Today, the day started with rounds to see the patients who had been operated on and were now recovering in the ICU. Little Isaac is doing great, as is Kenneth, though he is in a bit of pain. James is also doing great. He is lying on his side and I greet him with a big smile. 'I'm fine,' he replies, his usual response. We change all their dressings, and after a quick foray into the adult surgical wards to check on the rest of the post-op patients, we head back to the operating theaters.
Today's only surgical patient for Dr. Lieberman’s team is Moreen, 15 years young, with a congenital scoliosis, and who will be undergoing a correction of her deformity. I get to scrub in once again, and I actually get to place a fixation screw into her spine. The screws are integral to holding the spine straight until the fusion consolidates.
We are just finishing with Moreen, putting in her last sutures, when Lance, who was next door comes bolting into our room, 'We need an anesthesiologist. Ours just bolted out of the door.' Dr. Lubis, our anesthesiologist extraordinaire runs after him, sensing the panic in his voice. We are all puzzled as to what is happening and I hope to myself that everything is okay. Tom who is also next door comes in, a second later, also in a panic, asking for the keys to our storage room. He grabs them, then leaves, leaving us even more bewildered. As we are practically done with Moreen, Dr. Owusu hands Dr. Gorlick the needle holder so that he can complete the suturing and rushes next door to see what is happening. We are left bewildered but praying that everything turns out well! A little while later, Dr. Lubis comes back into the room, as calm as ever and we breathe a sigh of relief as we can sense that things are fine. She explains how their spine patient Eric's oxygen saturation (level of oxygen in the blood) had dropped down unexpectedly to the thirties and had set off a panic in the room as they tried to figure out what was going on. They were preparing to deal with the worst when they realize that one of the tubes for his airway had somehow gotten disconnected. The tubes are re-connected, his oxygen saturation levels go back up, and crisis averted. Eric was team Sparta's last surgery of the day and of the entire trip as they leave the next morning.
Next door, Moreen is finished with her surgery but concern sets in when she wakes up, groggy and cannot move her legs. Her symptoms are variable and she is still in a daze with a high level of anaesthetic on board and also injected locally into her back muscles, both of which could be contributing to the symptoms. Dr. Lieberman decides to wait and watch. We go to home, tired and anxious about Moreen, and praying for her to recover some movement.
Sunday, our rest day but it's still an 8 o clock start and I find myself chanting to myself the whole while to the hospital 'please let her move her feet,' in reference to Moreen, our patient from yesterday. She is the first patient we see when we get to the hospital. She is still not moving her legs, and so Dr. Lieberman mobilizes the operating team and we immediately take her back to the operating room to prepare for surgical exploration.
We all do our rounds, first in the ICU then in the wards, and then team Sparta (Ortho/trauma team) takes off to Entebbe to catch their flights. The rest of us go back into the operating theaters. Dr. Owusu starts his exploratory surgery on Moreen, discovering and draining a hematoma and then checking to see that the screws and instrumentation weren't compressing her spinal cord. Skylar simultaneously runs some neurological monitoring tests on her. A little later, Moreen is done and we wake her up. She is able to slightly rotate her hips this time and has better sensation in her legs, and maybe a tiny hint of movement. We wheel her back into the ICU, hoping that she recovers swiftly.
We finish our morning at the hospital and head back to the hotel for the rest of the day, getting in some rest and relaxation and capping the day off with dinner at the Agip Motel after a few hilarious rounds of 'heads up…'