The Woman, the Spine, 9 Hours, 4 Blackouts, the System — and 1 Life Saved: My First Real Taste of Neurosurgery
Happy Sunday everyone
WARNING: The pictures in this post were taken by me in the operating theatre. If you're sensitive to the sight of blood, please do not scroll further.
It's been just three days, yet each day feels like it ended only a few minutes ago. I am currently on my surgery posting, and for last week, I had the privilege of working under the Neurosurgery Unit - the "big boys" of surgery , lol.
Actually, I've had surgical experiences with neurosurgery while I was in school but most times because of the level of sterility needed for their surgeries since they're working on the brain, we are always kept at a distance. But three days ago, I had the privilege of experiencing the surgery in a close range less than 10cm away from the action point ~since I wasn't a medical student again but a practicing doctor, hehe,~ and honestly it was an experience I just can't forget anytime soon.
The patient is a 62-year-old woman who had an accident resulting in fractures of her vertebrae, that's the bones through which spinal cord passes. It affected the thoracic down to the lumbar vertebrae (T10- L3). An emergency surgery was needed to improve her quality of life and prevent permanent damage as such injuries possess serious risk of spinal cord transection.
The Procedure:
Posterolateral fusion of T10 to L3 using pedicle and screws was the name of the surgery.
It was a 9 hours surgery but that was really the most adventurous 9hours of my surgery posting yet. Knife on skin was made at 11:39am and the anaesthetist finally woke up the woman by 9:01pm.
From the knife on skin down to the final closure suture was really something golden to experience.
After the screws and pedicles were inserted, they needed to be sure of the positioning and alignment, not just with the physical eyes alone but also with an X-ray machine necessitating the various shots. Even before the imaging, you could already tell it was a job well done.
The Challenges We Faced:
Shortage of Equipments:
I don't think you're surprised hearing this because yes, I am a doctor practicing in Nigeria where the government prioritise flying outside to get their treatments simply because they don't want to fund their health sector, funny thing is that they fly out and most times get attended to by our Nigerian doctors who brain drain already took away from us. The doctors keep expanding their knowledge and getting better with the skill sets but then, the country doesn't think it's necessary to help us provide some of the basic amenities we need which is tiring and leads to the rapid brain drain the country is having.
Recent news had it that Nigeria currently Is at a ratio of 3 doctors: 10000 population as against World Health Organisation recommendation of 1 doctor: 1000 population
Yet the few doctors around aren't provided with the necessary equipments.
The Surgery was delayed because of incomplete equipments as we ordered from multiple suppliers, delaying the procedure. In fact, some screws arrived after knife on skin has been made.
Power Supply Issues:
This is a federal hospital hospital yet there's no constant power supply and the most annoying thing is that you see these hospitals generating these revenues yet they aren't provided with something as basic as power supply.
The power went out for about four times before the surgery ended and for each of them, we will have to send a health assistant to remind them that a surgery is ongoing; as if they didn't know despite them being were duly informed of the duration of the surgery, yet they kept on turning off the Generator thinking we're done...
It was quite a frustrating aspect of the adventure, at a point when we were already suturing, the chief surgeon had to resort to using phone torch to see what he was doing before they restored the light.
After the surgery, I stayed back to monitor the woman for four hours and ensure she was clinically stable before I finally left around 1: 00 am.
The next day, I did post-op PCV to check the level of her red blood cell and it was fine, we were happy everything went well despite our struggles.
All in all, I think the most important thing is that the surgery was very successful.
Now we await wound healing and her eventual discharge.
Thanks for reading and have a wonderful day ahead 👍
The challenges that plague our health sector are disheartening especially when you see how basic most of them are.
Doctors in Nigeria still perform at a high level despite these deficiencies, now imagine if things were much better.
Would really be astonishing honestly
That's why we are the centre of improvise, lol
This was an adventurous event. I always like hearing surgeons talk about their surgical procedures and experiences. It makes me remember the series greys anatomy...
I'm sure you can't wait to stop practicing so you can scrub in as a resident.
Hehehe, it's not always that easy to scrub in because that means someone's life is entirely in your palms but of course, with time, it gets better and better
I wanted to be a medical doctor, right now I don’t think so. Your team did a great job despite the challenges you faced. Good job
Thank you very very much....I really appreciate the feedback
My goodness 🤭🤭🤭
Which part of her body is this oo
Chimooo...is she still alive after this surgery ?
I don't want to talk about the shortcomings on our Nigeria health system because they never change
My second cs I did ..doctors faces light issues just at the point of anesthesia
No blood in the blood bank
Mtchew
Nonsense
Yes, she's alive, lol
It's never a life threatening surgery though
It's her back just before the buttocks
See you oo...how can this type of surgery be lightly ..u doctors too dey they take things simple oo...Dr Vic number one ...u don join them abi? It's alright 🤔🤔
Hehehe 😂
Maybe it's what the training do to us but honestly, the surgeries we're scared of are neck, heart, transplant surgeries
Those are surgeries with high mortality but if it's back, you're not actually entering any major organ so it's no big deal
I see...
😂
Thank you a lot
At this moment. I am free to call myself a grown-up, be sure I went through the whole post looking at the moahes without feeling like throwing up.
The lapses in our nation's health sector will never change. But then I'm glad the surgery was a success, and I pray for a speedy recovery.
Amen... Thanks a lot for your prayers for her and us too
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Thank you a lot
Wow, I mean the very existence of neurosurgery is a miracle in itself.
It's unfortunate that you guys had to go through such struggles. I'm sure the woman was under general anesthesia and therefore she had to have been hooked up to a ventilator, and ventilators require electricity to be powered so how did you guys tackle that?
Mennn, kudos to every member of the surgical team. I can't even begin to imagine what it must have felt like standing bent over and working on a patient, for 9 hours straight.
And special kudos to you Spero. Thankfully you're getting exposed to a variety of medical cases and emergencies so you are assimilating a lot.
Well done!
Yep, the ventilator was connected directly to the hospital's solar, that's why we didn't have to worry about the woman's breathing but then the rest of the appliances needed strong electricity
It wasn't easy honestly, at a point I was pitying the consultant.
I'm learning the most I can oh my dear, thanks for the inspiring comment