So sad

Chris has a patient at Provincial that is causing him some trouble. I won’t go too much into the whole long treatment disasters that are currently an issue but just thought I’d share. The patient is an illiterate black man that had cancer of the larynx (voice box) so a while back they removed his voicebox but he is now struggling with an open wound between his oesophagus and his skin, so basically his oesophagus is open to the outside with the result that he can’t eat food but has a tube through his nose into his stomach. The huge problem is that one produces 2 litres of saliva per day and this saliva (being liquid) follows the path of least resistance and the other issue is that saliva contains enzymes which begin the digestion process, so to try and close the wound and keep this large amount of fluid away from the wounds and not allow it to start “digesting” the stitches and whatever else is a nightmare. The man unfortunately doesn’t understand everything so well, so he keeps pulling his dressings off and moving his neck too much so that the flaps (pieces of skin and muscle that Chris is trying to use to close the hole) come loose. As soon as the hole is closed, he can start to eat again and get home (he’s from East London).

What makes me feel so desperately sorry for this man is that he is illiterate and because he has no larynx, he cannot speak. Just imagine that – having no means of communication whatsoever and you’re hungry (the tube feeding is never enough), you’re far from your family in hospital and you keep having operations that aren’t working because you don’t quite understand what you should and shouldn’t do (they do speak to him in Xhosa but he doesn’t seem to understand).

Ava is just starting to say a few words but not quite at that stage when she’s trying to tell us something and we don’t understand what it is she wants. That frustration that a young child feels when they’re trying to make themselves understood and can’t, is quite a difficult phase, but imagine experiencing that now. At least kids can throw tantrums…

Oh, and THAT black labrador is still in big trouble, a massive poo in the house last night (fortunately on the wooden floor) and there are pieces of wood and bark strewn all over the back veranda. As I type this here, he is letting off the most horrendous farts next to me so hope he doesn’t have some gastro looming, wouldn’t that just be a whole lot of fun.


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