Tuesday, September 6, 2011

Theatre Musings

I write this as I give moral and anesthesia support to Dr Nandamani as he is operating on JH, a 70 year old retired teacher from Satbarwa, our nearest market. JH had come about a week back with an acute retention of urine. We had put in a catheter and found out that he has enlargement of the prostate gland, a common condition in elderly males.
Doing the open prostatectomy

JH is fairly well off considering that he was a retired government teacher. And he is rich enough to go off to Ranchi and get a TURP done. TURP stands for Transurethral Resection of the Prostate where we widen the route of the urine  through the urethra by slicing off parts of the prostate using a endoscope which is put through the urethra. There are quite a lot of people who swear by TURP whereas the older surgeons would vouch on how better is an open prostatectomy.
We gave the options of either getting a TURP done at Ranchi or an open prostatectomy at NJH. We are not sure why – JH opted for the open prostatectomy which Dr Nandamani is doing today.
We request your prayers as Nandamani finishes his surgery and continues on with his list of surgeries today. Before this surgery, we already had a hysterectomy and a hydrocelectomy. Once the prostatectomy gets over, we would proceed to a burn contracture release for a patient who acquired the injury quite a long time back which has handicapped her.
And then there is a young man with an intestinal obstruction who has a hemoglobin of only 4 gm%. We told his relatives that we can operate only if we have at least 3 pints of blood. They have brought the blood today. So, we could be operating him soon after the burn contracture release surgery is over.
Dr Nandamani examining the burn contracture before surgery
Talking of low hemoglobins, we had a 37 year old lady, SD with a 1 gm% hemoglobin. Seems outrageous. She delivered her 3rd pregnancy sometime in the midnight. And her placenta was not coming out. The baby was dead – for the relatives’ description – it must have been dead for quite a long time. We knew that we had a uphill task. However, we took it up as a challenge. Dinesh, our engineer donated one pint blood and we proceeded to attempt to remove the placenta. It was a disaster. It seems like placenta accreta and the products being removed was stinking. I removed whatever I could.
The relatives have gone to get more blood. Her blood group being AB positive – that is not going to be easy. SD has pulled on so far. From a medical science perspective, she does not stand much chance. But here at NJH, we see quite a lot of miracles. And we pray for one more.
In the OPD, as I had written about in a previous post (http://jeevankuruvilla.blogspot.com/2011/09/tuberculosis-are-we-winning-war.html), we had more tuberculosis patients of whose 2 X-Rays are shown below.  

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