Saturday and Sunday, December 10-11:
Like all other weekends this was a weekend full of surgery for the most part. Different specialists come each weekend and this was certainly a weekend full of them. We’ve not seen the hospital this busy since we’ve arrived.
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There was an oncologist here from TATA memorial hospital in Mumbai, the largest cancer center in India. He comes to Walawalkar every 3rd Saturday, and sees EVERY oncology patient, both inpatients and out. This is the only hospital in the area that has any sort of cancer treatment so you can imagine how busy he is. On Saturday alone he was predicted to see approximately 180 patients! During this time he will see new patients to assess and create a treatment plan for them and current patient to follow up on their progress. We were scheduled to be with him for the day, but he sent us away shortly after we arrived because there was really nothing for us to do. He had done some of his work at St. Jude’s Hospital, therefore he was familiar with PA’s which is why he quickly realized there was little we would get out of sitting through office visits where everyone spoke Marhati and he just didn’t have the time to translate for us. In the end this was all ok with us because like I said, there are several specialists that come each weekend.
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The spine specialist was here just like every weekend. He did not have any surgeries to do so he followed up on his patients from the previous weekend, including the patient operated on for cauda enquina syndrome, and then assisted the orthopedist with some of his work. Another specialist in for the weekend was Dr. Daddi, a plastic surgeon from Mumbai here to run a cleft palate camp. He is over 70 y/o and still working like he’s in his 40’s. Typically he and his partner come to Walawalker once each month and will keep 2 OR rooms going for 2 days. His partner, however, was on holiday this particular weekend, so this meant a few less cases will be done.
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There was an oncologist here from TATA memorial hospital in Mumbai, the largest cancer center in India. He comes to Walawalkar every 3rd Saturday, and sees EVERY oncology patient, both inpatients and out. This is the only hospital in the area that has any sort of cancer treatment so you can imagine how busy he is. On Saturday alone he was predicted to see approximately 180 patients! During this time he will see new patients to assess and create a treatment plan for them and current patient to follow up on their progress. We were scheduled to be with him for the day, but he sent us away shortly after we arrived because there was really nothing for us to do. He had done some of his work at St. Jude’s Hospital, therefore he was familiar with PA’s which is why he quickly realized there was little we would get out of sitting through office visits where everyone spoke Marhati and he just didn’t have the time to translate for us. In the end this was all ok with us because like I said, there are several specialists that come each weekend.
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The spine specialist was here just like every weekend. He did not have any surgeries to do so he followed up on his patients from the previous weekend, including the patient operated on for cauda enquina syndrome, and then assisted the orthopedist with some of his work. Another specialist in for the weekend was Dr. Daddi, a plastic surgeon from Mumbai here to run a cleft palate camp. He is over 70 y/o and still working like he’s in his 40’s. Typically he and his partner come to Walawalker once each month and will keep 2 OR rooms going for 2 days. His partner, however, was on holiday this particular weekend, so this meant a few less cases will be done.
Upon Dr. Daddi’s his arrival we followed him on rounds and saw all the patients with cleft lip and/or palate, and a few others with deformities requiring assessment by plastics. He was very enthusiastic about his work and very patient with us. He liked to pimp us and tell us about the deformities we’d never seen or heard of before.
The first case was a cleft palate that Jeremy scrubbed in on, the second a cleft lip where Beth scrubbed in and I was the official OR photographer. After the cleft lip was completed Beth and I made our way over to the orthopedic surgical suite where the pediatric orthopedist, also in for the weekend, was performing a femoral osteotomy (removal of a piece of bone) on a little boy with rickets (Vitamin D deficiency in children leading to bone deformities and other complications). Some of the children with rickets here have deformities so severe that we were impressed to see they could even walk. They had adapted amazingly well! The correction for the bowing of the femur is to remove a piece of bone from the femur, place rods in the leg above the break and below it. Now these rods function as an external fixator (http://en.wikipedia.org/wiki/External_fixation). With external fixation the rods are screwed into the bone at a right angle from the lateral (outer side). There is one end that remains in the bone and one that remains outside of the leg. These portions outside of the leg, above and below the break, are fastened to one another to hold the leg in the correct position so it can grow back in proper alignment. This fixator will remain in his femur for 2 months until the break has healed. Once the first leg has fully healed, then the child will go back to surgery to correct the second leg in the same way. In this particular boy, the femurs were the only correctable deformity. Rickets may also affect other long bones of the body.
