At this point, I won't bore everyone with the typical morning details of a team breakfast; It's always just us eating, chatting, and cementing the plan for the day. Reminding everyone of who's in what room, the patient we'll be operating on, and the operation.
At the hospital, Alexis and I went on rounds, accompanied by Natasha, as we checked on patients from all the days prior. Gilda and Perepeta from the previous day of operating were doing significantly better, and each was beginning to move, and had the usual complaint of discomfort and pain. Abdu, the halo, was doing well, and reported some discomfort in the chest. We explained to him it's to be expected, as the halo vest is applying some pressure, and we sent him to get some x-rays for the day. Previous patients, such as Moses from Saturday, Jacinta from Friday, and Denis from a week prior, were all going to be discharged due to their well being or significant improvement. Others remained, due to long distance to travel, then the need to return, or they simply weren't quite ready to be sent off. Julius, from one week prior, unfortunately, in addition to his TB, developed another infection, and had begun treatment via IV and had to remain a few days longer so we could see the antibiotic doing it's job. The OR had four cases planned for the day; Three women, Allen, Gudena, and Mary all had similar operations set for lumbar decompression fusions, and we had a man by the name of Victor set for a corpectormy and cervical instrumentation and fusion. In terms of length, we had a moderate day set before us. Each case, while time consuming, went extremely smoothly, leaving us with most of the evening to plan the next day of operating. The next day of operating, however, wasn't going to be nearly as short; we were planning six separate cases for Wednesday, but things never quite work out how you expect. With operating done for the day, and the following day planned, we returned to the hotel, anxious to eat and get some well deserved sleep for the day, knowing we were planning many surgical cases for the following day.
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Every morning is an early morning with a team breakfast. 6:30 am rolls around, and we all begin to trickle down from our rooms to eat and plan the day in more detail than we did the day before; two fusions were planned for the day on a woman by the name of Gilda, with a fusion planned from L2 (quick note: the spine is split into 3 main regions; cervical, the neck, thorassic, the middle of the back, and lumbar, the lower back. Each is abbreviated using the first letter: C, T, and L) to her pelvis, and another woman met in clinic the week prior, Perepeta, with plans to fuse her from L4 to L5. Not a difficult day, and with, both Dr. St. Clair and Dr. Huang operating at once in different rooms, it should be a short day by comparison to others. However, things are never quite what you'd expect.
We arrive at the hospital, where Dr. St. Clair and Alexis join Dr. Huang, Stanley, Natasha and I on rounds, where they escort us to the emergency ward for a consultation that had come in; a young gentleman in a boda boda (it's similar to a motorcycle) named Abdu, who had fracture located at his C1/2 vertebrae, and in addition, he was unable to move one of his arms. So, we quickly made a plan to place him in a Halo, which is supposed to keep his head still and prevent movement, so the bone can move back on it's own as much as possible, and heal on its own. A surgery is possible in this case, but would cause a severe loss of neck movement. So, we added this case to the day. The other patients were all continuing to do better; patients like Godson were going to be discharged, while others like George and Jolly were already gone and out on their own, having been discharged over the weekend due to such rapid and successful recoveries. After this patient, Dr. St. Clair and Dr. Huang left to the OR to finish getting ready for the day. Rounds continued while surgeries were prepared for and started, with those of us on rounds arriving shortly after both incisions were started. Alexis and Stanley both went to scrub in, while Natasha and I took care of patient files and prepping the surgery schedule (as much as we could without Dr. St. Clair's approval)! Both Gilda and Perepeta were being operated on at the same time in different rooms, and with so many people wanting to learn and be a part of these surgeries, Alexis and Stanley came out for a break. We chatted over more of Sister Rose's homemade samosas, and went to go look for the halo going to be used on Abdu. After a little bit of searching, we found a box filled with halos and halo parts, there was one problem however; we could tell which pieces went to what, and if we had everything for the halo and halo