11/16/2014

MORE FIBROUS DYSPLASIA

I was recognizably human; I had at least the usual complement of legs and arms; but I might have been some shameful piece of garbage. There was something indecent about the way in which I was being furtively shuffled out of life-Peter Greaves, leprosy patient 


































She came to see me completely covered by a scarf. I knew immediately that there was something dark and terrible hidden away. She was subdued and timid from years of being shunned in her village. I removed the scarf and told her she did not need it at the hospital and would not need it  anymore. We would help her.


She arrived the day before I was leaving Nigeria so I promised that I would do her surgery on the next trip,  but I doubt she believed me. I showed her pictures of another unfortunate soul with a similar problem that I had repaired. I think I could see a glimmer of hope in her eyes.

She will have her surgery soon.

10/15/2014

EBOLA IN NIGERIA-MISCONCEPTIONS

Ebola is a terrible disease. Fortunately, Nigeria did a splendid job of eradicating the recent epidemic. Nigeria had 20 cases of ebola with 8 deaths-better mortality than any other country. The last diagnosed case was August 31, 2014.  All people in Nigeria who were sick with Ebola have now either died or recovered. Contacts of these patients have completed their 21-day monitoring period and are no longer at risk for getting sick with Ebola. The country is safe (at least as concerns ebola)

Common misconceptions:

1. There is active ebola in Nigeria.

2. West Africa is one country! Most people I speak with believe this! West Africa, also called Western Africa and the West of Africa, is the westernmost subregion of the African continent. West Africa has been defined in Africa as including the 17 countries Benin, Burkina Faso, island of Cape Verde, Gambia, Ghana, Guinea, Guinea-Bissau, Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, island of Saint Helena, Senegal, Sierra Leone, Sao Tome and Principe and Togo.

Therefore, it is meaningless to discuss "ebola in West Africa". It would be similar to referring to ebola in Southwestern USA. In fact, there is only ebola in Dallas.

3. Obviously, since there is no ebola in Nigeria, restricting travel to this area will do nothing to help the current epidemics.

4. Rejecting Nigerian students from American colleges will not stop ebola



10/13/2014

OLD FRIEND

Ameloblastoma
Ameloblastoma is common in Nigeria and West Africa. Despite what you might think, patients tolerate having half their mandible removed  quite well. They can eat and speak normally. This lady had a large ameloblastoma that had destroyed her right jaw. We performed a hemimandibulectomy and pectorals flap reconstruction in 2006. She came to visit us this past September. She is very happy.

Resected jaw


Postop day 3

Postop 1 year

Postop 8 years
Postop 8 years

HAPPINESS


This lady has a big problem, yet, amazingly, like most of my Nigerian patients, she is happy because she is finally getting some care. She has had 3 cycles of chemotherapy and soon we will remove her necrotic, fungating breast. She will probably die relatively soon (who knows?) but at least she will not die with the smell of rotten flesh around her. For an investment of a few weeks, she will be happier for the rest of her life, however long that may be.

Unfortunately, fungating breast cancer is common in Nigeria. For many reasons, such as economics and fear, the ladies come in late. With educational programs, we are trying to change this trend



ALBINO

It is very difficult to be an albino in the tropics. These patients often develop lethal skin cancers. It has been hypothesized that skin cancer prompted the evolution of dark skin.  On every trip to Nigeria, I see albinos with terrible skin cancers. Some patients come early enough that simple cauterization can solve the problem. However, they must come often since new cancers are always developing. This unfortunate patient came in very late. Soon we will perform a big surgery to remove the cancer and cover the site with new tissue.
Albino patients that frequently come for surgery

10/12/2014

PATRICK GODET EGLI VINCENT

Making a world class motorcycle is similar to surgery. Every detail must be perfect to get the desired result. Patrick Godet in France makes a beautiful motorcycle that is as beautiful as any surgery I have seen. Every detail is thought out and executed to perfection. What a surgeon he could have been.





ABUJA

This past trip in September, We made a trip to Abuja to do some surgery at Dr. Uche Nkeonye's new hospital. This was Eric Oje's (best nurse anesthetist I have ever worked with) first flight. The surgeries went well and we had a grand time.
Dr. Uche's Hospital

Eric Oje (nurse anesthetist), Ifeanyi Chiekwe (urologist),
and Uche Nkeonye (general surgeon)