Hillary versus Obama

Just kidding.

So It's been 11 days since Lent. I gave up all sweets and all chips. Without dieting, I have already lost 3 pounds! I only cheated once, and it was when I grabbed a peppermint candy after lecture one day, forgetting that I'd given up all sweets. What I did give up was the constant snacking on garbage that I do all day at work. Most of it is hunger driven because the only thing really good the hospital gives us is plenty of cookies and chips. Then there's the drug rep who brings us little miniature candy bars. Between all this, I figured out I'm eating an extra 900 calories a day. Yikes. Well. That's over. Who knew that just cutting out needless snacking could result in weight loss? So simple, yet so challenging.

Caution!

When working in the MRI room, make sure you take off all metal objects! They will either 1. get sucked into the machine or, 2. break. Last week I forgot to take off my watch and it promptly quit working, frozen in the exact time that I walked into the room. Strangely enough, it miraculously started working again a week later.

Can anyone explain this to me?

Out of the frying pan and into the fryer...

I was soooo happy to be finished with my trauma ICU rotation. As it turns out, I just traded in one nightmare for another. I had my second day of kids' anesthesia and it's really crazy. Kids are scary. They turn on you for no reason. Like today. My second case is cruisin' along and all of a sudden the baby became hypoxic and turned this awful grey color. We called a cardiologist to come in and do a quick enchocardiogram, but it yielded no information.

I got home and realized this is the first time in 2 months I've gotten home while it's still daylight, so I went on (what used to be) my daily 3 mile walk. While walking, a bird flew over and pooped on me.

Uh, God? Did I do something to upset you?

Almost....!!

Ah, nothing like the eve of my last day in the trauma ICU. My Hell-Month is over. I never have to think of it or dread it ever again. No more taking orders from surgery residents ever again.

I did like some of this month. I like getting to know the families of the patients and working with all the nurses. Everybody was really nice. I just don't like rounding all day. It's boring. I also felt like the surgery department's scut monkey, but that's a whole other story.

This month was rough. I lost some patients that I really cared about. The hardest part was watching their families suffer. I wish I could just bear half the weight they are feeling. The thing about the trauma ICU is, most of the patients are younger. It's filled with the 17 year old brain dead boy who just made a bad decision while driving...too new at it to know better. Or there's the 83 year old lady who was in a car accident and broke both her hips-and injury she won't survive. Then there's the 27 year old guy who got shot in the head and now there are 3 people alive today because he donated his organs to them. Anyway, you get my point. It's emotionally exhausting. Now I know why some doctors seem cold and emotionless. Doing this day in and day out would make anyone clinically depressed and divorced. I didn't spend enough time there to become that way. I hugged parents after their child died and then went home and cried myself.

To throw another event in all this, my 39 year old stepsister died suddenly 2 weeks ago today. She had been sick with an asthma exacerbation and in the hospital for a week. Back home, she still felt bad and just stayed in bed. Unfortunately, that set her up for a pulmonary embolus. I don't think she ever knew what hit her. She was short of breath and vomiting, then she was dead. Everyone in my family though it was her heart. I told my brother that 39 year old women don't drop dead suddenly from a heart attack, they die from clots in their lungs.

She and I weren't close at all. In fact, we hardly spoke to each other. We had some..er...differences of opinion on things. Now I'm left feeling guilty that I wasn't more friendly to her. I wasn't mean to her, but I wasn't nice either. I was nothing. She has three kids, two of which my dad is now raising because their dad's don't want them. I'm going to try and make it up to Angie by being good to her children.

This month is finally coming to an end and I can at least get some of my life back! I finished a 27 hour shift this morning. It was a horrible night. Our trauma center was so busy and all the patients that came through were critically injured. I think we had 5 new admissions, in addition to the ones we already had. Just about everyone is on a ventilator and one unfortunate woman actually has brain tissue oozing out the back of her head. I had the miserable task of talking to her family about her poor prognosis. What do you say to someone who's only child just got shot in the head?

