Spine in Mbingo

So it was like being gone on a long holiday and we have picked up right where we left off last summer.  Cases are coming in every day.  Dr Nana (Cameroonian Ortho Dr) had several spines waiting for my arrival.  We started Tuesday with our first one. A T5-6 fracture/dislocation from about 2 weeks ago. Very unlikely to get him to walk, but at least make him better able to transfer and receive care.  Was a good safe case to do out of the gate to make sure they were ready to do spine surgery again.

Blue line represents spinal canal.

There is also plenty of clinic and patients to see.  It amazes  me they come from 6-8 hours away going fast, probably 12-15 hours by common taxi/bus, they see us for 4 minutes, get told they have a problem we can't fix, don't have equipment to fix or doesn't need fixing.  They get some medicine and they smile (most of the time) feeling treated and cared for and "head to the house"  It's frustrating that so many of them could be so much better treated with a little bit of  the resources we burn through in the US.

Even if they have a problem that is treatable here, they are given a date in January 2013 for surgery, no matter how bad or urgent the outpatient problem is.  Motorcycles in the last few years have completely changed the landscape here and the wards are full, full, full of motorcycle trauma that ties up the resources (Staff, wards, equipment, most importantly time.)  Even the open tibia fractures wait, days and days to be treated.  It is one of my frustrations here, I just want them to give me two operating rooms and staff for one day and let me clean up the wards, get people treated and on with their lives.  But as a guest, I can only push so much and need to understand, that when I leave more people will break on motos and if we became more efficient at treating them, word would get out and more people would come for treatment.

I am learning how to finagle the system a bit though, I have a very good rapport with all the general surgery residents who have more OR time and staff.  I saw a cased of a contracted Achilles tendon after a tibia fracture.  The man couldn't walk or sit to use toilet, or provide for his family because he couldn't put his foot down.  Answer is, pay the money we will put you on list for January 2013, keep living with it till then. The residents and I agreed that wasn't a good enough answer.  I convinced the residents, that there was no bone involved in treating this problem, only a "soft tissue thing" so it really should fall under general surgery and we should do it together some afternoon and I would staff it.  He's on the books for the last week of June :)

You know your operating in Africa When....

1) There's cardboard taped up partially covering a broken window in the OR.

2) You hear your scrub clap his hands real loud, not because your doing exceptionally

well, but to kill flying insects.

Amy told you of our hike on Tuesday, more of those to come.  All work, makes the Ipsen's dull so we are getting out some. 

Planking for AB, SW and KV!!!

Wednesday brought another spine, a L1 burst fracture, with para-paresis, about 10 days old.  Again I wasn't to optimistic about return of function, but wanted to be able to mobilize the patient, and bracing out here is almost unheard of.

I saw him this morning...he lifted both legs off the bed!!  He and I were both pretty excited.  It's hard to fathom how much we changed his future, and it happens every day in a big way to alot of the people we touch.

So it would surprise many of you that know me to find out that after that case, I got a little impatient about how they were going to treat this 8 year old boy with a very bad elbow fracture, (Type 3 supracondylar for those that know)  He was put at the bottom of the list,  4,5,7,9 days from now to be fixed, already 5 days when he came.  I insisted that they let me have 20 minutes and him in a OR that day.  I thought I was going to pull a fast one and look like a hero, because the only x-ray machine they have even close to the OR is a small little machine for hands, but figured it would work fine on an 8 year old's elbow....  That would be if it still worked, which they didn't tell me until after he was already asleep and ready to go..Not that it would have changed much, still needed to be done.

Before

So we went ahead, did it blind and its better to be lucky (or blessed depending on your view) than good and we had a perfect shot, with a very good reduction.  He went home today, doing great.

After

Sign of advice for everyone entering the surgery clinic.

Finally, today brought Susan's surgery.  She is the daughter of Pastor Mendeh from Gambia, who works with Cindy at Open Doors Foundation, whom I went to Senegal with last year.  His daughter has pretty involved scoliosis and has continued to worsen.  Her surgery almost got cancelled this morning as we continued to struggle to find blood for her.  Thankfully, the man who's spine I fixed yesterday was a match, and the blood donated for him, he didn't need so they reserved it for her...which was a blessing as we needed some of it for her in the OR today.

Susan's back pre-op

Susan's xray

It went well, she didn't make it easy, she had a very stiff curve that wasn't easy to straighten.  Without spinal monitoring during the case I was hesitant to push for too much, so I took what GOD gave and know I improved her and will keep her from getting worse.  I'm anxious to see how much we got her corrected. During the case I wanted to grump at my instrument reps but they were no where to be found, as I couldn't find any sagittal or coronal benders ( help to do the final straightening touches)  But again, I have to accept that we got her treated safely, well and likely better than she otherwise every would have been... The impatient, type A in me just needs to put a number/measurement on how well we did today, so waiting a day or two for an xray post-op will drive me crazy.  She is doing well, post-op, sleepy which is better than hurting.

