The past week I've been on labor/delivery "days" rotation. Days=before 6am until about 7:30pm...running around the whole time! I've learned a lot this week, met a lot of big ladies, and witnessed quite a few miracles :)
Some of the highlights:
I had an entire conversation with a patient in Spanish! They have "translator telephones" but I didn't even use it - I just talked to her, and it went really well! Until I tried to tell her that her baby was cute, I don't think she really understood. She even asked me for some water and for some medicine-and I got it for her! I was really proud :)
I learned the drawbacks to being a tertiary care center - Friday around 4:15 when all the doctors from smaller hospitals wanted to go home they sent us all their emergency cases. One lady who lost a LOT of blood after she delivered her baby, and another who was 29 weeks pregnant and had ARDS (a respiratory disease that comes on quickly and has about a 50% death rate) were the scariest. However, there were all the patients that come in at the end of the workday that have been feeling sick, so triage filled up. In addition to all that, there were some ladies who were in labor and their babies were ready to come out! Friday afternoon was stressful for everyone involved!
Another scary time was when a 29 week pregnant lady came in whose water had broken and the baby was showing signs of distress. As we were wheeling her in for an emergency C-section she kept saying to us "This is too early! is my baby going to be ok? What is wrong?" and we couldn't tell her because we didn't have any answers. When they opened her up, they couldn't get the baby out because her uterus clamped down on the baby's head - they were pulling on it's tiny little feet! It came out and was whisked away by the neonatal specialists for resuscitation - it's Apgar scores were 1 and 2 (on a scale of 10 - not good) but from what I hear it is getting better.
I went to YPP clinic - basically a clinic for pregnant teenagers - and I really, really enjoyed it. I actually surprised myself by how much fun I had. I can't tell you why this was so fun, but I want to go back. I volunteered in the Florence Crittendon Home (a place for pregnant teens) in college and thought it was one of the most eye-opening experiences I have ever had, since having babies was the farthest thought from my mind when I was a teen. I liked the interaction that I had with them. I don't know if it is because I am finally more comfortable seeing patients on my own, or maybe because I was able to give them more advice and relate to them - I was just a teenager 3 years ago. Something to think about for the future.
Finally, there was the 400 lb woman in a C-section - this was probably the craziest case. This lady was 1) huge, 2) had an anterior placenta (which means that as soon as they cut into her uterus it starts bleeding like crazy) 3) had polyhydramnios (which means that there is a HUGE bag of water that had to be broken), and while THREE doctors are sweating and putting their whole body weight into wrestling with her (10lb!) baby trying to get it out, she says "why is this taking so long? Everyone is getting to hold the baby and I'm the one doing all the work!"
Anyway, a fun and exciting week. The hours were long but no two days were the same and I have definitely learned a lot. I still don't think I want to be an OB/Gyn when I grow up, but I think that if I had to be one it might not be so bad.
I hear nights are more relaxed...a little break would be nice!
Saturday, August 23, 2008
Friday, August 15, 2008
Wow - black hole
So I finally got on Blogger today, for the first time in a couple weeks and decided to write some updates! What an exciting two weeks it has been!
I started my OB/GYN rotation with two weeks on Gyn-Onc. It has been okay - most of the docs are super nice, they tend to ignore students, but nice otherwise. The surgeries aren't great because it's really hard to see anything (and I don't really like the operating room environment). But it has been a pretty good experience overall, and I've definitely learned a lot.
I got to see quite a few hysterectomies (occasionally on some really, really large women) and not much other than that. I saw a "chocolate cyst" (don't ask why it's called that) that held 1L of fluid! I was pretty nervous in my first surgery but I've seen quite a few now and I haven't lost consciousness at all! I think of that as Success #1! I also haven't been yelled at or made to cry! Success #2!
Before starting, I had heard that OBGYN rotation had the longest hours and I'd have to say I agree. I also heard that Gyn-Onc was the hardest part of OB/Gyn, so I'm glad that it's out of the way! Every day I had to get to the hospital at 5:30am to "pre-round" on patients - I had to wake them up, ask them questions and poke their bellies, write my findings in their chards, then go "round" with real doctors at 6:30 and present my patients. Then we'd usually have "team breakfast" at the cafeteria for a few minutes and figure out where we were going all day, and go to see surgeries, check on patients, etc.
