Monthly Archives: March 2014

Close Encounters with the Animal Kingdom

I have learned something new this week here in Tansen:  Lift up the toilet seat before sitting to see if anything has decided to take up residence while the toilet has been unoccupied!  I went to have a nice quiet visit to the toilet, and after sitting for a moment, realized I felt something tickling my leg.  I assumed it was a thread or something, but when I looked, I discovered to my horror a cockroach running down my leg into my trousers!!  Well – I am glad I wasn’t on video while I did the “remove your pants to get the cockroach out” dance!  I then smashed the offending bug on the floor of the bathroom.  Les chose that moment to arrive home, where he found me still frowning at the dead roach and moaning about being too old for these kind of dance maneuvers….  (Plus I hate cockroaches).

We had gotten complacent about leaving food out – until the other day when we discovered that a rat had decided to make his way into our kitchen again.  He had gotten into the sesame seeds which Didi had left out to dry – and had knocked over several other items therefore making his presence known.  We decided to look for him – and found him hiding behind the counters in the kitchen.  We armed ourselves with sticks, put down a couple of the “sticky” traps, and closed the doors to the kitchen.  Then we launched Operation: Kill the Rat.  We took turns poking the sticks under the counters to chase the rat out, but he was too quick for us to hit when he came out – he would quickly reverse back under the counter again.  (It probably didn’t help that Debbie refused to be on the floor – but was trying to stand on a chair and lean over to whack at the rat from her safe perch!)

At one point, Les cornered the creature, and gave it several good blows with the stick, but the mouse got out, ran down the hall, and Debbie managed to get off her chair long enough to open the door to the porch and shove the rat outside.  Whew!  (By the way – the rat ran right over the sticky traps – didn’t slow him a bit.  Waste of money…. I thought…)

Well – Les was sure this was one rat which would never come into our house again because he had hit it pretty hard.  So – Les went off to work, which included night call that day.  At bedtime, Debbie closed all the doors in hopes of keeping any rats from getting into the various rooms, but about 1 am she heard something in the hall on a plastic bag.  She cautiously opened the bedroom door with a slipper in hand (the only weapon in the bedroom) and found herself pretty much eye to eye with the rat who was sitting on the counter in the hall on top of a bag of corn chips.  Fortunately, he hadn’t opened them!  So – Debbie summoned her courage, and smashed the rat with the slipper, sending it flying down the steep stairs to the cement landing one floor down.  The rat was stunned (and we think it was still hurting from the beating from Les) so was still for a few moments.  Debbie tried to go down and push it out the front door, but the rat ran behind a set of shelves.  Debbie put traps around (including the sticky one – this time baited with bread), went back up and closed all the doors again and went back to bed.

About 5:30 am, Debbie heard the rat again.  She carefully went down the stairs, and found the rat actually stuck to the sticky trap and unable to run away.  She fearlessly placed a bucket over the rat, and left the work of getting rid of him to Les – definitely the man’s job at our house!

When Les arrived home after call at 8 am, Debbie met him at the door and said – the rat is under the bucket – please remove him somehow!!  Thanks, Les, for dispatching the rat and allowing the file on Operation: Kill the Rat to be closed.  Hopefully forever!!

Advertisements

7 Comments

Filed under Uncategorized

Bony Tumor

This was shared with us by the current Chief of Surgery here at Tansen Hospital.  He is a Vellore trained Nepali Orthopedic Surgeon, and he and his team are doing a great job here at the hospital.  This is such an amazing story, we wanted to share it.  NOTE:  This is much more medical and has some graphic images so read as you wish – this was not written by non medical Debbie, but we thought some might be interested in something more clinical.

Ashish is an eight year old boy who presented with a large bony tumor in the right scapular region. His parents noticed the swelling in early childhood. He presented late because he was wrongly informed by a  local doctor that he would not be operated on by any doctors till he was 8 years of age. The movement of the right upper limb and neck was limited because of the swelling. The swelling was painless and there was no history to suggest malignant transformation,  such as pain, sudden increase in size, loss of appetite or weight. Neurology was normal in the right upper limb, but the radial pulse was feeble on that side. There were bony swellings in all the four limbs.  His father and his grandfather also suffered from a similar illness. Xrays and CT scans revealed a bony tumor arising from the right scapula, measuring  20cm X 15cm. It was pressing on the right chest wall deforming it.  Diagnosis: Hereditary Multiple exostosis.

Ashish before the surgery. The bony tumor is arising from the right scapula. The tumor looks large externally, it was bigger internally as it compressed and deformed the chest wall.  It is obvious in the Xrays and CTscans

Ashish before the surgery. The bony tumor is arising from the right scapula. The tumor looks large externally, it was bigger internally as it compressed and deformed the chest wall. It is obvious in the Xrays and CTscans

The right chest was deformed due to pressure on it indicating a larger mass internally than what appears externally.

The right chest was deformed due to pressure on it indicating a larger mass internally than what appears externally.

The familial nature of the condition. The father has bony swelling with deformities in the upper limbs.

The familial nature of the condition. The father has bony swelling with deformities in the upper limbs.

X-rays of the chest  demonstrating the Bony tumor arising from the right scapula. Note the chest deformity due to  compression of the the tumor.

X-rays of the chest demonstrating the Bony tumor arising from the right scapula. Note the chest deformity due to
compression of the the tumor.

6

Tumor around the knee and ankle involving both the lower limbs.

Tumor around the knee and ankle involving both the lower limbs.

8

CT reconstruction demonstrates the bony tumor arising from the right scapula. The clavicle is seen anterior to the tumor.

CT reconstruction demonstrates the bony tumor arising from the right scapula. The clavicle is seen anterior to the tumor.

101112

Lateral positioning for the surgery.

Lateral positioning for the surgery.

Elliptical skin marking for incision.

Elliptical skin marking for incision.

Extensive dissection around the tumor to enucleate it.

Extensive dissection around the tumor to enucleate it.

Skin closure with two suction drains.

Skin closure with two suction drains.

The tumor weighed 1.72 kgs

The tumor weighed 1.72 kgs

Triumphant removal of the tumor.

Triumphant removal of the tumor.

Ashish recovering from the surgery. The radial pulse was normal and equal to the opposite arm. It would be interesting to follow him up and see if his chest wall reverts to normal shape.

Ashish recovering from the surgery. The radial pulse was normal and equal to the opposite arm. It would be interesting to follow him up and see if his chest wall reverts to normal shape.

Ashish on his 4th post op day.

Ashish on his 4th post op day.

10 Comments

Filed under Uncategorized