Gosh I'm so behind, so I thought I'd get you caught up.
Last Saturday night was call evening #2. Here is what happened:
1. So the beginning of the day was spent writing my personal statement for residency applications. Once I got rolling, things really took off, and I ended up writing about 75% of the statement. Then the trauma thing began (pronounce trah-mah).
2. Gun Shot Wound (GSW) to right leg which severed the popliteal artery, so a prosthetic graft had to be placed because the artery could not be repaired. The 3rd year student Seth scrubbed in on this one, so I'm not sure what happened post-op.
3. 21 year old punched by boyfriend, pushed out of truck, rolled over (tire mark on back) fractured pelvis, head laceration, lots of vomiting. I ended up stapling this girl's scalp (yes, with a staple gun) to prevent further bleeding. I saw her the next morning in the ICQ with low blood pressure and tachycardia (which can mean anything but often means the patient is dehydrated), so I gave her a liter of ringers lactate (IV fluid), and she was discharged later in the day.
4. Abdominal knife wound, we opened him up, and 2 liters of blood gushed out (onto my shoe mind you...how dare he). When I talked to him the next day, it turns out that his wife has a mental illness and stabbed him with a small knife. Unfortunately the knife knicked his mesentary (the thing that holds the bowel together and gives it blood supply), and he'd been bleeding slowly into his abdominal cavity. He is now doing fine.
5. I was asked to evaluate a young guy with signs of appendicitis. So I examined him, and agreed. CT scan showed inflammation but no perforation into the bowel (really bad if that happens) so he was scheduled for surgery later that night. He eventually went to the OR the next morning, so I missed that case.
6. 13 year old kid decided he'd ride on the back of a trunk. Unfortunately the driver reached speeds of 50 and more, and the kid fell off back of trunk onto the street. Apparently he had a seizure-like episode and hit his head. His CT scan was normal, but we kept him that night just in case.
Then Sunday was here, the post call Sunday. Basically I fell asleep floating on the pool, slept a lot, and finished personal statement while watching "The Birdcage" with my mother (such a fantastic movie). Is this a bad sign that I wrote the last fourth of my personal statement while watching a bunch of gay people try to fit in with straight people?
Monday
I participated in what's called a Whipple Procedure (or pancreaticoduodenectomy) which takes at least 5 hours. I was the 3rd person in the room behind Dr. Derrick and Dr. Holden. It was the coolest thing I've ever seen...because I was standing at the top of the bed watching the entire procedure without obstruction of view. A Whipple is when someone has a tumor in the head of the pancreas. The problem with a tumor in that location is that there are several structures in the immediate vicinity which makes things difficult. Commonly a piece of the stomach is cut out along with the first part of the bowel (the duodenum), the head of the pancreas, the common bile duct, and sometimes the gall bladder. Then all of that stuff is connected back together. I'll try and find a picture for your edification. Our particular patient's cancer was confined to the pancreas only with no metastases or local spread, so his chances of survival are greatly improved. Unfortunately, most people's pancreatic cancers aren't found until it's way too late, and most will die within 18 months.
Tuesday
I participated in the harvest of two kidneys from live patients (to different patients, two different operations). There were two attending physicians and me. So THAT was awesome. The procedure was done laparoscopically, meaning they didn't need to cut the belly open. Instead they used a camera and instruments that act like the surgeon's hands. They really were two cool procedures. Then I hopped in the car and drove to Houston. Upon arriving in Houston, I met up with Nick, Ryan, Todd (from Boeing), Denise, Jenn, and Ruth at The Volcano. I probably had a few too many frozen screwdrivers, but it was well-deserved. We had a lot of great conversation including the insight Todd shared with me about dating. He was pretty much right on the money for his Tommy analysis, so I appreciate the advice. I also got to chat with Ruth a bit who is friends with Jenn. Ruth seems like a nice girl, so I'll have to hang out with her more often when I get back to Houston. Then I went to sleep in anticipation of the big meeting with Dr. Potts (our program director in surgery) the next morning.
