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8/19/05 (Friday)

Today was an interesting day.  I had a new experience that occurred in the middle of the night.  I was asleep…stage 4 anesthesia type asleep…totally unaware of anything going on.  Yet, my brain was on alert and had the alarm system in place to bring me to consciousness in an instant if needed.  Well, the need arose.  All of a sudden I was awakened by something entering my left ear canal.  I didn’t know what it was but it was moving around and the sensation about drove me crazy.  I bolted out of bed and tried to do something in the ear canal with my finger to no avail.  So, in the dark of night I walked straight to where I keep my travel kit where I had some Q-tips.  I was able to find a Q-tip quickly and was able to explore my ear canal and catch the little critter.  I then went into the bathroom where we have a nightlight on and looked at the Q-tip finding a little ant carcass on the cotton.  There are these tiny ants crawling all over the place here.  We see them on everything, we have seen them in our suitcases, they crawl up and down the walls, and I’m sure we have even eaten a few.  They are very tiny, and with our eyesight the way it is, quite hard to see.  Yet, this tiny critter was able to almost disable a person millions of times heavier and bigger than it was.  All it needed to do was enter my ear canal and the world changed instantly for me.  The ant sacrificed its life for that little display of power.  I guess if you are going out, you might as well make a good show of it! J

We did 8 surgeries today.  One lady we brought back to the operating room for an exam.  She was a vaginal hysterectomy from yesterday that began bleeding rather heavy this morning.  We brought her back to the operating room to give her some sedation so I could examine her and find the cause of the bleeding.  Fortunately, the source of bleeding was a little bleeder on the edge of the incision and this was quickly controlled with a stitch.  We also had one lady on whom I operated a year ago who came in yesterday because of persistent pain post-op.  I remember her from June 2004 when I did a Burch procedure to manage stress incontinence.  She had some difficulty urinating afterward and I worried about her as she was going back to her home and we would likely never see her again.  This week she just showed up to see if she could be seen.  Now why would she come when I was here?  I feel God directed her here to get this problem taken care of.  She came back to the only surgeons who knew what was done to her in the first place and could evaluate her pain in that context.  We felt the pain was from those Burch stitches and we should try to remove them.  She was our last case for the day today and I am happy to say we were able to find the stitches in all the scar tissue and remove them without difficulty.  I prayed about this patient before and again last night and today because I was worried about whether we would be able to help her.  I have never had to remove these types of stitches before and I was uncertain about whether we could even find them.  However, once we had the area opened, there they were almost begging to be cut and removed.  I feel this lady’s pain will be much improved if not gone now and I give God the credit for all of this. 

At the end of today we had done our 28th surgery for the week.  This number does not include a couple cases under local anesthesia where a small skin lump was removed.  Last Sunday we removed a sebaceous cyst from a man’s eyebrow.  He had this lump for 7 years and it was the size of the end of your thumb.  Jane removed this easily under local anesthesia in the clinic room and not in the operating room.  The funny part about this was the man felt he needed to stay overnight to recover.  Now this was such a small procedure and this virile muscular man should have been able to take it without any numbing.  However, this guy requested to not only stay over night but insisted on staying over the second night.  We finally got him home on Tuesday!  Tomorrow we have one local anesthesia case to remove a lump on a lady’s behind.  These two local cases would give us 30 surgeries for the week…a record for Jane.  We did 15 hysterectomies, and the rest were a mixture of laparotomies for various pelvic masses, cysts, tubal ligations and a gallbladder.  I was the primary surgeon on all of these cases except for the gallbladder and a couple tubal ligations.  On those I assisted Jane instead of she assisting me.  It has been a long week of standing for 12 hours or so each day.  We are now done with everything except for the local tomorrow.  We will just relax and enjoy the day tomorrow reading and going into town to do some walking around viewing the sights. 

The lady who received our gift of Tamoxifen

The lady who received our gift of Tamoxifen

Jane operated on this older woman who had fairly significant breast cancer.  She had asked me if we could bring some Tamoxifen for her as this drug is very, very expensive in Ecuador.  The cost of the regimen would be more than a year’s salary, thus making it almost impossible for this lady to obtain it.  We were able to obtain some Tamoxifen very inexpensively from the hospital pharmacy and brought her the full supply.  She was so grateful for this second chance to live.




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