Wednesday, March 23, 2005

Extra room

So today I was on cardiac call (as faculty) usually that means you do cardiac cases during the day and then you take over the other cardiac rooms as your cases finish up, then you relieve others and you end up being 3rd from last to leave for the day.

Today was a bit different. The case that was scheduled in our room was cancelled so that a case that had been cancelled because of emergencies, scheduling, etc had been cancelled two days in a row could go. Unfortunately the original surgeon wasn't available so his colleague agreed to do the case for him. The patient wanted her surgeon to do the case, so she didn't want the case done today. So instead of one or two cases as usual, we had none. This you would think is a good thing. It's not. That means ANY case can be put in your room.

The day starts off with a page while I'm driving in that a cardiac case from yesterday needs to come down emergently for bleeding (well he's been bleeding all night) so I take over from the night staff. Usually in cardiac you are staffing one case/one resident at a time. Apparently there's some sort of flu going around (which I think I have, by the way) because two staff anesthesiologists call in sick (which never happens). We end up giving a bunch of clotting factors during the case, plasma, platelets, recombinant factor seven even (something like $5000 a dose) before the guy quits bleeding. As we're finishing up. I get a page. "Would you mind covering another room because we're short staffed?" I say sure no problem figuring they'd give me an easy room because 1) I'm a fairly new faculty and 2) I'm already covering a cardiac case (not a pump case but still) "So we have a ruptured aortic aneurysm coming in and by the way it's a relative of one of our nurse anesthetists" No pressure right? Yikes. If you don't know, a ruptured abdominal aortic aneurysm (AAA) is an anesthesiologist's (and surgeon's) nightmare. Only fifty percent of these patients even reach of the hospital. Another fifty percent of these never leave the OR, a fraction of those leave the hospital (alive that is) Luckily it ends up being a contained rupture of a previous endovascular AAA repair so it's much more stable than you'd think (which is good)

By this time. There are add-on's in my cardiac room. Not cardiac cases, but ENT cases instead followed by a neurosurgery case. bleah. PLUS i'm doing the to-follow vascular case in the other room. That's the breaks. Not bad for a day's work. I did get to leave fairly early for a call day despite the liver transplant added onto the schedule.


harmonic mean said...

I think anesthesiology is amazing. If it weren't for this field, people would still be slugged with some whiskey and clubbed in the head before a surgical procedure. So, hats off to you people.

I was anesthetized (is that even a word?) for my wisdom teeth extraction not so long ago. That was such a strange experience. The last thing I remember was saying, "Boy, this stuff works really faaaaaaaaaaaaast...." It felt as though I was asleep for a minute and when I awoke with a mouth full of cotton, I didn't remember a thing! It was such a twilight zone kind of, I'd do it again.

By the way, I'v been watching "First Days" on the Discovery Health Channel too (yay UM!). It's so strange the way TV shows romanticize and glamorize surgeons. What about anesthesiologists that work right along with the surgeons? It's like those crazy movies about nutty, misanthropic mathematical geniuses. What about the practical statistician that does all the b*tch work (actually the most important work) behind every research? Sorry, lol, I'm a little biased there since I'm a statistican myself ;)

bnug said...

Thanks for the support. Most surgeons don't appreciate that most surgeries can't be done without anesthesia. And conversly there's no anesthesia if there's no surgery.
Glad you've had good experiences with anesthesia.


Jerry said...

I just had laparoscopic surgury done for a double hernia repair (Thought it was just on one side, but the surgeon said it was on both. Hey, I got a twofer!) They prepped me, started laying me out and I asked what the anesthetic was going to be. (I get curious about these things.) I remember he replied (though I don't remember what he said) and the next thing I knew I was in the recovery room.

I was ill from the anesthesia - but I refused a shot for the nausea (well, it wasn't THAT bad in the hospital but when I got home - yech!) so that's my own fault. I really wouldn't have wanted to go through the process with a 'local', which I understand single ingual hernia repairs are done under. So, like Harmonic Mean, my hat's off to you!

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