Well this isn't nearly the exciting and funny post as I'd meant for it to be, but I'm a Tired Katie tonight. It is so hard to get up early every day, run around like crazy (and skip lunch every other day) then come home and try to get the grocery shopping done, laundry, and other things before crashing into bed. This is probably what residency will be like, though, so I'd better get used to it! One evening I dozed off in mid-sentence...I need to be getting to bed earlier! Speaking of, it's time to start winding down for the night (yes, it's 9pm) because I have a L&D (labor/delivery) 12 hour shift tomorrow from 7am-7pm. Next week starts L&D days, which should be pretty exciting!
I started my OB/GYN rotation with two weeks on Gyn-Onc. It has been okay - most of the docs are super nice, they tend to ignore students, but nice otherwise. The surgeries aren't great because it's really hard to see anything (and I don't really like the operating room environment). But it has been a pretty good experience overall, and I've definitely learned a lot.
I got to see quite a few hysterectomies (occasionally on some really, really large women) and not much other than that. I saw a "chocolate cyst" (don't ask why it's called that) that held 1L of fluid! I was pretty nervous in my first surgery but I've seen quite a few now and I haven't lost consciousness at all! I think of that as Success #1! I also haven't been yelled at or made to cry! Success #2!
Before starting, I had heard that OBGYN rotation had the longest hours and I'd have to say I agree. I also heard that Gyn-Onc was the hardest part of OB/Gyn, so I'm glad that it's out of the way! Every day I had to get to the hospital at 5:30am to "pre-round" on patients - I had to wake them up, ask them questions and poke their bellies, write my findings in their chards, then go "round" with real doctors at 6:30 and present my patients. Then we'd usually have "team breakfast" at the cafeteria for a few minutes and figure out where we were going all day, and go to see surgeries, check on patients, etc.
Well this isn't nearly the exciting and funny post as I'd meant for it to be, but I'm a Tired Katie tonight. It is so hard to get up early every day, run around like crazy (and skip lunch every other day) then come home and try to get the grocery shopping done, laundry, and other things before crashing into bed. This is probably what residency will be like, though, so I'd better get used to it! One evening I dozed off in mid-sentence...I need to be getting to bed earlier! Speaking of, it's time to start winding down for the night (yes, it's 9pm) because I have a L&D (labor/delivery) 12 hour shift tomorrow from 7am-7pm. Next week starts L&D days, which should be pretty exciting!
Friday, August 1, 2008
Orienting
Well, I survived our two-day orientation to third year and I am still absolutely clueless as to how this year is going to go. I'm not the only one, though, so I guess we're all in it together. It was a little sad to be back in class without Chris (and all my other MDPhD friends) there, but I think he's finally found a lab where he's happy and enjoys working. I still have absolutely no idea where to go on Monday morning, where to be, what to wear, what to bring, etc, but I've got my fingers crossed that I will be "in the loop" at least by the end of today.
Tomorrow is scut monkey day, an orientaton of sorts held by the now-4th year students. They teach us what we really need/want to know, like how to tie knots, start central lines, etc. Then, our group is having dinner together and I think it'll be really fun!
I need to think of some really awesome stuff to do on my last weekend of freedom!
On another note - I've started another blogger page for my recipes! It's http://bymouthasneeded.blogspot.com/ and don't make fun of me for the name. I was going to write "po prn" (which means "by mouth as needed" but in doctor-language) to be a big nerd, but "poprn" looks a lot like "porn" which made me a little uncomfortable to have it as the name of my recipes, you know? And I can't take entire credit for the name, Christopher is the real nerd who helped come up with it.
Anyway, I think after all that orientation I need a nap. I need to get rested up before I go catch babies!
Tomorrow is scut monkey day, an orientaton of sorts held by the now-4th year students. They teach us what we really need/want to know, like how to tie knots, start central lines, etc. Then, our group is having dinner together and I think it'll be really fun!
I need to think of some really awesome stuff to do on my last weekend of freedom!
On another note - I've started another blogger page for my recipes! It's http://bymouthasneeded.blogspot.com/ and don't make fun of me for the name. I was going to write "po prn" (which means "by mouth as needed" but in doctor-language) to be a big nerd, but "poprn" looks a lot like "porn" which made me a little uncomfortable to have it as the name of my recipes, you know? And I can't take entire credit for the name, Christopher is the real nerd who helped come up with it.
Anyway, I think after all that orientation I need a nap. I need to get rested up before I go catch babies!
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