Sunday, November 22, 2009

I Got What I Deserved

Being the first student at a hospital is bound to come with some hiccups. Like every other day someone changes their mind about what I can do in the OR. Well, on Friday, after observing 10 or so lap chole's (galldbladder removal via laparoscopy) I asked if I could scrub in to hold the camera. Dr. H said yes, asked the charge nurse and she said no. So the surgery starts, I'm sitting on the stool all pouty, and Dr. H finds that his gallbladder is actually gangrenous (very bad!) and he can't distinguish the anatomy because it's so inflamed. This means that a conventional cholecystectomy has to be done (with a big incision). The charge nurse tells another nurse to call the HEAD NURSE to see if I can scrub in because well there isn't enough people and Dr. H needs another person's help. The head nurse says "uh yeah, she's scrubbed in all week" so I go scrub in. Well let me tell you, I had to hold retractors (which is normally med student duty) and I had to hold them for a long time and hard. My hand became stiff, my back hurt for hours, and yeah I got what I asked for that's for sure. This poor man ended up having gallstones the size of olives with a pitt. Mmmm hope you weren't eating olives for lunch today.
In the office Friday afternoon I got to help with two I&D's on patients. Then the office manager asked if I would take off all her skin tags. I'm thinking "You do know that there is a surgeon in this exact room that could probably do a better job than myself." She wanted me to do it. Thank goodness I've already learned how to do this because I might have turned the job down otherwise. Halfway through, Dr. H comes in to check to make sure I'm not screwing up. I'm thinking "Umm now's a fine time to come check. I'm almost done."

I know I need to find pictures because people like reading posts with pictures more than just text but it's kind of hard since I can't really take pictures of patients. That was a Brazil privelege only.

Tuesday, November 17, 2009

Disgusting Things That Somehow Don't Bother Me

Medical school has definitely introduced me to some disgusting things. Somehow they don't really bother me.
Incident #1: ok this isn't really as disgusting as it is messy. A c-section is very very messy. Once you cut into the uterus, all the amniotic fluid and blood comes bursting out. Yesterday morning I scrubbed on two c-sections and at the first one, I just got sprayed from neck to happy that we're gowned up so well. We actually where booties that go up to our knees....making them more like leggings.

Disgusting incident #2: Being in my surgery rotation, I have to go wherever my preceptor goes. Tuesday afternoons, this includes the Wound Care Center. People come here with the most disgusting wounds I have ever seen. Some of them are small and getting better, but some of them are huge, gaping holes. There are some that are the size of a softball and are 3-4 inches deep. My job today was to debride them. This includes me taking a currette and scraping the wound. This one guy today had four huge ones. Two patients today had really smelly ones. I am perfecting breathing out of my mouth.

I have to say though, that if wound clinics didn't exist, these poor people would have no one who could help them. Their care is weekly, and they don't go away on their own; they just get worse. So Dr. H is a huge help to these people who are otherwise ignored from all their other doctors.

Sunday, November 15, 2009

My First Week of Surgery

Things haven't quite gone how I expected, but hopefully this next week the kinks will all get ironed out. I'm working with a really nice general surgeon named Dr. H. He is NOT the typical arrogant asshole who I imagined I'd be working with. He's hilarious, kind, and teaches me lots each day. The great part about this rotation is that I get to wear hospital scrubs everyday. This means way less laundry and way less thinking about my clothes. Oh yeah, and I get Wednesday afternoons off so he can go golf. Works for me.

Most of the surgeries this week have been cholecystectomies (gallbladder removal). I'm really interested in them mostly because I had my own out when I was 17. The coolest part about this surgery is that it is laparoscopic and it is JUST. SO. COOL to see the inside of the body that way. But because it's laparoscopic I don't really get to help. So that's a bummer. On Tuesday afternoons, we go to the wound clinic. Let me tell you, nothing can prepare you for these wounds. They are big gaping holes in flesh. Then you take a currette and debride the inside of the wounds. I was told this week, that is all me. Sweet. Actually, it will be good to do that by myself.