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After surgery to straighten the young boy’s leg we went back to the other ORs where the pastic surgeon was about to separate the fingers of a boy born with complex syndactyly, meaning that all his fingers (exception of his thumbs) were overlapping and fused together since birth. This unfortunately occurred to both hands and the surgeon gave the boy the option as to which hand he would like operated on first. Without hesitation he points to his left hand, the worst of the two. It was Beth’s turn to scrub into this case and the surgeon was more than happy to have her back. I again played photographer and sat with the boy during the case. The boy was not actually put under general anesthesia for this, he was given a nerve block in the shoulder to numb his entire arm and then just sort of put him into a “twilight” to relax him and induce a little nap. Toward the end of the case he woke from his nap and was trying to peak over the small drape next to his face. It was still pretty messy looking and not time to see, so I had to raise the drape and sat next to him for the remainder of the case. Otherwise everyone was on the other side of the drape and he would have been essentially. I obviously do not speak Marathi, so when I’d see his pulse rise I’d just hold his hand or gently rub his arm. I assume that’s a universal mom thing to do. Dr. Daddi said that though his fingers are shortened (they did not grow to their full extent due to the fusion) that he would regain full function of his now separated fingers. Beth and I walked out of the OR at nearly 10pm that night. Luckily dinner was still waiting for us when we returned!
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Sunday we started our day by doing rounds up in the pediatric ward on all the kids who had surgery the day before. There were 9 in total between the plastic surgeon and orthopedist. Some were feeling a little miserable, but all were doing well and had not developed any complications overnight.
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After surgery to straighten the young boy’s leg we went back to the other ORs where the pastic surgeon was about to separate the fingers of a boy born with complex syndactyly, meaning that all his fingers (exception of his thumbs) were overlapping and fused together since birth. This unfortunately occurred to both hands and the surgeon gave the boy the option as to which hand he would like operated on first. Without hesitation he points to his left hand, the worst of the two. It was Beth’s turn to scrub into this case and the surgeon was more than happy to have her back. I again played photographer and sat with the boy during the case. The boy was not actually put under general anesthesia for this, he was given a nerve block in the shoulder to numb his entire arm and then just sort of put him into a “twilight” to relax him and induce a little nap. Toward the end of the case he woke from his nap and was trying to peak over the small drape next to his face. It was still pretty messy looking and not time to see, so I had to raise the drape and sat next to him for the remainder of the case. Otherwise everyone was on the other side of the drape and he would have been essentially. I obviously do not speak Marathi, so when I’d see his pulse rise I’d just hold his hand or gently rub his arm. I assume that’s a universal mom thing to do. Dr. Daddi said that though his fingers are shortened (they did not grow to their full extent due to the fusion) that he would regain full function of his now separated fingers. Beth and I walked out of the OR at nearly 10pm that night. Luckily dinner was still waiting for us when we returned!
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Sunday we started our day by doing rounds up in the pediatric ward on all the kids who had surgery the day before. There were 9 in total between the plastic surgeon and orthopedist. Some were feeling a little miserable, but all were doing well and had not developed any complications overnight.
After rounding on the pediatric patients I spent most of the afternoon in radiology with Mr. Dr. Patil (there is a Mrs. Dr. Patil as well). While there I was able do a Thoracentesis, which is a minor procedure involving the guidance of ultrasound to drain fluid from a collection within the lung using a needle and syringe. He is incredibly patient and loves to teach, part of the reason I never mind hanging out in radiology.
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Ok… that’s one more day I am caught up on. Hope everyone is happy, healthy and warm!!
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Ok… that’s one more day I am caught up on. Hope everyone is happy, healthy and warm!!
Becky
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