Tuesday, March 15, 2005

Easy as heart surgery?

So yesterday, in a new hospital and rotation I was definitely running around like a chicken with my head cut off. I wasn't given a clear indication of where to go, what to do, who to do it with, etc. I haven't really been given any clear duties, just to follow around a person on the team, and be present in the OR as much as possible. Something I think I definitely managed quite well today. I got good practice at standing in one spot, without moving, and staying sterile for 7 straight hours. That's right, I did not move an inch for over 7 freaking hours. I'm still working out the cramps and knots in my calves.

Of course it wasn't supposed to have gone that way. I scrubbed in on an aortic valve replacement which is open heart surgery. They crack the chest and split everything open wide as you would imagine. The actual procedure of putting in the new valve went quite well, afterwards however, the patient wouldn't stop bleeding, and it nearly took us an hour just to find where the bleed was from. We had three suction units going and could barely keep up with all the blood loss. Now this may sound bad to most of you all recalling patients bleeding out in movies and then dying once the blood bank can no longer keep up with the supply of donated blood, however, this is Methodist Hospital, and the Debakey Heart Center of all places so they can afford handy dandy nifty little devices that take all the blood suctioned out, filter it to save all the cells and plasma, and then pump it right back into the patient. All in all, he bled almost constantly from his heart for over 2 hours and after it was all said and done barely lost more than 100 mL's of blood, which is pretty good for a surgical patient. Pretty amazing technology.
We ended up having to give him factor VII which is a very very expensive blood component that helps with clotting to get him to stop, which he did almost immediately after transfusion. Then, everything was great and we were able to close up, after about 7 hours after initial incision in the OR. I guess you could call it a pretty good learning experience into what life as a surgeon is like.

1 Comments:

At 10:23 PM, Anonymous Anonymous said...

7 hours? I got you beat by 30 minutes...hehe. That story sure takes me back to the day it took us 7 1/2 hours to repair a friggin' hiatal hernia--could have been done in 1 hour if open, but noooooo, we had to go laparoscopically. And worse, they made me drive the scope--a thankless job, you'll find out soon enough. And then I had to hold a liver retractor (also through a port) with the other hand...brutal, brutal days...I don't miss it at all. All is a learning experience though, right? :-) Be Blessed, Randy!

 

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