Good morning all! Well for those who prayed for Heidi and Micah yesterday, Micah did SO much better... she was very good for our friend Aurelli and allowed Heidi to scrub 2 cases with me in the OR yesterday... in general seemed much more content so your prayers worked... THANKS! Yesterday was a very good, very productive day for the most part. Thanks to our other good friend Dr. Sherwood Pope (a family doc who works over at Aselsi, one of the other Christian clinics here in Chichi), we were able to turn NOBODY away for consultas despite a full OR day. He scrubbed the entire first case with me and portions of the second while Heidi did consultas downstairs.
First 2 cases went beautifully! Uncomplicated vaginal hysterectomy with repairs who should do wonderful, and a nice abdominal hysterectomy for fibroids that made this poor lady look NOT pregnant for the first time in years! :-) We started around 8:30 and had those 2 cases done by lunch. Broke for lunch and came back for another vaginal hysterectomy with repairs on a complete prolapse... (btw if you aren't interested in surgery details, now is the right time to skip to the next paragraph)... after 2 hours of patiently trying to work my way down into this inside out anatomy, we had gotten almost nowhere and the uterus (which we'd previously thought farily normal sized), wasn't descending at all. We decided to open the belly, do the hysterectomy abdominally, and then, since neither of us have any real experience the abdominal suspensions, to go below and finish the repairs from there. Get in the belly and its a 14 wk sized fibroid uterus... no wonder its not descending, it doesn't fit. What I had palpated before on exam was her 8cm elongated cervix... *sigh* So we get it out from above, but as we are getting to the bottom, we start looking for uterosacral ligaments to attach the cuff to and her tissue is so bad, we can't definitively ID them... meaning there isn't much to keep this little vagina from fallling right back out when we are done. We close the belly, go below, repair the rest of the vagina and close the cuff, trying to attach to what MIGHT be uterosacrals but knowing that is probably not the case, but finished the closure anyway, and 7 hours later walked out of the OR VERY frustrated. Praying that God finds something to supernaturally scar the top of the vagina in to keep it in place... we are considering going back in to the belly to try again to find some semblance of uterosacrals vs attaching it to the sacrospinous ligament below (something neither of us have technically done). Considered sacrocolpopexy, but again, not much experience between the two of us and its a risky surgery... just praying for wisdom whether re-operating is even the right call... Would LOVE intervention for this lady by my prayer warriors out there... her name is Tomasa.
Today we have 2, maybe 3 cases and some consultas possibly (there are always a few stragglers on Tues/Wed). Again pray for safety and wisdom in selection for our surgeries. And again pray for the Spirit to conitnue to move here. We have one lady who we are a little worried about cancer today, she could use lots of prayer today. Off to shower and round on patients now. THANKS for your prayers!!!! Love you all and will be in touch!
Chris
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