Qana' Dominga

Just to update anyone curious, I went by and checked on Dominga, the patient I wrote about in my last post. The surgeons said it was a miracle she survived as they had to remove over 40 lbs of ovarian tumor and fluids from her abdomen. She is doing much better and should be out of the hospital in a week (although she will have to learn to walk again without those 40 lbs).

When I told her about my own surgical tribulations last week, she asked to see the scar. She laughed and then I got ripped on hard in Q'eqchi' for having such a wussy scar compared to the train tracks she now has on her stomach. I'm glad to see she's got a good sense of humor about it all. Here's a couple pics of her with her Dad.

More Missions and my busted appendix

I took a little break from blogging as the last few months had been pretty uneventful up until recently. Really, it’s been nose to the grindstone with work. I led a solid mission in February with a group of docs from Minnesota and spent most of March preparing last week’s triage mission. Somewhere in there, I got a few days off for Holy Week, but a terrible stomach bug forced me to hang close to a bathroom at all times.

Things got interesting last week with a triage mission in northern Alta Verapaz. This time around, we had three docs instead of the normal two, so I spent a lot of extra time and money on promotion. A good week of triage usually results in about 100 patients scheduled for surgery. We ended up at 250 by last Friday. I’d describe the week as loosely controlled mayhem.

Besides the shear number of patients, the types of pathologies coming into the mission were amazing and sometimes heartbreaking. The latter would be the at least 10 patients with various types of terminal cancer. Translating that diagnosis is always depressing, but the families usually know something bad is awry and are thankful that we tell them straight. The flipside is that for the first time we have a team committed to doing pediatric neurosurgery, so kids with spina bifida and hydrocephalus (aka gigantic heads) that we used to have to turn away will now get surgery. We should be able to operate about 30 in May. One patient that I will never forget is a woman who came in on Friday that looked to be pregnant with triplets. Turns out she’s had this growing mass inside of her for 17 years. The OB said it looked like a gigantic ovarian cyst. After an 8 hour operation yesterday, a team of 4 surgeons removed 40 pounds out of her abdomen. Here’s the before pic (my apologies to the squeamish).

In a previous post, I mentioned my axiom that after living in Guatemala for awhile, crazy shit is bound to happen to you. I’m now convinced it’s natural law. After we finished the mission on Friday, I woke up early Saturday morning with some stomach “issues” that I assumed was some undercooked meat from the night before. I had to drive the docs 5 hours back to Antigua, so I took some pepto, sucked it up and started the drive. I eventually had to stop the caravan to yak and wretch behind the van with everyone watching, but I wasn’t ready to concede the keys. Further down the road, it hit me that I was not a safe driver. We stopped for a break and sitting in my chair, I had such a fever that I felt like a broken dryer shivering myself across the floor. One of the docs volunteered to drive and I laid down in the car as I started getting the worst stomach cramps I’ve ever felt. I was a little embarrassed at how bad I was handling it all as I’ve had plenty of stomach issues before. I was convinced it was just a particularly nasty bout of food poisoning.

By the time we got to Antigua, we just went right to the hospital to get an IV as I had tossed all my fluids out the window on the last leg of the drive. In my whole life, I don’t think I’d ever felt so weak and just all around sick and miserable. Thankfully, I was in good hands with the three American doctors. They took one quick look and suspected it was my appendix causing all this fuss. The Guatemalan doctors did some tests and confirmed it. As such, I ended up in the OR about an hour after that with a ruptured appendix. I guess somewhere along that agonizing drive that disgruntled little appendix of mine decided it was time take down the house.

I remember having one lucid moment before the surgery thinking that most foreigners would freak out going under in a Guatemalan OR outside of the capital. Really though, I couldn’t have cared less at that point nor could I have raised much of a fuss. The gynecologist on our trip said he could take it out if need be and that was good enough for me. However, we ended up making some calls and found a recommended doctor who worked with the hospital. Dr. Humberto it was. All in all, it worked out best this way. It wasn’t until during the surgery that they realized the appendix had actually burst. Had we waited much longer, it would have been far more complicated. And if anyone was particularly worried, just have a look at the painting next to my bed; it was actually Dr. Jesus removing my appendix.

Thankfully, this is mostly behind me and another story from Guatemala to remember. I am out of the hospital and walking around pretty well. Besides the occasional laugh or sneeze that makes me think I’m gonna blow the stitches out of my side, the pain is managable. Lastly, here’s a couple pics of the hospital. It was actually a great place to recover.