Wednesday, December 30, 2009

the boredom finally hits me...

so i'm still in sick recovery...i've nearly cleaned up my room. i've explored all of facebook and read SDN way too many times. (i know, i'm a super nerd for enjoying the SDN forums. hee hee...) i've made bread pudding, loaves of bread, shrimp bisque, mushroom linguine, and fantasized about other items i want to cook. i've replenished my liquor and wine supply and watched enough food network to drive anyone crazy. i've caught up on all the "teen mom" episodes on mtv...don't judge me, i love that series! but now i think i'm bored. i want to go back to school, but not really. still haven't really cemented new year's plans, but that's ok.

i did some shopping yesterday and got some on sale sweaters. that makes me happy. i did get a wallet and BOOTS. everything else can wait...can't do too much at once. i could do laundry. oh yeah, and the ironing...blugh.

alright, fixing up lunch and then will deliver it to H. fun stuff!

Monday, December 28, 2009

happy holidays and oh yeah i'm sick

this happens to me every time we have an "extended break"...i get a cold. alas! for the past few days i've been runny nosing, sneezing, coughing (productive), blah feeling...alas. i thought i shouldn't get RSV again after having it with the children, so maybe an adenovirus? blah!

holidays were nice...got to see all my friends and H's friends and respective families. i am the proud owner of black pumps and whatnot...my mom went a bit overboard in getting me professional shoes but methinks it's ok in the long run. i'm waiting on K to be done with her morning stuff so we can spend the day shopping and possibly lunching. (i need to return one of the black pairs of shoes for brown...i always forget about BROWN!) i'm keeping my eyes open for cardigans (i'm old), tights (i'm regressing), sweater(s) for H, and whatever else catches my fancy. oh, a wallet. a part of me would love a charcoal gray nice winter coat that i could wear to interviews and nice events...so maybe i'll look out for that too. but mostly it will be nice to travel about town with friends and window shop.

this week i'm hoping to get back to school and volunteer some hours on L&D. i liked it, but am i liking surgery more? i also need to do a thorough cleaning/organizing of my apartment. it's my goal before the new year begins to have a clean apartment! ha, wonder if it will really happen...

sorry posts have been sparse, but i'm on vacation. ha!

Monday, December 21, 2009

on vacation!

two weeks of doing NOTHING unless i want to do something. christmas shopping is done and wrapping almost complete.

i really enjoyed plastics...i think i would love being a plastic surgeon for reals!

now i am going to lay on couch and watch tv, or nap, or whatever. i don't have to do anything! well, except get my tire patched. it's currently got a nail in it, alas...

Sunday, December 13, 2009

gangrene is the worst smelling shit ever

yesterday i was on call again...7 am to 7 am sat-sun. no prob. it was pretty slow, actually. first page was an alpha (which means get your butt down here NOW)...unfortunately the patient had already expired en route but the ER went through the ACLS code algorithm anyway. it was surreal...strange to watch, but at the same time i needed to watch it. first code i've witnessed as an med student. then we had some really long stretches of nothing. i knitted a lot, and i think i'm nearly done with my scarf. (i've been knitting this thing for about 3 years now i think.)

i went to bed around 10:00 pm or so, and wasn't paged until 4:30 am! i can't believe it! i actually woke up every few hours out of instinct i guess to check my trauma pager to make sure i hadn't slept through anything, but i'm really good at waking up to outrageously loud annoying beeps. i keep the pager right next to my head while i'm sleeping so i wake up pretty quickly. evidently there were 2 surgeries that were about to go: an open appendectomy and debridement of fournier's gangrene.

the open appy was already rolled back, so my call partner scrubbed in that one since i had already scrubbed in a case. so i waited for the fournier's. basically that's when a dude's scrotum and associated area becomes infected with GANGRENE and turns black...it's a total emergency and the only solution is to cut all the nasty out. omg, when the patient was finally rolled back, the stench was AWFUL. i can't even describe it...the worst smell ever, like poop and sewage sludge and rot and dead stuff all rolled into one. one of the residents told me to remember that smell because "that is the smell of death" because, well, the tissue is literally dead and rotting away. it was blackish brown and dripped juices. i even put cinnamon oil on my mask to help deaden the smell and it DID NOT work! everytime we had to move the patient, a waft of horrible stench would come out on top of the base layer of stench. the fifth year resident who went to task debriding the wound, well, he has a nose of steel. i couldn't have done that. i had to step back and just hold my gag reflex in check. (one of the ER nurses earlier told me "now you get to decide whether you want to dry heave or blow chunks!" in response to my musing of whether or not i should grab some food before the case.) the sight of it was gross, definitely, but the smell. omg the smell. ugh. the trauma attending goes MED STUDENT GO IN THERE AND HELP OUT! then he laughed. so i did just that, took some scissors and cut out a chunk of foul, dropped it in the bucket, and then said "ok, i'm a pansy, i can't handle it. look, i got juice on my hands (gloved, of course), so that means i experienced it, right?" the attending laughed some more and was like "ok you're good, but the smell, it's nothing!" then he took his mask off and sucked in a HUGE BREATH...everyone in the room just groaned. he must have a defective nose or something. so after that, i just stood by the scrub tech's table and watched from afar. after about an hour of torture, a different resident asked me to scrub out and print out some admission orders, which i gladly did, and then it was time for me to leave (thank goodness).

