Friday, August 26, 2011


On Wednesday this week, I had the opportunity to watch surgery. Crew are allowed to view surgery one slot per field service. This means you can either sign up to view from 9:30-12ish or 1:30-5ish. You're normally unable to find out what you'll be viewing before you get to the OR, but I have connections:) I have been wanting to see a cleft-related surgery since the last time I was on board- I just didn't have the guts last time. I felt like it was something I really really wanted to do since I have a cleft lip and palate, and when on earth do you EVER get to view the same kind of surgery YOU had?

Wednesday morning, I went down to the OR office to be sure I'd be seeing a cleft surgery of some sort. I was honestly not very interested in seeing anything else. I've seen eye surgery, I wasn't too keen on seeing a hernia surgery- I'd seen an umbilical hernia before and just had 0 desire to see the other kind. I went down and as it turned out, there was a man with a cleft palate who was supposed to have surgery in the morning, but was fed breakfast, so he was unable to be seen until the afternoon. Up until I heard that, I was pretty sure I just didn't want to watch surgery, but I got pretty excited after I heard this news.
Around 1:15, I started getting myself together. I had to wear scrubs, then at 1:30, I went down and they gave me little shoe covers, a hair cover and protective glasses. I felt ridiculous- but once I saw everyone else, I didn't feel so bad. I was given the lo-down of the rules- the biggest of which included NOT TOUCHING anything blue- at all... so you had to dodge everything and be VERY aware, and no talking unless you're asked something or you can do so quietly.
I entered the OR, and they stood me up on a stool. Honestly, being on the other side of the table only a few months ago made this extremely surreal and it honestly scared me for a minute. I mean- I'm so used to being the one going under, so when I saw this man, I started remembering how it feels to be going under and coming out of surgery... not a good feeling. But after getting dizzy for a minute and getting a flash of heat up my body, I pulled it together, and they got going. All I can say is IT WAS SO COOL!!!!!!!!

Dr. Gary has been doing surgery on board for 20+ years and so it was such an incredible experience seeing him operate on this young man who had a unilateral cleft palate and a poorly repaired cleft lip. Incredible the things that you can do to solve different problems. He used fatty tissue from the cheeks to help repair the palate, which was a very complex procedure. He told me that he would try it and if it didn't work, he would then have to do a pharyngioplasty, where he takes part of the back of the throat to repair the palate. I had this done, but mainly for speech purposes- when you remove this piece of tissue, it allows a cleft patient to speak more clearly. However, Dr. Gary explained that it is not as useful to West African patients. Mine was a part of a series of surgeries over my life, but this man had one shot at this surgery, so Dr. Gary was trying to do all he could to help his speech without follow-up procedures. Dr. Gary was a great teacher- he brought me over a few times to view up close what was going on and would show me everything he did and was getting ready to do- I just couldn't touch the blue... that's easier said than done;)

It was also great because my friend Allison was the circulating nurse- who is not scrubbed in and helps get supplies to the nurses helping the surgeon in a sanitary way and also helps those viewing by making sure they don't pass out, and takes pictures for them. It was great having her because I could ask her all kinds of questions that I knew she knew the answers to, and she understood my high interest in the surgery. The other nurses had no idea why I was so keen on seeing the surgery, but Dr. Gary has worked with my mom- so he totally knew. But- it was great having a friend there to help me understand everything.
After about an hour, my friend Seth, who is the scheduling coordinator for the OR, came through and asked if I minded going to another room while a couple came to view the surgery. I was a little sad- but had him promise that I'd get to see the end. Honestly, it was probably better- I think I needed a break. He brought me to another room and warned me before I went in that it was a little more of a bloody procedure. I was brought into a room with a woman who was getting a goiter removed. Goiters are extremely prevalent in West Africa due to certain toxins in uncooked foods- like cassava, which is a huge staple in Sierra Leone- which cause certain things to occur in the thyroid, which causes it to enlarge. In our diet, we have iodized salt, which helps break down these enzymes, but here it is too expensive for them to include in their everyday diet.

I was in the operating room with the lovely Lord Ian Mccoll as well as Dr. Kelly, who is only here for a few weeks. Lord Ian comes frequently, but doesn't stay too long- he's on the international board and is a well known surgeon- he's a real treat to have around. At first I was at the foot of the bed and couldn't see too much, but after a while, I was brought to the head of the bed an boy was there a good view. They had started to tear away any tissue they could, but had to isolate the veins and arteries so that they did not cause too much bleeding. They found the veins, tied them off on both the end of the thyroid and the woman's neck, then cut in between the ties. By the time I left, the whole right side was free, and they were close to removing the thyroid all together. It was awesome. There was quite a bit of blood, but once I got over that, it was totally cool.
I was then brought back into Dr. Gary's room to watch the final closure of the palate, as well as the lip repair. Super super super super cool... I'm so glad I got this experience- it was absolutely incredible.

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