Shoulder Reconstruction & "Spaghetti"

I’ve noticed that I have gotten into the habit of not wearing a seatbelt in most cases because almost no cars have seatbelts (or functioning ones) in the back seats. In our rental I always wear a seatbelt, but other than that I never can because I am in the back seat. It’s crazy the things that change when you are elsewhere; at home I am a seatbelt Nazi.

Today was my exciting orthopedic surgery scrub in day, and my surgery was so cool!! As soon as I arrived I was sent to scrub in, and we were doing a shoulder reconstruction surgery. The patient had chronic and constant dislocations so he needed his shoulder muscles to be moved around so that it would keep his shoulder bone in the proper place. I learned how to properly scrub in sterilely and then we started the operation. The surgeons I worked with, Dr. Rowe (aka “boss”) and Earnest were amazing. I have observed them over the past little while and really really like them. Earnest finished his internship in January and was trained by Dr. Rowe, so they have had a long relationship. Dr. Rowe is very praiseful and consistently complimented Earnest on his work during the procedure, which I think is great and much needed in order to build confidence in your abilities. I think that most tend to point out all of the mistakes instead of all of the strengths, which doesn’t help at all. So, I was really happy about how this was working out.

For most of the procedure I was holding a tool that held the muscles back so that Earnest could work and see in the area below it. I also held a tool that they put around the head of the shoulder bone to keep it in the correct place while they were preparing the muscles and tendons around it. My arm was SO sore because of the amount of force I had to exhibit for the tool to do the job it needed. The procedure was about two or three hours long, so my arm was dead that night. As they were progressing in the surgery, they would point out what they were working on and show me what everything was, and let me feel and help out. It was so cool. I also helped with the flushing and suctioning of the blood coming out of the open wound, among tons of other things. I also discovered that cauterizing muscles and tendons is the worst smell in the world.

During the procedure I accidentally became unsterile. I did this because my face mask was coming up and getting into my eyes and without thinking I used my forearm to pull it down a little bit, but my mask is unsterile so I had to rescrub in the middle of the surgery to continue. I thought Dr. Rowe would be mad, but he joked that this would just give me more scrubbing practice. After the long surgery, I helped Earnest stitch the muscles into place, and then stitch the man’s shoulder back together. It was so cool being this close to the procedure. Both Earnest and Dr. Rowe praised me for my help and good work afterwards as well, which was so nice of them to do.

The next patient was a 14 year old boy who needed his wrist to pretty much be stretched and repositioned, which is too painful to do awake. This is called a reduction. So, they brought him into surgery where they can put him to sleep for ten minutes to do the procedure. Earnest let Miles do the work. It required a lot of strength and my arm was exhausted so I was happy that Miles was doing it and not me. He was told what to do, and did it perfectly. Then Miles put the pop on, which he never did in orthopedics like Lauren and I did, so it was good experience for him.

The last surgery was an ankle reconstruction surgery, and a bad one. The man had broken his tibia and fibula two years ago from jumping out of a building running away from the owner or something like that. He was put into a Hoffman exoskeleton and then had surgery to get the bones fixed, but something went horribly wrong in the process because the bone is worse now than it was when he first broke it. It was noticeably broken; the bone was practically pushing out of his skin, and the x-ray was horrendous. It was going to be a long and gruesome operation. Miles scrubbed in for this one as well. To get this man sorted, they broke the other bone completely in half so that the only thing connecting his foot to his body was skin. They had to remove all of the bone that had tried to grow over the past two years, as well as the pieces that had become septic or dead, and then shorten it to be put back together. While trying to remove all of the bone growth and sepsis, it was easier position wise for them to bend the foot practically behind the leg so that the bone was fully exposed. The foot should obviously never normally be able to reach the point it did, so it was totally weird to see. It was incredibly grotesque but very interesting. Miles was still in surgery when uncle had arrived to pick us up, and he couldn’t leave in the middle; he was helping! So I left with uncle and Miles was going to be picked up later when the surgery was complete.

Miles was dropped off at my house when he was done and told me all about the rest of the procedure that I missed. It apparently took a long time to get the bone fixed enough to put back into place. One they finally did, they had to put a plate and nails in to secure it all. Earnest has the biggest arms I have ever seen; he looks like a rugby player, and apparently while trying to reshape the plate, he snapped the wrench in half. Who does that?!? I have never heard of anybody being able to do such a thing, and everyone in the operating room was in shock that he actually did it. How crazy is that. But, they found something else to do the job, and then secured the plate in his leg. At the end, his leg ended up being quite a bit shorter than his other, but that’s the only way they could fix it. All of the good bone they took out of his leg was kept for bone grafting if he might need it later. What a crazy operation.

During the day, I talked with the radiology technician a bit because he immediately recognized that we were from the States through our accents and told us that he has been to Oregon. I was really curious why he went to Oregon out of everywhere more famously world know to visit, so I asked and he had quite an interesting story. He worked for adidas and was doing a conference there (the adidas headquarters is in Oregon) because they were trying to get the South African soccer team to be sponsored by adidas instead of Nike as they currently were. He also apparently won an award for best presenter in the company or something along those lines, and I found out he is one of the inauguration speakers for the World Cup. Is that not the craziest run-in ever?? Who would have thought I would meet somebody like that in Cape Town’s gang yard hospital surgery theatre. You truly never know who you will run into.

For dinner, Joan told Miles and I that she was making spaghetti and I was sooo excited. Anything “American” sounds so incredible since I haven’t eaten anything of the like for practically three months. Miles was just as excited as I. When we sat down at the table, there was a pot of spaghetti as well as a pot of rice…Joan served us rice with spaghetti on top. Even foods we are familiar with come in such an unfamiliar way here haha. Oh, South Africa...