Well we've finished our time at the hospital and have managed to unload the 3 large suitcases full of supplies that we brought. I spent one last day in surgery yesterday and observed a successful excision of a lipoma (benign fat tumor) from a woman's clavicle and an above the knee amputation turned hip disarticulation. The lipoma excision was the first time I actually saw them use a general anesthetic for a surgery. Most likely because of the proximity to her head. For the most part, the surgery went quite well and the surgeon very skillfully removed the lipoma being careful of all the nerves and arteries that could have been nearby or wrapped around in the tumor. The anesthesia wasn't exactly top notch, but they do have limited supplies to work with and are also probably trying to conserve the anesthesia gas as well as not put her under too deep since they don't have the means to support her if it's too much. All in all, success.
The amputation was a long process. The elderly gentleman had been in a bike accident either this May or last, we're not exactly sure which, but regardless, his femur was not repaired at the time of the accident and he was now in very bad shape with his lower leg twisted 90 degrees inward from the break and open infected wounds. Dr Lee wanted to do a hip disarticulation from the beginning, but the anesthetist was concerned about how weak the gentleman was from low hemoglobin. They had 2 units of blood ready to transfuse as well as general fluid support. Dr Lee began with the above knee amputation, but once he started trying to clean out the necrotic tissue after removing the lower leg and broken part of the femur, he began having trouble tying off arteries and getting the bleeding under control. Mid-surgery, Dr Lee made the decision to do the hip disarticulation because he was able to tie off the main artery and control the bleeding better from there. The rest of the surgery went quite smoothly as he removed the rest of the femur and dislocated it from the hip joint. He ended up having to cut off quite a bit of skin to get the closure just right. The finished product looked much cleaner than when he came in, but I'm sure it will be an adjustment for him only having one leg. No idea how he's doing post surgery, but I'm quite confident that Dr Lee made the right decision and that he will fare better in the long run.
There is usually very little going on at the hospital on Fridays so we opted for cleaning out what was left of our supplies, donating our scrubs, stethoscopes, hand sanitizers and white coats and saying our good-byes. It has been an incredible experience that I'm sure I will think back to often throughout my training, but I am ready to come home.
We have one last adventure before heading home and that of course is our safari! We head out tomorrow morning for a 3 day safari to the Serengeti and Ngorongoro Crater with Soko Adventures. We've heard great things from people who have used them before and we are very excited. I think one of my favorite parts, besides the animals of course, will be not being stared at and called "mzungu" all the time!
Will try to post one last time before heading home on Wednesday, but no guarantees. It's actually gotten a bit cold here so it will be nice to be home in Portland's beautifully warm weather!!
Kwa heri!!
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