the worst part about it all? the smell seeped through my gloves and got on my HANDS. no juice on my hands, but the SMELL. omg. i had to wash my hands so many times to just get rid of the smell, and i'm still having horrible thoughts about the stench. i hope the patient is ok, but in reality, he's not going to be ok. he was really sick going into the surgery, and from what i could tell, he'll end up with a colostomy (where he poops in a bag outside his abdomen) and some sort of stent or tube or something in his bladder area because even though i couldn't see the penis (due to the ginormous scrotum that was all swollen with infection), i can assume they probably had to cut it off or do some serious damage to it.

so note to self: keep all your parts clean! stay as healthy as possible!

after i got home i had some breakfast with H, read some magazines for free, visited with K, napped, gymmed, and ate lunch/dinner. i suppose i should read some now. one more week of plastics then 2 blessed weeks of winter break! yay!

Thursday, December 10, 2009

plastics

just a quick check in to say that I LOVE PLASTICS! it is SOOOOO COOL! tomorrow i get to see a tummy tuck and breast reduction surgeries, but this whole week has been pretty much non-cosmetic stuff. reconstructive. hand surgeries. SO NEAT! and wound care...skin grafts! this week i got to use the bovie to cauterize blood vessels and use a scalpel to take off granulation tissue and use a dermatome to make skin grafts! how much fun!

so yeah, just wanted to let y'all know...also on trauma call again on saturday...wonder what else i'll see...!

Sunday, December 06, 2009

first trauma call

trauma call was interesting, fun. the weather was appropriately icy so we basically just had car crash victims. scrubbed in an abdominal aortic aneurysm repair! super long, blood squirting everywhere...even got yelled at by the attending but who cares. didn't really bother me because he was screaming like a toddler for a piece of equipment that wasn't going to be life or death at that moment. but now i know what it looks like, ha. won't dilly-dally for 10 extra seconds next time. not my fault the scrub tech couldn't get to it...don't put the retractors next to med student! got to do a lot of peds surgery consults too. dare i say it...i really enjoyed peds surgery! i don't want to move on. if you told me that i had to be a pediatric surgeon, i think i could do it. it just takes so long to get to that point, and it's so competitive...and i'm so NOT competitive at this point...oh well. next up is plastics. (this is the kind of stuff that gets me down sometimes...i know my path through med school happened for a reason, and i feel like i'm a better person now for it, but i feel like it's going to really limit me when the time crunch for residency selection begins. who knows. blah!)

so i spent the majority of today sleeping after i got home. now i'm craving a pb and j sammich. i think i'll make myself one and then lay on the couch some more. i've been so lazy, which is nice for once. i can't wait for christmas break...i want to get back to the L&D suite for a few hours, but really i'm just getting more and more confused. i feel like my personality fits in more with the surgery females moreso than the ob/gyn females, but blah. it's still too early in the game.

enough of this! eating time...

Thursday, December 03, 2009

woo!

today was super cool! surgeries were long, BUT, wait for it...

I HELD A KIDNEY IN MY HANDS! AND IT HAD A WILM'S TUMOR IN IT! OMG OMG OMG!

we had a radical nephrectomy case for a kid with a humongous wilm's tumor (that had been shrunk significantly by radiation and chemo). i got to see this kid a few weeks ago when i was on peds hem/onc. the tumor then was so huge you could plainly see it sticking out of the abdomen. in general, wilm's tumor is very curable, and the type this kid has is a "better" subtype, if that makes any sense.

tomorrow is a CHOLEDOCHAL CYST REMOVAL! even more rare than wilm's! omg omg omg! i am super stoked! evidently that was in clinic...alas!

am i weird in that i'm actually excited to be on call (not really excited, but more looking forward to being able to suture, or hopefully suture). haven't done much on peds surgery because they don't like us students to "practice" on babies where everything is so precise. i don't blame them. i wouldn't want an M3 practicing/learning technique on my baby...but i'm still learning so much by watching. but on call, maybe there's some lac or something that will need to be sewn up that an M3 can do...i've been practicing my knots and suturing this week...i've sewed on a lemon and a magazine (it was just laying there).

ok, bedtime. i should have gone to bed at 8:30, alas. didn't see the sun at all today. 13 hour days are grueling...

Tuesday, December 01, 2009

what i did today

today i got to school at 5 am. i left at nearly 6 pm. fought traffic all the way home. my feet hurt. but today was AWESOME! i was the only med student there, so that meant i got to scrub into everything. still haven't been able to do anything past retracting or cutting sutures, but it's super cool to finally see stuff i've only read about in notes, etc.

surgeries i scrubbed in today:
  • chemoport placement
  • another chemoport placement
  • laparoscopic liver biopsy and g-tube placement
  • anal polyp removal
  • omphalocele removal and belly button creation
  • umbilical hernia repair
  • exploratory laparotomy (and i got to feel intestines for the first time)
super cool. i'm really enjoying myself...i can't wait for when i finally get a chance to do something more, but for now it's really fun to watch. i like scrubbing in...i know, i'm weird. haven't been asked too many questions, and my team is super cool. they've been so nice to me so far...just don't want to disappoint, ha.