McDreamy and McSteamy rotation

Did you knoe that I’ll be rotating in Plastic and Neuro Surgery starting tomorrow for 10 freaking days?! I am too excited I dunno how to elaborate what I am currently feeling. Just a while ago, a new patient was endorsed to me, a little boring actually. Her OR will be tomorrow at 10. She has hemangioma awaiting to be excised.

Boohoo…

Well, I want something a little more exciting like boring holes through skulls and using scopes to do microsurgeries.

Right? Right? That would be very sweet!

I actually don’t knoe why they have to fuse these two surgical subspecs in one rotation.

Neuro and plastics?

I knoe, right?

Reminds you of McDreamy and McSteamy?

Well, that’s what I am feeling right nao… ROFL. Kid.

Well, as of nao, I have a urology patient and a pedia-surg patient (on pink post-its) ready to be endorsed as I leave the department.

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And 2 patients to welcome, a neuro-surg case (on green post-it) and a referral (white post-it).

Doctor meets Doctor

Yesterday was my first day in the department of surgery… you knoe… like Grey’s Anatomy kind of atmosphere. But since the other day, every swallow that I take made me cry in pain and despair, accompanied with fever and generalized body weakness, I detested submitting myself to the ward and work.

I instead visited a doctor in the University’s health service.

DOC: What’s the problem?
(his eyes on what the nurse wrote on my record:
Pain on swallowing, hyperemic tonsils, with febrile episodes, Rx Orofar L, Tylenol, Amox 1 cap q8 hrs completed 2 doses, Temp: 36.7)
DAK: Doc, it’s painful to swallow.
DOC: You’re a medical student, right?
DAK:
(Oh-oh, how did you knoe?!) Ahm, yes doc. (I wore a jacket due to several reasons, first as a prop cos t’was raining, second as a protection cos I felt cold cos and was too sick to function well and most importantly so as to not recognize my uniform as a medical student.) I am a medical clerk.
DOC: So, what do you think is your condition?
DAK:
(Are you kidding me?! I am here cos I need your help and not because I want you to evaluate me! Duh.) I think it’s tonsillitis.
DOC: Why did you say so?
DAK:
(Pft!) Cos I had tonsillitis before, and it felt the same. But this time, it’s a lot more painful. I think I woke up every hour last night due to severe pain everytime I swallow. I also have palpable and tender cervical lymph nodes. Doc, the left is more painful. However, I haven’t checked and seen my tonsils yet.
DOC: How come you didn’t inspect your tonsils?
DAK: I can’t find my penlight.
(My penlight’s actually not missing, the batteries were drained. LOL)
(Doc took out his penlight, a tongue depressor and checked my tonsils)
DOC: Say ah………
DAK: Ahhhh…………
(Alck! Ack!)
DOC: You have tonsillopharyngitis. The left if very red.
DAK: Oh ok. I already took 2 doses of amoxicillin. 8PM last night and 4AM a while ago.
DOC: I’ll shift your antibiotics to co-amoxiclav. Twice a day for 7 days.
(Which is a lot more expensive!)
DAK: Ok. Ahm, can I ask for a medical certificate?
DOC: For what?! What will I write in your medical certificate? You don’t even have a fever. Your temperature is 36.7.
DAK: Doc, I already took Tylenol.
(Duh!)
DOC: That’s the point, I don’t have a reason to excuse you from duty.
DAK: Doc, it’s my first day in surgery today. I was absent in our orientation this morning.

DOC: So tell me, what should I write in you medical certificate?
DAK: That I was too weak to get up from bed?
DOC: Just show them this prescription.
DAK: Oh ok. Thanks.

Luckily, there never was an orientation. And I am a lot better nao, better than your lazy dog. It’s not H1N1, freaks! ROFL.

So far, so good in surgery. First stop? Urology-pediatrics surgery. Let’s see… Let’s see…

City of Fabella

Starting at 8 AM yesterday, I was already draped with a silk-like see-through gown, my dark blue scrubs easily recognizable from behind. I dunno at that time if I am going to survive the surgery. I was not the patient just so you knoe, I was the second surgical assistant.

The baby was out in probably less than an hour; amniotic fluid and blood’s everywhere penetrating through my gown. Luckily I was pre-warned to wear an apron before surgery. I dunno why it’s supposed to be like it, comparing it with the previous CSs I’ve assisted, it was chaotic, vague and fast paced.

Next thing I knew while still on surgery right after suturing the wounded uterus, a Kelly which I think is actually an Ochsner forcep was clamped in the left fallopian tube, tied...

Mayo straight please…

Cut. Then followed the right. It was fast! I witnessed a bilateral tubal ligation, for the very first time.

