Goodbye Dutch, Hello Dutch

Well today we said goodbye to the first Dutch team we worked with and said hello to their replacements. I’m sure that they will have the same work ethic as the first team, hopefully they’ll be as nice and calm! That’s very important in stressful situations. It’s too bad that the first Dutch team is leaving, we were a well oiled machine when it came to getting through tons of cases, piece of cake. We have broken the record set in July for the numbers of cases completed since the inception of a medical facility in Kandahar. The previous record was set in July at 155 as of today, 28 August, we are at 176 cases. Again, not a record we wanted to break, but we blew it out of the water anyway!

There was a coordinated suicide vehicle bomber attack this week in Kandahar. There were 5 cars loaded with explosives that hit a Japanese construction company that employs Pakistani engineers. According to the Stars and Stripes article, the blast killed at least 41 people and injured 66. Fortunately we only received one patient from the blast, we were expecting a very large mass casualty.

So far I have scrubbed 107 hours of cases and our team has completed 271 cases since 16 MAY 09. I’m going to try to hit 200 hours of scrubbing by the time we leave here. I predicted that we would do 360 cases total, looks like we’ll also surpass that estimate!
Shayna is doing good still, getting ever closer to having the contraption on the right leg removed and very happy about that! Sorry I haven’t called as much Shayna, I’ve had some late nights the past couple of shifts. I can’t wait to be there relaxing on the couch with you!

Hours worked:
24 AUG 09: 10 HOURS
26 AUG 09: 16 HOURS
28 AUG 09: 12 HOURS (not a bad week as far as hours worked goes)

# & CAUSE OF SURGERY AS OF 28 SEP 09:
98 GSW
88 IED
6 SVBIED
5 SUICIDE BOMBER
7 ROCKET ATTACK
39 NBI
6 MINE
8 AIR STRIKE (SAME PATIENT 8 SURGERIES)
4 MVA

Sorry about not having any pictures this week, we’ve been pretty busy. I’ll take some and post a supplemental entry with nothing but pictures. I’ll have a lot of me just for you Shayna! I’ll try to keep them appropriate! Haha.

That’s about it for this week, it’s getting to be a little like Groundhog Day here! Shayna I love and miss you more every day and I’ll be there with you soon. Everyone else take care and keep in touch.

Dave

Resources

I was in the chow hall today and I overheard a conversation between an Army Captain and several enlisted guys. The Captain said that he was finding it really hard to tell his people that they should re-enlist in the Army. Basically because of the stories that I heard from the enlisted guys. One of them has been in the Army for 5 years, 3 years of it has been spent on deployment! That’s outrageous! He stated that it was really hard for him to have a meaningful relationship with anyone since he’s gone all of the time. He also said that he is nearing the end of his enlistment and that even if the Army gave him a gold plated Mercedes he was still going to get out, a few choice cuss words were used! Even though the Canadians do a poor job in utilizing the people with certain skill sets (not the people in this hospital it comes from higher up and yes I’m still pissed about Ron leaving for Kuwait!) they do take care of their deployed personnel. During a 6-7 month deployment they get to go on a paid vacation for 3 weeks to a destination of their choosing, and a replacement is sent out to cover their shifts while they are gone. What a deal! Some went to Greece, Italy, Spain, and Bolivia. Could the US Military do something similar with their troops, probably not due to the massive amounts of people deployed all over, and our Armed Services spread so thin around the globe, thank you Mr. Clinton! But I’ll tell you one thing, the morale and retention of the troops both would definitely increase. The Army is giving us 4 days of R&R to go to Qatar, which is a good deal and I think that you get a couple of weeks off to go home if you are deployed for a year. I think that they really need to re-evaluate that program and come up with a better plan to take care of their people, but who am I, I just count things in an OR for a living! Haha. Don’t get me wrong, the Navy has treated me very well over the last 19 years and I am very grateful for all the opportunities that my service as afforded me. I would still encourage all young people to do at least one tour in the branch of service of their choosing, it is a great experience and it instills a feeling of accomplishment and pride.

I wanted to give a shout out to the SUPPORT THE TROOPS OF HARTFORD, WI, HARTFORD VFW #8834, AMERICAN LEGION POST #19, PACK & SHIP OF HARTFORD, WI, SUPPORT THE TROOPS FRIENDS AND FAMILIES, ST. GABRIEL’S CHURCH RICHFIELD, WI, NORTHLAND MARKETING AND STARBUCKS IN WEST BEND, WI. Thank you all very much for the box that you sent out to me. It pretty much contained everything that I needed. Fantastic! I think that you are doing a great service to your country by doing this, and it is much appreciated. Thank you all again!

