Day 17

Celine's alarm went off around 6:20 today which was a blessing in disguise. I planned to run but I know the way I was feeling I would not have woken up. I forced myself out of bed to go and start moving my legs. It was a challenge today. Probably the one day where I wished so many people weren't waving and screaming hello to me as I ran because I could barely muffle out a "hey" with all the panting I was doing. I tried waving and smiling which most likely just made me look manic since I was breathing so hard. Yet at the end, as always I was glad I did it. It was the best way to jump start my day. Today I was in the OR in the morning again! Hallelujah!

I grabbed a few mangos for breakfast and was good to go. The man who had the cyst removal to his neck that Alex and I did yesterday came back for a wound check and dressing. We removed the drain and maintained hemostasis with pressure for a few minutes after. Then I put in 2 sutures where the drain came out, re-dressed his wound and told him to come back Saturday so I can monitor the healing process. It looked fabulous thus far.

The first surgery today I was first assistant to Brant for a sebaceous cyst removal right in the middle of the gentleman's forehead. It was very small so the incision had to be precise in order to not leave a scar. It went opposite of yesterday. Not much bleeding at all! This guy must have been eating his vitamin K which was nice. I got to close the wound with 5.0 silk, the thinnest thread we have so he would have little to no scarring. Future Plastic surgeon? Maybe. I do like facial surgeries. And it's quite an art trying to make the wound edges line up perfectly so it heals perfectly.

As soon as we wet done with that surgery, another was getting set up with Brigitte. An older man with a lipoma on his posterior neck, and Dr. Schuster asked me to be the surgeon for the case!! Yesssssss!! My first surgery! I was beyond thrilled! And I've seen so many thus far, each time paying close attention to the process so I was confident I could do it. Funny thing is, I wasn't nervous at all. Even with the first incision I felt as calm as a cucumber. I did love anatomy lab, so maybe that isn't surprising. Or maybe its because I'm so overly conscious and concerned that the patient is alright and comfortable that i don't have time to be nervous. After Brigitte numbed the area by injection of lidocaine with epi I tested the area to make sure he was completely numb before proceeding. I made an elliptical incision around the area of the lipoma, where the skin just filleted open beautifully. Then I used blunt and sharp dissection with the iris scissors, carefully dissecting out the lipoma, pulling back to reflect the skin the the hemostats. It was exhilarating! I loved every minute and it couldn't have gone better. I put in subcutaneous sutures to bring the wound together and let Brigitte close. It was a work of art and I really have the greatest team from which I learned from. Best day ever.

After lunch Brigitte and I went with Dr. Schuster to the DOT center in Sorsogon to meet with one of the directors of the clinic. The DOT center is responsible to seeing and treating those patients with TB since it is such N endemic in the Philippines. We are trying to do research to determine how they treat and process those patients with TB, how they diagnose and how and if they keep a database of all their information to say the least. We are going to conduct research on how TB is regulated and taken care of by these government and WHO regulated DOT centers with hopes of supporting and helping aid the system with our own interventions. First we bed the research on how they run as a clinic before we can make changes. The lady we met with was very pleasant and we have to go through a few more steps and meet with some others before proceeding. We'll probably get started next week. After our meeting we went into Sorsogon to pick up some more medications from the pharmacy with Dr. Schuster. While we waited Brigitte and I shopped around at some of the open markets and bought ourselves a pair of sweet Ray Ban sunglasses for the equivalent of about $2 American dollars. We got back to the clinic and dropped of the meds right at the end of the day, and helped the others finish up whatever needed to be done. It was a slow day most likely because there was the threat of a possible scheduled brown out. Yes, the region has days where they shut off the electricity to conserve energy and we've already had a few on the trip. It's not that bad, we actually make the most of it. 

Back at the dorms I worked out with Dan, then showered and had dinner before we packed ourselves into club Jeepney and head to Sorogon city for the night. We all caught up with our Internet needs and emails to attend to (my computer broke remember so it was a little limited) before trying to find a good place to go for the night. It was a bit of a fail in finding a place but we all still had a fantastic time riding around, blasting music and laughing at all the ridiculous things that were going on. We got back to the dorms and chilled for a little bit on the porch before deciding it was a good idea to head down to the dock. It is such an amazingly beautiful place and the moon tonight was exquisite as it reflected over the glassy water. I'll leave it at that for now because things got a little weird as the night went on. for example the part where we were almost kidnapped on a boat who's deck man wanted to take us to international waters. I use kidnap loosely as we were willing participants for this boat ride. Well maybe not me, because dark water for a non swimmer seems just like a horrible, even if Sidney Croaby asked me to come aboard, I think I'd say no. Ok now I'm really just going to leave it be and let you use your imaginations. Pirates of the Philippines much?

 We're taking a day off tomorrow to let the ENT surgeons tour the area and enjoy some of the Philippines. They will be leaving us on Saturday, so we're holding clinic then. Should be fun after all the events we have planned for all day tomorrow....and even more fun if there is more OR in my future. 

My dad hates when I use the word awesome, but I can't explain it any better then by saying today was an AWESOME day.