lap chole today- i was pretty much 1st assist to Dr. B. It was pretty amazing. New what went where, what he needed, next, where to make the incision, how to put in the trochars, how to grasp the gallbladder, retract the liver, everything. it was so incredible. today was the first day i got to say "scalpel" and a surgery tech handed me a scalpel to cut. i am really proud of myself :)
another surgery we did today was removal of a part of the parotid gland due to possible malignancy. the initial incision started at the anterior lobe of the ear, went under and around it to the back. we basically peeled back a large flap of skin behind her ear. i was retracting the patient's ear lobe for so long that eventually Dr.B put a suture right through the bottom and i used the string to hold it back. we had wires connected all around the patients head and a probe to use throughout the surgery to monitor the nerve action in the area we were dissecting so we wouldn't paralyze any of her facial muscles.
again, it was incredible. another 13 hour day and i am exhausted but still excited tomorrow to get to see and do more incredible things.
Tuesday, April 3, 2012
Monday, April 2, 2012
working hard, haven't had a day off, still loving it...
the PA students switched this weekend and the old PA who had been there for 2 weeks before me and 'trained' me left and a new one came. I have now graduated from camera holder to trochar placer/ grabber. i get to grab on to the gallbladder and move it around, etc. its a lot harder than it looks and for the past 2 weeks i have been pretty nervous to step up to this new role. moving up is down and vice-versa. you are staring at a screen across from you and doing the opposite with your hands. the only way to get good is practice...
this weekend we had several lap appys and a couple I&Ds. today we started out the day with a lap chole and then we took out a large portion of a women's stomach due to cancer [a partial gastrectomy]. this was the first open abdominal surgery i had seen with Dr.B. it was a large midline incision from the sternum to below the naval. another doctor, captain [he is a real captain in the navy...and the sweetest man who loves teaching and is good at it] was with us and i was next to him holding retractors and such getting to touch and feel whenever i wanted. it was amazing. they even let me anastomose a part of the stomach with a big 'gun like' tool. it was incredible. my hands where holding this women's stomach, grazing against her spleen and liver, and at one point had my hand entirely in her abdominal cavity. wowzers.
another great part of the day was when Dr.B said we could come with him to his medical mission down to Mexico in a couple weeks. its a Saturday day trip where we leave around 7am and come back late at night. i am super super pumped for that. :)
this weekend we had several lap appys and a couple I&Ds. today we started out the day with a lap chole and then we took out a large portion of a women's stomach due to cancer [a partial gastrectomy]. this was the first open abdominal surgery i had seen with Dr.B. it was a large midline incision from the sternum to below the naval. another doctor, captain [he is a real captain in the navy...and the sweetest man who loves teaching and is good at it] was with us and i was next to him holding retractors and such getting to touch and feel whenever i wanted. it was amazing. they even let me anastomose a part of the stomach with a big 'gun like' tool. it was incredible. my hands where holding this women's stomach, grazing against her spleen and liver, and at one point had my hand entirely in her abdominal cavity. wowzers.
another great part of the day was when Dr.B said we could come with him to his medical mission down to Mexico in a couple weeks. its a Saturday day trip where we leave around 7am and come back late at night. i am super super pumped for that. :)
Saturday, March 31, 2012
a bunch of characters
"what is this..[cut]"
"what are we doing"
"what the eck"
"much improved, must promote" -captain
"the first time is instructional, the second time is performance" -captain
"know what I'm saying" -captain
"ah, just a little dingle dingle [cut]"
"[clip], [clip], [clip], and one more for the lawyers, [clip]"
"what are we doing"
"what the eck"
"much improved, must promote" -captain
"the first time is instructional, the second time is performance" -captain
"know what I'm saying" -captain
"ah, just a little dingle dingle [cut]"
"[clip], [clip], [clip], and one more for the lawyers, [clip]"
Monday, March 26, 2012
Friday, March 23, 2012
well who knew...
