DAY 4 – August 17th:
We split up to tackle three surgeries today.
At Case, the A-team (Dr. Siemionow, Dr. Selvon St. Clair and Jordan) started the day with ward-rounds, visiting patients recovering from surgery. We discharged a 39 year-old woman who Dr.Kayanja and Dr. Selvon St. Clair operated on last Friday to relieve spinal cord compression that was causing leg numbness and pain. We also saw a new patient, H.K., a 4 year-old boy with muscle spasms in his limbs and delayed mental and physical development. We diagnosed him with Cerebral Palsy (C.P.) and explained to his parents that low oxygen levels before or at birth had caused irreversible neurological damage.
Dr. Siemionow, Dr. Selvon St. Clair and Jordan in surgery.
Coincidentally, the surgical patient at Case, 15 year-old A.W., also had C.P. Fortunately, an international C.P. organization sponsored A.W. to have surgery to correct his severely hunched posture (kyphosis). The incision was 14 inches long and the team, under the command of Sherron (the REAL boss of the O.R.) and Nurse Betty (actually an anesthesiologist) brilliantly inserted 14 screws and two titanium rods to straighten out the spine.
While the A-team was busy straightening spines, Ngozi and Amy ran physical therapy (P.T.) sessions for the patients recovering at Case.
Amy administering medication to a post-operative patient.
Ngozi worked for hours, sweat pouring down, in the overheated recovery wards. The complaints of the patients were minimal considering their operations, as Ugandans have a much different perspective on pain. Morphine is used sparingly, if at all, as addiction is overly feared. She was introduced to the new rehab ward, a tiny cubicle with one small bed and a chair. At first, Ngozi found herself butting heads with the staff physiotherapist, but things turned around when they discovered that our Texan hero had a doctorate in P.T. She was quickly volun-told to assist in patient teaching and to consult on a particularly difficult case tomorrow of a middle-aged man with 2 months of constant back and hip pain.
Ngozi, our physical therapist, working with a patient.
At Mulago, the DOUBLE A-team worked on 2 cases. The first was a 73 year-old male doctor with an infection caused by a previous surgery performed by a local surgeon one year ago. He requested to be operated on by Drs. Lieberman and Kayanja to remove the hardware and clean out the infection. The procedure was a success and the doctor had “no pain” when he awoke – just some mild irritation from the breathing tube. For the second surgery, Dr.Ilalov , (very slowly) acclimatizing to the Mulago O.R., worked with Dr. Robert Kasirye, the 4th year orthopedics resident at Makerere University College of Sciences in Kampala. They operated on a 35 year-old patient who broke her neck carrying a heavy jug of water on her head, causing tetraplegia. The surgery aimed at stabilizing her neck to reduce and maintain her ability to breathe on her own. Spinal levels C3, 4, & 5 keep the diaphragm alive!
Brian sharpening some instruments for surgery.
After a full day with all pistons firing, we retired to Mamba Point to sample the famous avocado pizza. Who knew that avocado worked with tuna, chicken, anchovies, pineapple and anything else one might normally put on pizza? After dinner, Dr. Lieberman ventured to the airport to pick up Noemi, his mother, and Judah, arguably the only Texan Jewish geologist in the world, and the securely-encased and very much-anticipated Torah scroll.