New Surgical rotation and conference presentation!

From vascular and gangrenous toes and feet we have now moved into breast lumps, breast cancer and hernias. Our general surgery team we are following over the next 4 weeks runs the breast clinics and carries out mastectomies and lumpectomies as well as general surgical abdominal management and hernias in outpatient clinics. Our first morning we sat in on a daily hand-over meeting introducing new patients to the various surgical teams. Then we met our team... well said hi and were whizzed off the the theatres right away!! So Illy and I found ourselves helping out with a bilateral mastectomy with lymph node biopsy and another unilateral mastectomy. The first lady unfortunately had recurrent breast cancer which was now very close to her pec major muscle under the breast and after having radio and chemo-therapy on the other breast  in the past few years had decided enough is enough and it was better not to have the breast particularly when the cancer is recurring. I admire her fight through the cancer and could understand her reasoning to have her breast removed!! After a quick lunch break we went to the breast clinic only to find we missed a few patients and the next ones did not turn up. Instead we had a thorough discussion about breast cancers, treatments and breast lumps. I found it all so interesting and i wanted to know more. To me breast cancer is an area i could go into in the future, alongside with obstetrics and gynaecology or paediatric specialist as a GP. We will see what the future brings!

Tuesday was a very short day, we had a morning tutorial and by the time we finished all the morning clinics and theatres ad started and it was too late to join in. We didn't really know our patient list so i took the rest of the morning to be productive at home and did an operation report, it was a good morning of study actually!! Then in the afternoon i had a lovely catch up coffee with Lex followed by a uni games meeting in the Octagon... wow it has come up so fast!!

Inflammatory breast cancer changes

Wednesday we had the morning hand over meeting and a ward round. On the way we met a lady who had extensive inflammatory breast cancer which is an uncommon but aggressive form which can occur at any age. The lady was in her late 80's and was otherwise healthy all her life, the only issue with this was it put her in such denial that she had breast cancer especially with no family history. As a result she did not present to her GP until she had severe pain, a large lump and the cancer had spread to her lymph nodes causing arm pain and even Horner's syndrome of the face invading her cervical lymph nodes and sympathetic chain. She had come to accept her diagnosis and was receiving a great amount of support from her family and friends which she initially denied at the start by not telling them about her diagnosis. While she wanted to stay strong and be the sturdy face of the family even in her 80's her family are there to support her through thick and thin and to give her the support she deserves particularly after all the support she had given them over her 8 decades of life! She was only too happy to speak to us as well and tell us about her story and we wished her all the best.

Types of hernia's

We then made our way to the general surgery outpatient clinic where i came across my first hernia patients. It is such a common condition i am surprised i have never really encountered them before! So i learnt all about the cough reflexes, diagnosing and treating hernias. Strangely enough one lady who i talked to in general med rotation back in March/April came in with a hernia and remembered me!! I was really surprised actually, she looked familiar and then when she said i had talked to her in hospital it all came back. Strange how it all works to see her again.

I felt quite stressed that day, thinking about Em and I giving our first conference presentation in Busselton on Friday at the annual WA Rural Health conference and preparing for it. Then uni games organising myself and mentally knowing i wasn't in the best running shape with my plantar fasciitis and telling myself i should not have high expectations of my running over there (lets just hope i don't become lapped more than once... especially in the 800m if that is possible :P). Then thinking about missing a week of surgery and catching up on work while trying to prepare for OSCE's in 5 weeks with which i have so much to do!! So it got the better of me and although i had a lovely chat to Kyle and some med friends i hate feeling anxious and not really being good company with my mind elsewhere. When i'm like that i just need some time to myself to relax and collect my thoughts and sit through the coming things one by one and day by day, write things down and not get overwhelmed. I was a little relieved after having edited our presentation for Friday and a trip to the gym at least.

Thursday i used the morning to go to the gym then made my way to the hospitals. We talked to a lovely lady who had abdominal pain in the ED department and another who had a post-lumpectomy seroma who was also lovely to chat too (a rarity in the hospitals really!!). Then i took the opportunity to have a much needed coffee date with Kyle at Santis! Went back and packed my bag and headed home to Bunbury. I was exhausted, i had a nice chat to everyone and an early dinner, then made my way to the forum and found some shoes for med dinner next Friday! They are probably the prettiest shoes I've brought with the rare occasion i buy shoes which are not used for running! I also got a needed haircut and felt ready to take on tomorrow :)

So it comes to Friday. Up early (I can't sleep past 6am these days even when i can!!) i made my way to Busselton (in severe weather warnings i might add!) and although took a wrong turn found the Bayview resort where the conference was being held. I didn't feel like a medical student, but i felt like a health professional! It was so good to mingle with rural doctors and medical coordinators, people would even ask 'so where do you work?' and we would have to say we are still students (though we probably looked like it they could have been just polite :P). But it made me so excited to be involved in the conference and to work in the rural workforce in the future! I had a wonderful opportunity to meet some of the rural clinical school doctors and coordinators i will be studying with in Busselton next year and even had the chance to chat to one of the students :) Our actual presentation wasn't until 3.30pm, i felt more relaxed as they day went on (although i was doing a lot of nervous eating!!) as the atmosphere was very pleasant and friendly. When we actually presented there were about 40 people. The conference had about 150 people and we all split up into 3 as there are 2-3 sessions on at the one time. Em and I were third out of the students and although we were nervous, everyone said we looked relaxed and gave a very good presentation! Thankfully they didn't ask hard questions afterwards and we finished on time, ti was a relief to have it done!! High five Em we just presented in our first medical conference!! :D One Aboriginal health worker there messaged our supervisor in Geraldton to say we did a great job and our supervisor passed on the message to us that night, it was a great compliment :) I look forward to going to the conference next year in Kalgoorlie if i can but more so to enjoy the talks and education as it is a wonderful conference. I drove home at 5.30pm in strong winds again and was flopped on the couch exhausted.... but relieved :)

Em and I after our conference presentation

Saturday i decided to stay home, although the conference was continuing in Busselton i wanted to do some work, exercise and sort myself out for Adelaide and Uni games!! So i went to the gym for a pump class (i look forward to joining there over summer :)) and finished some lectures i missed from Thursday, had a break and made some banana blueberry sugar free muffins i love, had a quick trip to the shops with mum and Sarah for some clothes and of course a trip to the health food shop! Did some more work and had a little walk along the Back beach with the puppies. Dad made a yummy salmon dish for dinner (Salmon AND as a home cooked meal!!).

So uni games you have come. I have tried so hard to be fit through my plantar fasciitis, i have worked hard to balance training with uni and life in general which is no easy thing and now i will fly half way across the country to see if what i have put in has made a difference, if the sweat and tears have given me any sort of edge. I haven't run for 4 weeks and i just can't wait to run no matter how slow i may be! But for my efforts sake i just hope i am not as slow as i think i am. So i have set myself a real goal, to try break 5 minutes in the 1500m (my PB is 4.47min) and to do at least 2 runs over the week depending on how my foot holds up. I will try look after it and not be silly. And i just hope to have fun and if all running fails, support the other competitors from UWA. It will be a great week none the less, i know my body and what has happened over the past few months, i almost gave in and called it quits so now instead i will make the most of this opportunity :) Go UWA!!! Uni games, Bring It On!!