How did my day go you may wonder? Here is a summary:
-worship at the hospital at 7AM
-about 8 lightning rounds on the surgical ward with the nurse Emmanuel who knows all the patients and tells me any of their problems
-A neck dissection for a salivary gland tumor with enlarged lymph node near by
-removal of a dental mass in the gums displacing the front incisors and removal of a couple of dead teeth
-surgical consultations that wait outside the OR- saw a necrotic/dying foot in a diabetic that needed amputation- he refused
-ER consultation for a burned girl who was burned about a week before
-prostatectomy
-more surgical consultations
Ended about 9pm
Ive realized some things about myself this trip. The tedious surgeries that take many hours are less enjoyable to me than the faster surgeries that take a couple hours or less. Thats a new realization. Doing the thyroid excision the other day and the neck dissection yesterday, they were interesting for a while- but after a couple hours I wish i were doing a different surgery.
Ill explain more now the dental mass. It was challenging to me and i did enjoy that. Ive not resected a dental mass like this before, in that location. But it was up to me to fix. A picture of the woman is down below. I know if you get to the marrow of a bond that granulation tissue can start from there. That’s how we fixed a child with exposed skull before in Cameroon. Expose the marrow and it granulated and covered the area. I wish i had a way to talk to my dental friends and get advise, but I didn’t.
She was brought into the OR and a visiting anesthesiologist from the US and parent of one of the missionaries did a nasal intubation. After that I placed a gauze in the back of the mouth to catch blood and started removal. After excising the mass and the involved two front teeth I had difficulty deciding closure. I created a mucosal flap and rotated it into the area to cover the exposed bone. I figured since the marrow was exposed it would probably granulate, but since I couldn’t confirm this with my dental friends, I created the flap. hopefully I will see today if my flap survives.
