Tuesday, April 26, 2011

More Magic from Team Goethke

April 21

Today was another very good surgery day.  Once again, Randy performed his usual magic and we finished with the first five cases by about 12:30.  We only had one afternoon case but it was a dandy.  A patient was transferred 2 days ago with an open fracture of her mid distal tibia and fibula.  She also had a complete laceration of the Anteror tibial tendon.  She had originally been debrided and an exfix
Terry, Carrie, and Randy doing a fracture reduction and casting
placed at a hospital a couple of hours away by a visiting foot and ankle surgeon from the US.  The surgeon was leaving the next day for the US and asked me to take over.   I extended the laceration toward the ankle and found the distal stump of the tendon and repaired it.  Then I reduced the fibula and fixed it.  I reduced the tibia and temporarily fixed it with K wires.  Then I put on a TSF and locked it down and took out the K wires.  I added a foot plate with metatarsal pins to hold the foot in dorsiflexion to take stress off the tendon repair.  The whole procedure took a while but came out nicely.  I really enjoy using the TSF.

April 22

Jeannie's birthday as well as Good Friday.  Only one patient showed up for surgery today.  He is a 14 year old who sustained an open fractured tibia in the earthquake.  He has had drainage nearly ever since.  The entire mid tibia had a big anterior bow and was very sclerotic.  I debrided the sclerotic area but didn't find a clear sequestrum.  I placed antibiotic cement in the canal.  I hope it gets rid of the
Carrie working in the Peds clinic
infection.  Jeannie and I went for a long walk in Carrefour with Randy and Carrie.  It has been really great having them here.  They leave tomorrow.  I had arranged for a birthday cake for Jeannie and we planned to celebrate with as many of our translators as possible.  They led us the back way to the Auberge and we got in a dip in the pool.  We all enjoyed a nice meal and then celebrated without the cake.  It was a lot of fun celebrating with Emmanuel, Roosevelt, Jacque, Franz and JJ.  JJ brought his mom who is visiting him from Boston.  They all escorted us safely back to the hospital well after dark.  While at the Auberge, I got a call from one of the mission projects about and hour and a half away.   A security guard had slammed a gate on his finger and amputated the tip of  a finger.  I told them to bring him over and they were waiting when we got back to the hospital.  We took him to the OR and I shortened the distal phalanx a bit so I could close the tip.

April 23

I took advantage of Randy being here and did an early morning case before they had to leave.  It was Randy's 26th anesthetic this week.  He has been surprised at the volume of cases and this has been a pretty quiet week.  I hardly scheduled any elective cases since I was all by myself and still recovering from whatever it was that I had.  I hope they can come back before our year here is over.  If not, there will undoubtedly be more opportunities in the future.

It is the Sabbath today, my favorite day of the week.  After finishing the case we made rounds.  After bidding Randy and Carrie 'goodbye', we went to church at the University up the street.  The rest of the day was very restful, just as God intended.  What a delight to be able to rest and read and send a few emails to family and friends.  I feel energized for the coming week.

A pediatric patient modeling the new gown sewn and donated by volunteers in Appleton, WI.

1 comment:

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