Wednesday, September 18

OB/GYN:wk6,day22

hahaha...i was sent home early today. i think my superiors are either feeling very very sorry for me, knowing that i will do poorly on my exam, or are afraid to be responsible for a person failing his shelf.

my body/head hurt again this morn, but what else is new? i went to round on my patients, to discover that one of them was having palpitations (her heart was jumping around in her chest), she was tachycardic (her heart was beating fast), she was short of breath, and she had a fever. i was like, oh no! oh no! this is trouble, but what KIND of trouble?! ah!!!

what made it even worse was that she was spanish-only. on top of that, she was DEAF. interviewing a spanish-only speaking patient who was deaf and in a panic because her body was out of whack is not easy, lemme tell you.

well, the residents, chief, and attending came over. we all re-examined her, etc, etc. basically, we were concerned of a PE (pulmonary embolism- a concern after every surgery, and especially cancer pts. it is a clot that starts elsewhere in your body, like your legs, then the clot dislodges and sticks in your pulmonary arteries, preventing adequate blood flow to your lungs.===>medical emergency), possible ischemia (heart not getting enough oxygen), etc.

chaos in the morning will wake you up really quickly. i felt the blood racing through my body, and the weight of the blood in my hands.

eventually, she was stabilized.

then, i took part in a laparoscopic dermoid cystectomy.
very cool stuff. a dermoid cyst is a cyst that's filled with products of the 3 germ layers of endoderm, mesoderm, and ectoderm. which means there was hair, teeth, skin, etc, filled inside a large sac (4x4x5 inches) in the pelvis. laparoscopy means that we make several small incisions (to minimize scarring, as opposed to opening up the entire abdomen) and use a cool lighted scope to guide us as we removed the cyst.

nearly 3/4 of the way through, the sac was punctured, and fluid leaked out. which was not good, because the contents of the sac could seed in the peritoneum (inner cavity lining of the abdomen), and cause more dermoids to form. lots of irrigation in an attempt to minimize that.

left after a while, for a mtg with mr. bigwig, my OB/GYN mentor. he bought us lunch. great guy.

after several hours of work, i was told to go home and study. yay....

two days left to cram for everything...*sigh...* this is going to be ugly, folks...

yakob at 3:48 PM

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