March 19, 2009
Thursday
No big developments today. It’s been raining on and off every day now for the past couple of days. Short OR day on my own, residents have teaching on Thursdays. Achilles tendon repair, a tibial sequestrectomy in a poor 9 y.o. boy and a thigh abscess drainage. Everything here seems to be about pus! A sequestrectomy is removal of all the old dead bone in an old infected fracture (or infection without a fracture), and then it is all left open wide to heal from the inside out over 8-12 months. The body is pretty good at isolating dead bone (sequestrum) and trying to grow new bone (involucrum) around it but at some point it wants to get rid of the sequestrum and pushes pus out of one or more sinuses in the skin (that’s how we know where to go in and dig out the dead bone). It comes out like a dead tree branch hidden inside the healthy bone, but not attached to anything, and then you just scrape out the pus, YUM!
Laura stayed back for the morning to meet the seemstress who will be making her African outfit with the fabric she bought at market – should be pretty fancy (and funky). She built a heart model in the meanwhile and joined me for clinic in the afternoon. We then went to market for drinks and got “grenadine” pop that tasted like cherry cream soda (awesome actually!). Cabbage rolls and shrimp toast (that’s a first) for dinner. Lazy rainy evening with no internet.