Today I want to tell you about something wonderful (at least, I think it is):
This morning, we had a CP child in the lab and Nathalie, a physiotherapist from the Dominican Republic, wanted us to make braces for the little girl. The only problem was, I found one side of the Achilles tendon to be really quite stiff. Okay, there are stiffer cases, but it would have become difficult for the mother to put on the required night braces without losing the corrective position again. Then Denise, a physiotherapist from the USA, suddenly appeared and I consulted with her. We agreed that an operation in the Achilles tendon region – prior to the provision of the splints – would be the best solution. The challenge was that operations on this area are not being carried out here yet.
It occurred to us, however, that two surgeons (of Chinese descent) were here from the USA for a week. As it was by then lunchtime, we decided to discuss the matter with the two surgeons over the meal (Eileen performs orthopaedic operations). No sooner said than done! While piling food onto my plate, I raised the issue and both doctors thought it would be best to look at the child there and then. So we immediately set off in the direction of the workshop to examine the child, who was still waiting there with her mother. Eileen said she wanted to operate on the child today – in a few free minutes – in the workshop. Naturally, I could not imagine an operation outside of the operating theatre, but Eileen said that the operating theatre was not necessarily that sterile and that because it is being continuously used for operations at the moment, there was no time for it and that the bureaucracy would also take too long.
The issue of paperwork here is really extreme. My flatmate Susanne – a paediatrician from Regensburg – is often on call, including at night. If there is an emergency, it takes about 1 – 1.5 hours before she finds out about it, because so much paperwork has to be completed beforehand (confirmation of the confirmation etc.). Unfortunately, people sometimes die while waiting and the director of the clinic – Ian Rawson – unfortunately can’t do anything about it either. At any rate, I am really glad that there is not so much bureaucracy in the lab – coming from Germany, one is used to something quite different ….
Back to the operation: the surgeons arrived back at the workshop at around 14.30 with their operating equipment and were finished half an hour later – UNBELIEVABLE!
The little girl was a very good patient. Before the operation, she could manage a dorsiflexion of -20 to -30 degrees. Once the partial transection of the Achilles tendon had been performed, she managed about 70 degrees (therefore gaining 40 – 50 degrees – see photo)! The whole thing was then stabilised in a cast, which I was to change after a week. The provision of the leg brace for this leg can commence in three weeks. For the other leg, we have already taken an AFO (Ankle Foot Orthoses) impression today.
All of what we achieved that day made me so happy, since it was something that was, in theory, impossible, but brilliant, – as well as being my first operation in the “medical supply store”. It really inspired me to once again see something impossible becoming possible! I am really proud of it. I can also see what can be done when people are passionate about their work – in this case, the work of the Chinese-American surgeons.
>>> click here to see the photos of the operation