Tenwek Day #10: Oh What A Day...

So in my last post this morning I said all I wanted today was lunch, and I got it.  I really have no business staying up and blogging all of this, but I haven't had a chance in 2 days to open my computer except for this morning for 10 minutes before I took off for surgery.  I just took the picture above.  I'm sitting in the kitchen at the guest house and it's almost 2 am.  I had to talk to someone about today while I could still remember it all  so I stopped in the guest house kitchen to chat for a while since I know you're there (and I don't want to wake up my roommate Luke since we both have to get up at 5:30 for surgery).  I was hoping for some dinner but the pans are all on the stove in the background and kind of gross at this point, so I decided to leave them un-focused for your benefit  ;)

Jumping back to last night, after we finished up our last case in surgery, we ran up to the guest house kitchen to join in the cardiology conference to discuss the latest info on the patients that have been evaluated so far.  The patient list changes daily as does the surgical line up.  There are so many children to operate on this week its been very difficult for the Doc's to prioritize who should receive surgery based on their initial diagnoses as well their prognosis for recovery while our team is still here to care for them.  I'm glad I don't have to make those decisions.  Last night, all I could wrap my brain around was who our first case of the day was the next morning, and I'd take the rest as it came as I searched the kitchen for some dinner while everyone was conferencing.  I finally decided on chili over mashed potatoes microwaved for about a minute to bring out the flavors.  Not so bad, you should all give it a try sometime. 

After conference in the guest house, Hoang and I went back to the hospital to set up for my first case of the day today. I got home around 12:30 last night in time to clean up for bed chat with Luke (he's back from safari) and GET TO SLEEP!

While I was blogging quickly this morning around  6:15 there was a knock on my door and my buddy Bea (cardiac scrub nurse and good friend from Children's Hospital San Diego where I worked for 4 years) was standing at the door with a packet of Starbucks instant coffee to share with me (no Starbucks in the general vicinity here) so I let her in and we started laughing up a storm while I ran next door to Dr. Mikes room to use his microwave to warm up my oatmeal.  Dr. Mike and I roomed together last year at Tenwek, and he really misses rooming with me this year, he just won't admit it.

This is Bea in the cardiac OR this morning trying to get me focused enough to get her the "funky Y connector" for the venous line.  She only had to ask me 6 times.  It's nice to look up and see Bea at the OR table again after being gone from San Diego for 5 years. 

This is Steven, one of our Kenyan cardiac nurses with Bea.  They make quite the team.  Its good to have you here helping us Bea!

Our first case this morning went very well.  It was challenging in a perfusion-kind-of-way which is always a good thing.  The patient did well and I was up to the guest house by 2 pm for lunch.  Things are looking good so far...  Back to the hospital for the 2nd case of the day.  On the way there I lose my calculator to a child in a wheel chair.  I need my calculator to figure everything I do in surgery, but I guess I can borrow Hoang's calculator... and there are only 2 more days of surgery...

While back in the OR one of our Tenwek medical staff stop by the cardiac room to check out with us because he has to do a case in the other room.  A kidney stone being removed the size of a baseball, and it wasn't anywhere near the kidney, and that's all I can say.... Goodness gracious...

The second case goes well, I'm assisting so that means more time to keep organizing things and trying to figure just where everything is, and hoping there's enough of what we need to do what we need to do.  Lots of photo ops during surgery, Jake got to help out at the table and I 've got some good photos and video to prove it.  We come off bypass in the OR around, I don't even know... 9:00 or so, and I head over to the ICU to see how everyone is doing and to grab a Fanta Orange.  My favorite Kenyan drink besides my chai (which I didn't get again today). 

Everyone in the ICU is doing fine, we find out that the surgery schedule has changed again for tomorrow, we'll need to reoperate on one of our prior patients, so it looks like we'll be operating right up till the time we leave on Friday.  Hoang and I head over to the OR to set up the pump for tomorrow's case (didn't we just do that?) and I hear that Dr. Mike is over in Casualty (Kenyan ER) so I "HAVE TO" head right over there to get the dish on what's going on...

Dr. Mike has only been here for 2 days and this is how I found him... Did I say Casualty?  I meant to say the lab  ;)  No, he's not being transfused with blood, he's actually giving blood for the anthrax baby (see story below).  Go Dr. Mike!  Can't pass up an opportunity to give him a hard time. 

I then head back to the OR to help clean up from the last case and set up the pump for the case in the morning.  Hoang and I are finishing up around midnight and Agneta, our senior resident pushes a patient by on a gurny and gives us a "what are you still doing here" look as we give her the same look right back.  Because of the speed she was pushing the patient, Hoang and I go next door to see if they need any help.  The patient had his throat cut from one side to the other.  Very sad, but interesting case.  I got my usual OR time with Dr. Russ outside the cardiac OR on an interesting case.  I always look forward to his explanations of cases not typically seen int he US.

A couple of days ago a young boy about 4 years old was brought into the OR suffering from anthrax exposure (apprarently acquired from eating contaminated meat).  The poor little guy was so scared while sitting on the OR table getting ready to be urgently put to sleep for a tracheotomy to help him breathe.  Another interesting case explanation and review.  Dr. Russ was in the lab tonight giving blood for one of our cardiac patients just before Dr. Mike.

While Dr. Russ and Dr. Agneta were putting the final stiches in the man's throat we hear a baby cry as Jackson tells us they just delivered a baby next door.  Well, you know how much I love the babies... so we step into the adjacent room to meet the newest member of our Kenyan family...

20 minutes spent blurring baby's privates (it's now 3:00 am) but loved how he was so relaxed and seemingly "chilling out" after his delivery with his legs crossed  ;)

What better way to end the day than this little miracle?  More miracles tomorrow... See you then.