Monday, June 16, 2014

Same old, same old...

Many of you know that I have a crush.  On Olen, yes.  But also on a group of people, the Fulani people.  I think that they are so interesting and cool.  

Someday I want to live with them.  Even just for a little while.  

Someday I want to have a camel here too, but I’m getting off of the subject.  Which was my day.  

My nice, restful Sabbath.  Teaching Sabbath School for the kids.  (not so restful).  Church with 3 kids.  (not so restful).  Potluck.  (getting more restful).  There aren’t that many of us because the Parkers and my parents are on vacation.  But we still had the 5 of us, Wendy and Cherise (Gary is in Kenya), David and Sarah, Jonathan and Melody and Gideon, Zach, Charis, Papa, Appo, John and Clemence (Antoine’s kids).  My favorite thing was Sarah’s pumpkin cookies.  Mmmmm…

I had planned to visit a patient’s Fulani village this afternoon, but he didn’t come back to guide me there like he told me he would.  We decided that we’d take off anyways and try to find one to visit.  

As I was walking back to our house, of course, a nurse came up to tell me that there was an accident.  I head over to urgence (the ER) and found a man with his testicles on the outside of his scrotal skin.  

Okay, fine. I’ll suture this up real quick.  I helped him walk to the OR.  Poor guy in his 60’s  I’m guessing (grey hair) had some sort of an accident while he was working outside today.  He had branch particles in his testicles.  

I inject some local anesthesia, irrigate him a LOT, and stuff his testicles back into place.  Then I quickly suture up the skin.  Nothing to it, except he probably would have benefited from having spinal anesthesia.  He was tough though.  And I really wanted to get on the road and didn’t want to wait for the OR team. 

Before leaving the hospital I saw another teenager in urgence who had fallen a “long ways” out of a mango tree around noon.  It was now 4 pm.  Nothing was broken, but he had some severe left upper quadrant pain.  I suspected splenic laceration or rupture or contusion if I was lucky.  His conjunctiva looked quite pink and his belly was soft, so I ordered a hemoglobin and lots of fluids, and a repeat one in 4 hours.  

And off I went in search of my Fulani village with my family, along with Wendy and Cherise.  

We drove off towards Lai and stopped along the side of the road when we saw some nomadic looking people camped.  Of course we don’t speak Fulani, but details, details.  

There were only a few people home.  Two women and a few kids.  They had a lot of cute little calves, so Olen brought the kids over to pet them.  It turns out that they weren’t actually Fulani and were instead Arabic.  But we still had fun trying to communicate in our 20 words of Arabic.  I did a cartwheel to try to get the kids to loosen up, but they were all very reserved.  I know they think we were crazy nasaras!  They enjoyed seeing our nasara kids though.  

On our way home we stopped to visit a lady named Merci, who had been our hydrocephalic baby’s mom before he died.  We had drained CSF from him for months (literally syringe into his head).  He had been doing much better before he turned for the worse and died (which had been expected).  

We got home and started to feed our starving kids.  Cherise hasn’t been feeling very well, so I ran up with Wendy to order a malaria and typhoid test.  A nurse found me with a bleeding miscarriage, so I told her to go get the patient for an ultrasound.  She had had a miscarriage 4 days before but started bleeding heavily today.  I found retained products with the ultrasound, so I pushed her wheelchair into the OR and helped her get onto the OR table.  My maternity nurse helped me get an IV, and I did a d&c under local anesthesia. 

We called in the lab and her hemoglobin was 5, but B negative.  I look in the blood bank.  No B negative.  Well, she’ll just have to be okay.  

Mango kid’s hemoglobin had been 10.7 at 5pm.

I run home to help finish feeding the kids, sing some songs with the kids, play a little before getting them into bed.  

9:30 pm.  Night nurse calls to say that mango kid’s hemoglobin was now 6.  

Oh, great.  But I don’t want to operate tonight!  I decide to go look at him.  He looks okay, but his belly seems more peritoneal.  I do a bedside ultrasound and can see that his belly is full of blood.  I poke it to verify with a syringe and out comes blood.

Okay, fine.  I’ll call the OR team in.  The pathway to the OR from urgence isn’t easy to navigate with a stretcher so I decide to carry him.  The kid isn’t big, so I grab half of him and make the dad grab the other half.  A student nurse grabs his feet.  We trudge over to the OR, bang through the doors, and finally into the OR before we drop the poor kid.  No, we didn’t drop him.  BEFORE we drop him!

Ndilbe and Alexis come in.  Alexis and I scrub and find a belly full of blood.  It’s a torn spleen.  I’m no general surgeon in America, nor have I had to do a splenectomy here yet, but I know enough about spleens to know that they aren’t nice to you!  We irrigate a lot.  There is a tiny amount of bleeding still after all of the irrigation.  I put a stitch in it, but it seems to cause more bleeding.  I hold pressure and irrigate more and can’t see any more active bleeding. bleeding, get out!  I put a drain.  He’s getting fluids and blood.  

The good news is that if someone survives making it to the hospital with a bleeding spleen in Chad, it usually has already stopped bleeding.  We finish the surgery at around 11:50 pm.  

I’m home ready to go to bed, but just wanted to explain the craziness of the SAME OLD things here.  

But I am so excited!  This next week we are getting a CRNA and his wife and 2 kids to move here.  They are landing on Tuesday in NDJ!!!  

And Friday my Mom and Dad come back from vacation!!! 

Please keep mango kid in your prayers.  He’s 16 or 17 years old.