The work week was rather redundant. I spent most of the days drawing blood and placing a series of i.v. lines every day. It has gotten to the point were I almost enjoy placing i.v. lines. I've been so successful that I see every new line as an opportunity to keep my stats up and take on challenges to push my abilities.
|"Hey Viktoria, want to place another i.v. line for me?" my facial response. Pure excitement|
There were so many to do though that I didn't even attend rounds the first few days! Except Tuesday for grand rounds. Chief asked a lot of questions again and I was more graceful with my answers than last week. I even low key impressed him when I answered a question. He told me that most gastroenterologists didn't even know that answer....which again surprised me because you could easily answer it if you knew the blood vessel anatomy of the stomach and spleen (which I guess I assumed most doctors did).
I admitted another patient. She was an elderly lady and the conversation went much longer than it needed to be. We ventured off into none medical topics as well. I think the two years I spent living with my grandparents and spending so much time with my grandma and her friends really influenced me. The idea of a big round of older ladies, coffee and cake sounds great to me....I'm guessing that's not the case for most 25-year-olds.
|Giving your intern ample amounts of chocolate for her help is most definitely appropriate|
Since it was my last week in the gastroenterology department, I really wanted to make sure I get to see some endoscopy procedures.
I watched an ESD (endoscopic submucosal dissection). It is a procedure in which, for example, neoplasms (new formation of tissue that shouldn't be there and could possibly be cancerous) in the colon are removed. Older procedures would use a type of electrical sling to remove that growth but the reappearance rate is high. With the ESD, the layer between the mucous membrane and the muscle layer is cut apart and if done correctly, practically diminishes the recurrence of new formations at that location. This procedure can take anywhere from 2-10 hours according to the chief. Its basically an operation an internist performs.
|Oh hey there BFF Coffee......what a surprise to see you here!|
I also was shown an ERCP (endoscopic retrograd cholangiopancreatography). Essentially, you go through the mouth, through the oesophagus into the stomach and on to the small intestine. There you'll find the opening from which the pancreas and gallbladder excrete their fluids. The passage ways of the bile and pancreas can be displayed using contrast medium. This is good to see where strictures or obstructions in the passage ways might be. The doctor also performed a 360° ultrasound of the upper gastrointestinal tract which was interesting to see and not so easy to interpret.
Besides that, I spent my time with the patients and their terrible veins.
Thursday, I left for Berlin after work to meet up with friends that were on tour in Germany and hung out with them for a few days, watched the shows and just had a great time getting away from it all.
|DJ Premier and the Badder|
|Posers. Practice. Preemo.|
Tomorrow, snap back to reality, Oh there goes gravity.......ok I'll stop there ;)
Stay healthy my friends!