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8/16/05 (Tuesday)

Today, Jane and I did 5 hysterectomies.  Two of the ladies were the Chachi Indians.  They don’t speak Spanish so it was difficult to communicate with them.  They were so dirty we had to give them showers before coming into the operating room.  The one lady was bleeding very heavily.  She walked from the patient ward where she was staying waiting on her surgery and dripped large spots of blood all the way into the clinic.  Phyl came to the clinic a little while after this lady arrived and she asked me if we had some emergency or something because there was this trail of blood all the way into the operating room.  I told her that it was this lady who was bleeding badly.  We took care of that problem for her and I assume her life will be a little easier now.  She has had a history of heavy bleeding for long periods of time and that is why she was sent to San Lorenzo for her surgery.  She probably walked all over the place bleeding and didn’t think a thing about it. 


After that surgery was completed, we then were called out to see a little boy.  This very cute 4 year old was brought in by his mother who was worried about him being able to urinate properly.  A few months ago a dog bit his penis off.  The very short little stump had healed and he did have an opening through which he was able to urinate okay.  She wondered if we could fix it.  Of course, there is absolutely nothing that can be done now.  It was sad to see this little guy who has a life ahead of him in a culture that puts so much pressure on having children.  Jane took a picture of his and planned to send it to a urologist in Ft. Wayne for an opinion to see if there is anything that could be done for this boy.


Our surgeries went well today.  We started a little after 8 am after seeing 5 post-op patients on rounds.  We finished at 8:30 pm after 5 hysterectomies.  One included a Burch procedure to treat the woman’s incontinence.  It was a tiring day.  My feet and ankles were swollen from standing all day.  Phyl came over and stood all day washing instruments and linens and her feet and legs are also swollen.  The Ecuadorians like to salt their food so all we eat is very salty.  I suppose the extra salt has also contributed to the water retention and swelling.  One activity we commonly engage in during surgery is killing flies.  The flyswatter is swinging all the time.  It is frustrating to be working along and you see this fly zoom in and land on your gloved hand or on the wound.  We get so we just shoo them away and keep on working.  It certainly is not sterile technique but what else can you do?  The rooms are not airtight and flies are everywhere. 


Tomorrow, we have 5 more hysterectomies and also added on the schedule a boy who came in today with an incarcerated inguinal hernia.  He has had this problem for at least 2 weeks before his mother brought him in so Jane didn’t feel he needed attention immediately.  He had just eaten so we felt it best to let his gut empty and we will do him in the morning.  We also saw a little boy who is just covered with warts.  They are everywhere and in large patches all over his body.  They were just gross.  It is sad to see these conditions, although the dermatologists would have a heyday. 


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