05-AUG-B-7
OUR OPERATING DAY B EGINS WITH ROUNDS
THROUGH
THE WARDS, AND THE COMMUNITY,
RECEIVING THANKS AND BLESSINGS OF GOD
AND ALLAH,
BEFORE A SERIES OF THYROID OPERATIONS:
THE FULL SPECTRUM OF THYROID MASS
LESIONS
August 11, 2005
Once again, it is a full spectrum day, this time revolving around the thyroid and the different mass lesions of the gland, with hyperfunction added for tomorrow’s list. In the middle of the day, Huda Ayas, recently arrived here form the GWU International Medicine Programs, came by to visit us and may join us and Dr. Meghiru Mehari for dinner tonight.
Our day began at a request form
Steve Katz, the professional photographer from
We got all that in overwhelming
abundance as I arrived to see the post-operative patients. First off the fellow who already recognizes
the differences that have happened overnight since his prostate resection and
recurrent hernia repair yesterday and is flexing his muscles in his arms
overhead, and clapping me on the back and showing that once again he has a new
lease on life. He is all smiles despite
all the tubes and bottles around him from the flow through irrigation. As I had said before, the operation is one part
of all this but the nursing care to be sure that the catheters do not become
plugged by blood clots. The nursing care was meticulous and thorough; in fact,
our Recovery Room nurse Tzion from
The prize winner in the praise and rejoicing department was the wife of the man with the bowel resection for intestinal obstruction. She was eager to see us, and clasped my hands kissing them and raising them to her head and then gesturing to heaven. During the rounds around our post-op patients not only did we see that they were all doing well, but I also had been blessed three times before God, and twice before Allah. She was in raptures since she knew as well as anyone that her husband was in extremis when he came to us, and that now he was full of smiles and was walking around with not only active bowel sounds but also “hunger!” as his chief complaint.
We then entered the larger patient
census of the pediatric ward where we saw a couple dozen cute kids in little
snowsuits with sun bonnets, each of which also had a nasogastric feeding tube
taped in place to force them with fluids for diarrhea disease as well as
nutritional support. They were cute kids who completely ignored their tubes and
even were trying to eat finger foods around them. I explained the principle “Under Five” Child
Survival programs called
We also met a number of our pre-op patients
including a few we canceled. One was a woman
who seems to have a lot of metastatic lung nodules apparent in her chest X-Ray,
and we are looking into hat after the X-Ray was repeated confirming the
same. I said she was at greater risk to
life from the metastatic disease than any worries about her thyroid. She was on anti-Tb Rx at one point but she
quit, and she has a negative AFB test now.
There were two smaller goiters I though might be deferred, with the
interval given to treating them with cold Lugol’s Iodine. Then we came to my young woman with the
inflammatory breast cancer. I explained
to her that we might need to take a skin graft from her thigh to put it on her
chest wall after the mastectomy and we would be giving her the medicine that we
would try to get her from
Huda Ayas had gone home rather than
risk the appearance in an OR setting in which she would have felt very
uncomfortable, and so had the photographer Steve Katz. We waited for our driver and the ambulance
ride back to the Central Hotel, but he was out picking up oxygen for the
\\.