Saturday, March 16, 2013

Plastics Screening Day

So Monday was a good day - we had screening day for the plastic surgeons to decide their final surgery list over the next month or two.  Now this is not plastic surgery like we think of in the west's more to restore function and in some aspects form than it is to just improve aesthetic appearance.

So 50-60 patients were scheduled to show up, to be seen by 3 doctors.  We in the physio dept would add some insight (mainly Emily, our expert hand specialist), and we were also taking preop assessments to determine ROM, strength, and function so we would know what to compare them to post operatively. 

I also have a student this week from the ship's Academy.  The middle and high schoolers do a week of observing in different areas they are interested in such as nursing, PT, IT, media team, etc.  So Lara helped out tremendously by working with one of our dayworkers to get any patients with arm involvement to fill out the Quick Dash - an 11 question form that help determines function and pain of the upper limb.  We were trying to move so quickly in the morning, it was a little crazy because we saw them outside after they'd seen the surgeons, just trying to keep track of everyone and get the correct measurements was just a tad hectic (insert sarcastic tone ;) ).  But surprisingly, we broke for lunch relatively on time, and then when we went back, there were a couple things we had to finish, but we actually didn't have any more pts to perform preop assessments on, making the day overall much less crazy than I thought it would be!!  I then got to go back up on the ship with Emily to meet some of the pts who just had hand surgery a few days ago as I will be seeing them for the weekend coverage.  I'm going to learn so much!!!

As far as the pts who were seen for screening, it was very interesting hearing some parts of their stories.  One lady tripped and fell into a fire - and received bilateral hand, neck, and chest contractures that pulls most of her fingers into a very bent position so that she has great difficulty using them.  Because of her deformity, her husband then divorced her. 

Another 20 year old man has a long term ankle contracture - he was bitten by a snake (a big black one) when he was about 7 years old and had several days of "traditional medicine" which didn't work and then he went to the hospital but I guess it was too late/they didn't know what else to do.  So now he must walk on his heel and his toes point up in the air.  (Yet he can play soccer...just not with closed shoes on!!)

A male teenager had a massive neurofibroma creating a sac like tumor hanging off of his forearm.  Imagine that jello like stuff under your upper arms weighing 5-10 pounds and atleast as big as a (American) football and being on your forearm.  About 10 years ago he'd had it taken off at a local hospital but it's grown back...unfortunately that's often a problem with neurofibromas...

Just a few ideas of what kinds of patients would come to a "plastics" screening!

Since Monday, I've gotten a chance to work on the wards with the hand patients and with some of the other patients - a little girl who had torticollis with her SCM released (for all you med people out there), who has been really difficult to get to come out of that twisted neck position because she's been in it for what, 6 years or so?  Nana is a hand patient who thinks she's going to come back to the States with me...I told her she could get really small and then I could put her in my suitcase...she wasn't a fan of that idea, but we have a lot of fun joking around!

Please pray for these patients to remain infection-free, grafts heal well, and they regain as much function as possible!!!