Uganda Spine Surgery Mission 2018 – Day 5

Day 5: What can we say? We just love late nights.

Our usual breakfast was filled with chatter about what we were hoping was going to be a short day; we had planned a procedure on a young, small girl named Shivan; a large instrumentation and fusion to fix her back, two hardware removals (one on a woman named Denise and the other on a gentleman named Steven). The final case, and the focus of the conversation, was on a young man named Emmanuel, who required a cervical 360, or possible 540. For clarification here, a 360 is when you begin a surgery on the front of the patient’s neck, then flip them over and finish the procedure through the back of the neck. A 540 involves an additional flip back to the front, where you finish. So, no one was really sure which would do; a 360 or 540, but we knew for sure it’d be one of the two.

Flash forward to our usual split at the hospital. We begin in the intensive care unit (ICU), where the previous patients (Stephano, Promise, Martin and Evanmille) are all recovering from their surgeries the previous day. Stephano is doing well, as he is awake, tells us he has no numbness in his limbs, and can feel touch. Prior to his operation, he had reduced sensation in his limbs, and limb weakness. This was a large improvement! Patients from previous days, such as Prima and Clency from day 3 were slowly beginning to do better, but were still in pain. Edward was doing absolutely fantastic, and Jecinta was able to go home, along with Poyasi.

It’s a weird feeling when a day feels both long and short at the same time. Individually, the cases may go by quickly, but as a whole, the day moves rather slow. Room 1 belonged to Dr. Lieberman and Dr. Villarreal, who intended to do work on Shivan (the young girl), followed by Emmanuel. Room 2 belonged to Dr. Hisey, who would do both hardware removals; Denise and Steven. And let me tell you, the hardware removals were both successful but, suction didn’t work again in one of the rooms (but, was once again fixed by the fabulous technicians).

Room 1, however, was much slower for necessary reasons. They could not rush with the correction on Shivan’s spine, or risked damaging her nerves. As we expected, Dr. Hisey finished the first removal, took a short break while the room was cleaned, and then went to begin the second while the instrumentation was still taking place in the other room. Fast forward a few hours, and room 1 finished their case much later than expected and started their second, while room 2 had been done. Now queue a group of people, all trying to ensure a surgery flows smoothly, sitting in a doctor’s lounge. You have a pretty good picture of us. Meanwhile, in between the cases, when Dr. Lieberman finished the first

We’re talking about the cases we’ve done, and seen, when Connor Peck, a second year medical student at Yale joins us, talking about a burn victim he’d seen waiting to have his burns cleaned, but couldn’t afford to pay to have his blood work done so he could be wheeled back into the OR. After short discussion, Connor took it upon himself to pay for his debridement (cleaning of his wounds), so he would have a chance.

The case was still in progress well into the evening, so the team split into two; while half the team grabbed their belongings to return to the hotel, Michelle, Sydnie and I would run to the supermarket nearby and buy water, and those not leaving would stay until the end of the case. We leave, buy the water, and return to darkness.

Yes, darkness.

During our absence, the power went out to the hospital, and with quick thinking, Dr. Benton started using the air bag to breathe for the patient, and those operating (who thank goodness were close to done), pulled out their lights and hurried to stitch the patient shut. Nothing like a good power outage to really keep you on your toes! Surgery complete, the others returned to the hotel, where we ordered ahead and had the food close to ready upon our arrival. We recounted the day, the time, and how successful we all thought it was, and wondered about the power outage, and how that would affect our final day of operating.

And let me tell you, did it affect us.

 

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