I've been watching a few Ghana Tag videos on you tube...Made me think a bit about how I want to train my children, regardless which part of theis vast and beautiful world we end up living in. Ghana has many issues, ignorant people and weird cultures...but we also have some of the warmest and most hospital persons with a huge sense of humour! I'm attaching a clip made by two light-skinned girls (mixed race) who make me proud to be Ghanaian. Enjoy!
Thursday 29 March 2012
Thursday 15 March 2012
twisted testicles...a bubble to my gloomy day!
other things amanzi: twisted testicles:(Made my day! couldn't help but share - a South African Surgeon's blog)
testicular torsion, to put it mildly, is a terrible condition. the testis twists around on its axis, cutting off its own blood supply. over and above the excruciating pain, if it is not operated within about six hours of it happening, well then you can pretty much kiss that testis goodbye. and to make things worse, it strikes young boys who have just entered puberty while they are awkward and unsure of themselves. it is seldom that they ask for help until long after it is all to late. at least that makes the operation easy... you simply cut out the necrotic testis, easy as pie. but at the operation, it is always important to remember that if the one testis has twisted, the other one tends to follow suit in due course, so, while chopping out the twisted testis, it is absolutely imperative that you suture the other testis to the scrotum so that it can't twist. of course if you omit this step, in all probability, in a few years time, the poor awkward teen is going to loose his second testis and this is really going to mess with his mojo, pretty much for the rest of his life.
but testicular torsion is not something that i deal with all that much. you see the condition falls into the realm of the urologists and if these humble creatures are to be found in your local hospital, then torsions go their way. however, even mighty urologists need to take time off. then us humble general surgeons step up and cut out on their behalf. recently i was put in this position and handled a testis torsion. but it reminded me of another one i dealt with a few years ago.
the patient, an eighteen year old young man, turned up at casualties about 20 minutes after developing excruciating pain in his right testicle. on examination it was clearly a torsion. but what i noticed immediately was the missing left testicle. i asked him about it.
as it turns out the patient had had a similar problem with the left testicle about a year previously. then, as was typical of young men of his age, he had waited a full day before he worked up the courage to go to hospital to seek help. of course the left testicle was already necrotic and had to be removed. the urologist tending to him at the time had done the right thing to the right testicle and fixed it to the scrotum so that it would not twist like its troublesome left counterpart. but still here i was faced with a patient with only one testicle and that one was twisted and in real danger of moving on to the hereafter (testicle heaven). also the urologist had previously operated the patient and, despite that, his remaining jewel was in danger. now that all the urologists were gone or on leave or dead or whatever, what chance did that poor nut have in my mere general surgeon hands? yet i felt the necessary urgency of the moment. one testicle is bad enough, but none??? unthinkable!!! i booked him for theater and demanded immediate theater time (something somewhat more scarce and valuable than fine gold in south africa).
surprisingly, soon i found myself (and the endangered testis) in theater. i opened the scrotum. the testis was twisted as i knew it would be, but, luckily, it was still viable. what was interesting was that the stitch that the urologist had placed a year or so earlier was still there. the testis had managed to rotate around the axis created between the stitch and its blood supply. this was clearly a testis hell bent of causing havoc and depriving its owner of full manhood. i was not about to let it do that.
i twisted the testicle back to its natural position, but somehow i needed to keep it there. one standard stitch by a urologist clearly had not been sufficient. luckily i was not a urologist. i would not be shown up by some young, single, upstart testicle, especially when my patient's very manhood rested on my actions. i fixed it and i fixed it good.
i replaced the urological stitch, then i placed four more stitches at the four points of the compass. i felt pretty sure that nothing would convince that testis to twist again. yet i still wasn't willing to take the chance of this young lad having to face life without all the questionable advantages of testosterone, so i felt compelled to do more. i used my cautery to burn multiple small scars into the surface of the testicle so that once i closed it in the scrotum, each little scar would attach to the scrotum, fixing it absolutely and permanently so that there would be and could be no question of any further gyrating and twisting. that testicle would do nothing without the scrotum knowing about it. i felt good. i had done my (or rather the urologist's) job and i had done it well. i had made a difference to a small testicle and his boy.
the next monday when the urologists had come streaming back from their no doubt deserved respite, they were quite eager to hear if i had handled anything for them. when i relayed the story of the stubbornly rotating testicle to the very one who had placed the first stitch a year or two previously, to no avail, apparently, i was not impressed when he questioned if i had sufficiently fixed the testis in place.
"are you sure that testicle won't rotate again?" he asked.
