Today was an interesting day...(this might be a little gory and PG rated lol...just warning the moms and teachers who read this to their kids)
Usual day at the clinic today....but there was this patient that we had scheduled to undergo a below the knee amputation before noon. This guy I had originally seen on one of my very first days I got here...he basically had a bad foot infection and we had to amputate his 5th toe. He got better and left the hospital. He then came back a few days ago with a worse infection....he had very poor circulation and his toes were becoming necrotic. I then got to amputate his 4th toe, which was an interesting experience in itself. However we realized that this wasn't going to solve his problem and that he really needed a below the knee amputation. The circulation was so bad that his foot would just keep getting worse and worse. However, amputations are taken very seriously here...some people would rather no get an amputation and hope for the best...which usually not the best choice. Most people fear amputations because Africa is not so amputee friendly...very hard to give these people the means possible to live a normal life without limbs...especially feet. But we managed to convince this poor man in pain and he agreed to get an amputation of his leg below the knee. As we were going to the theatre (OR) to get ready for his surgery...we were told that he is going to get bumped because a young man needed emergency surgery for a gun explosion in his hand. We went to go see what was going on....uhmmm...let's just say I never saw a hand hanging by few tendons, in pieces and unable to even tell it was a hand but for the random pieces of fingers to give you a hint. Well...we ended up amputating his arm off. This was a very sad case...young man with no arm....this happens so quickly here...people play with explosives here like its candy almost....I don't really understand why...these guns don't have bullets but explosives and lots of people come in with injuries here because of that.
Once we finished, we had lunch and then headed back to the OR to do the leg amputation for the man who was waiting for us. We brought him into the theatre and the anesthetist got him ready for a spinal anesthesia. Once that was done...we were all talking in the OR getting everything ready to start the surgery. All of a sudden, the patient starts breathing very heavily and seemed to be unconscious...we were trying to figure out what was going on....his blood pressure dropped so low that you couldn't feel any pulses....all of a sudden he stopped breathing and arrested. I took over chest compressions and the anesthetist tried to intubate the patient....I have to say that the equipment we have here is there but not up to any standards back home. It works...but it wouldn't pass back home. We continued doing cpr and gave him fluids and ventilated him...gave him some ephedrine...but that's the most we could do....no ECG here to see what his heart rhythm was like....we just hoped that what we were doing would work and get him back. After about 8-10 minutes, I was giving up hope...thinking that with what we had available, this poor man had no chance to survive. I was wrong...all of a sudden he started showing breathing movements on his own and his heart started back up....I was in shock! Everyone was! We actually removed the tube few minutes after, its not like we can bring him to the ICU and put him on a ventilator. He actually is doing much better right now, I went to see him on the ward and he was awake, responding to our questions. This was amazing....very happy to see that he survived this unexpected twist of events. We didn't get his amputation done....so he's in pain now in his chest from our compressions and pain in his leg from his infection. Hopefully he will be fit for surgery again on Monday...but who knows what will happen till then!!
Once this was done...we headed back to clinic to see the patients that were left. Next story I am going to share is probably one of the funniest moments I've had here with the people....but it may not be appropriate for all ages...but I will share this anyways. A patient came for a follow up visit because he was having infertility issues...he has 2 wives and hasn't been able to get them pregnant for the last few years. Now he was supposed to have returned with a semen analysis which they can do at the lab here. His result wasn't in the chart and I told him that there was nothing I can do until we see his result. So through the translator, I told her that he had to get this done. Now, I am just thinking of how this gets done back at home....so I explained to her that he should go now and come back whenever its done. He then tells her that his wives aren't up to it now and he can't do it. I was confused as to why he needed one of his wives to be there...and asked why? The translator then said well they must do it for the semen. I was like....well tell him to go and do it himself. Now she was confused....and told me how? Then I explained with some words and motions...she starts laughing and said Ohhh...then tells him "You must go massage it and it will come" We all started laughing and the poor man was kind of embarrassed but I had no way of knowing because I only heard what the translator told me. Supposedly here...in order to collect semen, you need your wife and once the deed is done, a nurse will go and collect with a syringe...I was shocked! But figured that was the norm for their culture and can't believe I just told a Ghanaian man to go "massage" himself....lol oh well He will come back with his wife one day and they will get the analysis done...The nurse even suggested he comes on weekend when the clinic is closed and they can use an examining room instead of someones house in the village nearby the hospital! Omg I was laughing so much...I couldn't believe it! I then explained how they do it back home....the nurse then said: "Ok doctor, next time you come, please bring some calendars (she referred to the magazines as calendars) for us...it will make it easier for them men"Haha can you imagine me bringing magazine material here instead of medical supplies....wow!! It's amazing how different the worlds are and yet we are all living in the same "times". One of the younger translators a boy in his early twenties was confused about how the "sperm" would come if the man does it himself as opposed to doing it with his wife! He was very shy about it but we explained it to him. Goood times :)
ok...it's time to get back to the house. I am hooked on the tv series The Wire...gotta watch 1-2 episodes before bed :) and tomorrow we get an extra 30 mins of sleep because its the weekend! A bunch of people are planning to go out and visit some natural site nearby...going to try and go with them if there's enough room in trucks. It's my last weekend already :(
Good night everyone!
