Uganda Spine Surgery Mission 2016 Team One: Day 9

​Overnight we were joined by another group of new team members: Dr. Kerner and her plastic surgery crew, including Dr. Susan Benton (anesthesia) and her surgical tech, Lorna. As it happens, they arrived at a very opportune time, as several of our patients were desperately in need of interventions from both services.
 
Case in point, Prudence, a young lady who was the unfortunate victim of a car vs. pedestrian accident on the side of the road (she was the pedestrian in this case) had suffered a Chance fracture of her L1 vertebral body and posterior elements that was in need of stabilization, but she also had a penetrating wound to her lower back and buttock area that required a rotational flap by Dr. Kerner. Both surgeries were completed in the same day, and Prudence is now recovering well.

​Prudence’s L1 Chance fracture.

​Dr. Kerner treating Prudence’s penetrating sacral wound with a rotational flap.

​Prudence recovering after surgery in a high-tech “blanket”.  When you don’t have what you need, you make do with what you have. I think Sirge (one of the local anesthesiologists) chose this material for a blanket partially because the air provides insulation, but mostly because he liked popping the bubbles (three of our anesthesiologists; left to right: Rachel, Alvina and Sirge).
 
Our second case of the day was Sara, a lovely young lady with neuromuscular scoliosis. Drs. Leiberman and Holman spent hours instrumenting and correcting her curve. They even removed a portion of several of her ribs (known as a thoracoplasty) to improve the appearance of her back (patients with scoliosis develop abnormal rib curvatures as well as spine curvatures, and these ribs abnormalities lead to unsightly protuberances of the upper back.

​Sara’s preoperative X-rays.

​Dr. Holman correcting Sara’s deformity. Thanks to Enova Illumination for being so kind as to provide us with several headlights for the trip (which Dr. Holman is sporting here). These headlights were so bright that we almost didn’t need the overhead OR lights.

​The headlights from Enova were also quite handy to have during the occasional power outage in the OR (don’t worry, the anesthesia machine has back-up battery power).
 
Sara’s surgery was long, and by the end, it because she was slow to begin breathing on her own (due to the length of surgery and the continued presence of anesthetic in her system), it was decided that it would be best to leave her intubated overnight.  Although our team has become accustomed to relatively long, complex surgeries, our interventions are serious, complex, and a huge stress to the human body. Patients like Sara serve as a reminder of that fact.
 
Although exhausted, the second day was also finished with discussion around the dinner table and learning from each other. The lessons of the day ranged from clinical knowledge about different types of anesthetics to the value of family to care for one another.
 
Quote of the day (from one of Michelle’s physiotherapy patients who was recovering from a back injury and was worried about re-injuring his back in the proverbial act):
 
“What positions should I use to please my wife?”