Everything else is good, fast approaching the weekend, another burst fracture tomorrow to do, and a complex elbow fracture that I was given after the child's elbow went well, they decided I'm an upper extremity specialist also.  Then it will be June the 9th, for a second year in a row here Africa, and should be great...37 I think, getting to old to remember.

Sorry so long a post, I will try to be more frequent or at least directed in my stories from now on, but had alot to get out over the last 4 days+.


BI

First today I need to start by thanking Miss Sandy for the dresses she made for Grace.  They are very easy for her to wear and change into when we need to go up to the hospital or dinner.  And I think she is rather cute in them!  The girls in our hood also like them and we think there will be enough for most her size to have one.

We took our first mountain hike the other day.  Brian got home early from work and so we decided to go on an adventure.  Actually not to much of an adventure, we took the same path last year, but a good one to start.  Joe took his friend Jesse with us and Grace brought Susan.  It was a good cardio workout and a great view from the top.  Susan had never seen mountains before coming to Cameroon, she kept asking if we were really on a mountain, and she loved it. She was very excited to reach the top!  Jesse wouldn't take his coat off  and said he was fine even though I was sweating profusely and hot (another crazy Africa thing).  The kids were all troppers, especially Toby who only asked to be carried once on the way down (we made him walk...he's four this year after all).   You can see by the pictures (which I can never get to do justice) that it was beautiful day.

 After the hike we headed to dinner at the hostel.  Margaret treated us with hamburgers (kinda small and taste like beef jerky) and a big plate of tomatoes.  I have to add for all who know B, he even ate the tomatoes.  Since we are making the kids try a bite of everything on their plates, he needed to be a good example.  On that note, for those who know my Tobs, knows how picky he is.  We have been very proud of him for trying new foods.  Both of my boys actually have been eating very well considering.  We are snacking on fruit every day.  I was thinking of Pastor and Karen yesterday when I was slicing up a fresh pineapple and some mango from the tree behind our house.  I wish I could send some home for you all.  I tell the kids it's God's candy cause it's so sweet.


The last picture I took of Joe, he was running ahead of us to the hospital.  It was kinda a where's waldo kinda pic.  Thought you might enjoy it.

I'll have to let B blog his hospital, clinic, surgery experiences thus far.  As always, nothing simple, nothing common, and nothing easy.  You know...things that make you go humm?!?!

Later friends,
amy lea




Almost home!

All of our friends are still here from last year except one family.  They must of had word that we were coming cause most of the kids were waiting for us in the yard when we arrived on Sunday evening. Even Margaret, our expert cook, came over to hug and welcome us. That made us all feel really great. As excited as we were about coming again, there was a little apprehension about the unknowns of this year. We are not in the same house as last year, but are in the duplex right next to it. We are happy for that because it is a little newer and I don't think there will be worms in the shower this year.





Our African friends from the hood




Daddy's soccer goal he made and we brought in our suit case.  It is a real hit!




Toby's pic of Mt Mbingo



 We are into day three so I'll back up and fill you all in on some of the happenings to date. Like I said earlier, Monday it rained...a lot...so we didn't do too much.  There was a lull in the rain mid afternoon which gave Brian just enough time to get the soccer goal put together that we brought. He had cut pvc pipe into sections short enough to fit in one of our totes, then connected and glued them together here. The hood kids love it and are very mindful to hide it behind the house at night so that it doesn't get stolen. (Don't know how anyone could steal it, kinda obvious where it came from and hard to hide, but what do I know.) They have played until dark the last two nights. While trying to pack all our nine totes for the journey, I thought it was not worth the space...I was wrong.

 Toby has taken to photography.  He wants to take pictures with my camera all the time.  So I'll probably be sharing some of his photos with you throughout the trip.  He took this picture of Mt Mbingo behind our house. He showed it to me and it had this pretty rainbow reflection, very nice Tobs!  It is interesting to see pictures from his view.




Grass cutting day, it took them all day to finish this field by hand.





So, as I said yesterday it has all come back and hit me, the senses, the feelings, it is just hard to wrap your head around how different life is here.  I feel so blessed to have this opportunity and that my kids are learning lessons they will never have in the States.  I have forgotten how hard the people here have to work to survive and live.  And yet they don't think twice about it, they just do it.  So I don't mind at all washing my clothes in the sink or walking a mile to eat every meal ever day.  We have it very good and they are taking care of us as guest.  Yesterday morning we were surprised by a 7:15am knock on the door, it was a boy that lives close to us.  He has a bag of bananas and a broom, his mother sent him to give it to us as a gift.  They have very little and yet they are gracious and want us to feel welcomed. 

The other thing I forgot about was the STARES!  It is so odd to be the minority, sometimes walking around I feel like were freaks or something, :).  I had a man ask me yesterday if I would use my camera and take a picture of him with my children so that he could take it to his village and show his children.  Kinda weird, but I would have if only I had brought a printer of some sort.  I had thought about that when we were packing, to buy a little portable one, but decided we didn't have enough room.  Remind me next trip I need to get one.  It bothers Grace that everyone stares at her.  Joe is indifferent.  Toby, I think it just pisses him off and he won't even look or talk to them.  Brian and I are trying to be good examples and encourage the kids to be friendly non the less.

