Emergency surgery...

Last night the surgeon called us at the house saying that one of the patients (10 days post-op) was unexpectedly bleeding and needed to go to the operating room for a cystoscopy to figure out what the problem was. At first it didn’t seem like he would need my help, so I stayed at the house. But an hour later at 2230 I was called and asked to come in as well. Apparently the patient’s bladder was very distended due to a very large blood clot and the surgeon needed to do an emergency laparotomy.

Now, on a Sunday night in Africa it is tough to get your staff rounded up…cell phones aren’t switched on, transport is difficult to find etc. Fortunately we were able to call the anesthesist as well as the lab technician (who went to get units of blood). We also managed to call two OR nurses, one to circulate in the OR and one to scrub in and hand the surgeon the instruments. However, one more person would be needed to scrub in and assist. Well, that someone was me!

Fortunately the patient was stable and the blood arrived quickly. Our surgeon and I scrubbed in and started the case. I was a little nervous because it had been about 4 years since I had scrubbed in! In the end however, it was another good experience. I suctioned, sponged, held retractors, helped search for the ureters and in the end stapled the wound closed. We managed to get rid of the blood clot and irrigate the bladder much to the patient’s relief. The sweetest thing was that as soon as the case was over the patient was saying thank you to the surgeon. I was glad to see she was still doing well in the morning.

Needless to say it was yet another unexpected occurrence in Salone. Fortunately with a good ending. The only bad part was that I didn’t get home till 215am and had to be back at the clinic at 8am- for crazy Monday clinic! So, I worked from 8-6 today seeing 55 patients! I have to admit I am pretty tired now!