Reflections on my last month in Guinea: Follow up on Plastics

So I've been home now 4 weeks, started a new job, gotten back in the swing of things somewhat.  I would like to give a bit of a synopsis of my last couple months.

Continuation of Plastic Surgery Rotation:
For the first time, I got to work with many patients on the wards inside the ship instead of in the outpatient tent.  For 50-75% of most days I was on the ward for a couple weeks, getting to work with Emily and Sharon, both hand therapists from England.  I tried to absorb as much of their knowledge as possible, as hands are not an area that I have much practice in!  Many of the patients had burn contractures that were released by surgery.  I got to stand in for a different type of surgery, one in which Dr. T was taking a patient's index finger and transposing it to the area in which his thumb should be.  Mamadou's hands and forearms were malformed at birth, very twisted and only having 4 fingers on each hand.  He now can oppose and hold things in his hands - he was playing cards holding them in his operated hand (his other hand had been "done" in the fall).

Em and Mamadou before surgery

So I got to work with many of the patients who had a release of their armpit - probably my favorite (and the favorite I think of many of the moms of the young girls) was a former street dancer until he was burned about 1 1/2 years ago in a house fire in which 2 other people died.  He was in the hospital for about 5 months due to severe burns on his arms and back.  When he came to the plastics screening, he could bend/straighten his elbows very little - unable to get his hand to his mouth, unable to raise his arms up above shoulder level on both sides.  After his surgeries, it was a 3 person job to make 2 airplane splints and while he was in so much pain just a day or 2 post op.  However Ous was a trooper and we finally got it made up.  While in the treatment sessions, sometimes I would get to snag about 4 patients who had had upper limb surgeries and we would hang out in the stairwell of the hospital and dance.  I'd get Ous to pick out a song from his phone, and then I would "lead" my little troupe in a couple songs, focusing a lot on getting the arms up overhead, but just trying to move as much as possible.  I'm sure it was quite comical...but I had a blast.  The patients seemed to enjoy it as well.  Another reason Ous might have been a favorite of mine was because I would go on a run or bike ride early in the AM and go past the Hope Center on my loop which is where the patients that lived far away stayed in Conakry after they were released from the hospital portion of the ship, but still needed to return for outpatient treatments (wound care or therapy).  Twice I saw Ous was outside by the Hope Center gait at 6:30 am doing his exercises.  Now if that doesn't make a PT's heart happy I don't know what does.  I had to brag to my teammates on him, and he had excellent outcomes, full passive shoulder ROM, and improving elbow flexion.  While he seemed to still be lagging behind on the elbows, one day Emily thought we could just strap him in for more of a prolonged stretch - so we found a baby sling and rigged it up around his neck to pull his hand in.  He had it on his R arm for probably 30 minutes or more and when we took it off, he wiggled it around then put his hand on top of his head, then slid it down his face - you could see the smile from behind his hand however...  I asked him, "le premier fois?"  (the first time), and he nodded yes.  Again, things that just make your heart smile as a PT.  Thankfully we just happened to have some cookies in the tent that day and got to watch him go hand to mouth for the first time in 1 1/2 year.  WOW.  :)

Ous and I at the Hope Center

Another good story of plastics was the development of my nickname...in its various forms: French, Susu, Malinke, and even Pular eventually - respectively:  Bonne travaille, Eh baga wali, Eh barra barra, Eh goulee (I have no idea how to spell those translations...)  Apparently I told my patients "Good job" a whole lot.  They picked up on it.  So when I would walk down the hallway, as patients (or their moms) would see me, you would hear a chorus of "Bonne Travaille!", and then I would yell out some other version of the same.  I don't think any of the patients except my special friend, Nana, knew my real name.  At one point Emily was treating a patient in the inpatient treatment room, she told her patient "Good job" in French.  The patient then looked up to the door to see if I was coming in.  Crazy!  :)  Papanie, one of the other crew, was dubbed "Move It" because of his tendency to sing "I like to move it, move it" when he visited the wards (think the song from Madagascar the movie), so I guess it could be worse...