Bere 5/2025 #9
Monday is usually a busy day. I’m called to see a woman at 2AM who isn’t progressing in labor. It’s the nurse I don’t have confidence in so I’m not sure if I should start Oxytocin or not. Unfortunately I awaken Dr. Staci and ask her. She thinks it’s less risky to just wait till morning. At 7AM I’m in worship when the nurse finds me again and says I need to see the same woman after worship. I go there and nothing has changed. Dr. Staci comes in and we decide after watching her contractions and how the babies heart slows down with each contraction and takes a little while to improve- that we should do a C-section. So we find the husband who is avoiding us, because he doesn’t want to pay for anything, to go and get the lab work paid for and so we can proceed. We keep telling the woman not to push because it hasn’t made a difference all night. She can’t or won’t stop. Looking between her legs suddenly the baby head has dropped down and is on its way out. With another push the child is on the bed and crying. Yay! She didn’t need a C-section after all. Thank you God!
One of the first operations today is a TURP- transurethral resection of the prostate. I’ve always done Friers prostatectomy. Andrew was learned to do TURP and so I watched him set up the complicated thing then using the TURP wire, it it a loop of wire, it shaves off a little trench in the prostate and then the same loop cauterizes. Then another trench of tissue and cautery of the bleeding. He showed me the landmarks to use and had me do quite a few. It is a neat way to take care of excess prostate. But I think I’ll need some more training on landmarks to be certain where to do it and where is deep enough. We worked on shaving off pieces for a few hours. When we were done it seemed like a bloodless field and we left a foley catheter in place.
There were many clinic patients to see so I headed over to the next building. Now a day later, can I remember what I saw? Only some of them. I saw the teen with drainage coming from a previous fracture site only in the rainy season- 8 months ago, maybe a sequestrum, but definitely not obvious. I could see something on the X-ray. Told him if it starts draining again, to come back then. Rain started and it was a downpour. Rained for a while and cooled everything off, even through the evening. Another patient in clinic was an older woman with body aches, saw a few with bladder stones on ultrasound who couldn’t pee well and were set up with orders for a stone removal surgery and sent to the pharmacy to pay the equivalent of about $40 for the surgery. By the way, some of you sent me with some money to use here. They have an indigent care fund, and that is what the money went towards. Other patients I saw were a kid with a huge splenic cancer I could see on ultrasound. Another was a pastors wife with one of the largest spleens I’ve ever seen. Covered her whole abdomen, except for a small portion of the right lower quadrant. Spent the whole afternoon in clinic. When I was done and walked out of the building- what a refreshing feel. It was a cool 75 and smelled like it had just rained. Other than being awakened by a call at 3 AM, I slept quite well that night!