Indelible Roots

10/26/2007

Wow! Things just are not going to die down and become routine here apparently. Rounds this morning were disturbed by the squealing of pigs next door, just beyond the six foot wall and barbed wire. However, no one else seemed to notice but me. I gave my report to the “I’m the big man on campus” surgeon concerning the young girl with the fingers contracture releases and he decides to send her home. As it were, she lives three hours by car away and they don’t own a car. Discussing this further with Samath, we decide to keep her on even though the order on the chart is to send her home. What ever, I’ve given up on making sense of things.

In case she is sent home over the weekend, I make her a small splint for her pinky to try to stretch it back out. The ring finger is a lost cause until surgery is performed. I also show mom how to stretch her and make her use the fingers. Overall she is doing better daily with no extension lag now, so full passive ranges after stretching. She is also pulling things out of putty with some force.

I also broke out my splinting pan and splinting material for a dorsal wrist and hand splint. During rounds we saw an older woman with burns to the neck and left arm post two years. She had just had a contracture release to the neck and had no plans to release the contracture at the elbow that was drawing her wrist into flexion and fingers into hyper extension. I have her come in to the therapy cubical and splint her to improve alignment, prevent further contracture, and to prevent the possibility of dislocating the MPs. I did discuss this with Samath as it was using a lot of splinting material and I did not want it to be a waste. He agreed with the plan.

Right before lunch I go upstairs to get on the internet. A short time later a runner comes to get me saying Dr. Jim wanted me in surgery. ‘Cool’ I think to myself. I get there, scrub up, and walk in to find Jesse on a gurney and Dr. Jim describing how he wants me and Samath to get some leg elevation pillows and abduction pillows made. We are apparently going to be doing a lot of hips surgery next week along with spinal cord surgery. Dr. Jim’s son will be here doing those.

So I’m thinking that Jesse just had some lymph edema problems and his legs are swollen up. The right one is wrapped up and laying on a pillow. Samath and I design the pillows on paper and I go to see Jesse in the recovery room. We start talking and he tells me this bazaar story about why his foot is wrapped up and why he’s got IV antibiotics dripping in. The morning of my first day here, he was asleep with Goldie, the nine month old yellow lab. The night before we had been drinking and I had to wrestle a shoe from Goldie. She then went on to rip a doll to pieces. In the morning, Jesse awoke to the sound of crunching bone! Goldie was chewing on his foot and since he has a complete T10 spinal cord injury he didn’t feel it. By the time he woke up he had lost the first three toes and part of the foot! This is something out of a Stephen King book I’m thinking. I’m looking for him to say it was a joke, but he is dead serious.

After that story I was pretty hungry so I excused myself and walked to the chow hall with Trish, an Australian anesthesiologist who was on her last day of a two week stay. Most of the staff sits outside, but I always sit inside with the younger crowd. Mr. Jenna, the head nurse is there and tells one of the nurses that she is to take Jesse to Dr. Jim’s house when he’s done with the IV. She is not to stay there. They keep talking, but I’m zoning out, though there is a lot of laughter and what not. I do catch that the nurse (don’t remember her name) says she is embarrassed and for them to stop it. I’m thinking that they know Jesse and his crude behaviors. Mr. Jenna turns to me and asks me if I understand what they are saying. I tell him about what I understand and he says ‘no,’ they are on a second discussion now. Did I know the nurse was single? Would I do anything about it? I tell him I’ll look into it and the room cracks up.

After lunch I eval a young woman with right arm deficits due to polio. They are planning on fusing her shoulder and wrist and Dr. Jim wants me to evaluate her to compare with Samath’s report. I do so on a sheet of paper as usual as I didn’t have any forms. When he returns he looks at the both of ours and yells at me about having difficulty reading my form. I have to point out things for him several times, but the only real problem was my measurement of wrist extension. I guess I just don’t push as hard as he does. He also mentions that Samath isn’t putting down both active and passive ranges and I mention this to him when I see him again.

After that Samath and I go next door to Veterans International who makes prosthetics and orthotics for all. We bring in a baby who had been casted for club foot. VI however, does not want to make him orthotics today as it was nearing closing time. They tell us to come back Tuesday or go to the other clinic in the same province as the family. We decide that I would make some temporary orthotics and get VI to make the more permanent ones on Tuesday. Actually, Samath decided that as I never would have said I’d make one for a kicking, crying baby. The end result is the ugliest pair of orthotics you’ll ever see. I just hope he doesn’t get sores from wearing it over the weekend.

After work Dr. Jim invites me to dinner. We all meet at this nice restaurant where you cook your own food at the table on butane stoves. Hot food on hot burners on a hot night resulted in some sweaty patrons. Dr. Jim, his wife, his young son, Jesse, Dr. Jim’s cousin, and a couple of others are there. It was a good end to quite a strange day, and interesting week.

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This entry was posted on Friday, October 26th, 2007 at 8:14 pm and is filed under Travel. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.