A tough case and a beautiful hike

April 18, 2009

Today during Jeremiah’s morning nap, John David and I went on a hike to a nearby mountain. It was incredible. It took us about 2 hours to get up there (you can imagine, but it was up-hill all the way) and 1 hour to get back down. We took a lot of great pictures along the way and talked with many Kenyans. We met a lot of children that asked us if we had any sweets; unfortunately, we forgot to take some with us. And something that John David and I kept talking about was how most of the Kenyans walk around barefoot. We were looking at the road we were on and couldn’t imagine having no shoes on. Also, we passed a lot of adults and children working in fields around us. We would hear a child yell “hello” and look far off in the fields and they would be waving at us with a huge smile. There was even one woman working in the field with her child strapped to the back of her. I thought to myself-now that is a woman. It was a great time for John David and I to spend some good time together just talking. We haven’t gotten to spend much time together-just the 2 of us-and it was great. It was also a good “trial run” for Carl and Francie to have Jeremiah b/c JD and I will be leaving next Friday for our safari trip. Here are a few pictures from our hike. I wish we could post more pictures but it takes forever for them to load and half the time it doesn’t work.

April 18, 2009 Later in the day- From JD

Yesterday, we had kind of a light schedule in the OR. One of the nice services that we are providing to Tenwek is that the Long Term Missionary Orthopaedic Surgeon, Dr. Galat, has been able to take some time off. I must say, it is much needed for him. As result of him taking off, we do not have as many elective cases, mainly just trauma, etc. So we got to the OR yesterday morning with 2 cases on the board- a hip replacement and a hardware removal of a Femoral Nail. Dr. Albertson assigned me the hardware removal. I was excited about getting to operate alone again. However, I have seen a few of these femoral nails taken out and most of them are not very easy. So I was a little worried that I could be in there for a while, but at the same time, I didn’t care because I love operating. When the patient arrived in the OR, I asked him why he wanted the nail out. He told me that it was because of pain (most of the time, these nails never need to come out, but occasionally people have pain associated with them, and if the fracture has healed, we can take them out). The next thing I asked him was how long ago did he have his surgery to have the nail put in. His reply was “2 YEARS!!!!” That may not seem that long ago to you guys but to an orthopaedic surgeon who is about to try to find screws and then try to pry out a nail from a bone that has had two years to heal, it makes the surgery VERY difficult. I knew I was in for fight. The first screw came out pretty easily. My confidence faded as soon as I got to the next screw. I made the incision, dissected my way down to the femur where I thought the screw should be, and then started to feel for a screw head. After a few minutes of searching, I felt what seemed to be a screw head. I tried placing the screw driver in but no success. I tried for a few more minutes with no victory. Finally, we brought xray in. I placed a metal tool where I thought the screw should be and then took an xray. To my dismay, I was exactly where the screw was but it was buried under about a ½ cm of bone. Yes that’s right, the bone had grown over the screw head. This was true for one other screw and then also the head of the nail. 4 ½ hours later we were finally done with the case. I took my lead jacket off and my scrubs were completely soaked with sweat down to my knees. I thought to myself as I sat down to write orders, now I know why Dr. Albertson assigned me the hardware removal!!!