this has been one of the busiest rotation weeks i have had yet. but, it is by far one of the most fun weeks i have had. i love surgery and everything about it. i have seen: lap chole’s, appendectomy, colectomy, mastectomy, tracheotomy, abscess incision and drainage, etc. i have put in stables, taken out stables, shot up patients with lidocaine after surgery, ‘steered’ the laparosopy camera during surgery, and of course...held a lot of retractors :) i have worked in his clinic which he has tuesday 9-1 and thurs 2-6 where i saw a ton of patients and worked as fast and efficiently as i could. i have really enjoyed it all. and even though i walk in the door late sometimes [8:30 or 10:30pm] i really am not upset about it. as long as i have a snack in the afternoon, i survive and i enjoy it.
the surgeon i am working with is an older philipino man who is the most gentle, patient, and hilarious doctor i have worked with. he is incredible in surgery and with his patients. everyone loves him. He is also amazing because he appreciates the time we [the PA student and I] are putting in and knows we are working hard. he repays us for this hard work by teaching us during surgery and letting us get valuable hands on experience. he and his colleagues, who are all very old friends, are entertaining as well as wonderful teachers. i consider myself extremely lucky for having the opportunity to work with all of them. after the past week, i drove home today being confident in myself and my abilities. that is what good preceptors are supposed to do. teach, help you with your mistakes, and build you up. during surgery yesterday, another surgeon asked if i was following what they were doing and dr.B said, “of course she does, she is a very smart girl.” i was so grateful to hear this. also, a patient today told me i am going to be an amazing doctor. that was a great feeling too.
ironically enough, for the last 3 years when people asked what specialty i wanted to go into i would answer, “i am not sure yet, but i know it will not be surgery.” HAH. now it is getting pretty high up on my list... i love the procedures, the formalities of scrubbing in, the importance of what you are doing and [i know this makes me sound like i have a huge ego] but i love how important it makes me feel. whenever i talk to a patient, wether it is someone i am following post-op or a new consult, they value everything i am doing and most importantly, they appreciate me. they value my time and thank me graciously. thats a damn good feeling.
during an axillary node dissection on tuesday, i stood over the patient looking at dr.B make sure to find the axillary n,a, and v as to avoid them at all costs.[he pressed on the nerve and made her arm jump when i asked how he knew that was it...] when he was pointing out the structures, i realized how much damage he could do with a single small stroke in the wrong direction. one slip and this women would not be able to move her arm again. i kinda told myself right there that i dont think i would want to have that on my hands everyday of my life. though surgery would be a blast to do, realistically, it is more anxiety that i would rather take on. i am sure once you get enough practice with it, it is easier. but there are still times when you can cut the wrong thing, accidently nick the bowel, etc. i just dont think i want to deal with that. but, no final decisions have been made. what i do know, is that going into ER seems a lot more fitting because i know i can get good at procedures and i think under pressure, i will be able to handle things. yes, i can still do damage in the ER and make lifelong effects, but i dont think the stakes are as high as in surgery.
i am not done with my work week yet [worked 60 hours so far i think...which isnt as bad as i thought it would be actually] because i have to work saturday and sunday also. though that sucks, im kinda ok with it. its not like i am just doing admissions all day like my last couple rotations. i get to see the patients we have operated on, see potential pre-op patients and then there is always the chance that someone will come in and need an operation right away. thats kinda fun for me. :) today i rounded on 17 patients myself because the PA was at school today. i was able to handle it. tomorrow there will be less because some were discharged. either way, this entire experience has been an amazing opportunity to see how far i have grown and how much i have learned in the last 3 years, esp this year in clerkships. i am self sufficient, efficient, and though i may not be the smartest person in our class, i think i can make up for that in other ways.
the surgeon i am working with is an older philipino man who is the most gentle, patient, and hilarious doctor i have worked with. he is incredible in surgery and with his patients. everyone loves him. He is also amazing because he appreciates the time we [the PA student and I] are putting in and knows we are working hard. he repays us for this hard work by teaching us during surgery and letting us get valuable hands on experience. he and his colleagues, who are all very old friends, are entertaining as well as wonderful teachers. i consider myself extremely lucky for having the opportunity to work with all of them. after the past week, i drove home today being confident in myself and my abilities. that is what good preceptors are supposed to do. teach, help you with your mistakes, and build you up. during surgery yesterday, another surgeon asked if i was following what they were doing and dr.B said, “of course she does, she is a very smart girl.” i was so grateful to hear this. also, a patient today told me i am going to be an amazing doctor. that was a great feeling too.
