theatre: round two

Another week down in the operating room and I assure you, it was just as interesting as the first one. Throughout the week I saw four more hernias of different sizes, a hydrocele, 3 C-sections, a circumcision, a hematoma and last but definitely not least… a foot amputation.

I’ll start with the foot amputation and spare you the pictures. The man who was being operated on had severe diabetes that he left untreated and got really bad gangrene as a result. The man already has his left leg completely amputated and half of his right foot bone was deteriorated. Before the operation the doctor showed us his x-ray and explained that for now he’s going to leave the heel and just get rid of the rest of the right foot. After about a week he will check on the wound and see if the tissue is functioning. If the gangrene hasn’t travelled up the leg he’ll just do a skin graft and leave the right leg alone. The amputation itself didn’t take very long and all he needed was a normal scalpel since the foot was already so mushy and infected.

I’m pretty sure the c-sections I experienced this week gave me some pre-mature gray hair. The only c-sections they do at our hospital are emergencies so it’s always stressful and the doctors are racing against the clock. On Tuesday, the mother’s placenta had moved out of place and was blocking the cervix. When the baby came out he kept going limp and turning blue but eventually stabilized after the midwife slapped him a couple (hundred) times. On Wednesday I got to see twins be delivered! The midwife didn’t correctly read the charts before running into the surgery so it’s a good thing I had a pair of extra hands to help her hold and clean them after the surgeon handed them off. Child birth is really unemotional and routine here because they all have 5-10 kids so once the baby comes out it’s like a football that they just pass around until it’s stable and can return to the maternity ward. Before I left for Cape Coast today we had a baby get delivered with a cone shaped head and no heartbeat for about 3 minutes. The baby was past due and ended up passing feces while in the mother. However, after a lot of suction and CPR the nurse anesthetist (who pushed the midwife out of the way) was able to get the baby to cry and turn pink again.

The hydrocele patient was another surgery I definitely won’t forget. A hydrocele is fluid filled sac in the scrotum. This young man let it get extra big before coming to the hospital so when Dr Paublo popped it during surgery it was like a massive waterfall that got everywhere (including all over the Spanish intern’s scrubs). Usually hydroceles are simple surgeries with little complication but the next day we had to operate again on the same patient because a hematoma had developed in the same place. A hematoma is a blood filled sac that is a complication of surgery when the bleeding isn’t completely stopped before suturing the patient up. Over the 24 hours the hematoma grew into a massive size and Dr Paublo was really upset with himself. He explained to us that it was completely his fault the hematoma formed and that he’s usually so careful before closing the patient’s up.

All I’m going to say about the circumcision it that it was way more violent and awful than I expected and I’m really happy the baby will never remember what happened. Other than that, I learned how to dress different types of wounds and remove stitches. I won’t be in the theatre anymore but it’s safe to say I learned and experienced way more than I expected to.

This weekend we have exciting plans to carry out a community assessment project in a remote village about an hour away. I’ll be facilitating one of the focus groups in order to pinpoint the major problems of the community and help in creating an action plan to fix those obstacles. It’s going to be quite the experience so I’ll be sure to write all about it before heading back to Asikuma on Sunday. It’s insane to think I only have two weeks left in Ghana but I couldn’t be happier with my trip so far. I already know it’s going to be extremely hard to leave such a remarkable country but being able to go home makes is VERY bittersweet. Talk to you soon!