Bere 2018 #6
It’s nearing sundown, about a half hour left and I want to get out and call my wife from that special tree on the road! We got done with rounds in the hospital by about noon, I rounded on surgical ward, and saw consults in the ER, and rounded the medical ward. In the ER there was a guy who had had a prostatectomy 2 months ago and was having urinary incontinence. As I looked at his abdomen, I could see his bladder poking up from below and went all the way to above his belly button. WOW that is a full bladder. I ordered a urine catheter and urine bag. They went of to the pharmacy to get them and came back with them. The nurse called me that she couldn’t get it in. I looked and she had only gotten in about 3 inches. It was sticking mid-penis. So I had them get a child’s sized one- also wouldn’t pass. I started talking to the nurse and I look over and the guy has the small catheter in his hand feeding it into his penis to try and get it through. I scold him- but also understand his desperation to have it in. Then the decision was- call in the OR crew for a stricturoplasty of the urethra now or get him by till tomorrow. I chose to get him by till tomorrow, review stricturoplasties (if I have anything that covers that)?! So I took a 16G iv catheter and poked it (sterilely) through his belly. We taped it in place and put and IV tubing to it with an empty IV bag and lay it on the ground. Urine was flowing freely out. Now I have bought myself some time to decide what’s best to do. He said the original catheter before surgery was a very small one so I suspect he had a stricture (narrowing) of the urethra back then. This can happen when the urine catheter balloon is not inflated in the correct spot, or other reasons too.
After getting him “tucked in”, I went to Dr. Olen’s motorcycle and jumpstarted it with a truck that had just come back from Lai. I ran it out to the airstrip about 15 min away to charge up the battery. On the way back, I ran out of gas. Gas is sold in the market in various sized glass bottles, but none out where I was. So I pushed the moto to the market and got a couple liters. Then it started right up again. Now I’m about an hour from sundown. I text Audrey to see if she can talk if I went to that special tree. She responds and I have about a half hour of sunlight left to run out the 20 min drive. Many people are walking along the road, motos are kicking up dust. Donkey pulled carts are carrying supplies. A bull cart is carrying a bunch of people. Kids are fishing in the rice swamps for catfish. Eventually I arrive at about the spot and I have 3G. I try for 5-10 minutes to get an internet signal- eventually it works and I’m able to connect. We have a good conversation, I’m blessed to have a wonderful wife and daughter!
I drive back in the dark, being pelted by bugs in my face and chest, but moving at least keeps the mosquitoes from having a festival on me like when I was talking on the phone. I sure hope I avoid malaria this time! I get back to the hospital and a nurse wants me to see a patient so I do. It’s that same guy. I reassure them a little blood in the tubing is expected and tell everyone I’m on call. Now I sit here in my room, with a ceiling fan running above me. Finally cooler that the whole rest of the day.