Divide and Conquer!
August 14, 2019
Morning came way too soon for us this morning. As for my roommate Sherron and I, who slept straight through the alarm, the getting ready process was especially rushed! We were all downstairs by 7:00am for a quick but hearty breakfast before we left. Some brought some leftover breakfast along for a mid-day pick-me-up (which are much needed!).
On the schedule for the day, we had five surgeries planned. That meant if we wanted to get through everything and get out at a reasonable time, we were going to need to divide and conquer. Dr. Schaffer started by rounding on yesterday’s surgical cases while Dr. Kayanja and I set up in the lobby of the surgical floor for clinic. At the same time, the rest of the team was prepping the OR and the patient for the first case, which was a 6-year-old scheduled for an I&D of an upper thoracic recess. Dr. Schaffer tackled this one with ease. Next Dr. Schaffer got started on a biopsy of a tumor of the right scapula. At the same time, Dr. Kayanja got going on an instrumentation and fusion in the next room over.
Dr. Schaffer working on the I&D of a suspected neurofibroma.
Dr. Schaffer working on the biopsy of the right scapular tumor.
Dr. Kayanja and Jason Ash starting the work on a T12-L5 instrumentation and fusion.
The T12-L5 instrumentation and fusion proved to be full of surprises. When the neuromonitoring technician, Ashlee, started prepping the patient and places her needles and wires, she had to unwrap some bandages on the patients’ right foot. She had had a previous ankle fracture which had been operated on. When the bandage was unwrapped, she exposed an open ankle fracture wound and a large, necrotic calcaneus wound. This threw a little bit of a wrench in our plans, and we had to stop to thorough debride the wound before proceeding. After this case, we had patient with probably Pott’s disease, scheduled for a corpectomy and fusion. This case was also long and grueling!
Dr. Kayanja working on our difficult T12-L5 instrumentation case.
While we had five cases planned, our final patient came to the floor for surgery and it was discovered that she had not taken her blood pressure medication in two days! We decided it would be safer for her to wait until tomorrow to operate, after she had had time to take her medication and allow her BP to come down. It also had gotten very late. While we were off to a speedy start, due to delays and some challenges, we did not finish our fourth case until 10:00pm.
But we were still able to finish four great cases and Dr. Kayanja got our total number of patients seen in the clinic up to 98 patients, plus many patients that we saw twice to examine scans we had ordered for them! We headed back to the hotel and most people skipped dinner and went straight to bed—looking forward to a little extra sleep and a big breakfast in the morning.