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Uganda Spine Surgery Mission 2017 – Day 6

Uganda Spine Surgery Mission 2017 – Day 6

Day 6: That Case Was How Long?

A typical morning, as usual. A workout for some, an even earlier morning for others, and sleep for the rest of us. We discuss the plan for the day over breakfast; a challenging and long fusion on a teenage girl named Jacinta, another fusion and decompression in the cervical region (top of the spine, below the skull) on a gentleman named Elias, and a third fusion and corpectomy (removing part or all of a vertebral body) on a woman named Annah. Doesn’t sound like a lot, but we were planning on staying late.

At the hospital, we split as we normally do at this point; Dr. Huang and I leave to do rounds, while the others all prep the operation rooms and begin. The two patients who stayed overnight from the previous night, Jolly and George were first on our list to check; Jolly wasn’t doing as well as she had hoped and told us there was a numbness in one of her arms, but after a quick exam to check her neurologically to see if there was a problem, she had great strength and no difficulty resisting or pushing us when directed to. George, however, stated he already felt like he was doing better, and his reported pain before surgery was diminishing. After directions to both patients to begin walking, we departed to check on everyone else in the surgical ward.

All of the patients in the ward were all beginning to do better; some, like Norah, was close to being discharged from the hospital. Others, like Julius, had smaller improvements. He was begging to move his legs and was getting close to moving, but there was concern over a possible infection in addition to his presumed TB; it was hard to make a decisive call, as we were still waiting on cultures (some infection was removed and allowed to grow in a controlled environment to determine what it is) to be certain. After some antibiotics were given, we made our way to the OR.

The OR was already busy; Dr. Lieberman and Dr. Perry had already begun operating on Jacinta and Annah, respectively. We all expected Dr. Lieberman to take a significant amount of time due to the condition of Jacinta’s back, and thus, the two other cases were given to Dr. Perry to complete. But oh boy, did it take a while.

When we started at close to 8:00 am, there were some guesses about how long the one fusion would take; 6 hours, 7 hours, 9 hours. Deep down, we all knew it’d be a while, but having it take a little over 9 hours is absolutely exhausting for all those who worked on it. With the condition of her spine, it was challenging to correct, as a sudden correction caused Kerri’s equipment to repost a lose of motor function. So, slow, gradual changes are the way to go, but, after a significant amount of correction, we were all extremely thrilled. Meanwhile, Dr. Perry completed Elias with almost no difficulty, but Annah was taking longer than we all expected, due to an infection, adding a slight challenge to the case as we had to be thorough in cleaning it out. Between cases, however, for the 3rd time this week, Brian somehow managed to tear his pants once again, hopefully learning the important lesson that paper scrubs aren’t very efficient when you’re doing lots of manual labor and moving a lot. You think he would have learned this after the second time!

Both cases finally finished around 6:00 pm, with the each patient being closed at approximately the same time. But, after doing such long surgeries with so many small tools, both being finished at the same time, cleaning, sterilizing and prepping of tools takes about twice as long. While Brian cleaned, Dr. Lieberman did a short hallway clinic, and the rest of us lounged around in the doctor’s room, half asleep, waiting for a warm dinner.

As Dr. Lieberman finished the clinic, Brian was close to being done, the sun was gone for the day. 8:00 pm, the time we were leaving. Exhausted, worn out, satisfied with the work, and hungry for dinner. After dinner, we laughed and talked, enjoying our last night together as Team 1 before everyone left the next day.

 

Texas Back Institute