Wednesday, January 26, 2011

Gabon - January 2011, 26

Wednesday has been interesting.

Started with giving a lecture to the hospital medical staff - primarily nurses. It was a modified version of one I give at the IU School of Medicine - Purdue each fall. Fun to show them the "big" cases which are from their own hospital and are shared in the US.

I'm not sure what happened for the scheduling, or what kind of word got out last week, but this past Monday nearly every patient I saw needed a hysterectomy! I was actually grateful to see someone with a snake bite, and another with a gangrenous finger (smell and all) just so I could schedule something else!

Thankfully Jean Claude also was seeing patients - so it wasn't me alone who scheduled these cases - and he had the same! So...we are in the middle of a three day stretch of 7-8 hysterectomies and myomectomies - with a lap chole, a couple of scopes, and some debridements to break things up.
Yesterday and today we had two of the toughest ovarian cyst and hysterectomy cases I've had in the past 12 years. Tough describe, but the best comment is that my neck is sore from bending over :) And, it is comforting to know that I haven't seen the worst cases yet, seems I keep stumbling into them on these trips. The good news is that even with long days I've made every supper invitation thus far this trip! It's the "small" things :)

One picture I decided not to include was the debridement of a man's hand - that was today.
He ran it into a wood planer and effectively lost the three middle fingers of his left hand. He was seen in another "hospital" for the past week, and then came here out of desperation when he saw it swelling further. We opened it up, removed more bone, and closed. It was a bloody but welcome break in the marathon of removing uteri. He was grateful as well.

So far I've only seen three snakes - all dead. Those are generally the best variety when it comes to poison and close proximity to me. We have two guys in the hospital secondary to snake bites - thankfully both have survived. The spiders have all been the "good" variety as far as what has been running around in my house. And we, Dr. Johari and I, survived an excellent restaurant excursion. Granted the restaurant did have electricity AND a lightbulb this time. And, the food was quite good given the accommodations and state of the "kitchen"!


Our lady with the punctured brain is doing quite well. That is a no small miracle.
She tripped and fell onto a small sapling. It had broken off and the end ran directly up her nose. They said when they pulled the stick out her nose bled a lot. She arrived with stroke-like symptoms, and was treated accordingly. About 4 days later her entire history was re-reviewed by the medical doctor here, when the family complained of water running out of her nose. Thankfully she immediately ordered a head XRay (see above) - which revealed air in the patient's skull. That led to a consult from surgery (us) and the question of what to do was entertained.
Air was taking the place of her fluid, and you could see the fluid level in her head on the X-ray. Sort of like looking at a pitcher of water and seeing how full it is.
It was at this point that the "water" running out of her nose was diagnosed as Cerebral Spinal Fluid by the medical doctor who assured us that the patient was definitely a "Trauma" patient and not strictly speaking "medical". I quickly noted we were not going to open her skull and try to patch it!
We agreed that the patient really was a trauma patient, layed her flat, gave her antibiotics, and prayed. It has been 4 days now without any more leak (that we can tell), and much of her muscle function is returning on her "stroke" side, although I doubt she will ever be able to open her eye. She will have some permanent damage. But she is still alive!! (and her brain is still on the inside of her skull).
There are always surprises here.
She is a really nice older lady too. Hoping and praying she continues to do well. Appreciate your prayers.
That's it for a Wednesday!
Almost forgot - had a really great supper at Lisa's house with the other visitors and short-stay workers. People, patients, and friends which make life full and good. God brings the fulfillment in all of it. In a place like this you see His work very clearly. The effect of those who hate Him is just as evident. Thankful to be serving the one, True, and living God. Walking with Him brings order out of the chaos. Literally :)
Here's a picture of the sweet old lady who happened upon the stick:


2 comments:

Anonymous said...

"He comes to us as One unknown, without a name, as of old, by the lake side, He came to those men who knew Him not. He speaks to us the same word: 'Follow thou me!' and sets us to the tasks which He has to fulfill for our time. He commands. And to those who obey Him, whether they be wise or simple, He will reveal Himself in the toils, the conflicts, the sufferings which they shall pass through in His fellowship, and, as an ineffable mystery, they shall learn in their own experience Who He is."
by Dr./Pastor Albert Schweitzer

The touch of humor, joy, and compassion in your writing help make suffer-able reading your encounters with human suffering. There certainly is a "(holy)ghost writer" authoring your story. Thanks for sharing. MJG

Enel said...

You have to email me the hand stuff.