Sunday, April 26, 2015

17.4 WEIGHT LOSS

There are many ways to do it here in Bere. One way is with pure heat
exhaustion.

It’s hot season now. We have 3 visiting ER docs from Loma Linda. I
was happy, well not happy, but pleased. Anyway, I noticed that one of
the ER docs was completely drenched with sweat when we took off our
non-disposable surgical gowns after a complicated C-hyst (hysterectomy
done at the time of Cesarean-section, a very undesirable surgery for
both patient and surgeon, but necessary on rare occasion). It was
nice to know that I’m not the only one that sweats like a pig in the
operating room. Visitors do it too. You constantly have to replenish
your fluids here between surgeries or you will pass out (or get kidney
stones, which both of our fathers have managed to do here). However,
it’s one method of weight loss. At least until you rehydrate on the
plane trip home.

Another effective method is eating the ripe mangos that fall to the
ground without washing them in bleach water first. Giardia. It’s a
beast. First comes the belching of rotten eggs. Then comes the
bloating that you wish would go away. Then comes the diarrhea that
gives no warning and runs like a faucet. We’ve said you’ve never
really been a missionary till you’ve pooped your pants (we accept
sheet-soiling as an acceptable equivalent). It’s also a quite
effective method of weight loss if left untreated for too long.
Flagyl treats it, but also makes everything else taste metallic and
nasty, furthering the anorexia and weight loss. Once your poop stops
sounding like urine hitting the toilet bowl, you usually put the
weight back on.

Typhoid, Malaria, traveller’s diarrhea… all good methods. Being an
insanely long way away from any good restaurants or stores that have
processed foods, another good method. All easily correctable once you
return to America, however.

Watching what you eat or exercising. I’m going to have to say, not
really toppers of our list here in Bere. Unless you count refusal to
eat rice for the 21st time in one week as watching what you eat.

Although all of the above methods are good and effective, by far the fastest method of weight loss here at Bere Adventist Hospital is to undergo our state-of-the-art surgery. In February we had 3 visiting medical students from Loma Linda. They were eager and ever ready to help when needed. So when I asked them if they could help me with one patient who had been suffering with her problem for 4 years, they jumped right in. They just didn’t know it was going to be such labor
intensive work! It’s hard work to get rid of weight sometimes!

My patient was a bit unusual, however.
She looked like she was
Note how thin her arms are
pregnant with 5 babies. The only problem was that she had been the same way for 4 years! Samedi brought me her carnet (medical booklet), asking how the hospital could help. I had seen her back in 2012 and forgotten about her after filling out a surgical form for surgery.  She came back a year later and was told that she still needed surgery.  Now, 3 years later, she still had no money. So we decided to do her as a social case.

Here she is preop. I was quite nervous there would be huge vessels attached everywhere. But thankfully it was relatively mobile.

We took out a 17.4 kg ovary! (That is like having 5 full term babies in your belly at the same time!) The other ovary was small and looked normal. Her uterus was small. I WISH I had pathology. She did well post-op (in her weight-loss course) and was discharged home in normal condition. I saw her 3 weeks later and she still was going well.
Dr. Bland hold the mass
Not everyone has it so easy, but I must say, she is someone who deserves to lose weight easy as she suffered with a “pregnant” load in her abdomen for 4 long years! That poor woman! Praise God we were able to remove it relatively easy. Thanks Mason, Dad, Megan, Mai-linh (and thanks for prividing the pictures!), and Kelsey for your hard work helping!


The best part, when you take out a huge mass in Africa, is the gawkers outside of the OR. That is like the icing on the cake. Oh, and in
case you were wondering, she hasn’t regained the weight.


missionarydoctors.blogspot.com
danae.netteburg@gmail.com
Olen Tigo: +235 91 91 60 32

Danae Tigo: +235 90 19 30 38
Olen et Danae Netteburg
Hopital Adventiste de Bere
52 Boite Postale
Kelo, Tchad
Afrique
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