Hi everyone.
We had a busy day today (Sunday 1/30). Most of us had very little sleep last night. Maybe it was nerves. Maybe it was sleeping outside. Mostly it was the wild dogs barking all night and some tribal chanting which was coming from across the ranch.
Only 24 hours have gone by, but we have already made many friends. The smiles on the healthy children’s faces contrast sharply with the fear on the faces of the injured. We did some good orthopaedic cases and quite a few wound debridements. There are many amputation wounds, as we expected. The patients in the census for the most part have clean wounds now, thanks to the efforts of OAM team 2. We seem to be reaching the point of no return with regard to fracture management. They are now 2 1/2 weeks out from day of injury and starting to heal. Closed reduction is no longer an option. Open reduction and internal fixation is a challenge, particularly in the children who heal so quickly, but also in the adult long bones. 2 1/2 weeks of muscle contracture have resulted in bayonetting, which is difficult to stretch out to length. We had to accept some alignments that normally would be unacceptable, but there isn’t much choice.
Today we served a young woman with a femor fracture; a large surgery and we had no chance of giving blood products if we got into trouble. Mike Jabara and I tag teamed it, with heavy manual traction on the leg. After lots of sweat it came together. Fortunately things went smooth and we only lost a little blood.
We had a 10 year old boy who walked in with his father pointing at his umbilical hernia. It looked simple enough but turned out that he had an acute bowel rupture. Our general surgeon friend (Dr. Andy), who thankfully arrived today, took good care of him. Unfortunately post-op sepsis lead to rapid deterioration and manual ventilation most of the day. Ultimately we had to ship him off to the USS Comfort. We are not really equipped to run an intensive care unit.
Tonight Mary Herzog, our orthopaedic resident, put her OB skills to work on a term labor in the early stages. Stay tuned and pray for a happy delivery.
Peace and love
John Anderson and the members of Team 3
