DAY 9 – Monday August 22nd:
Monday morning started with shock and awe. Throughout the week Skumolski and Lieberman, like a Swiss train consistently opened the gym at exactly 5:30 am for their workouts. Occasionally Brian and Ilalov would wake early enough to get there as well. This morning however the exercise addicted duo were astonished that the girls, Ngozi and Jordan, sporting their morning faces, succumbed to the peer pressure and came to work out as well. The small gym was packed with team members working off the great food of the week.
Once showered and fed we started with the clinical day and visited our post-operative patients. P.T. , the 14 year-old girl with scoliosis and the elevated chest plate, was recovering well on the breathing machine. The second part of her surgery would have to wait until next summer. She smiled at the sight of her new teddy bear, one of several Sherron brought for our pediatric surgery cases. I.K., the 64 year-old ACDF patient from Saturday noted improvement in her leg pain, recovered speedily and was discharged today. A.W., the 15 year-old boy with cerebral palsy and kyphosis smiled at first sight of the team.
P.T. with her teddy named “Nice.” She is wearing the BPAP machine installed by Drs. Szkulmowski and Kusza.
Surgery at Case began at 10am. The patient B.A. was a 7 year-old girl with congenital scoliosis who was seen in the penalty box one week earlier. She had a T7-L3 instrumentation and fusion procedure, which involves the installation of screws and rods spanning 9 vertebrae and placement of bone chips to grow into and stabilize the spine. Drs. Lieberman and Ilalov strategically placed the Globus-supplied screws then contoured the titanium rods to match the contours of a healthy skeleton. Both would assert that surgery is just another word for “controlled violence.” This surgery went off without a hitch and at the end Dr. Ilalov patiently taught Jordan how to throw some stitches.
Dr. Lieberman and Dr. Ilalov work hard on the last case at CASE.
Having completed our sole case for the day earlier than expected, the team decided to relish in our early finish! We planned to drop off our stuff back at the apartment, then take a walk through the slums of Kampala. Key word: “planned.” Kirill, Jordan and Brian just had to make one quick stop at Mulago to pick up some instruments from storage for Tuesday’s Case case. The Mulago spine theater was locked so Brian called Sister Sarah, who said she would arrive in 30 minutes. Two and a half hours later, after Jordan had finished 3 daily blogs and Kirill had become a Ninja Fruit grand master, Sister Sarah finally showed up to unlock the room. We reminded ourselves, again that we were “on Uganda time.” When we finally got home, Lieberman jested:
“Sister Sarah strikes again!” We should be lucky she struck at all!
The doctor from whom we removed infected hardware was found to have a serious multi-organism infection, resistant to most available drugs, including the broad-spectrum antibiotics he was already taking. We all hope he can get a permanent intravenous line and the appropriate antibiotics. Luckily, he is a prominent physician in Kampala and has the means, the connections and the know-how to afford and self-administer the treatment.
Quote of the day:
“If I slow down my thoughts I speed up my productivity.”
Ngozi will have this patient walking around in no time!