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Uganda Spine Surgery Mission 2016 Team One: Day 10

7/19/2016

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​Wednesday began with a yoga/pilates/sweat session led by Dr. Lieberman at 5am. We were all a little beat, but it was nice to get some exercise. Our favorite yoga pose turned out to be the “corpse pose”, mostly because this pose basically involves just lying there on the floor.
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​5am was a little early for Brian. Here he is perfecting the corpse pose.
 
Our operative case for the day was on a man named Julius. Julius suffered from a spinal deformity likely related to a tuberculosis infection of the spine (known as “Pott’s disease”) that was causing weakness in his legs.
 
To add to his plight, Julius had no family or friends with him in the hospital.  In American, not having any visitors makes for a lonely affair, but in Uganda, it can mean much more. While U.S. hospitals staff plenty of nurses to care for admitted patients, the staffing situation at Mbarara University Hospital is less optimal and all medical care in the wards at Mbarara University Hospital (giving medications and monitoring health status, e.g.) is instead provided by a given patient’s visiting family members and friends. Luckily for Julius, the family members of patients nearby in the ward were kind enough to check on him occasionally and provide a basic level of care for him.
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Julius’s pre-operative CT.
 
While we were operating on Julius, Dr. Holman was in the penalty box, seeing a few clinic patients. One of these patients was a young boy named Ezekiel, a patient with scoliosis who had undergone a vertebrectomy and fusion one year ago, who now returned to clinic with an infected wound on his back and horrible back pain. His X-rays revealed that his fusion construct had failed. One of the rods holding his spine together had snapped, and was pressing up into his skin, causing skin breakdown and infection. 
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Ezekiel’s rod had broken. His hardware needed revision and the area of skin breakdown and infection on his back needed to be debrided and closed.
 
Dr. Holman added Ezekiel onto the OR schedule, and after finishing Julius’ case, we began work on Ezekiel. After several hours and the assistance of our plastic surgery team, we had finally revised the hardware satisfactorily and addressed the infectious tract leading from his skin to his spine.
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Ezekiel recovering in the ICU the day after his hardware revision. This is one tough little man. Although we are sure he must be hurting after this big operation, he always insists, “I’m fine”, when asked.
 
Dr. Kerner’s team also performed four cases of their own today, including multiple releases for burn victims with contractions, a syndactyly repair and a keloid removal. The pictures alone give you an idea of what these patients have been through. These procedures are not merely cosmetic, for many patients they are life changing.
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​A burn victim with contractures that Dr. Kerner’s team released.
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