Uganda Spine Surgery Mission 2016 Team One: Day 11

​Our operative case for the day was a young man named Bashir, who had lived almost his entire life with a progressively worsening scoliotic deformity. Over time this led to lower-extremity weakness that left him almost non-functional.
 
Scoliosis surgery is no small operation. Many cases are long, blood loss is anything but trivial, the post-operative pain is nothing to shake a stick at, and some patients develop serious complications. The fact that these patients are willing to go through with such a major operation is a testament to how deeply they are impacted by this disease. I distinctly remember Dr. Lieberman having a conversation with Bashir wherein Dr. Lieberman bluntly asked (through an interpreter):
 
Lieberman: “Do you understand that your leg weakness might get worse after surgery?”
 
Bashir: “Yes.”
 
Lieberman: “Do you understand that you might not survive the surgery?”
 
Bashir: “Yes.”
 
But Bashir did not hesitate to consent. In fact, he seemed rather eager to get on with it. 

​Bashir, our exceptionally motivated young patient with scoliosis and lower extremity weakness severe enough to prevent him from walking. After a ilittle coaxing from Michelle he could at least stand on his feet with the help of a walker, but it was clear that he needed something more done.

Bashir’s CT scan showing an almost 180 degree complex curve.

​Bashir’s scoliotic curve. The center line is the primary incision, and the left-most area is where the thoracoplasty was performed.
 
We decompressed Bashir’s spinal cord and instrumented him into position over an 8-hour stretch on Thursday, hopefully preventing any future progression of his deformity. We also performed a thoracoplasty, removing several areas of rib prominence, improving the cosmetic appearance of his back.
 

Jordan also had a busy day Thursday. She scrubbed into a surgery for the first time, assisting Dr. Kerner with several plastics cases.

Jordan apparently learned how to set up a mayo as well.
 
We also said goodbye to many team members today, as the majority of Team One (except for Michelle, Stanley and myself) returned home, leaving us with a skeleton team compared to the 15 or so members present on Monday. Dr. Holman is also returning home tomorrow, but Dr. St. Clair’s team will arrive late this evening to provide a fresh energy and a new set of faces to the group.
 
Lesson of the Day (from Dr. Holman): It is entirely acceptable to order two beers at once after a hard day’s work.