Día 8

BEST DAY EVER. Seriously though, we saw so many cool things!

It didn't start out that way though - more classroom stuff to start off our day. Or at least we thought. Turns out, we were just getting briefed on the patients that would be going in to surgery today. Thirty minutes later, and we're being dragged into some room with the residents. We make a collective decision that we don't want to be stuck doing nothing again for an entire day, so we walk out and head to surgery. You could say that we acted like we owned the place - grabbing masks, head covers, and little booties to cover nuestros zapatos (our shoes). 


Off to Quirofano 7. We walk in, and the baby laying on the table has this huge pink mass of something protruding from his estómago (stomach). The large mass resembles a heart, but it's coming out of the area where you would imagine his belly button to be. Turns out, this large mass is most of his internal organs. This poor child was born without an abdominal wall to keep his insides from falling out, so basically all of his organs came out of his belly button - or so I assume from what I can see and what I can make of the doctor's explanation. In this mass, we found his kidneys, stomach, bladder, colon, and what would develop into his genitals. The doctor makes an incision above the mass and begins pulling intestines out of the incision. He has eventually pulled out so much of his intestines that he's now able to pull some of this mass back inside the gaping hole it's all hanging out of. Well that's a start. They begin to sew the baby back together, and we decide to leave. We didn't get to see the outcome, but I'm sure it ended better than it began.

And now, neurocirugía (neurosurgery). This kid's head is literally the size of a cantaloupe, or small watermelon. I'm somewhat in shock, but I can't control my laughter. That's mean, I know. But honestly, if doctors got upset about every sick child or patient that they saw, how would they make it through a day? You have to joke about your job when it's something as serious as this. I couldn't imagine being sad all the time, I would be so depressed. So instead, we laugh. The nurse explains to us that this child has a genetic defect that doesn't allow his cerebral spinal fluid to flow naturally. Instead, it all collected in his brain when he was first born, causing his skull to expand. The insane amount of pressure makes his head look like an alien's head, and his eyes look like they're about to pop out. Babies have a soft spot in their heads, called a fontanelle that allow them to come out of the birth canal with much more ease than with nothing but a hard skull. Well, over time, the soft spot becomes hard as the skull grows and closes the gap. Sadly, this baby already has a completely hard skull, thus leaving him with a permanently large head.  The doctor makes a superficial incision in his stomach and forces a metal rod under his skin and up through his abdomen, neck, and finally into the skin covering his skull. He replaces the rod with a catheter that he inserts into the brain that contains the spinal fluid. In doing this, he has created a place for the fluid to go - somewhere into his abdomen - that allows the fluid to circulate through his body. Although he'll have to keep the catheter forever, there will be less pressure in his skull and less pain in every day life.

There are so many different things I saw today, each of which I could write a novel about. But I'll try to keep the rest of these cases as brief as I can. We saw something called a Sistrunk Procedure, which removes a thyroglossal cyst. This is a cyst that forms right around where an Adam's Apple would be. We watched a circumcision in a 4 year old boy - not too exciting. The last surgery we attempted to watch (before we had to leave), was another neurosurgery. We didn't get a whole lot of information on what was about to happen, but I do know what I saw. This poor 3 month old little girl, had part of her brain coming through her sinuses and sitting on the front of her face. No joke. By looking at the MRI pictures, it looked there was an enormous build up of fluid in the brain that wasn't allowing her brain to rest naturally in the skull. The only place it had to go was through her sinuses and out on to her face. I'm not sure how they planned on fixing it, but it was pretty crazy to see.

Most of these extreme cases are the result of congenital defects, and are the worst of the worst in the entire country. They may also be the result of such poor living conditions in this country - anything from toxic water, poor sanitation, bad hygiene, to poor habits during pregnancy. I wish that there was something I could do to help them all out...one day I will though. Fortunately, we met a doctor who I guess really liked us, because he told us that if we wanted to we could scrub in to surgery and actually help with the procedures. UHM YES PLEASE. Much like the 'taking blood' situation, I'm not going to get my hopes up too high until it actually happens. But this was very promising and we were told that on Friday there will be lots of surgeries that we can help out with. I'm soooo excited! Wish me luck! Adios!