This post is being back-linked from May 22nd's post: Tuesday's Toe Trauma. It was written/posted by Britt.
Congratulations if you were bold enough to click over to this post. I promise you won't be disappointed. ;) I am excited to show you the morning's excitement. Here it is, first glimpse: (notice the little gnats, a special Haiti-esque feature)
The cut went all the way from the back of his foot to the top and right through the third toe. Back and front, post-cleaning and partially sutured:
About 30 minutes into cleaning/suturing .... a special delivery was made. I wish that I could say the "package" was as useful as it was entertaining, but ... no. The delivery-man gets an "A" for presentation though. I love how the green of the leaf contrasts the chunk of toe, don't you?
After I had come as far as the above pictures, I stopped. Right when Tiroy showed up, I had my mom email a few of our doctor friends to get their input on treatment. I knew that the toe needed to be amputated, but I just wanted to get some outside, more knowledgeable, & experienced advice. I also should note that I've never amputated a toe before. I learned how to amputate fingers in October when Jamie & Sharon visited (pictured in 10/23/06's post), but I only did a couple and haven't done any since then. I really was just trying to determine if I could actually do the procedure, and in doing so, that I wouldn't be causing him any more harm than good.
This is probably the coolest part of the story. I had a pre-op conference call with our above-mentioned good friends, Dr.(s) Steen. But because our internet phone has been working so poorly lately, Jamie couldn't hear me at all. So I had my mom type my response to what he was saying on the phone on IM. So it went like this: Jamie talks, Britt listens and dictates her responses/questions to Tara who sends them via IM to Iowa, and Sharon does the same on their end of the IM. It was really weird but cool at the same time; I just kept laughing and shaking my head. Thank goodness for multiple forms of technology, huh?
Needless to say, I got the go-ahead from Jamie & Sharon and Lori via email; they all agreed the toe had to go. Jamie did an awesome job of reassuring me that I could do it and gave me a quick refresher on digit-amputating "how-to. " If it's not apparent, I kind of dig that I can post this picture and make you cringe. But it's SO cool, from an anatomy point-of-view. You can't knock that. So here it is, my friends, the bone:
I clipped the bone all the way to the base of the toe. I had skin left to flap from the middle joint. I cut-away some of the skin to get it to match up better and flapped the skin back, sewing to the bottom of the foot. Here is the finished product: (front, back, and top view)
The top view is definitely my favorite. 24 stitches total. I'm really glad that I was able to do this; it was definitely a challenge, but in the end - well worth it. Please be praying for Tiroy, that he is spared from infection and will heal quickly and without too much pain.
Here's something that I thought was cool and worth telling about:
This was caused by a insect. (Ya, I know, now you really want to come visit us) The wound is on the back of the leg of a good friend of mine, Ameslin. She came a week ago, saying that she had been bitten in her sleep by a bug, an 'anni-pye.' I tried to look up the bug's identity in my Creole dictionary, but I couldn't find it. To me it was just this nasty, unidentified bug that must have been pretty big to bite and wound a rather large surface-area.
I used to think that I am kind of good at conclusive reasoning, but maybe not. 'Pye' means foot/feet in Creole .... bug + feet ...... what did you come up with? Centipede! A centipede did this ... sick, huh? So she came back today and the wound has progressed from just a surface irritation into a pretty deep hole. I'm treating it like an abscess and plan to pack it daily w/ betadine packing. If you think I should be doing otherwise, please tell me. And let me know if you ever see a centipede big enough to cause this so I can catch it to show my bug-loving little brothers (who unintentionally kill everything they catch.)
Thanks for reading about my day ... it was pretty fun. I'm excited about being back into the swing of things. If the rest of the summer is anything like the last two weeks (I've had 9 stitches patients), I will enjoy a busy & exciting summer. :D