The stuff I've seen this month is so horrible that most of it I can't write about. I'm looking forward to not being exposed to all this human cruelty and getting back to just doing anesthesia.

An apology to my friends

I've neglected all of you lately. I missed getting to wish everyone a Happy New Year and all that. My excuse is a lame one: I've just been working All THE TIME. If I'm not at work, I'm in bed (sleeping). I worked 90 hours this week, which left no time for me to do anything else. Sadly, New Year's Eve I was in bed by 9:30pm because I had a 24 hour shift starting at 6am the next day. I hated it. All this being said, I think about all ya'll a bunch and hope everyone's year is starting off good!

What has made me so busy is my trauma ICU assignment this month. It's notoriously known as the worst month of the anesthesia residency, because the hours are so long. It's also depressing. Just about everyone has traumatic brain injuries from various accidents, whether it is putting up Christmas lights and falling off a ladder, or mostly, car accidents and gang members shooting each other. Most of these guys are on a ventilater and not showing much hope of coming off. Some of the awful trauma I see makes me want to never leave my house, for fear of ending up like these guys.

I just woke up from sleeping all day after a 30 hour shift last night. We're having our annual anesthesia department party tonight which is pretty fun. Everyone dresses to the hilt and we have free food and drinks. What am I going to do instead? Order out sushi and watch back-to-back episodes of "Flip That House". I just want to stay home tonight and chill.

My month in a netshell

1. Went to NYC for an anesthesia conference
2. came back and had no power for 5 days due to Ice Storm 2007
3. came back sick with a cold that I am STILL recovering from
4. Had an altercation with a male attending who shoved me in the OR. It's turned into a big mess and now I (yes, ME!) have to apologize in order to save face and not make it difficult to get a job in 2 years (even though I did nothing wrong!)
5. Lost my voice for 2 days while I was sick. No fun talking to patients with no voice
6. went to dad's for Christmas celebration
7. had another Christmas celebration at my house
8. got drunk and danced at at fellow residents' Christmas party
9. looking forward to the college football bowl games
10. dreading next month working in the trauma ICU where I'll get to work 100 hours a week!
11. I'm not kidding about the 100 hours-thing
12. being jealous of Pastor's Bride who gets to go to Israel while I'm working 100 hours a week
13. Not being jealous of Pink who keeps taking trips to Iowa

Crazy week

Late last week I went to NYC for an anesthesia conference. I had a great time but I'll save that story for another time. I came home and found that my power was out due to Big Ice Storm 2007. My house was so cold that you could see my breath. Yikes. I shacked up at my friend Julie's until Friday when it came back on. Friday! 5 days without any electricity! My poor kitties survivied it though. None of the food in my fridge did. And my yard was a mess of branches that had broken off from the weight of the ice.

It's just been a crazy week. I came home from the conference with a bad cold, and as soon as I got back, it's back to the daily grind of 13 hour days at work, then I was on call until 7am this morning. I'm worn out. One day was particularly bad. I think it was Thursday. I developed a migraine and it just went on and on forever. I was at work and could not leave. (doctors don't get sick). I felt so nauseated that I had to put an alcohol swab inside my surgery mask. (little known fact that sniffing alcohol helps with nausea.I learned this from one of our nurses). I finally got off work that night at 7:30.

I surprised myself. I always wondered what would happen when I got a migraine at work and couldn't leave. I survived.

Well the Dog Silencer appears to be working like a charm. The dogs absolutely will not bark anywhere near my house. Even when a random cat walks by, they won't bark at it. They do, however, bark when they get out of range which makes me think I should buy another one for the back of my yard. It wouldn't be so bad, except those two dogs start barking at two other dogs nearby and between the 4 of them, it gets really loud! Especially at 2am.

