Monday September 9

    We are excited entering into our second week: excited to see what cases we will have this week, excited that we already feel a sense of accomplishment, and naturally excited to return home at the end of the week. The first thing we learned this morning is that all of our patients are doing well. I was particularly pleased that Rashid looks good, as does the lady who had the choledochoduodenostomy. She will get to eat real food today !  We then went to the OR to find 5 cases planned for us today. Jonathan started out with a man with hemorrhoids, then I had a woman with lymphadenopathy in her left neck and left axils which was thought to be suspicious for lymphoma. Fortunately for her I think our pathologists will say it is TB and she can start treatment. Then Jonathan had another baby with imperforate anus and also some genitourinary abnormalities; he and Diego put in a supra public bladder catheter and did a colostomy. John and I ended the day with an interesting case, sort of: she is 8 years old, and appears to have precocious puberty with breast development, but also significant obesity. We were asked to see her because of an umbilical hernia, but she was found to have a rather tender abdomen. When we explored her, we found that she had a ruptured appendix as we had suspected. We carefully looked at her ovaries for any abnormality that might play a role in her precocious puberty, but they appeared normal.
     As virtually always happens on these trips, throughout the day we were approached by people who work at the hospital asking if we would see a friend, or a relative, about some medical issue. As we get closer to our departure, it gets harder and harder to fit them in for surgery if they need it. But we try to see everyone, and do what we can now. For this trip, I had some business cards printed up with "HEARTT SURGERY TEAM.  JFK HOSPITAL" and a big heart with a bandaid on it; we can give them to some patients to remind them to follow up with us on our next trip in 6 months. I'm hopeful they will work !
      We got back to the bungalow around 7:30, had dinner, and everyone retired early after a long day. I expect we will have a similar day tomorrow.