned and we were able to see Priscilla and schedule her for surgery. This meant that she would have to take a leave of absence from school for several months, and although this would set her back a bit in the process of becoming a nurse, she did not want to let the chance slip away again. We spent the morning and early afternoon correcting her deformity and fusing her spine into a new, straighter position. Our second patient was a young lady named Jolly who presented with back and leg pain. She was found to have fractures and erosion at L2-L3; the appearance was suggestive of an infectious process. Indeed, when we reached the area of the fracture, we found infectious material within the disc space. This was removed along with part of the eroded/fracture vertebral bodies and her spine was instrumented into a more normal alignment. We sent cultures of the infectious material and placed some antibiotic powder into the wound before closing. During the day, Dr. St. Clair saw several new patients in the wards, one of whom was a man with a cervical spine injury in need of stabilization. The practice of carrying objects on one’s head has existed for centuries in Africa and other developing countries. Unfortunately, this patient was carrying a large load of firewood on his head when he tripped, applying a heavy flexion and axial compression force to his neck, which resulted in a fracture/dislocation at C4/C5. He lost function in his arms and legs almost immediately after the injury, and because the event occurred days before he reached us, his prognosis for recovery of limb function was poor, but he was in need of stabilization to prevent and further deformity or injury from occurring. We took the patient to the operating room after our second case, where we reduced the dislocation and removed some herniated disc material that was compressing his spinal cord at that level.
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