There once was a girl named dot
On horses she liked to trot
To do EM (??) = internal strife
Making choices that last all her life!
A crystal ball may assist in her plot.
-Fanga
Saturday, April 14, 2012
Monday, April 9, 2012
Last week of surgery...
Thursday was our last surgery with Dr. B before he left the country. We removed a very large lipoma from the neck of an old man. we started out by slicing the superficial skin all the way around and under his chin. after lots of dissecting and digging out the fatty mass, we began to close up. Dr. B started on the right side and I started on the left side and he had me do vertical mattress sutures until we met in the middle at the chin. It was great practice, I put in at least 20 of them. It was def frustrating at times as I was just starting to get the hang of the instruments but it was very very fun.
Friday we started working with Dr. E who works more than any other doctor I have worked with. It was good Friday so I got the night off since I had to... go to church.... after church, I went to joey and laura's birthday party and got home around 2am. Saturday I got up at 6am and was in a lap chole by 7:30. I had no idea that this shift would end up being around 18 hours long....if I had known, i might have gone to bed a bit earlier.
Sunday was Easter and I got the afternoon off. Monday I joined another doctor and the Captain for an exploratory laparotomy for a SBO. It was on a patient that I admitted and had been following for more than a week and it was a great way to see the whole course from her admit, hearing her symptoms, doing her PEs, looking at her imaging and labs, and then being able to actually see the anatomical reason she was having all of these problems. Surgery went long, about 4 hours, and when they started to close the doctor suggested I go talk to the family and tell them everything was OK. Since i had met the family several times, I was happy to go outside to the waiting room and explain that everything went great and the biopsies done during the surgery were all benign. They thanked me a ton and treated me like a key part of the surgical team. A very cool experience to end 'my patients' journey.
To note, during this surgery was when I decided as much fun as surgery is as a specialty, it is not for me. It was a 4 hour long surgery and though it was not boring at all because we were searching around in this women's pelvis and I got to touch intestines, see her uterus, where the sigmoid colons sits, etc etc....there were several times when I just about lost my patience and drifted off. I dont think i have the stamina and patience to do surgery's like this. it would be very hard to start a case thinking it will be quick and then you can get home to your family/friends for dinner after only to find out when you open that things are much complicated and you are going to be there for hours longer than you thought...having no say in the matter. I enjoy my free time and though it is a tremendous job to have because of the healing power and abilities you have, I think i will stick to ER. It has the procedures and fun patient interaction but with a set time shift.
Friday we started working with Dr. E who works more than any other doctor I have worked with. It was good Friday so I got the night off since I had to... go to church.... after church, I went to joey and laura's birthday party and got home around 2am. Saturday I got up at 6am and was in a lap chole by 7:30. I had no idea that this shift would end up being around 18 hours long....if I had known, i might have gone to bed a bit earlier.
Sunday was Easter and I got the afternoon off. Monday I joined another doctor and the Captain for an exploratory laparotomy for a SBO. It was on a patient that I admitted and had been following for more than a week and it was a great way to see the whole course from her admit, hearing her symptoms, doing her PEs, looking at her imaging and labs, and then being able to actually see the anatomical reason she was having all of these problems. Surgery went long, about 4 hours, and when they started to close the doctor suggested I go talk to the family and tell them everything was OK. Since i had met the family several times, I was happy to go outside to the waiting room and explain that everything went great and the biopsies done during the surgery were all benign. They thanked me a ton and treated me like a key part of the surgical team. A very cool experience to end 'my patients' journey.
To note, during this surgery was when I decided as much fun as surgery is as a specialty, it is not for me. It was a 4 hour long surgery and though it was not boring at all because we were searching around in this women's pelvis and I got to touch intestines, see her uterus, where the sigmoid colons sits, etc etc....there were several times when I just about lost my patience and drifted off. I dont think i have the stamina and patience to do surgery's like this. it would be very hard to start a case thinking it will be quick and then you can get home to your family/friends for dinner after only to find out when you open that things are much complicated and you are going to be there for hours longer than you thought...having no say in the matter. I enjoy my free time and though it is a tremendous job to have because of the healing power and abilities you have, I think i will stick to ER. It has the procedures and fun patient interaction but with a set time shift.
Wednesday, April 4, 2012
sarah strikes again
It's that time of the year when our dear BOT/LJ/Pooper/Sasquatch and our cherished Mustache model get older!
Come out this Friday to celebrate these two stunning individuals' triumph through the birth canal 27 years ago.
We will be raging at GABE'S CASA in upland starting around sixish cruising alll night. And DUH there IS A THEME. The theme is "L" "J". So you either have to dress up as or bring something that begins with and "L" or a "J". And jeans don't count. Jameson however, does. So does Jalapenos, lollipops, Lord of the Rings, abraham Lincoln, and jello.