Pictured is me, Parris, Linda and Martyn sporting our t-shirts that were sent out to us from the Inter-National Hero to Hero.US campaign and the Red Deer Fire Fighters Association. Thank you to both organizations for the gifts! You are awesome!

Also pictured is Ron in his last Kandahar picture! You can tell by the picture how much stuff is floating around in the air, and who knows what we are inhaling into our lungs! woohoo. We’ll see you in a couple of months Ron, take care and we miss you already buddy, tell John I said hello.

Shayna is doing great with the legs. She has been dedicated to beating the odds and not getting a pin site infection, and is winning the battle. September 3rd is the magical day of getting the first external fixation device removed, and she is ready for that! The left leg fixation gets removed somewhere around mid-October. It’s neat that we are both going through a trying time for the past 7 months or so, me with the deployment and Shayna with the surgeries and we are both going to be ecstatic when this time is over. Shayna I love you and am very proud to call you my wife!

CASES:
I’m going to stop listing the cases and instead have a running total of types of causes and hours spent at the hospital per day. I’ve spoken with several people and they said that they generally skip over the case listings stating that it is a boring entry. I’m going to still keep a tally of surgeries completed and the country of origin of each patient if anyone is interested in seeing that, just ask me when I come to visit. Here we go:

15 AUG: 1 hour (we were called in to assist the Canadian team with several patients at one time)
16 AUG: 10 hours
18 AUG: 17 hours
20 AUG: 14 hours
22 AUG: 7 hours, huh? Woohoo!


# CAUSES OF INJURIES AS OF 22 AUG 09
91 GSW (GUNSHOT WOUND)
84 IED (IMPROVISED EXPLOSIVE DEVICE)
38 NBI (NON-BATTLE INJURY)
6 MINE
5 SVBIED (SUICIDE VEHICLE BOMBER)
5 SUICIDE BOMBER
6 ROCKET ATTACK
7 AIR STRIKE
2 MVA (MOTOR VEHICLE ACCIDENT)

If anyone is interested in having me return to having the surgeries listed please leave me a message and I’ll be happy to list them once again.

Shayna once again I love and miss you very much, can’t wait to see you. Everyone else take care and keep in touch.

Dave

Well....

Well we’re at that stage of the deployment where we’ve seen just about all there is to see in trauma. Been there done that, got the blood on the shoes! Now that I’ve said that we’ll probably get something really freaky in! haha. We are on track to destroy the July record that we set, hopefully we don’t break it, we don’t want to see people get hurt. We had a conversation with a father of one of our child patients (pictured), through the interpreter. He lost 3 sons and a daughter and is at the hospital with his remaining son. The conversation left me with a warm feeling, he said that he now sees that the coalition forces are here to help and not hurt the people of Afghanistan. We have done multiple surgeries on his son who has lost his left arm and had some chest injuries that have since healed. You could tell by just the body language the tremendous loss that the father has suffered and how much he loves his remaining child. It’s really sad to see the suffering that the Taliban has brought to this region. Hopefully this push will eliminate all Taliban presence in the area, hell hopefully all the Taliban everywhere will be gone by the time we leave!
Shayna is doing great after her second surgery and has completed the last adjustments on her external fixator on her left leg. She had x-rays done on her right leg and if all is well she’ll be having that removed by the end of this month. Can’t wait to see those legs! Haha.
We have 5 paydays to go. Time has really flown by and hopefully it will continue to. In a couple of weeks I’m going to go to Qatar to enjoy some time off, looking forward to that. They have a lot of trips that you can take but all I’m really interested in is not carrying my weapon, getting some golf in, and laying by the pool! I should have plenty of pictures to post after that trip, probably one of me breaking a club in half after another great shot into the sand, water or woods!
CASES:
10 AUG: 1. Face washout, tracheotomy. 2. Washout right buttock. 3. Washout right buttock, wound vac placement. 4. Wisdom teeth extraction. 5. Removal of hardware right ankle.
11 AUG: 1. Craniotomy.
12 AUG: 1. Open reduction internal fixation zygo and orbital fractures. 2. Abdominal abscess drainage. 3. Removal of wound vac and closure of wound. 4. Dressing change on 30% burn patient. 5. Washout of left arm amputation, wound vac placement, closure of chest wound. 6. Washout right arm, wound vac placement. 7. Craniotomy.
14 AUG: 1. Left arm amputation washout and closure. 2. Exploratory lap, I&d. 3. Removal of IO needle from chest. 4. Trache. 5. Exploratory lap. 6. Left lower extremity external fixation and fasciotomy. 7. Washout right arm, amputation of thumb, closure of head wound. 8. Closure of bilateral calc fractures, left lower extremity external fixation. 9. Washout left foot.
Shayna I love and miss you very much, hang in there it’s almost over for both of us! Everyone else take care and keep in touch.
Dave

