Updates

Ok, so that callander I posted about... not doing it. If you want to know the details of my schedule, just ask. :)

But... I found a way to post my Kodak Gallery stuff for you to see without me having to post the link to each album. So, now you can go to www.kodakgallery.com/aleathea and see my pictures at all times. :) If you want automatic e-mails of when my album is updated, give me your e-mail address and I'll add you to the update list that Kodak sends out.

Remeber those kids?

Remeber those kids that could never quit building bigger and better things with their Tinker Toys?

Or my generation - those kids who built crazy big cool things with their Knex?


Know how they were all kind of considered to be nerdy kids? (not that I wasn't a nerd too...)
Ever wonder what happened to them?

My best guess... they're all orthopedic surgeons trained in using Ilizarov External Fixators.

Today I learned how to use them.

Here's all the types there are on one skeleton.


And here's one that's almost just like what I did today.


And here's what it looks like on a person.


I would hate to have to wear one of them... but apparently they're amazing to help bad fractures.

Smart and silly...

I can tell you about lots of stuff today that would make me sound smart... like how we took off this large melanoma off the bottom of a man's foot. How they let me do a skin graft all by myself. How I learned how to do a breast reduciton. And how to make a nipple when one has been removed. And all kinds of stuff...

Then I have my silliness... tonight American Idol starts a new season! Yay! :) I'm such a dork. But oh well. I love American Idol.

Doggy bag

Today I helped with two knee replacements. The first guy was the most interesting. He's a pretty big guy, only 54, already had the other knee done. He asked the PA if he could have the parts of the bone we cut off to bring home in a doggy bag for his dog. Would you want YOUR dog chewing on your own bones???

Partial Hiatus

Hello everyone. I'm am appologizing in advance for my partial hiatus from blogging. This is not because I'm tired of blogging. It's mostly because I'm just plain tired. Surgery is long hours. 11-12 on a good day. Today, 15.5 hours. The last 7 hours was one surgery. Sigmoid colon tumor resection. Supposed to be a 2-3 hour surgery. This guy had a 10 pound mass in there filling up his whole pelvis. We had no idea it was that big before going in. It was a rush to be done because he had ignored it a long time and now his bowel was totally obstructed. We also found in process that one of his ureters (the tube from the kideny to bladder) was running through the tumor and also was obstructing urine flow out of that kideny. So, needless to say... it was much more complicated than planned. All out with having to call in a urology surgeon to fix the ureter we had to remove... he took a short part of it and moved the bladder a bit and re-attached them. It was pretty cool to see all the stuff they did. Before the surgery he told the nurses, "Don't mess up my penis, if you do, my wife will be pretty upset." Another example of a couple in their 70's that are still quite sexually active. Anyway... we didn't touch his penis except to put the cath in. Except we had to take one of the vas deferns (where the sperm runs from the testicle out the penis)... so he's down to half the sperm count. But hey, if he really wanted he could still have children. So, we adhered to those wishes as much as possible. When first looking at that tumor we wern't sure we could get it all. But, after 7 hours of work, I think we did, AND we reattached almost everything to where it belonged. If things go as we think they will... this guy may actually be cured. 10 pound weight loss from removing the tumor and all. Anyway... all that to say... long days at the hospital, studying, and sleeping, I dont' have much time left for anything else. So, if I don't post very often between now and February 10th, I'm sorry. I promise I will sometimes, but it may be once a week. Please don't take it personally.

What?

Does someone want to remind me what month it is agian? It's 5:30pm, and I just got home and it's 53 degrees outside. The highs for the rest of the week are as follows: 48, 54, 52, 54, 54, 56. And the lowest low is 36. It dosen't even drop below freezing at night. There goes my hope of seeing any snow in the near future. I guess I left it all in Minnesota.

As for my rotation today... I watched a gastric bypass. And I assisted in a thyroidectomy (removal of the thyroid gland) and a complicated cholecystectomy (removal of the gallbladder, but his was all crazy scarred and his abdomen was all distended... so it wasn't easy). That plus rounding on patients and such was my first 11 hour day. Yay.

