Thursday, February 21, 2013

SIGN nail


Today was kind of a momentous day in the OR.  We did our first SIGN nail procedure!  This is a technique of fixing a fractured bone by passing a metal nail down the center of bone and then putting screws through the bone and the nail.  It was the culmination of a very long process. 

Generally, with a new procedure, you try to pick an easy one.  This one was far from easy.  In fact, an experienced orthopedic surgeon told me that it probably wouldn’t be possible.  It is a woman who had fractured her tibia a year ago.  It did not heal.  The pieces of the bone were separated from each other and it simply would never have healed. 

It wasn’t an easy operation.  I had actually been up most of the night vomiting and felt pretty weak.  The first couple of instrument sets that we opened up did not pass the sterilization test and had to be rejected.  (Had they not been sterilized for the proper time?  Were the tests themselves bad?)  Anyway, we eventually got the ends of the bone mobilized and succeeded in passing the nail down the bone.  I’m not sure if the bone will actually heal or not, but I believe that this procedure will offer her the best possible chance.  Maybe it’s good to start out with a tough one.  They will all seem easy after this one!  I believe that this operation is not available anywhere in this part of the country and once the word gets out, we will probably be inundated with fractures.   There are many people in this country who suffer from mistreated orthopedic injuries.   

We’ve had some pretty tough cases here.  There have been a few victories, but also a lot of heartbreak.  It is hard when you do everything you possibly can, but the patient dies.  It’s even harder when a patient dies because of an operation that you did.  There are a few of these that I could tell you about, but it is too hard to relive them.  I have a medical student who is spending a few months “shadowing” me.  After a run of pretty hard deaths, I turned to him and asked him, “Do you really want to do this?  There are easier ways to make a living!”  I think he was a little taken aback.  Later he came back and told me that he had thought a lot about what I had said.  He said that if he could think of anything else to do with his life, he would, but that it kind of felt like a calling. 

Otherwise we are doing well.  We have settled into our home.  We are learning a bit about life in community.  At the present time there is only one guest (the aforementioned medical student) but for the past couple of weeks we have had seven people in the house.  This is a lot of fun, but also stressful in ways that I had never imagined.  There are times when I just want to walk around in my underwear, and that’s simply not possible.  It does feel like a ministry of sorts.

Every day has its new challenges here.  Tomorrow my challenge is removing the kidney from a young man who suffers from a huge renal tumor.  That and dealing with the many unexpected patients who will walk through the door needing help.  My challenge is to deal with their problem in the best way I can, but also to show them compassion.

For the moment, all is quiet.  It is a wonderfully cool night and the evening is full of the noise of crickets and frogs.  I am feeling much better, and that gives me a much better outlook on life.  At these moments it feel like an incredible blessing to simply be here and to be part of the work that God is doing here.

Warren   

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