"no, i am not!" i replied, "but i can assure you if it tries to rotate again, it's going to take the whole patient with it, so look out for a guy walking down the streets doing a pirouette every so often and you'll know that's the guy i operated!"
testicular torsion, to put it mildly, is a terrible condition. the testis twists around on its axis, cutting off its own blood supply. over and above the excruciating pain, if it is not operated within about six hours of it happening, well then you can pretty much kiss that testis goodbye. and to make things worse, it strikes young boys who have just entered puberty while they are awkward and unsure of themselves. it is seldom that they ask for help until long after it is all to late. at least that makes the operation easy... you simply cut out the necrotic testis, easy as pie. but at the operation, it is always important to remember that if the one testis has twisted, the other one tends to follow suit in due course, so, while chopping out the twisted testis, it is absolutely imperative that you suture the other testis to the scrotum so that it can't twist. of course if you omit this step, in all probability, in a few years time, the poor awkward teen is going to loose his second testis and this is really going to mess with his mojo, pretty much for the rest of his life.
but testicular torsion is not something that i deal with all that much. you see the condition falls into the realm of the urologists and if these humble creatures are to be found in your local hospital, then torsions go their way. however, even mighty urologists need to take time off. then us humble general surgeons step up and cut out on their behalf. recently i was put in this position and handled a testis torsion. but it reminded me of another one i dealt with a few years ago.
the patient, an eighteen year old young man, turned up at casualties about 20 minutes after developing excruciating pain in his right testicle. on examination it was clearly a torsion. but what i noticed immediately was the missing left testicle. i asked him about it.
as it turns out the patient had had a similar problem with the left testicle about a year previously. then, as was typical of young men of his age, he had waited a full day before he worked up the courage to go to hospital to seek help. of course the left testicle was already necrotic and had to be removed. the urologist tending to him at the time had done the right thing to the right testicle and fixed it to the scrotum so that it would not twist like its troublesome left counterpart. but still here i was faced with a patient with only one testicle and that one was twisted and in real danger of moving on to the hereafter (testicle heaven). also the urologist had previously operated the patient and, despite that, his remaining jewel was in danger. now that all the urologists were gone or on leave or dead or whatever, what chance did that poor nut have in my mere general surgeon hands? yet i felt the necessary urgency of the moment. one testicle is bad enough, but none??? unthinkable!!! i booked him for theater and demanded immediate theater time (something somewhat more scarce and valuable than fine gold in south africa).
surprisingly, soon i found myself (and the endangered testis) in theater. i opened the scrotum. the testis was twisted as i knew it would be, but, luckily, it was still viable. what was interesting was that the stitch that the urologist had placed a year or so earlier was still there. the testis had managed to rotate around the axis created between the stitch and its blood supply. this was clearly a testis hell bent of causing havoc and depriving its owner of full manhood. i was not about to let it do that.
i twisted the testicle back to its natural position, but somehow i needed to keep it there. one standard stitch by a urologist clearly had not been sufficient. luckily i was not a urologist. i would not be shown up by some young, single, upstart testicle, especially when my patient's very manhood rested on my actions. i fixed it and i fixed it good.
i replaced the urological stitch, then i placed four more stitches at the four points of the compass. i felt pretty sure that nothing would convince that testis to twist again. yet i still wasn't willing to take the chance of this young lad having to face life without all the questionable advantages of testosterone, so i felt compelled to do more. i used my cautery to burn multiple small scars into the surface of the testicle so that once i closed it in the scrotum, each little scar would attach to the scrotum, fixing it absolutely and permanently so that there would be and could be no question of any further gyrating and twisting. that testicle would do nothing without the scrotum knowing about it. i felt good. i had done my (or rather the urologist's) job and i had done it well. i had made a difference to a small testicle and his boy.
the next monday when the urologists had come streaming back from their no doubt deserved respite, they were quite eager to hear if i had handled anything for them. when i relayed the story of the stubbornly rotating testicle to the very one who had placed the first stitch a year or two previously, to no avail, apparently, i was not impressed when he questioned if i had sufficiently fixed the testis in place.
"are you sure that testicle won't rotate again?" he asked.
"no, i am not!" i replied, "but i can assure you if it tries to rotate again, it's going to take the whole patient with it, so look out for a guy walking down the streets doing a pirouette every so often and you'll know that's the guy i operated!"
Wednesday 14 March 2012
Anniversary Blues!!!
Not in a writing mood today... So I'm posting my first voice blog. Maybe when I'm back to happy me...I'll write my thoughts too. Ok..later.
Sunday 4 March 2012
ANTI-CLIMAX!!!
So i was super excited about going on leave like 5days ago...last monday to be precise. I was really looking forward to my 18 working-days leave and then some(after four long months of non-stop 7days a week job) and i was looking forward even more to our 1 year wedding anniversary on March 19th. It seemed everything was going to plan until that faithful morning....Yes the morning of my last Emergency duty shift before leave started.
Its about 5:10 am,Wednesday Feb 29th, and hubby gets a call. His kid sister is on the line...she's frantic about their dad not being well. He tries to calm her and picks up his car keys, informing me he's heading home to see his dad. I try to go back to sleep thinking..."i hope she's not exaggerating..it's a bit early for that", but i'm also thinking..."I hope He is well".
Approximately 5:15 am, my phone's ringing. Hubby "Babe, can u go with me, my dad is said to be unresponsive". I bolt out of bed immediately, thankful i went to bed in a maxi dress, my hair looks hideous as i catch a glimpse of myself in the mirror. For a moment, i'm confused, don't know where my slippers are at, where my stethoscope's at...I grab my white coat...pass my hand through my hair and dash downstairs.
