[It’s actually Nov 9 and i am going back to finish up writing about my last 3 weeks of OB/ GYN. its not that i didnt like the rotation and didnt want to write about it, it was the exact opposite. I loved it so much and was working so hard that i really had no time to write, and when i did have time, i was sleeping or enjoying the minimal outside hospital life i had. i hope i can incorporate all the details and feelings i had during this time but really, i dont think i will be able to because i really loved this rotation and am having a hard time trying to convince myself to NOT go into OB/GYN because as amazing as it is, the lifestyle is just so poor.]

Monday morning of this week started with a grunt as i pulled myself out of bed. I had just done my 24 hour  shift and got home Sunday morning and then now i had to go back to work to another 5 day week. no bueno. It was just a clinic day and we ended really late, i didnt leave until 6:30pm.

Getting home around 7:30pm on Monday night, i ate dinner, showered, and went to sleep. I had to be at the hospital for rounds that started at 6:30am so i left the house around 5:30am. In the middle of rounds i left with Dr. S [a resident] to go into the OR to start an entire day of surgery. I was pretty excited given the fact that the last laparoscopic surgery i was in was rad!

The first surgery thing i did that morning was an exploratory laparoscopy on a female who they thought had endometriosis [it was the same procedure i was in last week.] the lady ended up not having any major endometriosis in her abdomen so we closed up. my biggest accomplishment was scrubbing in correctly and not looking like an idiot :)

The next 2 procedures were D&C’s [dilation and curettage]. Both were to make sure there were no products of conception left in the uterus after both women had missed abortions [aka a miscarriage, aka a NON therapeutic abortion.]

Then the big one came up. We were doing a total abdominal hysterectomy. Thus, we were taking out a woman’s uterus by cutting open her abdomen. reason for her surgery was that her uterus had become a very large fibroid and was causing a lot of post- menopausal bleeding and some major abdominal pain. The attending [Dr.W] and the resident [Dr.H] stood on either side of the body and i stood between the legs as they were spread apart in stirrups [i know this sounds gross but everything but the operating field are covered in blue sterile drapes so really it wasnt that bad.] We started the surgery around 2pm and i had no idea what i had gotten myself into. actually, the resident and attending felt the same way. we started dissecting down to the uterus and every time we cut or cauterized, the patient would bleed more. the fibroid had been there for so long and was so large that it had creating a million different new blood vessels to sustain itself. this thing was huge, it measured 19cm on ultrasound [to put this into perspective, your uterus should grow 1cm each week during pregnancy. thus, this ladies uterus was acting like she was 19 weeks pregnant]. 

The procedure took us hours. we had to be so careful every step of the way to make sure she didnt hemorrhage and all of us were exhausted. most of all, the attending. she actually got a really bad cramp in her arm and had to stop for about 15 minutes. this procedure takes a lot of muscle. im talking ripping open stuff, using muscles to get to the right location, etc. Dr. W was sweating like a pig [and of course we are under hot hot lights.] She must have gotten so dehydrated that her arms started cramping up and needed a hydration boost. we all joked about hooking her up to an IV and rehydrating her with some saline. 

when we finally got the uterus out it was the most disgusting thing i have ever seen. it was huge. it also was extremely funny looking because it had an aborting uterine fibroid. she had let this thing grow without getting any medical care for so long that the middle of her uterus began to fibrous and it got so large and heavy that it began to DILATE her cervix and fall out. DISGUSTING.  

Of course, we finally finished the procedure [even though i thought it would never end] and before we closed up the abdomen, Dr. W looked over at the resident and said, “let’s look around and find something cool for Dorothy to look at.” I was ecstatic. Mostly because she knew my name,this attending was a hardass and as cool as she was, she never really learned anyones name. But hey, she learned mine. point me! 

I left the hospital at 7pm that day and didnt mind a bit. i was so freaking tired but it was a really great day. sadly, i had to be back at 5am on Wednesday to see my post-surgical patient’s before rounds. damnit.

I woke up late on Wednesday and got to the hospital around 5:45am. oops. i was talking  to my patient who we did a TAH on and in comes the resident, we ended up talking to her together and doing a quick physical exam, then left the room. i got some major attitude from Dr. H. she pretty much scolded me for not being there earlier enough. “you are supposed to be there waaay earlier than me.” she kinda rolled her eyes and left and i felt like crap the rest of the morning. we had a pretty good relationship i thought so it was surprised. but hey, we all have our moments and i have to admit, i was really late that day so i guess i deserved it. 

After rounds and lecture i went to clinic. there was a first year from UCR there that was shadowing [why he was spending his last remaining summer shadowing at a hospital i will never figure out...] He came in with me to watch a pap smear and pelvic exam and when we got out of the room he went, “wow, your really good at that.” i didnt know whether to be flattered or not. is that really something to be proud of? i guess...

This was the first day i had an inmate as a patient. she was a young girl named Mikeala and at first i was really hesitant to go in the room. she ended up being really cool and i kinda felt bad for her. she was pregnant and in jail, that cant be fun. even worse, we arent allowed to tell inmates any plans or dates of things [because of the potential of setting up a way to escape] so i couldnt even tell her her due date. bummer.