So, tomorrow I am traveling to an anesthesia conference in NYC. I'm actually staying in Newark and will take a train to NYC everyday, due to the cost of all the hotels in NYC being $500 a night. Tonight I've been trying to devise a plan of travel from my hotel to Times Square. I'm confused. My hotel is adjacent to Penn Station which has two different trains, a bus, and a subway. They all go to NYC. Why are there 3 different rail systems? Which one should I take? Where will I end up? How late do they run?

Sigh. God help me. Anyone out there who knows me, knows I am going to get hopelessly lost. All by myself.

And don't even get me started on the NYC subway system. I pulled up a map of that tonight and thought I was reading some ancient hierogyphics. Why can't they all be like the D.C. rail system? That was easy to figure out!

Life is weird. I am really, really good at a lot of things. But the things I'm not good at-I'm horrible at.

Well, at least my hotel has a Starbucks. Coffee makes everything better.

Woof!

I have a problem. His name is Bentley. He is my neighbor's new dog and he barks ALL THE TIME! I can't even go into how much sleep I have lost over that dog barking right outside my bedroom window at all hours of the day and night. Talking to the neighbors about it only helped marginally. I mean, come ON! Would you want your anesthesiologist to be sleep deprived?

One night last week I absolutely had enough. I tucked a benedryl into a piece of cheese and gave it to the dog. I felt a little guilty, especially when I didn't see the dog for a few days. Benedryl is harmless, but what if he had some weird reaction? Well, he didn't. He woke me up one morning when I was post-call. He's fine.

Since I really don't want to resort to drugging the neighbor's dog everytime I want to get some sleep, I bought a new gadget called the Dog Silencer Pro. It's kind of like a dog whistle that goes off everytime the dog barks. I got it tonight and I am cautiously excited. While I was setting it up, the dog freaked out and started barking at me. The gadget sent it's ultrasonic noise (people can't hear it) to the dog and the dog actually quit barking! Could it be? Oh if only it's true!

Sleep, here I come!!

On call yesterday. Highlights of my day include:

1. providing anesthesia for a skinhead who's chest said, "In God's grace is the white race", and, "skin head" across his shaved eyebrows. He was also covered in swastikas. He killed 3 people and was being guarded closely. You know the guy is a bad dude when the sheriff actually puts on scrubs and escorts him to the OR with us and stays until he is asleep. I was glad when we finally put him to sleep, I was tired of listening to him talk. In the holding area, he kept asking me where he can find a bone saw like the ones orthopedist's use because he thinks it would be "fun to cut people up". He also likes to dine on fried blood, so he said.

2. Gang-banger trauma: My next case was a gangbanger who got shot. We spent $100,000 worth of blood products (120 units of blood) alone trying to save a man who is going to die in the next day or so no matter what we do. He was apparently wanted by the fugative task force for murder, and they called us last night wanting to know if they should take him off the list. Not yet, but probably soon.

Of course, as I'm finding out, the only people who ever die are nice people. It's hard to kill a drug addict or a gang banger.

I drove home this morning wondering if I really did society a favor in the last 24 hours. My job is so depressing.

Thanksgiving Harvest

I survived being on call on Thanksgiving. We actually were not very busy so I got to get some work done and watched football most of the day. Around 10pm we got called to do an "organ harvest". Somebody who has been pronounced brain dead and their family wishes to donate their organs. In this case, it was a teenager killed in a drunk driving accident. They took his heart, kidneys, pancreas, and liver. Organ harvests are strange. The person is legally dead, but they are on a ventilator so their body is still alive. It's actually easy from an anesthesia standpoint. There's really not much for me to do. I just have to watch his blood pressure and give some heparin when the surgeon says to. During the whole case, his chest was open and you could see his healthy heart pounding away. I could have reached out and touched it. After they clamped the aorta, the alarms on my monitors went nuts. His heart went into irregular rhythms, then asystole. My job was officially over and I turned off the ventilator and the monitors. I peeked over the curtain and they had poured ice all in his chest to cool the heart (a cold heart needs less oxygen). About 10 minutes later, it was put in this ice chest. An ambulance arrived to take the surgeon and the heart to the airport where he boarded a private plane to go out of state to perform the transplant. He has 4 hours from the time the heart comes out of the donor until it must be in the recipient, and the surgeon who performs the organ harvest comes from the recipient's hospital. That means, whoever is getting the heart is already in surgery and has his chest open and ready for the transplant when the heart gets to the hospital. Our surgeons are not involved at all. The other organs have a lot more time before they have to be transplanted, but they cannot be harvested unless there is a recipient ready and waiting. A lot of paperwork takes place before the harvest can be started.

