Rolling Stones...

Thursday was our last day operating, and as it usually happens, all heck breaks loose on days like that. Things started pretty well with a gentleman who had been having trouble urinating for years, who was found to have a large prostate and a `stone`. We decided to scope him first, and I saw what appeared to be a large jack stone, and a slightly enlarged prostate. We decided to open him up, and lo and behold, he had a HUGE stone in his bladder, at least 4 or 5cm. The pics will be quite illustrative of our surprise after digging this thing out. Later we spent over an hour trying to get a larger suprapubic tube in our Fournier´s patient from earlier this week. The last case was a Jehovah´s witness patient who had previously had a channel TURP earlier in the week, and we were now bringing back for stone retrieval. Using a Lowsley grasper (which before this trip I didn´t even know existed), I pulled out about 6 stones, with minimal visualization. After a long day, and literally a pain in my neck, we finally wrapped up with rounds and headed back for a delicious dinner.

I´ll let you guess what the weather was like.

Friday, we rounded on the patients while the rest of the team packed up the OR. Our patients have done amazingly well. All of our flank incision patients have done remarkably seeing as how there are no narcotic drugs available, and other than a couple of doses of toradol and tylenol, have basically gotten by with ice packs and were ready to go within a couple of days. Our prostatectomy also did very well and is already home.

After rounds we took a bus ride up into the mountains and ate a deliciuos lunch at a roadside cafe, where the main dishes were walking around in the front yard. We then went further up into the mountains, close to the Guatemalan border, where the coffee growers live and work. We stopped at a house that was built in the 20s by the brother of Eva Braun (wife of Adolf Hitler), who was a coffee plantation owner. Because it was such a high altitude, it was actually much cooler than in Tapachula, and there was a pretty constant drizzle, broken up by sporadic rainshowers.

We got back to Tapachula later in the evening, and after a short siesta, we had a fantastic dinner at a restaurant on the edge of the city. Dr. Rodriguez sent us off with a beautiful message, and we also celebrated Ricardo´s 34th birthday.

Again, I cannot say enough about how spiritually fulfilling and refreshing this trip has been for me. Despite working just as hard as I do at home, I feel no stress, I feel closer to my patients and co-workers as we are working towards a similar goal without layers of paperwork and nonsensical rules separating us, and I appreciate the training that I have received thus far, which has guided me even in unfamiliar cases.

I do miss home and look forward to returning soon.

~Kmoses