The other strange thing is that it appears that the local people cannot tell white people apart.  We've had discussions about it before but I experienced it first hand yesterday.  I had a man stop my, "Oh, doctor doctor.  You remember me?"  "No, remind me" "Yes, here are my records.  Please look at my test results.  I come to see you."  Yep, not me!  Now if my friend Liz was his doc, I would understand! :) One of the other volunteer docs (brown hair, beard, green eyes) told me that when he lived in Africa for a year with his friend (blond hair, no beard, blue eyes) that the people they worked with every day always got them confused.


Susan and Grace are becoming great friends!

And let me tell you about Susan, we call her Susie Q (she calls me mommy pooh after my Gracie McPooh Pooh).  Susan is from Gambia.  Brian met her dad when he was in Senegal last year, he is one of the pastors there.  Susan has very severe scoliosis and has come to Cameroon to have Brian operate on her cause it was easier for them than travel to the states.  Susan is 14 and is absolutely delightful.  Her and Grace hit it off from the start and I am so glad.  Grace will be a good support for her after her surgery since she is only here with her dad.  Her curve is 90 degrees.  One of the worse Brian has seen.  It will be a very intense surgery so please pray for Susan, her dad, and Brian.  He is trying to get it done tomorrow (Thursday) if they can get all her pre-op test done today.  She is excited about having the surgery cause she will be taller and the kids will no longer stare and tease her.
 
Ok, Tobs says I need to share the computer.  So I'll blog y'all later.




amy lea


PS-We enjoy hearing back from you as much as I hope you like hearing from us especially since we have no cell phones this year.

OK my blogger friends and family, I am finally online!!  Everything here is such a time consuming process (reminds me of trying to get things done on church committee meetings!).  It is hard for a not so patient, getter done kinda gal like myself to adjust to the no concept of time or urgency of Africa.  So...squeaky wheel gets the oil and now I have Internet.

I don't even know where to begin.  Yes I do...Let's just jump in continuing on with "the crazy things you see in Africa" list.  A hoodie, without the ie!  Yes, there was a women with a hood from a hoodie that was drawstringed tight around her face without the sweatshirt attached.  CRAZY!!

So when we landed in Douala on Saturday it all just came back and hit me.  I started a list in my journal on the 6 hour van ride from Douala to Mbingo on Sunday, "The senses of Africa".  It ended as a running list two pages long.  Examples: the humidity, the smell of Africa, the honking, corn growing in ditches, babies on motos, men holding hands while walking down road, cold filtered water, fresh baked bread, open roadside markets, and the list went on.  These experiences and sensations that are unique to Africa, I have to say I missed and am glad I have the opportunity to experience them again.

I thought on Monday that I was going to have a weak uninteresting blog this year as day one we spent all day in the house due to rain, rain, and more rain.  Not much accomplished besides napping, reading, and settling in.  B worked in clinic and settled in as well.  But after a few days have now passed, woman in "dieless" hoodie changed my mind.  I wish that I can describe to all of you the details of this amazing place and do justice to the people here and their culture and country. 

This is the start to Africa 2012.  Let the adventure continue and may God lead us where we are destined to go.  "I will praise you forever, O God, for what you have done. I will trust in your good name in the presence of your faithful people." Psalm 52:9.

Signing out till after lunch and I can get my photos uploaded. 
Love you all!  And thank you so much for all your prayers, keep them coming.
amy lea

Ordering my Rosetta Stone today.  Parlez-vous francais?  Countdown is on, my family is getting excited!

Africa 2012

Our tickets are bought!  We will be leaving Joplin for Mbingo Cameroon on June 1st and will be home on July 4th.  Stay tuned for another Ipsen adventure!

Ernest & Hemingway.... Returning Home

This is Brian,
Start by saying sorry for not blogging lately.
The Internet has auctually been worse and completely unavailable for last few days.

I'll like to point out we are freezing our butts off waiting for our delayed flight.
Funny, checked weather.com and heat advisory is awaiting us when we make it.
We've been up since 7:00 am, now 12:30am next day, plane to leave 5 hours late at 1:40 am.
16.5 hours of flying to Atlanta and we don't know what our connection is going to be because will will miss scheduled flight and they won't assign new flight until we are in air and have better guess of our arrival. So we may get there by Sunday night,,36-40 hours after we started.

Kids have done great, this Africa thing has really toughened them up and made them much more flexible. Except for Toby and his eating... Who still refuses to eat anything different.
We went to restaurant in Johanasberg mall today and had fish sticks/chicken Nuggets and fries....kids were like a pack of lions on a "pajama donkey" (zebra).
Saw the first McD's in 6 weeks and kids didn't even ask to eat there.

So we've been here at airport for 9 hours now, all our electronics (iPhone, nintendo dS, computer) all dying and no stupid converters or plug ins here, was going to be long trip.
Was....is key word..in McGuyver greatness, I found that the fancy LG flat screen advertising TV's have USB ports in back that can be plugged into and charge some of our electronics!!!!

Would love to add pics, and may if we have time in ATL, but will see you on the other side of pond.

BI