Uganda Spine Surgery Mission 2016 Team One: Day 5

Quote of the day: “Don’t forget that you know what you already know”
Guest Blogger: Dr. Michael Hisey
Day 5 was our first day after Dr. Lieberman joined the team in the wee hours of the morning. We had two cases planned, so after a quick breakfast, it was off to the hospital. It was the usual routine, with Sherri, Brian and Kari setting up the room and getting the patient ready, while Dr. Barber, Dr. Hisey and Michelle made rounds with one of the local surgeons, Dr. Kisinde. This time we needed to introduce all of the patients to Dr. Lieberman, as he would likely be planning surgery on them over the next two weeks.

Josephine’s spine showing the semi-vertebra.

Brian (in the red hat of shame) getting a chance to scrub with Sherri and Dr. Barber

Surgery started with Josephine, who was born with a partially formed vertebral body. These can cause severe curves in childhood (like several of the patients you will be reading about over the next several days), but she fortunately avoided this. Unfortunately, though, the area became severely painful and required a fusion. That went smoothly, with Dr. Lieberman at the helm, then it was time for Yoweri.

Dr. Lieberman’s first case in 2016, with Dr. Barber, Sherri and Brian.

Yoweri’s CT showing the destruction of the front of his spine caused by TB.

Yoweri has tuberculosis in his spine, which has eroded the entire front of his spine over several levels and has caused collapse of his spine. His spinal cord was intact, but was threatened by the severity of the collapse. There were even (skip to the next full stop is squeamish) two holes in his back where pus continuously Dr.ained. Yoweri needed his spine stabilized and the areas of infection cleaned out. The team performed a fusion on him from T9 – L3 and opened up the front of his spine to clean out the infected areas. With that and the appropriate antibiotics he should be able to heal up the infected areas. We did have an issue, though, with Dr.aining his bladder. Usually for a long operation, we place a bladder catheter. Several attempts were unsuccessful. At home, when this happens, we normally call a urologist. Since that resource wasn’t available we had to go back to our teachings from years ago for what to do when a catheter doesn’t pass. We just had to remember that we “know what we already know” and selected a different catheter design which slowed the catheter to pass. Sounds simple, but using knowledge from many years ago saved us from having to put a needle into Yoweri’s bladder.

Local surgeon, Dr. Kisitu working together with Dr. Hisey.

Dr. Lieberman hard at work on Josephine.

After surgery, we saw a few clinic patients in the outdoor hallway of the hospital (the weather is beautiful for an out door clinic, by the way) then headed back to the hotel for our usual dinner of whole fried fish. For me, it was an early night. The previous two nights I was up late to watch the European soccer semi-finals, but no game to night. Looking forward to the weekend and a morning Yoga or Pilates (does anyone really know the difference?) session lead by Michelle.