Sunday, January 25, 2015

Week 10: "Well, you don't place tracheotomy tubes, now do you?" rude! Get over YOUR fear of the penis Sir.

This week seemed incredibly long. This was mostly due to my numerous little naps in between. I am really able to fall asleep almost anywhere and sometimes I'm refreshed after just sleeping a few minutes.

Monday through Friday I got up at 4:30am, studied for the USLME until 6:10am, slept until 6:30am and went to work. Consequently, I went to bed around 9:30pm to at least get 7 hours of continuous sleep. Studying and answering questions in the morning significantly increased the amount I was getting right. It's still not where I want it in the end but I still have until the end of March to get there. I looked through the questions and worked on flash cards after work.

I attended a lecture Monday night held by Prof. Dr. Harald Lesch. He is a German physicist, astronomer, natural philosopher, author, television presenter, professor of physics at the Ludwig Maximilian University of Munich and professor of natural philosophy at the Munich University of Philosophy. He held a lecture about the smallest and the largest components of the universe and how they fit together. It was really interesting and refreshing to learn something different and new!

Wednesday, I was called into the OR to assist with a hydrocele operation. The patients ascites (excess water in the abdomen) was so extensive that it had reopened the processus vaginalis (connection between abdomen and scrotal sac) that usually closes in early development. Basically, he had excessive amounts of fluid in his scrotal sack....and since there was a lot of pressure from the fluid in his abdomen, it was like turning on the water faucet once we opened the membrane in the scrotal sack.
Cucumber, Apple, Basil, Lime Juice for the OR

Wednesday was a long day. The day involved ward work, operation, pathological conference lecture, evening meeting which was then still followed by a short educational lecture by one of the attendings. Luckily I had my back turned towards everyone to face the screen.....because I totally fell asleep for a minute or so....good thing I didn't snore. I was just so tired!

Friday looked like a busy day from the get go. One of the three interns wasn't there and the other didn't show up. We had two huge operations and two wards that needed to be tended to by interns.....and there I stood! My ward doctor was afraid I wouldn't be around to draw all the blood and his fear came true. Directly after the morning meeting I was sent into the OR immediately. I grabbed a coca cola and a biscuit and hurried off to the OR. I usually don't drink Coke, I did while in Ghana because coffee or tea wasn't very accessible and I needed caffeine. Now I do sometimes when a big operation gets sprung on me unexpectedly and I wasn't able to have breakfast yet. Caffeine and sugar to keep me from passing out while standing for 5 hours. Luckily the other intern had just overslept and was able to assist in the other huge operation.
Sometimes I just have to...
I was operating with the chief and he is tall. Although it was a 5 hour operation, my back didn't hurt nearly as much as it does when I operate with shorter surgeons. It was really nice operating with chief because he kept asking me questions. Sometimes anatomical, sometimes surgical or just logical to get me to think like a surgeon. He is an examiner for the board exams so it felt like a mini board exam.

Saturday I decided to tag along for an 24 hour on call. We started Saturday morning at 8am and I went home this morning at 8:30am. I slept for 2 hours and then again for 3. During the day we had quite a bit to do. The wards had to be tended to, the emergency room would call every now and again and we'd go there to check out the patients. We had some postoperative patients that weren't very stable and had to be transferred to intensive care. I hardly sat throughout the day.

We were called by the ENT-ward because they had a patient that hadn't peed in a day and a half. We asked them if they had placed a trans-urethral catheter. The doctor retorted that we (urologists) didn't place tracheotomy tubes so why should they place a trans-urethral catheter......Um....because every nurse should know how to!!! The genital area seems to be a big Tabu for many of the other departments and some doctors don't even take the time to look at the patient when it comes to urogenital tract problems and proceed to just call the urologist on call. Get over it people! Look under the blanket! Its only a penis!
Middle of the night, glazy eyes.

Late evening we were informed that a patient was being brought to the hospital with horrific labs. The patient was placed on acute dialysis when they arrived and desperately needed the kidneys drained. We couldn't do that until the acute dialysis was over though....which was around 1:30am. The doctor and I slept for two hours before being called to the CT to check out the patient's pictures and get the attending and nursing staff on call to come to the hospital and coordinate the anesthesiologists for the procedure. We were back in bed by 4am and slept uninterrupted until 7am. It was a long on call but also really interesting and the doctor and I get along great so that was nice too.
Outta there and walking home in the snow!
I get three days off in the week for being on call over the weekend. I am taking Wednesday-Friday off. Thursday I turn a quarter century old...  (0_0) ...... I'm heading to Heidelberg for the Semi-Live Urology Conference during my free days.

Hope everyone had a lovely week! Stay healthy!



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