The journey to get his dad was a formula 1 race experience for me...we eventually caught up with the car that had conveyed his dad to a private clinic ...as usual, there was no doctor on the premises. I did the best i could to stabilise my father-in-law, who at this point is deeply unconscious and having a mild seizure. Then it was another formula 1 experience back to Korlebu Teaching Hospital, amidst pouring rain..and traffic.We almost did a full spin once and nearly crashed into a wall.
Six-thirty am: We arrive at the emergency unit, where my shift will be starting at 8am that morning. The doctors on duty see him and we get a CT scan done. My father in law has a stroke which was secondary to a heart condition, atrial fibrillation to be exact. He had thrown a clot from the heart into the brainstem...the prognosis did not look good. It was really devastating watching my husband almost break down! We did our very best, but my father-in-law passed away 8:30pm, Thursday March 1st, 2012, leaving us all broken.
Its been a difficult 3 days since. Its been sad seeing my husband who looks so well composed and almost unshakeable break down every so often and cry when he talks about how his dad, despite his faults would chat with he and his 3 siblings, how he thought him some aspects of his trade as a dentist, how he insited on a simple and short funeral if and when he passed away, how he was proud that all his kids had graduated from university and were making him proud, how he's say "i don't want any tributes at my funeral...you guys are my tributes!"
These moments sadden me and make me want to cry too. I try to be strong for my hubby, so he'd be strong for his mum and siblings. These moments, however, make me realise what i'v been missing in my own home. While i wouldnt want to wash my dirty linen in public, it hurts me to know that my family unit is not half as happy as the Glover family was while Papa as they called him was alive; that my dad hardly talks and laugh with us,that my parents seem to be distant towards each other...that the few times we've sat together as a family over dinner, it felt really odd, almost uncomfortable...i could go on an on...but i won't. I am resolved to make my marriage work; to have a happy bubbly family no matter what it takes..to help my husband be the best husband and dad he can ever be...to put smiles on the faces of the children God blesses us with..and above all...to lead my family to Christ...and to stay in him.
For now, i take delights in these words: "Come unto me, all [ye] that labour and are heavy laden, and I will give you rest." Matthew 11:28
Its about 5:10 am,Wednesday Feb 29th, and hubby gets a call. His kid sister is on the line...she's frantic about their dad not being well. He tries to calm her and picks up his car keys, informing me he's heading home to see his dad. I try to go back to sleep thinking..."i hope she's not exaggerating..it's a bit early for that", but i'm also thinking..."I hope He is well".
Approximately 5:15 am, my phone's ringing. Hubby "Babe, can u go with me, my dad is said to be unresponsive". I bolt out of bed immediately, thankful i went to bed in a maxi dress, my hair looks hideous as i catch a glimpse of myself in the mirror. For a moment, i'm confused, don't know where my slippers are at, where my stethoscope's at...I grab my white coat...pass my hand through my hair and dash downstairs.
The journey to get his dad was a formula 1 race experience for me...we eventually caught up with the car that had conveyed his dad to a private clinic ...as usual, there was no doctor on the premises. I did the best i could to stabilise my father-in-law, who at this point is deeply unconscious and having a mild seizure. Then it was another formula 1 experience back to Korlebu Teaching Hospital, amidst pouring rain..and traffic.We almost did a full spin once and nearly crashed into a wall.
Six-thirty am: We arrive at the emergency unit, where my shift will be starting at 8am that morning. The doctors on duty see him and we get a CT scan done. My father in law has a stroke which was secondary to a heart condition, atrial fibrillation to be exact. He had thrown a clot from the heart into the brainstem...the prognosis did not look good. It was really devastating watching my husband almost break down! We did our very best, but my father-in-law passed away 8:30pm, Thursday March 1st, 2012, leaving us all broken.
(Papa getting his drink on)
Its been a difficult 3 days since. Its been sad seeing my husband who looks so well composed and almost unshakeable break down every so often and cry when he talks about how his dad, despite his faults would chat with he and his 3 siblings, how he thought him some aspects of his trade as a dentist, how he insited on a simple and short funeral if and when he passed away, how he was proud that all his kids had graduated from university and were making him proud, how he's say "i don't want any tributes at my funeral...you guys are my tributes!"
These moments sadden me and make me want to cry too. I try to be strong for my hubby, so he'd be strong for his mum and siblings. These moments, however, make me realise what i'v been missing in my own home. While i wouldnt want to wash my dirty linen in public, it hurts me to know that my family unit is not half as happy as the Glover family was while Papa as they called him was alive; that my dad hardly talks and laugh with us,that my parents seem to be distant towards each other...that the few times we've sat together as a family over dinner, it felt really odd, almost uncomfortable...i could go on an on...but i won't. I am resolved to make my marriage work; to have a happy bubbly family no matter what it takes..to help my husband be the best husband and dad he can ever be...to put smiles on the faces of the children God blesses us with..and above all...to lead my family to Christ...and to stay in him.
For now, i take delights in these words: "Come unto me, all [ye] that labour and are heavy laden, and I will give you rest." Matthew 11:28
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