Records

Well it’s official, we had the busiest month EVER recorded at the Role 3 hospital in Kandahar during the month of July! It’s pretty exciting being a part of that milestone. I asked those in charge if we get a t-shirt or something, but they just ignored me! Haha. If we keep going the way we have been during the month of August the previously set record will once again be shattered. Our shift is basically every other day, with being on call on your “off” days, so during July I calculated how many hours were spent at Role 3, here it is:

1st week of July: 57.5 hours in 4 days
2nd: 45 hours in 3 days
3rd: 56.5 hours in 4 days
4th: 45 hours in 3 days

It doesn’t seem like a lot of hours, that’s why I put the qualifier of working every other day. So needless to say we have been pretty tired, but we are doing some amazing surgeries in such a Spartan setting. We still are not beaten so, again, bring it on!

The first picture is of team NOODLES (NLD for Netherlands + US for the United States = NOODLES!) We are a really good surgical team. It’s nice to be able to draw from such a wide range of experiences to make the team work well together, there isn’t much that we are not able to do. Pictured from left to right is: Dr. Ralph De Wit (general/ortho surgeon), Carol Water drinker (OR nurse), Dr. Peter Keijzers (Anesthesiologist), Linda De Jager (OR nurse), Jere Tien (OR tech), myself (super nurse! Haha), Omar Cannich (CSR tech, we’ll miss you buddy!) and Martyn Van Steennis (nurse anesthetist). Jere and myself are the only US individuals, all the rest are Dutch. The second picture is of the thermometer we have outside of the room, and it definitely isn’t -50 degrees! It pretty much hits that temperature every afternoon, it’s really something when it’s windy! Just imagine sticking your head in the oven with a hair dryer on at full blast, that’s about the best analogy I can come up with, completely unbearable. I just feel for all the coalition soldiers out working in the heat every day, God bless them!

I weighed myself today, 3 AUG, and I’m down to 143 pounds, that’s 20 pounds lost in 4 months or so. Thanks to the diet and workout advice from my beautiful wife, heat in Afghanistan, and working out every other day when I can. Hopefully I’ll be able to keep it up once I’m home with all of the temptations of ice cream sandwiches, Cincinnati chili, etc.! haha. I weighed 135 pounds when I graduated high school.

CASES:

2 AUG: 1. Bilateral fasciotomy extensions. 2. Exploratory lap, bilateral washout legs. 3. Washout and closure of multiple wounds to the right leg, skin graft to right hand. 4. Washout right leg. 5. Amputation left lower extremity. 6. Craniotomy. 7. Washout left leg.

4 AUG: 1. Washout and wound vac change. 2. Open reduction internal fixation zeugmatic fracture. 3. Craniotomy. 4. Washout and closure multiple wounds right hand. 5. Amputation left arm, amputation left foot, washout wound left leg, external fixation left femur, washout and packing of face trauma.

6 AUG: 1. Face washout and temporary closure, left arm irrigation and debridement, left leg irrigation and debridement. 2. Left foot amputation, right leg fasciotomy. 3. Exploratory lap, chest tube insertion. 4. Bilateral arm washouts, external fixation right arm, bilateral leg fasciotomies, right carpal tunnel release. 5. Hemi-laminectomy, decompression of spinal cord. 6. Removal of rectal abcess. 7. Thoracotomy. 8. Amputation of left arm, exploratory lap, abcess drainage, primary closure of ileum. 9. Amputation left lower leg, washout of face, repair of trach. 10. Washout neck wound, removal of bullet. 11. Washout of left arm.

8 AUG: 1. Right femoral nail, skin graft from left thigh to right thigh. 2. Irrigation and debridement right buttock. 3. Washout left lower leg amputation with wound vac placement, washout face. 4. Washout right lower extremity. 5. Exploratory lap, colonoscopy. 6. Washout right thigh.

Shayna I’m very lucky to have such a beautiful and patient wife, I love and miss you very much. Everyone else take care and I’ll see you soon.

Dave