My guess is, 5 people had a very happy Thanksgiving.

Not-so-glamorous-life

Anyone out there who thinks residency is glamorous like it is on Grey's Anatomy should think about this: I have to work two 24 hour shifts this Thanksgiving break. One on Thanksgiving and then again on Saturday. But wait! No fair! I've already worked 44 hours over the last 3 days! Oh... I'm a resident. I forgot. No family, friends, or yummy food for me. Instead, I get to hang out for 24 hours tomorrow eating a greasy cafeteria burger while all my loved ones get to eat tasty turkey and nap on the couch.

Sigh. Tell me again why I'm doing all this?

Another sigh. And Hillary and John think doctors make too much money. I'd be willing to bet THEY are spending Thanksgiving with loved ones.

Oops. I got political. I get a little edgy when I'm tired. ; )

On an interesting note, I had to provide Malignant Hyperthermia anesthesia precautions today for a man who that condition runs in his family. A very rare disorder. I'll probably never have to do that again for the rest of my career.

over-the-top embarrassing moments

1. yesterday: I'd been at work for about an hour when one of the nurses informed me that I had a big tear in the back of my scrubs and you could see my underwear.

2. Today: I was living life on the edge and took two Tylenol at the same time to treat a headache. One of the pills promptly got lodged in my throat. I started choking and eventutally couldn't breathe. One of my attendings had to perform the Heimlich maneuver on me. It worked, as evidenced by my being able to write this blog. It scared me so bad I started crying afterwards. Too bad the doc is married. That would be a great "how we got together" story.

See Robyn? This is another reason you should go to medical school. There's always a doctor around to save your life if you ever need it.

Nobody puts Baby in a corner!

I found out today that this year is the 20th anniversary of Dirty Dancing. Somebody please tell me how this happened! How did I become old enough to celebrate this momentous occasion! Pink? Michelle? Robyn?

You guys are right here with me you know...

This one is for Robyn

I had this patient today who sufferred some pretty bad injuries to her face this weekend. She had a rather angular face, but who am I to judge? Her face was bruised and swollen so I have no clue what she normally looks like. My attending kept accidentally referring to her as "he". I was embarrassed for him and he kept doing it, but to the patient's annoyance. So me, being the clueless person I am, am getting ready to intubate her. We have her on the table, I'm giving oxygen, my attending is putting meds in the IV. What to do you suppose tipped me off that this was really a dude I was dealing with? Was it his very large Adam's apple? Was it his stubbly face and square jaw? Or how about his deep voice? No! What tipped me off that this was really a guy, was that when I looked down his airway, I realized I would have to use a Mac 4 blade to get the tube down. I only use Mac 4's on dudes! That's what tipped me off! It is official. The only way I can tell apart men and women is by direct largyngoscopy to see what size blade would reach the eppiglottis.

It's official. I'm am now what you'd call in the truest sense, a Nerd.

Another example of people who dish it out but can't take it

Remember my last post about the mean bossy scrub tech who couldn't handle people giving some back to her? I've got another example. I was on call (for the 4th time in 9 days) last night when a gunshot wound guy came in. He was a skinhead who was getting drunk with his buddy when he accidently got shot right above his jewels. The bullet wound wasn't really all that serious. His friend missed all the important stuff, but he had to go to the OR for a "rectal exploration" to make sure he didn't damage any of his large intestine as well as irrigation of the wound itself. In the OR, the guy was really freaking out. Yes, this guy who spends his life scaring people and intimidating people with his "white power" BS was crying like a big baby right before we put him to sleep. Kinda makes you realize who the true cowards are in this world we live in.

