Mondays - after a long travel, then a full week of work, then hard tourism on the weekend - are always more difficult than other days of the trip. But here we all are, back in the swing, and a very full and long day.
It is always fascinating to see the ReSurge surgeons working so seamlessly with the host surgeons. It shows how universal the language of medicine is, and the collegiality that prevails over the many cultural differences. We are all enriched by this cooperation, and the patients benefit. Here Dr. Gary Fudem and Dr. Yogi Aeron work together to help a child form a new life with the reality of her burns.
I've never put the wrong volatile agent in the vaporizer, but we have done so deliberately here. Our vaporizers were not released from customs, so we had one to choose from in the ORs we are using. The vaporizers are tailored to the properties of a specific anesthetic agent, but the agents do have some similarities. So while not recommended, this is a safe thing to do, and we proceeded cautiously with this plan. It has worked out fine and got my brain thinking again about partial pressures and other such Board exam questions.
Also missing some of our instruments, the surgeons had to be creative. Not all surgeons are able or willing to do this, but our team of surgeons has made it all look so easy. Some surgeons must have each detail specifically so or there is shouting and other tantrums to deal with, while others would work in the gift shop if they had to. Luckily we have some patient and innovative doctors and nurses on our team who have flourished in this difficult situation. Here one of the surgeons retracts for the other with a needle he bent to the desired shape. It was that or deprive some of the children of a chance to improve the function of a limb.
Dr. Yogi assessing the leg of a young patient who had so much pain with movement of her burn-fused calf and thigh that she could not be really examined before getting anesthesia. Here the range of motion and skin folds are inspected for a possible solution to her limitations before an incision is made. Dr. Yogi almost approached this problem like a tailor, pinching skin like fabric for possible tucks and patches. The hope is to give her the ability to walk, and all the muscles and joints must be considered along with the need for extra skin and wound healing.
Another angle. Her hip is fully mobile, but her thigh and calf are fused, and her ankle as well. Her foot is rotated out so this view exposes her heel and sole.
After surgery and grafting - amazing change so far. Hopefully each day will bring more extension of her leg. We'll all be watching and hoping.
One of our nurse helpers is very flexible and can fold his fingers onto his palm. I have only known one other person who can do this!
Dr. Deb Rusy, at work. I am a lucky person - my two team colleagues are academics with tips and ideas to share. I always learn from my team and am humbled by the dedication and innovation of this team in particular.