Last Saturday night was call evening #2. Here is what happened:
1. So the beginning of the day was spent writing my personal statement for residency applications. Once I got rolling, things really took off, and I ended up writing about 75% of the statement. Then the trauma thing began (pronounce trah-mah).
2. Gun Shot Wound (GSW) to right leg which severed the popliteal artery, so a prosthetic graft had to be placed because the artery could not be repaired. The 3rd year student Seth scrubbed in on this one, so I'm not sure what happened post-op.
3. 21 year old punched by boyfriend, pushed out of truck, rolled over (tire mark on back) fractured pelvis, head laceration, lots of vomiting. I ended up stapling this girl's scalp (yes, with a staple gun) to prevent further bleeding. I saw her the next morning in the ICQ with low blood pressure and tachycardia (which can mean anything but often means the patient is dehydrated), so I gave her a liter of ringers lactate (IV fluid), and she was discharged later in the day.
4. Abdominal knife wound, we opened him up, and 2 liters of blood gushed out (onto my shoe mind you...how dare he). When I talked to him the next day, it turns out that his wife has a mental illness and stabbed him with a small knife. Unfortunately the knife knicked his mesentary (the thing that holds the bowel together and gives it blood supply), and he'd been bleeding slowly into his abdominal cavity. He is now doing fine.
5. I was asked to evaluate a young guy with signs of appendicitis. So I examined him, and agreed. CT scan showed inflammation but no perforation into the bowel (really bad if that happens) so he was scheduled for surgery later that night. He eventually went to the OR the next morning, so I missed that case.
6. 13 year old kid decided he'd ride on the back of a trunk. Unfortunately the driver reached speeds of 50 and more, and the kid fell off back of trunk onto the street. Apparently he had a seizure-like episode and hit his head. His CT scan was normal, but we kept him that night just in case.
Then Sunday was here, the post call Sunday. Basically I fell asleep floating on the pool, slept a lot, and finished personal statement while watching "The Birdcage" with my mother (such a fantastic movie). Is this a bad sign that I wrote the last fourth of my personal statement while watching a bunch of gay people try to fit in with straight people?
Monday
I participated in what's called a Whipple Procedure (or pancreaticoduodenectomy) which takes at least 5 hours. I was the 3rd person in the room behind Dr. Derrick and Dr. Holden. It was the coolest thing I've ever seen...because I was standing at the top of the bed watching the entire procedure without obstruction of view. A Whipple is when someone has a tumor in the head of the pancreas. The problem with a tumor in that location is that there are several structures in the immediate vicinity which makes things difficult. Commonly a piece of the stomach is cut out along with the first part of the bowel (the duodenum), the head of the pancreas, the common bile duct, and sometimes the gall bladder. Then all of that stuff is connected back together. I'll try and find a picture for your edification. Our particular patient's cancer was confined to the pancreas only with no metastases or local spread, so his chances of survival are greatly improved. Unfortunately, most people's pancreatic cancers aren't found until it's way too late, and most will die within 18 months.
Tuesday
I participated in the harvest of two kidneys from live patients (to different patients, two different operations). There were two attending physicians and me. So THAT was awesome. The procedure was done laparoscopically, meaning they didn't need to cut the belly open. Instead they used a camera and instruments that act like the surgeon's hands. They really were two cool procedures. Then I hopped in the car and drove to Houston. Upon arriving in Houston, I met up with Nick, Ryan, Todd (from Boeing), Denise, Jenn, and Ruth at The Volcano. I probably had a few too many frozen screwdrivers, but it was well-deserved. We had a lot of great conversation including the insight Todd shared with me about dating. He was pretty much right on the money for his Tommy analysis, so I appreciate the advice. I also got to chat with Ruth a bit who is friends with Jenn. Ruth seems like a nice girl, so I'll have to hang out with her more often when I get back to Houston. Then I went to sleep in anticipation of the big meeting with Dr. Potts (our program director in surgery) the next morning.
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