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Today was our final day of operating in the hospital. The plan was to fix an airway on a young man who had a history of a car accident and head trauma. Again, after having a tube in his airway for 18 days, he developed a lot of scarring. He had some kind of tracheal surgery in the past and now his airway was completely blocked by scar and he was unable to speak.
Area below the vocal cords is completely blocked. You can see the suture and unknown foreign object from the prior surgery.
In the operating room, after his airway was opened, we noted that there were too many changes due to the prior surgery (of which we did not know details) that would have made it potentially unsafe to proceed with the surgery. We had to remember to First do no harm, even though we really wanted to help him. We did suggest alternatives for the future, such as removing the scarred larynx (voice box) and allowing him to speak through his esophagus (food passage). This is something the family can decide in the future. He made it safely to the recovery room.
We had a lot of discussions about his case because we had noted similar scarring in other patients here who had similar procedures performed. It would be interesting to follow these surgeons, to see their techniques and help give them suggestions on how they can prevent scarring like this. (Stay tuned for debriefing tomorrow.)
Our other three patients are doing WONDERFUL. One is already speaking and is TRILLED. The two patients in the PICU are already moving around and becoming good friends.
The critical care team has been doing a fantastic job in the ICU. It is very different for them because in the United States, supplies are disposed of after use where here a lot of supplies are reused. There are just such limited resources. Unfortunately, reusing supplies can increase risk of infection. Our team brought a bunch of supplies for the mission and will leave them with every thing that is left over.
They have not only been caring for our airway patients but also helping with other patients in the PICU. There was a baby with sepsis that our team helped care for but unfortunately he became brain dead and passed away this morning. Dr. Yager received a text from the intensivest at the hospital stating “You have been angles sent by God because as hard as this is, I am at peace knowing that everything has been done.”
Tomorrow we travel back to Boston. While in the airport, I will get more stories from the nurses to share with you. Also, we will reflect on all the positive accomplishments from the mission so STAY TUNED 🙂