a little girl's life saved

The child two days after removing the obstructing foreign body from her trachea.

Today we saved the life of a two and one half year old girl who aspirated a groundnut (peanut). She presented with severe shortness of breath, had a seizure, was brought to the operating room and the peanut blocking her trachea was removed. Several pieces of peanuts blocking her bronchi were also removed. The child is now well. All the equipment had been prepared for such an emergency and when the video camera did not work, the clinic's video camera was used successfully. Now, how to fix the broken video camera, which is essential in these small children.

A positive outcome

Mother and Child two days after removal of the seed.
Seven month old girl two days after removal and going home.
The removed seed.
The round oval object in front of the third vertebra with the dark vertical lumen is the seed in the pharynx.

This week we saved the life of a seven month old girl. Her mother was preparing a meal when the child, who was crawling on the ground, started choking and coughing. The following day the child was brought to the hospital in respiratory distress. The X-ray showed a large object in the pharynx. The nurse anesthetist did not want to do the child until after a blood transfusion and even afterward he refused to do the procedure that day. Arguments with both him and the general surgeon could not change their minds. Later that night a visiting anesthesiologist arrived and when the child began to fail, he readily agreed to help. A large "Baba" seed was extracted from the child's throat and the child improved. A month before we lost a 13 month old who aspirated a corn seed into the trachea. We originally referred this child to the capital city of Accra, but the child was brought to the village to die. We called the child back, but were unable to remove the corn seed which totally obstructed the trachea. I have to focus on the ones that are saved rather than despair over failures.

A post written last month, but now being posted

We are beginning to see the light at the end of the tunnel. After two years of hard work, our ear, nose and throat clinic and operating room are modern and functioning well. We have advanced from just handling emergencies to doing elective cases. Our first elective case was a 62 year old woman with a 2.5 cm submandibular stone. She did fine. There are many cases waiting with extensive congenital branchial cleft cysts, teratomas, dermoids and chronic ears and nasal polyps. These patients cannot afford to travel south for their surgery. On a tragic, sad note, Eunice, my excellent recently graduated nurse, cried when a seventeen year old boy died from complications of a fish bone lodged in his throat. The boy presented after ten days with retropharyngeal, retroesophageal and neck abscesses, septicemia, mediastinitis and anemia which led to a brain abscess, seizures, inappropriate antidiuretic hormone secretion and cardiopulmonary arrest. After the boy died, Eunice asked if I believed in witches as she found it difficult to understand why a young boy died so quickly from a fish bone.

All items from the two containers have been distributed and now I can spend my time solely on otolaryngology. Some of the equipment worked for a while then stopped, so maintenance is a problem. After surgery the equipment does not always get back to us and missing pieces of equipment are a problem. The pieces show up eventually, but one cannot do some surgery confidently until the equipment is located and working again.

Follow up on the child with malnutrition after feeding

This photo was taken recently of the malnourished child described in the December 29 blog entry. The child was merely fed by the hospital giving food to the mother. No surgery has yet been done except for the removal of dead bone which simply fell out. He will have closure of the oral opening after he gains more weight. Everyone was happy here except the patient. When the child first presented, he did not have the strength to cry, sit up or stand by himself. He was so skinny. Notice how his color has improved, no longer an anemic paleness.

A tender handshake that I felt in my heart

Today a six year old, severely injured boy shook my hand in thanksgiving. This lad was in a traffic accident five days ago, split open his face and lost the front portion of his jaw. During surgery, his life was marginal. Now after five days he is alert and with everyone's care he will live. His reconstruction will be a major problem. In the same accident, his mother lost her ear and had to have her arm amputated. There are daily visits, dressing changes and frequent directions with the nurses. He understands English, but cannot speak because of the tracheostomy which was necessary to enable him to breath. Today, he persistently and with determination seeks out my hand. At first, I thought it was to prevent me from hurting him as we dressed his wounds. But, he shook my hand in thanks. I felt this tender handshake in my heart and it will be remembered my whole life.