There was a little snafu this week regarding a surgery center that Dr. H goes to on Friday mornings and Monday mornings. I wasn't able to go with him so instead I went to a different hospital to go work with Dr. P (the dr who took me to Brazil) and was able to scrub in on all of her surgeries. We repaired a rectocele, did a laparascopic assisted vaginal hysterectomy, and a vaginal hysterectomy. Oh yeah, I also got to catch a baby! I love it. It seriously is a very fun thing. It was a girl and she was perfect. The mom had some issues with her placenta though and we had to take her to the OR to get it all out. Unfortunately, it came out in about 30 pieces and she lost a lot of blood. It was very messy. I didn't get home until 2 am and then I had to walk the dog that I am currently dogsitting. It was a long day.

Tomorrow, I'm scrubbing in again with Dr. P on some c-sections! Then I'll be heading back to the other hospital to see patients with Dr. H in the office.

Wednesday, November 11, 2009

My Grandpa

This is not medically related, but today is Veteran's Day and I thought I would quick post about him. He served in the Korean War when he was a youngin :) Today at the place where he lives, the group hosted a veteran's party where they decorated, served food, posted pictures, and honored the men who had served. Each guy spoke and told his story. One of the local news teams found about this luncheon and came and "caught the story." They interviewed my grandpa and apparently they fielded phone calls all day since everyone they know in town saw it. So here's the video. He's famous :)

Thanks for serving Grandpa!

Wednesday, November 4, 2009

Last Week of Peds :(

Yup that's a sad face. I hate leaving Jake. Bah. Anyways, this rotation has gone really well. I have to admit it was a pretty easy rotation. I mean, yeah I have to work hard and all, but my hours were amazing, and seeing only 20ish patients a day is pretty sweet.

I have some good stories from today.

Story 1- I'm in the room doing well child checks on siblings: 6 year old boy and 3 year old girl. I ask the 6 year old what he likes to do for fun. His response: "I like to throw fake spiders at my sister and make her scream." How fun! Seriously, it's pretty close to impossible to not laugh at these hilarious things. At the age of 3, kids should be able to answer questions like who's a boy or girl, hot and cold stuff, etc. When I asked if she was a boy or girl, she looked at me like it was the stupidest question in the whole and in a very exasperated tone: "Giiiiirrrrl." Like duh Jenny. When I asked if her brother was nice to her "Nope."

Story 2- Twin 4 year old boys. I asked them to each draw a picture: Twin 1 of his mom and twin 2 of his dad. At that age, it's really crazy, but they usually will not add the body. It's usually a head with a face, two very long legs OR arms (not both) and feet (or hands). So twin 1 draws his beautiful picture of his mom. Twin 2 draws his dad and then says "Oh wait, I didn't draw his penis." Somehow, I held it together and said "Well that's ok." He drew it anyways...right between his legs. Again, how do you not laugh?

Story 3- I'm doing a physical on a 12 year old boy. He's relatively overweight. We get through the history, and I tell him to take off his shirt so I can examine him. He starts sobbing. His mom tells me that he's very self conscious. Wanting to avoid all conflict and 12 year old sobbing episodes, I tell him to forget it, I'll just work around his shirt. Mom, however, disagrees with me and yells at him, saying that everyone goes to the doctor and has to take their shirts off. He ended up doing it, but was not a happy camper. I was just so surprised at his sudden outburst of tears. I'm used to the 2 year olds crying, not 12.

Story 4- We went to the hospital to go check on a newborn. I've seen this baby for a few days now so we "know" the family. When we walk in the hospital room, mom has her shirt around her neck, a breastpump connected to one boob and the other just hanging out. Now, being in medical school, I've seen a lot of boobs, but that was a first for me. It's just like one of those moments where you're thinking "WHOA!" but you can't show any surprise on your face. I see and hear the oddest things every day, and somehow just keep a neutral look on my face (at least I hope I do).