ironically enough, for the last 3 years when people asked what specialty i wanted to go into i would answer, “i am not sure yet, but i know it will not be surgery.” HAH. now it is getting pretty high up on my list... i love the procedures, the formalities of scrubbing in, the importance of what you are doing and [i know this makes me sound like i have a huge ego] but i love how important it makes me feel. whenever i talk to a patient, wether it is someone i am following post-op or a new consult, they value everything i am doing and most importantly, they appreciate me. they value my time and thank me graciously. thats a damn good feeling.
during an axillary node dissection on tuesday, i stood over the patient looking at dr.B make sure to find the axillary n,a, and v as to avoid them at all costs.[he pressed on the nerve and made her arm jump when i asked how he knew that was it...] when he was pointing out the structures, i realized how much damage he could do with a single small stroke in the wrong direction. one slip and this women would not be able to move her arm again. i kinda told myself right there that i dont think i would want to have that on my hands everyday of my life. though surgery would be a blast to do, realistically, it is more anxiety that i would rather take on. i am sure once you get enough practice with it, it is easier. but there are still times when you can cut the wrong thing, accidently nick the bowel, etc. i just dont think i want to deal with that. but, no final decisions have been made. what i do know, is that going into ER seems a lot more fitting because i know i can get good at procedures and i think under pressure, i will be able to handle things. yes, i can still do damage in the ER and make lifelong effects, but i dont think the stakes are as high as in surgery.
i am not done with my work week yet [worked 60 hours so far i think...which isnt as bad as i thought it would be actually] because i have to work saturday and sunday also. though that sucks, im kinda ok with it. its not like i am just doing admissions all day like my last couple rotations. i get to see the patients we have operated on, see potential pre-op patients and then there is always the chance that someone will come in and need an operation right away. thats kinda fun for me. :) today i rounded on 17 patients myself because the PA was at school today. i was able to handle it. tomorrow there will be less because some were discharged. either way, this entire experience has been an amazing opportunity to see how far i have grown and how much i have learned in the last 3 years, esp this year in clerkships. i am self sufficient, efficient, and though i may not be the smartest person in our class, i think i can make up for that in other ways.
Monday, March 19, 2012
Day 1- Surgical Success!
Holy cow that was a hectic but fantastic day. Saw lots of surgeries including mastectomy, lap chole, and fibroma removal. Did 4 patient progress notes and 1 surgical consult. Day was from 9am-8pm. Not too terrible...
did some stabling during surgery and of course, the obligatory holding of retractors and cutting suture [as every medical student will do in their carriers]. its only gonna get better from here though because there are no residents at either of the hospitals i am working at. just the surgeon, sometimes another surgeon to assist him, a PA student and me. sweeeeeeeeeet :)
I have high hopes for this rotation, even though I will be working for the next 30 days straight...
did some stabling during surgery and of course, the obligatory holding of retractors and cutting suture [as every medical student will do in their carriers]. its only gonna get better from here though because there are no residents at either of the hospitals i am working at. just the surgeon, sometimes another surgeon to assist him, a PA student and me. sweeeeeeeeeet :)
I have high hopes for this rotation, even though I will be working for the next 30 days straight...
Sunday, March 18, 2012
Surgery Day 1 tomorrow!
didactic week is over. had OSCE's on Tuesday, 2 shelf exams on Wednesday, a couple plenary sessions for my upcoming rotations [including one with a drill sergeant doctor] and then Friday morning a couple of us decided to go to Vegas to meet up with a bunch of people that were going. decided to go to Vegas around 11am, was on the road by 1pm.
it was a fun weekend but tomorrow surgery is starting. think im going to be busy for the next month straight, all while trying to set up rotations for next year. Stresssssssss
now im gonna go stitch up some oranges and bananas to prepare for tomorrow...
it was a fun weekend but tomorrow surgery is starting. think im going to be busy for the next month straight, all while trying to set up rotations for next year. Stresssssssss
now im gonna go stitch up some oranges and bananas to prepare for tomorrow...
Subscribe to:
Posts (Atom)