KENYA 2-13-13

Dr. Schulte doing an ectopic pregnancy that came in through the ER right as we were preparing to start surgery. Then there's a picture of one of the many signs posted in the hospital with the costs on them. These signs are also in Swahili. This is quite different from other missions I've been on. Working side by side with the local ENT doctor and having lots of students along slows things down immensely. Then add in equipment failures, using Kenyan equipment and electrical problems it can be quite frustrating. My ENT colleague had never seen the tonsil mouth gag I use or how to do a tonsil with cautery. She said they only pack the adenoid and if its still bleeding some surgeons hold the babies upside down so they don't choke on blood. A novel approach. She also
Was very curious about the nasal septum I did as she apparently doesn't do them at all or does them very differently. The L&D nurses are trying to convince the nurses that fetal monitoring, fundal checks and Oxygen on newborns who don't move much are useful things to do. Today they are going to work on post parting things I won't go into here. They are extremely enthusiastic. We're going early today to make rounds. Two of the horrible tumors are going to Nairobi. It looks like both are lymphoma and need chemotherapy rather than surgery. The parotid mass almost fits under my hand if its fully stretched out. She can't hardly move her head and also is HIV positive. She can't go start chemo till she has $200 to be seen in Nairobi and so will probably die soon.
It turns out there is stew at every meal so guess. What we're eating?! NN