April 15, 2016

We have had several amputations lately. One was a diabetic dead foot so a BKA. Yes there is some diabetes here also. Another was a necrotic hand with severe infection so an amputation midforearm. Another was a dead arm with just bones sticking out and all covered or "dressed" with cow manure. It was amputated mid humerus. We had two strangulated inguinal hernias yesterday. We recently had a 35 day old baby brought in very distended and "had not had a bowel movement yet "but had "passed a little bit of gas." It was amazing that he was still alive. So I thought there must be a little bit of passage somewhere. With a finger or blunt instrument could not find any but saw a small possible passage. I used a urethra guide wire (that was given to me by a urologist in OKC) and was able to pass it easily through an apparrently very stenotic rectum congenital about an inch (2 cm) above the anus. I passed dilators over the guide wire and finally was able to dilate it more with cervical dilators. Immediately he began passing a large amount of stool which he continued to do much of the night. We also have a baby with meningocele that otherwise seems normal. Also an infant with a large mass or lump on her occiput which I aspirated some cerebral spinal fluid from. Maybe we will try to remove and close it. We also have a young man with minimal evidence of trauma to head that is now paralyzed on left side. We did anothyer small intestine resection and reanastomosis for a large obstructing cancer of the intestine today although had large mesenteric nodes. Recently we did an antrectomy (lower part of the stomach) and gastrojejunostomy (hook small intestine to stomach) for an obstructing tumor of her lower stomach. Probably not curative although no nodes or liver nodules. We recently had an Arab lady that we took out a large cancer in her pelvis but could not get it all but in the process her ureter was cut and had to be repaired so we kept her in the hospital a few weeks. She and the family were so very nice. She would always smile when we made rounds even though it was very evident that the cancer was coming back with a vengence. She finally went home and today the husband called Danae saying she had died. The husband had helped Danae with the camel also. Sometimes we are the ones that are helped in some situations.

Maybe rainy season has arrived. It has rained a few times but only about 0.2 inches at most each time but the humidity is staying up much of the time over 50% so the 90F at night feels hotter as you sweat more but don't cool much.

Dolores is still working with lots of mangoes when she is not watching grandkids.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com.
Rollin and Dolores Bland
Hopital Adventiste de Bere
Boite Postal 52
Kelo, Tandjile, Chad, Afrique