P.S. So proud of you Evie...she's graduating very soon from her teaching program and she just told me she got a few A's here and there...no big deal ;) So proud my love! You work so hard and deserve it and that's why you probably don't miss me as much :p
Usual day at the clinic today....but there was this patient that we had scheduled to undergo a below the knee amputation before noon. This guy I had originally seen on one of my very first days I got here...he basically had a bad foot infection and we had to amputate his 5th toe. He got better and left the hospital. He then came back a few days ago with a worse infection....he had very poor circulation and his toes were becoming necrotic. I then got to amputate his 4th toe, which was an interesting experience in itself. However we realized that this wasn't going to solve his problem and that he really needed a below the knee amputation. The circulation was so bad that his foot would just keep getting worse and worse. However, amputations are taken very seriously here...some people would rather no get an amputation and hope for the best...which usually not the best choice. Most people fear amputations because Africa is not so amputee friendly...very hard to give these people the means possible to live a normal life without limbs...especially feet. But we managed to convince this poor man in pain and he agreed to get an amputation of his leg below the knee. As we were going to the theatre (OR) to get ready for his surgery...we were told that he is going to get bumped because a young man needed emergency surgery for a gun explosion in his hand. We went to go see what was going on....uhmmm...let's just say I never saw a hand hanging by few tendons, in pieces and unable to even tell it was a hand but for the random pieces of fingers to give you a hint. Well...we ended up amputating his arm off. This was a very sad case...young man with no arm....this happens so quickly here...people play with explosives here like its candy almost....I don't really understand why...these guns don't have bullets but explosives and lots of people come in with injuries here because of that.
Once we finished, we had lunch and then headed back to the OR to do the leg amputation for the man who was waiting for us. We brought him into the theatre and the anesthetist got him ready for a spinal anesthesia. Once that was done...we were all talking in the OR getting everything ready to start the surgery. All of a sudden, the patient starts breathing very heavily and seemed to be unconscious...we were trying to figure out what was going on....his blood pressure dropped so low that you couldn't feel any pulses....all of a sudden he stopped breathing and arrested. I took over chest compressions and the anesthetist tried to intubate the patient....I have to say that the equipment we have here is there but not up to any standards back home. It works...but it wouldn't pass back home. We continued doing cpr and gave him fluids and ventilated him...gave him some ephedrine...but that's the most we could do....no ECG here to see what his heart rhythm was like....we just hoped that what we were doing would work and get him back. After about 8-10 minutes, I was giving up hope...thinking that with what we had available, this poor man had no chance to survive. I was wrong...all of a sudden he started showing breathing movements on his own and his heart started back up....I was in shock! Everyone was! We actually removed the tube few minutes after, its not like we can bring him to the ICU and put him on a ventilator. He actually is doing much better right now, I went to see him on the ward and he was awake, responding to our questions. This was amazing....very happy to see that he survived this unexpected twist of events. We didn't get his amputation done....so he's in pain now in his chest from our compressions and pain in his leg from his infection. Hopefully he will be fit for surgery again on Monday...but who knows what will happen till then!!
Once this was done...we headed back to clinic to see the patients that were left. Next story I am going to share is probably one of the funniest moments I've had here with the people....but it may not be appropriate for all ages...but I will share this anyways. A patient came for a follow up visit because he was having infertility issues...he has 2 wives and hasn't been able to get them pregnant for the last few years. Now he was supposed to have returned with a semen analysis which they can do at the lab here. His result wasn't in the chart and I told him that there was nothing I can do until we see his result. So through the translator, I told her that he had to get this done. Now, I am just thinking of how this gets done back at home....so I explained to her that he should go now and come back whenever its done. He then tells her that his wives aren't up to it now and he can't do it. I was confused as to why he needed one of his wives to be there...and asked why? The translator then said well they must do it for the semen. I was like....well tell him to go and do it himself. Now she was confused....and told me how? Then I explained with some words and motions...she starts laughing and said Ohhh...then tells him "You must go massage it and it will come" We all started laughing and the poor man was kind of embarrassed but I had no way of knowing because I only heard what the translator told me. Supposedly here...in order to collect semen, you need your wife and once the deed is done, a nurse will go and collect with a syringe...I was shocked! But figured that was the norm for their culture and can't believe I just told a Ghanaian man to go "massage" himself....lol oh well He will come back with his wife one day and they will get the analysis done...The nurse even suggested he comes on weekend when the clinic is closed and they can use an examining room instead of someones house in the village nearby the hospital! Omg I was laughing so much...I couldn't believe it! I then explained how they do it back home....the nurse then said: "Ok doctor, next time you come, please bring some calendars (she referred to the magazines as calendars) for us...it will make it easier for them men"Haha can you imagine me bringing magazine material here instead of medical supplies....wow!! It's amazing how different the worlds are and yet we are all living in the same "times". One of the younger translators a boy in his early twenties was confused about how the "sperm" would come if the man does it himself as opposed to doing it with his wife! He was very shy about it but we explained it to him. Goood times :)
ok...it's time to get back to the house. I am hooked on the tv series The Wire...gotta watch 1-2 episodes before bed :) and tomorrow we get an extra 30 mins of sleep because its the weekend! A bunch of people are planning to go out and visit some natural site nearby...going to try and go with them if there's enough room in trucks. It's my last weekend already :(
Good night everyone!
P.S. So proud of you Evie...she's graduating very soon from her teaching program and she just told me she got a few A's here and there...no big deal ;) So proud my love! You work so hard and deserve it and that's why you probably don't miss me as much :p
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