Well, this last Wednesday Toby was back with Dr. Heidi in the operating room at the Good Samaritan Hospital in Chichicastenango, this time for what turned out to be a much more eventful surgery. This week they were doing a vaginal hysterectomy and repair for a 40 year old patient that had been suffering for awhile with inconsistent vaginal bleeding and bladder incontinence. The benefit for the patient of doing the surgery vaginally rather than abdominally is a much faster recovery time and a lot less pain. The surgery went rather well, with Heidi and Toby actually removing the uterus in about an hour. To accomplish this Toby had to hold a variety of instruments to help Dr. Heidi see while she clamped and stitched the elements that attached the uterus to the body. Toby would often have to remove clamps and cut the stitches while Heidi tightened the stitch to stop the bleed of the cut area. Once close to the end of the removal of the uterus, Heidi was having a difficult time actually taking it out. It turned out that a large baseball sized fibroid mass was attached to the end of the uterus. Previous ultrasounds had only showed 1cm fibroids so obviously over the last year this particular mass had been growing. Once the uterus was removed all that remained was to stop the extra bleeding…herein was the problem.
Heidi worked for about one and a half hours to stop the bleeding but for some reason it couldn’t be controlled. Heidi had thoroughly stitched the walls of the vagina but feared the bleeding might be coming from the abdominal cavity. The difficult thing about this situation was the circumstances of the surgery. First, the woman was fairly overweight, making it more difficult to see what Heidi needed to do. Second, unlike in the U.S. Heidi was operating with no backup and no additional doctors that could potentially help her or give her advice to stop the bleeding or to achieve a better view into the vagina where they were working. Here Dr. Heidi is in
After a short break and an important prayer, Heidi felt it necessary to open the woman’s abdomen to stop the bleeding. So…Heidi went outside to talk to the family while the anesthesiologist intubated the patient and began the process to put the woman to sleep (she had previously been awake, although highly sedated). Fortunately for Heidi she had explained the possibility of having to do an abdominal cut to her family and all 20 of so of the family members waiting at the hospital were very understanding and told her to take her time. Rescrubbing in, Heidi rejoined Toby in the OR to start the abdominal incision. They began the procedure with Heidi giving Toby a small token of thanks for his hard work (it is in reality VERY physically demanding to assist in this kind of surgery) by allowing him to make the cut on the patient’s abdomen and begin the surgery. Heidi even allowed Toby to do some cauterizing and additional cutting during this procedure. Once inside the lower abdomen, Heidi was somewhat relieved to see that she had made the right decision when she saw a significant amount of blood in the abdomen. Once inside it was very easy to see what was happening and Dr. Heidi was able to stop the bleeding very quickly. Although the patient will take a much longer time to recover the bleeding had to be stopped and Toby had the opportunity to see some VERY interesting things. Once the bleeding subsided, it didn’t take Heidi long to stitch up each of the individual layers of the abdomen and get the patient to her room to recover.
After five hours in the OR; both Toby and Heidi were exhausted, but happy to join spouses Brittany and Matt, along with Matt’s parents at the doctor’s house for pizza and relaxation. Looking back, this was probably one of the most unique experiences in Toby’s lifetime and he was so fortunate to have a doctor and friend such has Heidi to allow him to share in that experience. It seems that this surgery may have solidified Toby’s desire to go to medical school after he retires from a successful career in law…we’ll see :-)
No comments:
Post a Comment