COVER OF MY NEW BOOK

RETURN

I am returning to Nigeria on August 11. Many patients are waiting. Also, I am almost done with a new "picture book". Here is a small sampling.

SONOSITE M-TURBO

We desperately need a new US machine at NCH. Our current machine is dead, The Sonosite M-Turbo seems to be the best choice for us. We have raised about $2000. It will cost $10,000 with probes. I am hoping to take this on my Aug trip. Please help! There are about 100 visits to the site daily. If everyone contributes $100 we can get it.

If you decide to help, send checks to Earthwide Surgical Foundation, Attn Brian Camazine, MD, 1933 Easywood Drive, Henderson, TX, 75652 OR donate dierectly to Earthwide via Paypal using briancamazine@gmail.com.

HELP

YOU HAVE SEEN A SMALL SAMPLING OF THE PATIENTS WE ARE DEALING WITH BUT YOU DON'T KNOW THEIR STORIES. THE NIGERIAN MONEY, THE NAIRA, HAS DEVALUED GREATER THAN 50%. MANY PATIENTS CANNOT AFFORD EVEN THE LOW PRICES WE CHARGE AT THE NIGERIAN CHRISTIAN HOSPITAL. EVEN FEWER CAN AFFORD POSTOPERATIVE CARE SUCH AS CHEMOTHERAPY, RADIATION THERAPY, FOLLOWUP XRAYS OR EVEN CRUTCHES. PATIENTS ROUTINELY HEAL POORLY BECAUSE THEIR DIET IS LOW IN PROTEIN. I CONSTANTLY TELL THEM TO EAT 6 EGGS PER DAY BUT FEW CAN AFFORD THEM. PLEASE HELP. I WOULD LIKE TO RAISE $7500 BEFORE MY NEXT TRIP ON AUGUST 15. 

IF YOU CAN GIVE A LITTLE, PLEASE SEND A CHECK MADE TO EARTHWIDE SURGICAL FOUNDATION, ATTENTION BRIAN CAMAZINE,  1933 EASTWOOD DRIVE, HENDERSON, TX 75652 OR SEND A CONTRIBUTION VIA PAYPAL -BRIANCAMAZINE@GMAIL.COM. 

HELP THIS LADY GET SURGERY!

HELP THIS LITTLE GIRL GET CHEMOTHERAPY. HELP THIS GIRL GET HER FACE CORRECTED. HELP GET REAL CRUTCHES FOR THIS WOMAN!

TRAM

AMARACHI

Amarachi came to us in September , 2015. She had been treated at another hospital and now had recurrent breast cancer on the right chest that extended almost to the axilla and was fixed to the chest wall. She also had breast cancer in the left breast.  Despite the situation, she had a very good functional status.

We decided to proceed with excision of the recurrence. Unfortunately, resection left a much bigger wound than I had initially expected. This was a significant problem because we wanted her to get healed as fast as possible so we could initiate chemotherapy.

While looking at the gaping hole we had produced, it occurred to me that we could do a TRAM Flap (transverse rectus abdominis flap). The TRAM, consists of the skin, fat, and muscle of the lower abdomen with its blood supply, which  is tunneled beneath the skin to the chest. This would be a perfect way to cover the wound with healthy tissue. The only problem was that I had never done this procedure before. After a few minutes of reading, we proceeded.

The flap was raised using the skin between the umbilicus and the pubic bone, keeping it attached to the rectus muscle. We then tunneled the skin to the chest and the skin paddle perfectly fit our surgical defect. We then closed all the wounds and Amarachi healed great. She had a nice tummy tuck as well.

In January, 2016, I returned to find her doing very well. She had actually added some weight and was healed. We then proceeded with a modified radical mastectomy on the left side.

When I saw her in April she was already back on chemotherapy . Her weight was stable and she had no signs of metastatic disease. Of course, statistics are not in her favor but she is living a healthy life and I expect she will be around for some time to come. She may dies from this cancer but she will avoid a fungating cancer on her chest .  Most importantly, she is happy with the results.

ORBITAL TUMOR

This little girl has a rapidly growing retro-orbital tumor. At a later time i will post her CT scan. She required enucleation. We are waiting on the pathology to determine future treatment. 

These tumors are rare but include  rhabdomyosarcoma, neuroblastoma metastases, optic pathway glioma, plexiform neurofibroma, leukemia, lymphoprolipherative disease, orbital inflammatory syndrome, dermoid and epidermoid inclusion cysts, and Langerhans’ cell histiocytosis. Vascular lesions reviewed are infantile hemangioma and venous lymphatic malformation.

MALIGNANT PAROTID TUMORS

Parotid tumors frequently come to the Nigerian Christian Hospital. Parotidectomy is a technically difficult operation requiring dissection and preservation of the facial nerve. In the picture below I the facial nerve trunk can be seen at the clamp at 6 O'clock and major branches are visible at 5 and 8 O'clock. This patient had a superficial parotidectomy and the nerve was preserved.

Unfortunately, some of these tumors are malignant and require excision of the nerve with the tumor. This was the case with the following patient. Removal of the tumor not only required removal of the 7th nerve but also left a large defect.

We closed this defect with a pectoralis major myocutaneous flap:

The patient had a good recovery and will be ready for adjuvant radiation therapy much faster as a result of the flap coverage

MORE JAWS

Ameloblastoma is common in Nigeria. (see http://earthwidesurgicalfoundation.blogspot.com/search?q=ameloblastoma). Ameloblastoma (from the early English word amel, meaning enamel + the Greek word blastos, meaning germ) is a rare, benign tumor of odontogenic epithelium (ameloblasts, or outside portion, of the teeth during development) much more commonly appearing in the lower jaw than the upper jaw. Treatment is resection. This is well tolerated in patients who have a tumor on one side of the jaw since people can eat and speak quite well with half the mandible removed. Surgery is more difficult in patients who have a central ameloblastoma or one that is so advanced that surgery requires removal of the entire mandible. Nonetheless, these patients can eat well (especially since the favorite food is gari which is not chewed). Speaking is more difficult but still understandable.

The following old woman had a very advanced tumor that required near total mandibulectomy. She is doing quite well since surgery and is happy with the results.