Wednesday, June 29, 2016

What a day!

Today was one of my favorite days! When I got to the polyclinic, an amputation was being performed on a kid from the knee down by an intern. Dr. Ganesh Kumar apparently let him do it and I do not know anything about amputation but I could tell that the procedure wasn't going as planned by the look on the intern's face. The bone of the leg was still exposed by the time he cut half of it off. He was then trying to sew skin together over the bone. I was talking to Sahana and Sangamitra about it and they both knew it was not the proper procedure but were keeping their mouth shut until Dr. Prasanna came in. Dr. Prasanna came in and at first did not notice what was going on but once he found it he started giggling. He was telling me that first off, the amputation should never be done with half of the leg still attached. An animal can learn very easily to walk on three legs but has a very tough time adjusting to three and a half. Because the amputation had already been started and the anesthetic was wearing off, he would just finish the leg and leave the goat with 3.5 functioning limbs. The first thing he did was move the goat to a clean table and then he tied off the top half of the leg with tubing to cut off the circulation. He acted fast while using a bone saw to cut off the remainder of the tibia. There was little to no blood when the bone was cut due to the lack of circulation. He then sewed up the skin and wrapped it up and it looked so much better. Apparently the other hind leg also had a fracture and at first Dr. Prasanna told the owner he should just send it to slaughter but get this, the owner wants to keep the goat as a pet and insisted that we do what we can to ensure a long life (statements like this make me love this profession). The other leg was casted and it looked great! I have high hopes for this kid and owner! The next few cases were routine, parvo and vaccines. The parvo cases are still shrinking and all the cases are returning patients on the way to recovery! After a while I stumbled upon my favorite case since arriving at the clinic. A goat came in because it had been in labor for over eight hours but had not passed her kids (seems normal but wait). She was administered some drugs to help dilate the vaginal wall. After a while one of the interns got to put his hand in the goat and check where the fetus(s) were (goats usually have kids in multiples). I thought this was routine so I walked away for a few minutes but when I walked back he gestured to me to come see and he had pulled the head and one of the front legs out of the goat but was struggling to get the rest out. This became an intense game of tug of war between the intern and the vagina. Finally after several minutes he pulled the goat out which was dead due to a genetic disorder which causes a fluid build up under the skin. The front half of the first kid looked normal but the fluid had built up around the back area making it look like the bottom half was full of water. When I looked back up I could see a small hoof coming from the momma goat. The intern pulled for a good ten minutes without any progress. Seeing the problem, Prasanna put some gloves on and got into the goat. After some time they were able to grab the head and an arm. This fetus had the fluid buildup around its face, giving a bull frog appearance. When pulling it out, the leg had too much tension and burst off of the fetus! I should let you readers know that the first two babies were and had been dead due to this disease. Getting this fetus out was an obvious struggle but after ten mins they did it. The excitement had died down a bit by the time they had reached for the third fetus. Dr. Prasanna was assuming that it would also have the disease but to his and all of our surprise when they pulled it out it started moving. It was alive and completely normal! I was cheering loudly when I heard it cry and got made fun of a bit by the assistants afterwards but I did not care. Seeing a live baby after two dead ones were pulled out was an amazing feeling of surprise and relief. That case put me on a high for the rest of the day. After that the cases just trickled in but Sangamitra brought henna to pass the time and decorated the inside of my arm and hand. It is incredibly beautiful and impressive and she said she will do my other hand in the morning (yay)! 
 The leg before and after Dr. Prasanna.

The bloated baby giving an appearance of a bull frog. 




Dr. Prasanna, Dr. Ganesh, Vijay (doctor at the private clinic), and I headed off to a feast today at two. The drive was two hours long and we could only eat for thrity minutes if we wanted to be back at the private clinic in time. The drive there was actually really fun. We drove through a lot of agriculture towns and Dr. Prasanna explained to me what each plant was used for. We drove through a eculyptus farm and Prasanna informed me that eculyptus trees are often cut down because they hoard all the water and nutrients from the other plants. When we finally got to the feast, I found out we were late by two hours! Even so, we all sat down with our banana leaves (equivalent to a plate) and ate whatever they put in front of us. I did not each that much because I just wanted to try everything and did not want to risk upsetting my stomach but everytime I looked over, Vijay and Prasanna were finishing another plateful. Keep in mind that a banana leave is about the size of a food tray (if not bigger). Vijay is a tall skinny doctor and I kept asking him where he was putting it all! After a short feast we headed back. During the drive back Prasanna informed me that a serial killer had just been caught and he had killed six girls in one day by taking a knife and slashing a line from their mouth to the jugular. Half-way through the drive (without warning) Prasanna showed me a picture of one of the victim's faces. I shouted "What is wrong with you!" in between laughing he said, "I don't know, man. I thought you wanted to see it. I couldn't sleep after seeing it". I will never understand the humor here but for a while it was nice to just laugh at the weirdness of that moment. When we got back we just saw a few cases. Most were vaccines and one was a check-up for the lab that had a hematoma. The wound was cleaned and almost healed so Prasanna did not even wrap it up thinking it would be just fine. Not five minutes later the owner came back covered in blood. The dog had started scratching the wound and re-opened it! There was blood everywhere (what a doofus). It eventually got wrapped up and a cone was placed on the dog. What a day! 

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