More Operating Time...

Wow, God really kept us busy yesterday, so we're really glad we got a little bit of a break today! I don't know if the time stamp on this thing works, but it's about 5:30 p.m. and we are essentially done for the day, after a nice lunch and even a little market time...

We did have several consults to do today on clinic patients, and Carrie and Tom stayed scrubbed in to a particularly tough gallbladder case for about 5 hours!! Unfortunately, the other patient we had scheduled for today did not show up, and she is the one who probably needs her surgery the most! Please pray for Julia, who needs surgery for about a 10 cm mass in one of her ovaries-- pray that it is not cancerous, and pray that she gets the surgery that she needs soon to know for sure! Her husband is away working down near the coast right now (cutting sugarcane, most likely...) and likely did not give her permission to have her surgery without him here. A very sad state of affairs on many levels, and one of the realities that many Guatemalan women live with.

We do have good news, in that all of our post-operative patients seem to be doing well overall! Yesterday we operated on three ladies who needed various kinds of hysterectomies (for you OB/Gyn types out there who are interested, a TAH s/p 3 C-sections, a TVH with anterior repair, culdoplasty and perineoplasty, and another TVH with culdoplasty, perineoplasty, and a prayer that it holds since her tissues were too post-menopausal to do anything more substantial!) The second case took much longer than we had hoped but so far the outcome has been good and that's what really matters this week. In the long run, of course, we just hope that they will feel the love of Christ while they are here and know that it is only because of this that we are able to help them at all...

Today brought an interesting "mystery" story our way from clinic-- A lady who is around 49 years old, who came in stating that she had a hysterectomy last September done by some visiting North American doctors down in Antigua, Guatemala. She says she had her surgery because of some heavy bleeding she was having, and that they told her they also took out both ovaries. She was doing well until January 1st, when she started bleeding again like she was having another period, which has kept going through today! She brought in a pathology report with her name on it that said her uterus, tubes, ovaries, and cervix were all sent to pathology and that she had a cervical cancer found on pathology! Luckily, the cancer was small enough that the surgery should cure it permanently.

But imagine our surprise when we went to examine this lady and found that she has a cervix, a uterus, and at least one ovary still intact inside!!! Hmmmmm... where to start?! The patient strongly believes that she had her uterus removed, but was unaware that the pathology report (which is obviously NOT hers as she still has her cervix intact!) read "cancer". So now we have TWO problems-- Someone DOES have cancer, DOES need to follow-up with regular pap smears and doesn't know it! And THIS lady... well, has a uterus, what appears to be a complex cyst in one ovary that probably should come out, but unfortunately also has very uncontrolled diabetes making us more than a little hesitant to operate on her just to find out for sure what's going on!

I tried calling both the pathology lab and the Hospital where the surgery was done (both generally quite reputable places down here...) and talked to very nice people who promised to call back soon when they found some information but whom I have yet to hear from. Maybe tomorrow we'll hear something, but I won't hold my breath! I checked some lab work to make sure she's not anemic, biopsied her uterus, did a pap smear, and then sent her with some paperwork to try to get a CT scan a little ways up the road to get a better picture of what's going on with this ovary of hers! Tom is nice enough to follow all this up in a few weeks, and we gave her a lecture about controlling her diabetes better in case she needs surgery, but who knows where it all will lead?!?! I'll call the hospital again tomorrow and see if I get any further...

Speaking of tomorrow, just a few quick general surgery cases (gallbladder and two lymph node biopsies), and hopefully we will send almost all of the patients from this week home. Then the girls will surely hit the market hard again, assuming that we don't have another 20 clinic patients to see!

A few random pictures today... The first is of Carrie with the family (or maybe the whole village, it would seem!) of the first patient we operated on yesterday-- Yes, that is the lady's uterus that her husband is holding in the basin there! They like to see the "parts we took out" here after surgery... Usually a new cultural experience for most people that come down here!



The second is from inside the hospital, a nice view of the courtyard that everyone enjoys and takes good care of...




Will try to bring you more stories tomorrow!