Quiet Saturday

Don't ever say the "Q Word" when you are on call. It's a jinx. Q is for quiet. The minute you say it's quiet, it gets busy. Now, I'm not a superstitious person, but I'm not going to chance things, either. Plainly put, I had one of the best Saturdays on call ever. I only had 2 cases the whole 24 hours. One at 7am and one at 11pm.

My first case was kind of funny. It was a tracheostomy on a guy who has been intubated for awhile. I think I've mentioned before about fights breaking out between staff during the surgery. Well yesterday yielded a pretty good one. The scrub tech was being bossy to everyone. Yes, the scrub tech. The least educated person in the OR thought she was somehow the most powerful person in there. She was hateful to me, bossy to the nurse, and just generally being a pain in the ass. Finally, the surgeon had enough and told her that he really didn't need her in the case and could do her job for her just fine if she wanted to leave. She left, and we enjoyed the rest of the case. Of course, now the scrub tech is saying that we were all mean to her. Funny how there are people out there who can dish it out but can't take it when it's given back to them.

My other case was an extremely intoxicated fellow wrecked his motorcycle when he tried to drive it with the front wheels locked. He was nice to me, but being very mean to the recovery nurse, yelling at her a bunch. He sounded like a monster the way he was growling at her and carrying on. I finally had enough and told him he needs to be nice to the person who is giving him the pain medicine. He slept the rest of the night. Yes, I know it's mean to threaten to withhold pain meds in exchange for civil behavior, but in this case I felt it was appropriate.

They're Magically Delicious!

I have fallen in love with the new Chocolate Lucky Charms. I tried some generic ones at a friend's house last week and thought I had died and gone to Heaven. I don't think in my 36 years I have ever bought kid cereals, but yesterday I sought out and found Chocolate Lucky Charms. Imagine, those tasty marshmallows from childhood combined with the chocolately goodness of Count Chocula! It's sheer pleasure in a box! I figured while I'm at it, I might as well get some Fruit Loops, too. I always thought those cereals were awful breakfast food but you know what? They are less calories per serving than my Grown-Up Cereal. Plus, kids cereals are much tastier and may motivate me to get out of bed early enough to actually eat breakfast. Could it happen? Naw, but it's a nice thought.

Well so not many blog worthy things have been going on, really. After my wild vaca, everything else is just...boring. Today was my 12th day in a row to work. That's not really that much compared to some people, but I'm happy to have the weekend off to catch up on sleep (seeing as how I did not do that on my vaca).

So today in a big case, the scrub tech had an asthma attack. She was in her sterile gown and couldn't touch anything, so I got the inhaler that automatically comes with my drug tray and gave her some puffs of albuterol-all without touching anything but her mask and her mouth. Asthma attacks are nothing to mess around with. Many a asthmatic has died because they waited too long before they got help. I had a patient (who smokes) just last week go into bronchospasm in the middle of the case. I couldn't get her to oxygenate through her breathing tube and her lung pressures were way high. Scared me to death. Got through it, though. Long term smokers don't do too well with surgery.

So one of our interns has a 6 month old baby that was fine and dandy until a month ago when the baby suddenly collapsed and quit breathing. She and her husband (both doctors) resuscitated the baby at home and got her to the hospital. She survived but has a very bad congenital heart problem that no one knew about. Her only chance is a heart transplant. They have decided to forego surgery and bring her home on hospice. I was thinking today what a brave decision that was for them. I know it was really difficult and I hope they don't question their decision 10 years from now, wondering, "if only we had..." They saved their baby a lot of suffering in exchange for their own.