Revolutionizing Spine Care…Changing Lives

Uganda Spine Surgery Mission 2017 – Day 9

Day 9: Let’s Get Cracking!

Every morning is an early morning with a team breakfast. 6:30 am rolls around, and we all begin to trickle down from our rooms to eat and plan the day in more detail than we did the day before; two fusions were planned for the day on a woman by the name of Gilda, with a fusion planned from L2 (quick note: the spine is split into 3 main regions; cervical, the neck, thorassic, the middle of the back, and lumbar, the lower back. Each is abbreviated using the first letter: C, T, and L) to her pelvis, and another woman met in clinic the week prior, Perepeta, with plans to fuse her from L4 to L5. Not a difficult day, and with, both Dr. St. Clair and Dr. Huang operating at once in different rooms, it should be a short day by comparison to others. However, things are never quite what you’d expect.
We arrive at the hospital, where Dr. St. Clair and Alexis join Dr. Huang, Stanley, Natasha and I on rounds, where they escort us to the emergency ward for a consultation that had come in; a young gentleman in a boda boda (it’s similar to a motorcycle) named Abdu, who had fracture located at his C1/2 vertebrae, and in addition, he was unable to move one of his arms. So, we quickly made a plan to place him in a Halo, which is supposed to keep his head still and prevent movement, so the bone can move back on it’s own as much as possible, and heal on its own. A surgery is possible in this case, but would cause a severe loss of neck movement. So, we added this case to the day. The other patients were all continuing to do better; patients like Godson were going to be discharged, while others like George and Jolly were already gone and out on their own, having been discharged over the weekend due to such rapid and successful recoveries. After this patient, Dr. St. Clair and Dr. Huang left to the OR to finish getting ready for the day.

Rounds continued while surgeries were prepared for and started, with those of us on rounds arriving shortly after both incisions were started. Alexis and Stanley both went to scrub in, while Natasha and I took care of patient files and prepping the surgery schedule (as much as we could without Dr. St. Clair’s approval)! Both Gilda and Perepeta were being operated on at the same time in different rooms, and with so many people wanting to learn and be a part of these surgeries, Alexis and Stanley came out for a break. We chatted over more of Sister Rose’s homemade samosas and went to go look for the halo going to be used on Abdu.
After a little bit of searching, we found a box filled with halos and halo parts, there was one problem however; we could tell which pieces went to what, and if we had everything for the halo and halo vest (it pushes down on the chest with rods, keeping the halo in the desired position). So, with each of us filling our arms, we took the parts into the doctor’s room, and got to be engineers for a few minutes as attempted to build the halo and halo vest (which, was successful, by the way)!

Both surgeries went through with no difficulties; the patients were stitched up, covered, and sent to the post anesthesia care unit (abbreviated PACU), and Abdu was sent for. He arrived and planned for the halo and vest. The halo has 4 screws used to hold it on the patient; 2 screws carefully placed above the eyebrows and slightly off center to prevent from hitting a nerve, and the other 2 screws are placed 1 above each ear; the halo is then attached via rods to the vest to maintain the desired position. Local anesthetic was injected into the pin sites, and we began to insert the screws into the halo and the patient, and quickly set up the vest on him. The whole process took maybe 30 minutes, and we sent him back to the ward.
The day was rather short, so we returned to the hotel, where we all changed, played our favorite pastime, Jenga, ate and drank, and enjoyed each other’s company. Thus, ended the first day of operating with Team 2.

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