Calendar

For a little more idea of what I'm up to... any planned events will be posted at http://www.localendar.com/public/aleathea

You can add events to my calendar if you would like. :)

Li-Fraumeni Syndrome

Today I experienced one of those cases where you're like "Wow, I can't believe I get to see this..." but at the same time you think about the patient and how young she is...

"Li-Fraumeni syndrome is a rare inherited disorder that greatly increases the risk of developing several types of cancer, particularly in children and young adults. The cancers associated with Li-Fraumeni syndrome include osteosarcoma (a form of bone cancer), soft tissue sarcoma (cancer that occurs in soft tissues such as muscle), breast cancer, brain tumors, adrenocortical carcinoma (cancer of the adrenal gland, a small hormone-producing gland on top of each kidney), and leukemia (a cancer of blood-forming tissue). Other types of cancer also occur more frequently in people with Li-Fraumeni syndrome." National Library of Medicine

My patient is a 21 year old female. Her mom was diagnosed with breast cancer at 23 years old, was dead by 36 years old. Then, when this patient was 13 she was diagnosed with osteosarcoma of her right femur (big leg bone) and went through 12 months of chemo. Now she's 21, married 4 months ago, and was diagnosed with breast cancer (ductal carcinoma in situ to be specific) in her left breast. So, today she had both breasts removed and expanders implanted in preparation for permanant implants. She also had 3 possible melanoma lesions removed. One of the other fairly young people in the room said "Man, it's tough to see someone younger than you that's so sick..." I agree. I can't imagine going through all that already in my life.

But, then I think about how cool it is that I actually got to see a case of this. It's strictly genetic, you will not get it unless direct relatives have had it. There are less than 400 families WORLDWIDE have this syndrome. And I got to see it the first week of my surgical rotation.

Some days it's hard to balance the wonder of being able to see these things and also how depressing it can be to think of the patient it is affecting.

Thought of the day.

Not a great day for Aleathea

Today I woke up at 4am feeling very nautious, it was worse laying down, so I sat up and tried, emphisize TRIED, to sleep for 2 1/2 more hours. I attributed it to the greasy burger and fries the night before. When I finally got up I downed some Pepto, ate some cereal and headed off to the hospital still not feeling too great but figuring it would pass. I scrub into my first surgery of the day, a cholecystectomy (gall bladder removal). I was holding the camera for the surgeon, all was well... all of a sudden I get overwhelmingly hot and sweaty and feel like there is some iminant vomiting. I told them I was nautious and left the room. (That's what your supposed to do). As soon as I cooled off away from the big spotlights, I was fine. My head hurt though. Later, I scrubed in on a submandibular gland resection (the salivary gland in your chin area). Same thing, was doing well holding stuff for awhile... got hot and nautious, and had to leave the room. Agian I was fine when I cooled off. But my head hurt even more. Plus I was frustrated with myself becuase I wanted to see this stuff and didn't want to seem like a wuss, didn't want the people who would be grading me to think I can't handle surgery, didn't want to fail this rotation due to the fact that I couldn't stay in even one surgery... hopefully it gets better. Oddly enough, I have hope, becuase none of that may have been due to the surgeries. I still feel sick as a dog. Feel like my head may burst, my back is achy, still nautious, and my skin hurts when my clothes rub on it. Blah... I hate being sick. This sucks. Not my day.

Bad blogger...

Ok, so I neglected blogging while I was home, mostly because dial-up annoys me, so I spent as little time online as possible. I got to visit a lot of my friends and family while home which was wonderful. I got to sleep a lot too. I got to play with my chinchilla Fiona. I got to enojoy the snow, skiing, shoveling, re-learning how to drive in it... Braden started walking. I got to meet my dad's dog Missy. And lots of other stuff... Long day of travel to get back out here yesterday. In order to use the least of my frequent flyer numbers... I took 3 flights instead of one... Minneapolis to Grand Rapids, MI... Grand Rapids to Detroit... Detroit to Philly. Blah. But all was on time and my bags got there so all is well. Settling into Dan & Susan's house... Dan showed me around town a bit today. I got new shoes for standing in surgery all day. I got groceries. Yup. That's about it. I'll update tomorrow about my first day. :)