I assisted a total of 4 or I think 5 cesarean deliveries in a 24-hour duty; See? I barely recall how many babies I’ve seen coming out of an incised abdomen. I think there was even a twin pregnancy. I forget.

I dowana label it like a slaughter house but it kinda felt like I was in a slaughter house. To be totally honest? I delivered 3 babies all by myself in less than 30 minutes. And they’re all first time preggies, from a first time medical clerk that is, that I need to do an eposiotomy incision to make the “passageway” wide and very open for the baby to come out.

Luckily, all went fine and turned out well and sound. Initially, a midwife and a nurse was there assisting me. I was like…

Wait, what should I do? This is my very first, own vaginal delivery. Should I anesthetize now? Should I cut now?

LOL. I was trembling and sweating!

After that very first, came another…

Primi! Primi! Fully! Fully!

Then another…

Primi! Primi! Fully! Fully!

2 nursing students assisted me in each patient. They were like waiting for me to instruct them something to do. I am not used to it, dictating this and that, to get this and get that. I thought I did it in a very tacky way. But they were all friendly and nice, so I didn’t have any problem at all. It was really sweet and cool. LOL.

Doing an episiotomy incision, that is cutting to make the vajayjay widely open needs to be… apparently… repaired immediately right after. Repairing is a lot harder than cutting, of course, and it takes a lot of time to repair than wait for a crowning baby to come out. LOL. And repairing should be very tactful and it should be nicely done, to make it still functional for future use. ROFL.

Being a runner is another role that we hafta do in Fabella. And being a runner literally means to really run fast. Run to the laboratory to send specimens, get the results and request for blood products. And imagine, their laboratory is located outside the hospital building and in the night the grounds of Fabella is hived by giant mosquitoes that can suck your blood even right through your clothes, I swear! It’s crazy.

Another meaning of run by a runner is to run and find food for the team, and “team” means the whole doctors team which includes medical clerks, residents and sometimes consultants. Geez, right? What more if we include the midwives and the nurses and the orderlies… What?! LOL.

For 30 hours from 7AM yesterday up until 1PM today, my eyes were widely open and about to cry due to tiredness. I dowana sound like a maudlin though. And even if I am, I probable wouldn’t able to let a single tear to form and drop from my widely opened eyes with swaying eye-bags right beneath ‘em due to over dehydration. You should have seen my darkly colored and well concentrated urine I voided when I was back home. I was so tired, I also hardly recall all the patients I handled, not even their number codes.

After duty in the morning starting at 8AM, we hafta visit all the patients of our residents assigned to us to make progress notes of each individual patient’s condition; and I am just so “lucky” that I am assigned to a first year resident wherein thousands… okay hundreds… hmmm… okay let me say a minimum of 15-20 patients are under her because majority of patients had spontaneous vaginal deliveries which are being handled by junior residents. Awesomeness, right?

It ain’t cool.

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So by 11AM a while ago, I was still in the wards calling out numbers… via a microphone…

Patient 581, please raise your hand…

The ward is so huge! A single ward is like a basketball court filled with beds of patients designated each with numbers. And each bed has 2 or at the most 3 patients lying is opposite directions. At first, I was in awe and a little excited, you knoe I have this fascination with microphones and being friendly-friend-friend with patients. LOL. But after a few minutes of crying out loud, I was irritated. Calling out a patient’s number is not a joke, especially when you lack sleep. There are a lot of hard patients, they don’t raise their hands, they don’t care anymore and don’t want to be monitored. I am so hating them nao.

After all the efforts to deliver their babies?! Gawd!

The saddest part of our duty yesterday up until this morning was when a primi (meaning first pregnancy) mother had severe preeclampsia. Her condition was rapidly progressing or… hmmm… worsening, we wondered why. First she was having continuously elevated blood pressure despite the efforts to put it down, then signs of pulmonary congestion was apparent until she lost consciousness and efforts to breathe which made them decide to immediately put her with a tube and assisted respiration. They opened her up to deliver her baby, in a snap! Questionably, she was deteriorating so fast! Until I was already resuscitating her back to consciousness, compressing her chest until it became a blur if she can still be revived. I was too tired, but I just kept pumping. It was tragic.

I dunno if I cried a bit, but I think I was “emotionless” probably brought about by the lack of sleep and swollen feet.

A patient died while my hands are on her chest early this morning.

It’s not haunting me though. Today. And hopefully not in the future.

All these things happened in just 24 hours. I can’t comprehend how it was possible but it was!

Well, everything happens in Fabella. Hopefully, it will be a little “less-harder” this coming Friday.

That’s all for now. Ciao.