We will be grillin a lil bit as well, so if you want to grub something in particular, bring it over red rover.
I strongly recommend that you wander up. There is also a pool and hot tub so bring necessary equipment.
Come out this Friday to celebrate these two stunning individuals' triumph through the birth canal 27 years ago.
We will be raging at GABE'S CASA in upland starting around sixish cruising alll night. And DUH there IS A THEME. The theme is "L" "J". So you either have to dress up as or bring something that begins with and "L" or a "J". And jeans don't count. Jameson however, does. So does Jalapenos, lollipops, Lord of the Rings, abraham Lincoln, and jello.
We will be grillin a lil bit as well, so if you want to grub something in particular, bring it over red rover.
I strongly recommend that you wander up. There is also a pool and hot tub so bring necessary equipment.
scalpel day 2
another great day. unfortunately, we found out yesterday that Dr.B's mom had a stroke and he would be leaving the country to see her. he leaves tomorrow and depending on her condition, may not be back until the following weekend or later. thus, tomorrow at 11am is our last surgery with him. he apologized to us and today, he let me do a lot more with him. also, all day he was much more verbal about teaching anatomy and such. i think this was his way of saying thank you. i am very sad to not being able to work with him for the remaining week. he may be back next Wednesday night, we shall see.
I felt pulsing so I said, "an artery"
"good, what artery" -Dr. B
"the femoral" -me [considering where we were during the dissection]
"good" -Dr. B
i had my finger on the freakin femoral artery. we were working so close to it that we had to make sure we knew where it was at all times. after having me stick my finger in a couple other places to feel where we were and what we were looking at, he started to close and said,
"dorothy, you see this here [points with pickups]"
"yes" -me
"this is sub-cutaneous fat. suture there" -dr. B
then he had me come around on the side of the table that he was on and I closed up this guys sub-cutaneous tissue. then i stapled together his skin. i tried not to shake with nervousness but i think i still did when i was tying my knots. after i closed he said "dorothy, i want you to take this man's staples out during clinic next week. then you will be able to see how you did and how you can improve." best teacher ever.
the next case was a lap chole. when we prepped the patient and about to begin he said to stand across from him and then he told his assisting doctor [Dr.E] something in Tagalog. musta told him i have graduated from observer to do-er because i stayed there the whole surgery and like yesterday, put in the trochars, grabbed the gallbladder, etc etc. i was basically the first assistant [with the real doctor on next to me in case something happened] the entire surgery. i closed up all the incisions, prepped em with marcaine and we were done. during the whole surgery, dr.B complemented me and told me i was doing a very good job.
next case was a tracheostomy which i have seen a couple times before. didnt get to do much because its way more serious, as we are cutting into the patients airway. but he taught a lot.
rounded on all my patients before the OR so i was done around 4:45. an early day. one of my patient's this morning made the point to tell me before i left the room that she thinks i am going to be a great doctor.
now im going to take a nap.
today started off with a inguinal hernia. at one point he stuck my finger into a hole in the inguinal canal [inside the body] and said:
"what do you feel?"I felt pulsing so I said, "an artery"
"good, what artery" -Dr. B
"the femoral" -me [considering where we were during the dissection]
"good" -Dr. B
i had my finger on the freakin femoral artery. we were working so close to it that we had to make sure we knew where it was at all times. after having me stick my finger in a couple other places to feel where we were and what we were looking at, he started to close and said,
"dorothy, you see this here [points with pickups]"
"yes" -me
"this is sub-cutaneous fat. suture there" -dr. B
then he had me come around on the side of the table that he was on and I closed up this guys sub-cutaneous tissue. then i stapled together his skin. i tried not to shake with nervousness but i think i still did when i was tying my knots. after i closed he said "dorothy, i want you to take this man's staples out during clinic next week. then you will be able to see how you did and how you can improve." best teacher ever.
the next case was a lap chole. when we prepped the patient and about to begin he said to stand across from him and then he told his assisting doctor [Dr.E] something in Tagalog. musta told him i have graduated from observer to do-er because i stayed there the whole surgery and like yesterday, put in the trochars, grabbed the gallbladder, etc etc. i was basically the first assistant [with the real doctor on next to me in case something happened] the entire surgery. i closed up all the incisions, prepped em with marcaine and we were done. during the whole surgery, dr.B complemented me and told me i was doing a very good job.
next case was a tracheostomy which i have seen a couple times before. didnt get to do much because its way more serious, as we are cutting into the patients airway. but he taught a lot.
rounded on all my patients before the OR so i was done around 4:45. an early day. one of my patient's this morning made the point to tell me before i left the room that she thinks i am going to be a great doctor.
now im going to take a nap.
Tuesday, April 3, 2012
"scalpel"
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.
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.
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]"
Subscribe to:
Posts (Atom)