June 22 and 23

June 22

Yesterday I was on late shift at work  (10-7). I ended up helping out in the general surgery rooms. We had a great day and finished our lists in time to get some dinner! The ship gets most of its food shipped from the United States or The Netherlands (except for fruits and fresh veggies grown here...ie cucumbers and tomatoes...and sometimes lettuce), and you can tell that we are desperately waiting for the arrival of the next shipping container. Dinner for the last 4 days has consisted of rice, rice and more rice. Hopefully the container will come before I leave. Now that I am feeling better, I hope that I can try something other than rice!

I have been on call for the last 2 days. Last night was my last night at the bible study that I have been attending, so after work I went and baked some brownies as a treat for everyone! As I walked into the cabin of the family that hosts the group, my pager went off, so I turned around and headed down to the OR. We ended up having to bring a patient back to the OR who had a large blood clot. We removed the clot, washed out the wound and then cauterized anything that looked like it might be bleeding and sewed him back up. By the time I left the OR and got back to my bible study, they were just finishing. I still had time to chat with people and have brownies of course!

June 23

Today I was back in maxillo facial surgery. We had an interesting day. I started off scrubbing for a case where a woman had a neurofibroma covering the right side of her upper face. In the past, she had had a surgery to debulk this tumor, but with neurofibroma tumors, if you can't remove them completely they will grow back. The location that this tumor prevented us from being able to remove all of it. It is sad to know that even though we did a good thing by removing the tumor, it will continue to grow back. We did another similar case after that and then had a quick bite to eat.

After lunch we did a maxillary tumor. When I went to check in this lady she looked quite normal. Her right cheek was a little bit larger than her left but other than that you wouldn't be able to see her tumor, until she opened her mouth. The tumor had grown into her palate. It was a very interesting operation. The surgeons had to remove her palate along with some of her maxilla and half of her upper teeth. He then used a piece of the temporalis muscle (see pic below) from her head to create a new palate. It was an amazing surgery to be a part of.

Here is a picture where you can see the tumor bulging from the roof of the lady's mouth. you can also tell that her right cheek is larger than the left

We used a piece of the temporalis muscle to create a new palate

Here is a picture for all of my anesthesia friends back at Sick Kids. During the surgery that I described above, we noticed a gurgling noise coming from the airway. Wondering if the cuff had deflated, Gary (pictured) went under the drapes to check. He couldn't find the cuff! After searching around under the drapes, he managed to find it, completely separated from the endotrachial tube (as you can see him holding the balloon above. The anesthetic machine wasn't reading a change in the leak at all and the patient was ventilating fine. We had placed a throat pack at the beginning of the case, so we just plugged onward... ha ha we couldn't decide whether to to blame sabotage from the surgical end or the endotracheal tube for being reused to many times!

Working hard and having fun!