Surgery Week 3

I had a wonderful relaxing night Sunday to prepare for the week ahead! Lex and i had a girls night and met in Subi for Wagamama's dinner, i had one of the nicest meals i have had out! It was ponzu stir-fry with chasoba noodles which was stir-fried chicken (or tofu) with red and green capsicums, carrot, spring onions and spinach, served with a spicy ponzu sauce on top of green tea noodles.... yum!!

Ponzu Stir-fry!

With our hunger satisfied we made our way to the ACE cinemas to see The Sapphires which we have both been wanting to see for a few weeks! It was a really good movie and although had some nice messages behind it also had some humour, i loved the voices of the Aboriginal girls they were amazing! But the night was not complete without a quick trip to San Churro's where we both tried a dark hot chocolate and an Aztec/chili truffle for me to sweeten off the end to an already lovely night out :)

And then the next week of surgery began. It was an interesting one that is for sure! On Monday after ward round i went to an amputation gym and met a young man who lost his foot due to a bone cancer and was learning to use a prosthetic joint after a below knee amputation. He will be running soon with no doubt :) it was a different story to some elderly patients who may never get to walk with a prosthesis after an amputation. Many may have a number of co morbidities which prevent them from obtaining a prosthetic joint to begin with, then the strength to use a prosthesis can be an extra 75% most elderly patients cannot achieve this. I was almost  ashamed to admit that i assumed almost anyone could get a prosthetic joint after an amputation but there are so many factors involved both physically, mentally, psychologically and socially which need to be taken into account before a prosthetic joint can be considered.

Monday afternoon we had outpatient clinic and met many patients who had had stents put in for aortic aneurysms and dissections and these appointments where to see how the stents were going and to assess for any 'endo leaks' causing the vessels to dilate up again around the stent. With a tutorial from the registrar at the end it was another valuable learning experience.

Aimee Mullin

On Tuesday i followed the gym up with an amputation clinic and met some patients at their follow up appointments to see how they were going, how their prosthesis was fitting their limbs and any complications they are having which again reinforced what i learnt with how much more complex a prosthetic joint can be and how difficult they are to use initially!! Although i did have respect for those with prosthetic limbs i have even more now and admiration to those athletes in the Paralympic games at the moment in London... they are the true Olympic hero's!!!

On Wednesday i went into the theatres to see a couple of toe amputations - they were quite quick compared to other operations and with no real need for me to scrub up and assist i found myself answering my registrars phone while he was undertaking the surgery... scary answering calls from other specialists as a medical student!!! Then we went up to the Cath lab to see a person have a stent put into her aorta and align over her renal arteries which according to our doctors didn't happen to often being more complicated!

Thursday was a long but awesomely productive day. In the morning 3 of us went to the outpatient Ear, nose and throat clinic and were exposed to what seemed like a whole new realm of medicine we have had so little information on!! I wish i knew most of the terms they were talking about but i learnt quite a bit in the 3 hours i was there. I hope to follow up one lady who had her thyroid removed due to an invasive cancer but now damage to her recurrent laryngeal nerve meant her vocal cords where affected and made breathing difficult so she is to have a surgery to open part of the cords next week. I also saw a disabled patient have a tracheotomy changed but felt ill hearing what sounded like the patient chocking in his own secretions. His carer said he was putting on a show for us but in all honesty the sound was horrible :(

Aorto-bifemoral bypass
(white tube)

After a lunch break that afternoon i went into an amazing surgery where a lady was having an aorto-bifemoral bypass (and a toe amputation). Basically they opened up her groin to clear up each femoral artery then they opened up her abdomen to get to her aorta which is behind all the intestines and GIT organs... it was the first time i had seen the insides of the abdomen on a living person and it was quite amazing even though i was 2m away and couldn't get a good view not being scrubbed up. Luckily one of our peers was right there which would have been amazing!! To attach the graft to the aorta then into her leg they passed the tube under all the ligaments in her groin by hand! I thought it was amazing how they were able to clamp the aorta for an hour or so with no adverse effects too. Such a good surgery to see. But i also had some success as i put my first catheter into this patient, i was a little nervous about putting them into females but it went really well! Another tick off my little green book :)

I left the surgery after 5 and headed to the wards to do some heparin injections on patients and learnt to leave the needle in for a few seconds afterwards as this prevents bruising and bleeding at the injection site and was proud to see when i took the needle out there were no spots of blood :) Leaving the hospital at 6.30pm it was a long day, but well worth it :)