A Weekend On Call...

by Mike

​Life has been a bit busy. I'm sure many who read this can relate - if not everyone. This past weekend I was on call. I thought I'd share a few glimpses into my surgical role here at Tenwek.

Things got started Friday night with a one month old boy having seizures in Casualty (the ER). Imaging revealed he had bleeding around his brain - a subdural hematoma for the medically inclined. He was showing signs that the pressure inside his head was building and we needed to remove the blood in order to protect his brain. However, he was bleeding from every poke he had received to place an IV and check some blood tests. It seemed that the cause of the head bleed was some type of bleeding problem. In our area, this was likely to be related to some herbal medicines given at home. But it's hard to know for sure. No tests to confirm it. We gave some medications that might help for some other possible causes but he was still obviously bleeding. So we decided to do a smaller and potentially inadequate procedure to avoid a larger procedure that might cause him to bleed to death. Right decision or no? We proceeded to drain the blood and left a drain to remove any ongoing bleeding. We brought him back to the nursery and told his mom we needed to pray that his bleeding issue would resolve. We had treated, we needed Jesus to heal him...

One of our chief residents showing a second year resident how to secure the drain so our little guy would do well after the surgery. Cool to watch the knowledge being passed down.

​The weekend got a bit quiet after that and we continued to monitor and treat our existing patients with few major new patients. The boy struggled but showed small signs of improvement.

We then had another infant come in to Casualty. This time it was an intestinal blockage causing blood in the stool. We made the diagnosis and proceeded to theatre (the OR). For the fifth time since I've arrived, we attempted to resolve this type of problem (intussusception) without operating. Instead we used an air pump to push air into the intestines to fix the problem by pushing one piece of intestine out of the adjacent one which had caused the blockage. We tried several times to get it to work and made progress on the X-ray but it wasn't completely fixed. We had almost given up and were about to make the decision to operate when one last effort and some prayer led to it getting sorted. I actually jumped up in the air I was so excited. He avoided an operation and we had our third success. This type of thing is done commonly in most of the developed world but we have just begun doing it here at Tenwek. It was a great success. Super fun to see it work.

Shortly after we finished (at 2am), another patient arrived needing our help. ​He had been shot in the face with an arrow and wasn't moving his left side.

We don't see as many bow and arrow injuries anymore but this x-ray shows an arrow deep within this man's face...

​We spent a few hours getting blood available in case we needed to transfuse him during the operation. Then I reviewed the case with the other surgeons in the morning and came up with a plan to remove the arrow. It went well and a visiting cardiothoracic surgeon was a great help in accessing the arrow to remove it. Now we are waiting for him to recover. Like Tenwek's motto, we had treated, we needed Jesus to heal...

So I am recovering from lack of sleep and some anxiety over caring for these and other patients this weekend. And I continue to pray that God will be gracious to these souls who need mercy and healing. 

Thank you to all who enable us to be here and be the hands and feet of Jesus to these who need skillful and compassionate assistance. It's a great privilege.