Happy Sunday everyone
WARNING: The pictures in this post were taken by me in the operating theatre. If you're sensitive to the sight of blood, please do not scroll further.
It's been just three days, yet each day feels like it ended only a few minutes ago. I am currently on my surgery posting, and for last week, I had the privilege of working under the Neurosurgery Unit - the "big boys" of surgery , lol.
Actually, I've had surgical experiences with neurosurgery while I was in school but most times because of the level of sterility needed for their surgeries since they're working on the brain, we are always kept at a distance. But three days ago, I had the privilege of experiencing the surgery in a close range less than 10cm away from the action point ~since I wasn't a medical student again but a practicing doctor, hehe,~ and honestly it was an experience I just can't forget anytime soon.
The patient is a 62-year-old woman who had an accident resulting in fractures of her vertebrae, that's the bones through which spinal cord passes. It affected the thoracic down to the lumbar vertebrae (T10- L3). An emergency surgery was needed to improve her quality of life and prevent permanent damage as such injuries possess serious risk of spinal cord transection.
The Procedure:
Posterolateral fusion of T10 to L3 using pedicle and screws was the name of the surgery.
It was a 9 hours surgery but that was really the most adventurous 9hours of my surgery posting yet. Knife on skin was made at 11:39am and the anaesthetist finally woke up the woman by 9:01pm.
From the knife on skin down to the final closure suture was really something golden to experience.
After the screws and pedicles were inserted, they needed to be sure of the positioning and alignment, not just with the physical eyes alone but also with an X-ray machine necessitating the various shots. Even before the imaging, you could already tell it was a job well done.
The Challenges We Faced:
Shortage of Equipments:
I don't think you're surprised hearing this because yes, I am a doctor practicing in Nigeria where the government prioritise flying outside to get their treatments simply because they don't want to fund their health sector, funny thing is that they fly out and most times get attended to by our Nigerian doctors who brain drain already took away from us. The doctors keep expanding their knowledge and getting better with the skill sets but then, the country doesn't think it's necessary to help us provide some of the basic amenities we need which is tiring and leads to the rapid brain drain the country is having.
Recent news had it that Nigeria currently Is at a ratio of 3 doctors: 10000 population as against World Health Organisation recommendation of 1 doctor: 1000 population
Yet the few doctors around aren't provided with the necessary equipments.
The Surgery was delayed because of incomplete equipments as we ordered from multiple suppliers, delaying the procedure. In fact, some screws arrived after knife on skin has been made.
Power Supply Issues:
This is a federal hospital hospital yet there's no constant power supply and the most annoying thing is that you see these hospitals generating these revenues yet they aren't provided with something as basic as power supply.
The power went out for about four times before the surgery ended and for each of them, we will have to send a health assistant to remind them that a surgery is ongoing; as if they didn't know despite them being were duly informed of the duration of the surgery, yet they kept on turning off the Generator thinking we're done...
It was quite a frustrating aspect of the adventure, at a point when we were already suturing, the chief surgeon had to resort to using phone torch to see what he was doing before they restored the light.
After the surgery, I stayed back to monitor the woman for four hours and ensure she was clinically stable before I finally left around 1: 00 am.
The next day, I did post-op PCV to check the level of her red blood cell and it was fine, we were happy everything went well despite our struggles.
All in all, I think the most important thing is that the surgery was very successful.
Now we await wound healing and her eventual discharge.
Thanks for reading and have a wonderful day ahead 👍