vest (it pushes down on the chest with rods, keeping the halo in the desired position). So, with each of us filling our arms, we took the parts into the doctor's room, and got to be engineers for a few minutes as attempted to build the halo and halo vest (which, was successful, by the way)! Both surgeries went through with no difficulties; the patients were stitched up, covered, and sent to the post anesthesia care unit (abbreviated PACU), and Abdu was sent for. He arrived, and planned for the halo and vest. The halo has 4 screws used to hold it on the patient; 2 screws carefully placed above the eyebrows and slightly off center to prevent from hitting a nerve, and the other 2 screws are placed 1 above each ear; the halo is then attached via rods to the vest to maintain the desired position. Local anesthesic was injected into the pin sites, and we began to insert the screws into the halo and the patient, and quickly set up the vest on him. The whole process took maybe 30 minutes, and we sent him back to the ward. The day was rather short, so we returned to the hotel, where we all changed, played our favorite pastime, Jenga, ate and drank, and enjoyed each other's company. Thus, ended the first day of operating with Team 2. Saturday morning. Bittersweet as we of Team 1 share our last breakfast together before everyone leaves Dr. Huang and I behind to join Team 2 as they go to a conference in South Africa. We recall the events of the week and the one case planned for the day over our usual breakfast, and laugh as we recall Brian tearing his pants multiple times, and the severity of each tear.
We planned for rounds and a single case today, a cervical fusion on a gentleman named Moses; this would give us enough time to visit all the previous patients, the new patients from the previous day now in the ICU, participate in the surgery, and pack supplies so Team 2 has enough space for their supplies. Patients were all doing well; many were close to leaving, such as Medias, Denis, and a few others. The patients in the ICU were all reporting pain and discomfort (to be expected), but were all able to sit up and move, and thus, they could be moved later in the day from ICU to their respective wards. The case on Moses was quick; no power outages, no surprises, nothing. A peaceful way to end our last day; Then, the packing. All our equipment needed packed up and set in another room for pick up at the end of week 2, as the incoming team has their own supplies. Time passed, and the sad realization hit that this was it; they were leaving. We returned to the hotel, with Stanley, giving everyone departing a chance to grab their bags, have one last drink together, and take a group selfie. After some sad goodbyes, everyone piled on the bus, leaving Dr. Huang and I behind. Team 1, thanks for a fantastic week! The rest of the day for Dr. Huang and I was filled with many much needed naps, food, drinks, and more naps before we successfully called it a night, waiting to meet all of Team 2 upon their early morning arrival during breakfast. Sunday, and Team 2's arrival. There was mention of it earlier in a different day; there is no sleeping in, only early mornings with doctors. Team 2 arrived at 6:00 am, so Dr. Huang and I went down for a 6:30 am breakfast to meet and greet them. Team 2 consisted of Dr. Selvon St. Clair from ?, ?, Sherron Wilson, an RAN (resident nurse) from Florida, Alexis ?, Dr. St. Clair's personal assistant (PA), Megan ?, from?, Bogdan Popa from Safe Passage Neuromonitoring, Chris Gutman from ?, as the Medtronix representative, and of course, Dr. Huang and I. We are and chatted before deciding that some sleep would be beneficial for everyone, and parted ways. Noon rolled around, and we all headed piled on the bus, medical supplies on board, to unpack and get situated in the hospital, in addition to prepping the surgery schedule for Monday and doing rounds to introduce patients to Dr. St. Clair. We met a few new surgical candidates while we walked, and checked on all the post op patients; each one continuing in their improvements. Once finished we finished unloading everything, we left to reserve a table for dinner at Igongo, and then made our way to Lake Mburo national park in order to get on a boat to view hippos and crocodiles, in addition to the other animals, such as warthogs, monkies, zebras, and gazelles. But, it was in this park some of us learned a valuable lesson; when nature calls you behind a bus, make sure there are no other vehicles approaching from that direction! Unfortunately, we missed the boat by only a few minutes, so we turned around to a small trinket shop, where most of us bought souvenirs, either for ourselves or friends and family. Following a successful shopping spree, we returned to the restaurant, where we ate and were merry. |