Postcards from the Field - Papua New Guinea

Postmark July 24, 2015

PostmarkJuly242015 Pic1 Edited

Our last surgical day and we met over breakfast for a “tough cases” surgical conference. Over the course of the week in addition to many patients with drooping lids, we also saw several patients with orbital masses and a young woman with a very large facial neurofibroma. It was so large that she couldn't really lift her head, and walked around with a beret over half of her face. It was wonderful to have Edward with us as during the week he worked with the radiology tech to obtain wonderful images of our patient's faces. With these images, we could more carefully plan the needed surgeries. Of course, it's not a CT scan, but helped figure out which masses would be safe to remove, and which we should leave alone and get more imaging.

Once we got to the OT, we started with the pediatric cases and once again tried to reconstruct our little 5 year old child with neurofibroma. Unfortunately, he still could not be intubated, and so I prepped the anesthesiologist into the operative field and managed to close the wound well. This was the most challenging of our cases to date. After this I straightened Stivin's other eye under retrobulbar block with Dr. Jambi assisting. He did equally well with this surgery, but was a little bit delirious from the valium. He whispered to me: “if you buy me some shoes, I can go to school and play.” I was wearing my crocs, so I took one off my foot and tried it on him – too girly, then I returned with my surgical shoes, and these green crocs fit his feet perfectly. I gave him my shoes as he went to recovery, and tied some rags onto my feet to continue operating. I only needed the shoes for the rest of the day, but he needed shoes for a lifetime!

PostmarkJuly242015 Pic2 EditedA story that really touched me today was we had the oldest patient in the group be led into the clinic by his son. His son told us his dad had not opened his eyes in over 20 years because of the scratchy eyelashes. When we examined him, the patient had an unusual entropion (inturning of the upper lids). We took him to the operating room and rotated his eyelids and lashes. When our 5 year old Samuel found out about grandpa having had surgery, he walked out of his ward to go visit our oldest patient. When the icepack was removed after surgery, grandpa opened his eyes and tears came to all of our eyes.

PostmarkJuly242015 Pic3 EditedFinally, it came time to start our last case of the trip. At the surgical conference, after much debate, we decided that even though treating the large neurofibroma would be more than one step procedure, while we were here, we should do SOMEthing. Poor 25 year old Singha deserved a chance to lift up her head and not always have a beret hat over her face to hide from unfriendly stares. Alison, Michael and I worked for 4 hours carefully separating and removing the neurofibroma tissue and piecing everything back together safely. I was happy to use some tips I picked up while doing large neurofibroma cases in Ethiopia. We finished the case late into the night (9PM) and then cleaned the operating theatre and prepared for our departure on Saturday.



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