Well, I've been away for some time, having the "Dry ink yndrome" not being able to write it seems, nothing much going on really apart from a very useful spine course I attended a part of arranged by the Cleveland Clinic at Cairo's Mina House Oberoi, then coming to elGouna where I had a warm greeting by a patient with a huge Fronto-Temporo-Parietl Subdural Haematoma (Brain Haemmorage in English), the hospital actualy phoned me as I was going down from the plane (we were already three hours late but that is another story!!) and sent a car to collect me from the Hurrghada airport to the operating theatre literally!! I finished surgery at 9 am where I went to bed skipping the morning clinic for the first time in my life and went to the hospital at 6:30 to check on my patient and attend to the afternoon clinic hours. The follow up CT showed a residual temporal part of the Haematoma, I expected so as I was prevented by high ICT from actually opening the dura and had to use some snips and subdural irregation (for the highly sophisticated surgeons out there I tell them that this was the best option I had considering the circumstances and I did actually remove 80% of the original haematoma, improve the brain oedema and resolve the midline shift) the patient recovered nicely with an improving concious level but I decided to readmit him for removal of the residual temporal haematoma that was exerting pressure on the left temporal lobe, Cairo was fine with my decision so I went ahead the following day and operated with a full dural flap and managed to deliver the remaining now very solid haematoma. The patient was sedated and hyperventillated post operatively to give him the best chances out of this, he is young and healthy and the follow up scan showed no compression so if he's gonna improve there is nothing stopping him now, but eventually it all depends on the primary injury the patient sustained and the compliance of the neural tissue itself and the general condition of the patient.

Any way I am leaving elGouna today off to Cairo where I will have a continuation of my now three week long circuis round doing errands for the house that involve so much red tape and paper work that it's killing me literally, I also need to take my car to the shop again cos there is some funny noise coming from the engine after they did the regular maintenance last week. After finishing so I will pack my things and drive to Alexandria then alamein where I will spend a week as the on Call Neurosurgery specialist in the North west coast?! I dunno about that but it's kinda funny how I ended up being the marine neurosurgeon lately running from Sharm elSheikh to elGouna and now Alamein and God only knows what's next.