Friday, April 27, 2012

Surgery - and more surgery   March 28, 2012

     If you don’t like surgery descriptions then skip the next paragraph. Dolores says that most people wouldn’t want to hear about that but some do and that is what I have been the most involved with.
     This weekend a little boy was brought in that had fallen out of a mango tree two days previous. His abdomen was tight and resonant and tender. At surgery his abdomen was full of old blood, his small intestine was twisted around its pedicle and strangulated and there was much retroperitoneal blood and a tear in his spleen that was not bleeding. He almost died on the table and did expire a few hours later. Nearly his whole intestine had a poor blood supply and was greatly dilated. We think we had the bleeding stopped but he died anyway. Another case was a young lady that delivered a live baby 2 weeks previously and stated a painful mass began afterwards but at surgery there was a huge retroperitoneal mass (about 18 cm diam) somewhat overlying the left kidney and aorta and vena cava etc. It had huge veins all around it and the left ureter went over part of it. I think it was the most vascular mass I had ever messed with. It obviously had been there for quite a while. By careful dissection, clamping and tying etc we finally were able to extract it. It was a semisolid mass and we still don’t know exactly what it was. I hope she appreciates the nervous energy it took to do the case. The mass appeared slightly like a kidney but no definite structure. The lady is doing well. We also removed a large goiter under local anesthesia and IV sedation which so far is doing well. I saw a lady today with a huge mass left mandible and extending into her mouth. We had to tell her that there was nothing we could do for her. She said that it had been coming on for 5 years.
     I heard about another strange case. Some boys picking mangoes heard a baby cry in a nearby pit toilet. The baby was somehow recovered from the worms and excrement in the pit and was brought to the hospital where it is doing well. Apparently the young mother did not want the baby and put it in there although I don’t know for sure if this is true as I understand she is now breastfeeding the baby and the grandmother who also recently had a baby is able to breastfeed the baby. The baby is getting antibiotics now . I think there will be more to this story later.
     We had a baptism this past Sabbath with 31 precious souls which is an almost unheard of event for Chad. They were baptized in the river that is about 7 km away. There are supposed to be about that many more that will be later from this set of meetings that just concluded.
     Zane is getting IV quinine for his malaria also getting zithromycin for possible typhoid as suggested by a specialist back at Harvard. It is not the most fun thing trying to keep an IV in a 9 month old but he is fairly tolerant. Danae was getting stressed out and is watching him almost continuously along with Dolores and Olen but I think he is getting better. He had a course of oral quinine before but did not seem to respond to it. He has also had other antibiotics and antimalarials.
     We hear that Ron (Dolores’ brother) is starting his first round of chemotherapy then they will reevaluate him and go from there. We are praying for a huge shrinkage of the tumor.
     Our container has been shipped from Grove to Houston but is waiting there for some special batteries (about a ton) for the hospital electrical system so that the generator does not have to run all the time. They say we could have plenty of electricity for the whole hospital and doctor houses if we had an extra $1000/month. Donations anybody? We recently got another generator, a big 30 KW Hollinsworth diesel that once was from the US Army. Our regular generator has been a Catapillar diesel 20 KW which has been about maxed out part of the time esp if the OR AC and the water pump are running at the same time. We get by ok as is although it would be nice to have more than 5 or 10 watt bulbs for light. We do have good light in the OR now. Recently got a good light given and put in place which makes surgery a lot easier. Headlamps just don’t work as good.
     We had a birthday cake with candle and got Dolores some cloth for a wrap around for her birthday so now she is as old as I am again. No, there are no fancy restaurants or something nearby to take her to. Besides that you need wheels to get anywhere much. It does not matter much when you are our age but just be thankful that you still have birthdays. We are already older than almost everybody here although a lot of people here don’t know their age or birthday. There are some around that have gray hair at least.
     One has to learn to sleep with various noises. The neighbor’s dogs bark under our window esp about 0300, also the fruit bats make noise almost all night. The guineas and chickens are awake at the first sign of daylight. Also there are loud bumps on the roof when fruit from a large tree fall, but the fruit is not edible and is about 1 inch diameter. The lady next door sweeps the yard and starts cooking on her charcoal stove about 0500. The dust is everywhere including in the bedding by overnight although it isn’t quite as bad now. But it is getting hotter as no dust to shield from the sun. If you wash clothes they will dry almost instantly in the dry heat.
     My biggest problem still is learning French. To me it sounds as if they re talking through their nose with a mouth full of mush. Maybe it’s the gray hair that is keeping it out of the brain so maybe if I would cut the gray hair off than it would be better ha :-) Yes I know that the real problem is that I haven’t spent enough time with the books and Rosetta Stone and Pimsleur, etc., but still I just don’t soak it in as fast as I once could which of course means that I need to spend even more time.
     Surgeries should start slowing down and the hospital work in general begins to slow down in April when it is over 100 in the shade so they say. So far the 90 and 100 weather has bothered too bad.
     We appreciate emails and will try to answer when our internet is functioning.

Love to all,
Rollin and Dolores

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