this morning i got down to the OR at about 8am and got to talk to dr. gary (surgeon) a bit...he was concerned that the tumor would involve some of the major vessels in peace's neck, in which case she could easily lose too much blood..."she may not make it out of the OR alive, but if we don't operate then the tumor is guaranteed to kill her..."
i'm happy to report however that the tumor did
not involve the vessels and in fact was fairly well circumscribed. we removed about 3/4 of her lower jaw bone (hemimandibulectomy) along with the tumor, and replaced the bone with a metal plate. she has only a couple of lower molars left but that will be good enough to be able to crack groundnuts with. the whole procedure took about 5 hours and she already looked
so much better. i plan to go down to recovery later this evening and see how she's doing.
some observations from my first day in the anastasis OR (or theatre, as they call it here) :
-- it was amazing to see how they make do with so few supplies...they only have one or two bair huggers (the inflatable part) and so they just wrap it in a sheet and use it over and over...all of the IV tubing and supplies are mismatches so you have to make sure you have the types that fit together...only one operating light...the metal plate they used is a type that they can buy cheaply from a european company who has a bunch left over since they moved on to a newer/better design...no such things as foley or central line "kits"...must assemble supplies individually, from things that may not have been made for that specific purpose.
-- the ship's crew serves as the blood bank...peace is B+ so this morning they rounded up the four people on board who are also B+ and drew a unit from each for use during the procedure (and it must be used within four hours or else it goes bad).
-- peace's body temp was running too low so the anesthesiologist had me running back and forth from the OR to the break room to microwave her IV fluids (fyi, three minutes on high for a one liter bag will do)
-- blood loss was estimated and replaced accordingly by counting the number of blood-soaked laps (each holds approx 100 ml)
-- intubation can be a bear with these huge intraoral tumors...luckily that's one area where the ship is well-equipped...we did an awake fiberoptic nasal intubation on peace.
-- there are three portholes in the operating room...it was funny being able to look out and see the horizon bobbing up and down during the procedure.
-- the OR staff were
so nice and optimistic...a noticable difference from the cynicism so prevalent in US operating rooms.
despite all of the so-called "deficiencies," i don't think that the surgery could have been any more elegant, clean or safe than if it had been in the US...maybe sometimes less is more.
# posted by Jenn @ 12:19 PM