Technical difficulties...

Sorry for the delayed entry-rained again last night and the internet went out...

Nothing too crazy in the ER this morning.  I did a debridement of this little girl's leg before I went upstairs to the OR.  During that storm the other night a huge pole fell on her home and a concrete cylinder block fell onto her leg while she was asleep!  It crushed her leg causing a really bad soft tissue injury, but thankfully she had no fractures.  Crazy... 

Little guy's xray from this morning's case!

Today was a tough one in the operating room.  I had some 'technical difficulties' with some of the equipment.  Remember the kid with the 2 femur fractures?  He finally went to surgery today.  On one side, the tools I was using weren't the greatest and I was fidgeting around alot trying to hold his bones together; when I finally got everything where I wanted it, the dang clamps fell off!!  I stayed cool though and got it back together-then right when I was using the drill to make the screw holes  for the plate the drill bit broke off!!  At this point I was like "man!!"  The nurses and anesthesiologists in the room were all smiling, saying "welcome to L.I.B.!!"  It kinda kept the mood lite in the OR when I started using some of the Liberian slang-they all were surprised that I'm learning so much so quickly-it was pretty funny.  Anyway, I was able to retrieve the broken bit fortunately and ended up finding another one the same size which worked.  Next, when I was looking for the appropriate size screw there were no more left!  I had to take longer screws and cut them down to the right size.  Ultimately everything turned out just fine, but it took much longer than I would've liked.  I have to share my intraoperative difficulties as well-don't want you guys to think that every surgery is just a cake walk!  By the end of the case I was sweating like crazy (cutting those screws is tough man) but I was pleased with the outcome-I think the patient was too; he pee'd all over the nurse at the end of the case!!



Struggling to cut screws!

The second case was a guy with a 2 week old foot dislocation that needed an open reduction.  It was actually more difficult than I had expected.  For those of you who care, the guy had a subtalar and talonavicular dislocation with a talar head fracture.  After struggling with the reduction I ended up placing an external fixator on him b/c it was so unstable.  The last case of the day was an extensive debridement of that guy I mentioned who had the bad femur fracture and degloving injury to his leg-we convinced him to stay!  After the surgery, he was left with significant tissue loss-poor guy.  I had another surgery scheduled, but we had to move it to Friday b/c it got too late.  Everyday not only am I becoming a stronger person mentally, I feel like my operative skills and experience are improving as well; it's like I'm starting my trauma fellowship early!



Still smiling after a tough case..

I was pretty tired when I finally got back to the dorm this afternoon.  The shower felt great.  I'm going to have to leave my scrubs here when I leave-there's no telling what's soaked into them by now! LOL.  Many people have asked me to leave them here for them when I leave.  One of the guys today told me to leave him my bookbag!

Looks like it's going to be another rainy evening-it's already started coming down again.  Hope to get some good sleep tonight.  I need it after this one...



Me and Kashif chatting.

 

"God will not look you over for medals, degrees, or diplomas, but for scars."

-Elbert Hubbard