Considering my life is currently dominated by all things orthopedic surgery, I felt it appropriate to change the picture on my blog, to that of a post-op. x-ray of someone with total knee replacements, a surgery that is not uncommon in ortho.
For those of you who, at times, know me better than I know myself, you know that I am an EXTREMELY stubborn person, and, sometimes to a fault, I am very set in my opinions, and my feelings on what I like, and what I dislike (or think I dislike).
Such was the case coming into my required surgical rotation for the summer. Months ago, back in January, we all had to fill out an inquiry form for our surgical rotations, indicating our preferences for surgical specialties (general, GI, urologic, trauma, orthopedic, etc.). I just remember that, when I did fill out the form, I ranked every other specialty above orthopedic surgery; the idea of ripping apart joints, using tools seemingly better suited for a carpentry shop, and operating on bones really freaked me out.
So, much to my dismay, when we received our assignments for the summer, I saw that not only was I placed in Greeley, but in orthopedic surgery...what, was this the universe showing its hatred toward me?!?! In the weeks leading up to the one I just completed, I tried fervently to find positive things about my assignment ("well, this should make it easy for me to realize I don't like surgery;" "I'll reinforce what I don't like, which will inevitably help me know what I do like when it's time for me to pick a specialty," etc.) Seriously, there was no one dreading a rotation more on the planet than me, last Sunday night, as I went to bed before my first day in the ortho. clinic.
I must admit, my first day of the rotation was a little uneventful, since it was a clinic day. My preceptor operates 2 days out of the week, and sees new consults, pre- and post-operative patients the other 3 days in clinic. A lot of range of motion testing, special tests, and trying (and failing most of the time) to interpret x-ray and MRI studies to determine what caused pain, swelling, redness, limited motion, etc. All throughout clinic on Monday, I was thinking about (and dreading) Tuesday, because I knew that would be my first day in surgery, and when I finally had to encounter all of the creepy things that made me think I hated orthopedic surgery. I was terrified that at the moment I heard the revving of the jigsaw used to remove small pieces of bone, I'd pass out cold on the OR floor.
I didn't sleep a whole lot on Monday night...too nervous to calm down and sleep. I got to the hospital at 6:30 am for the scheduled 7:30 am start of the first surgery. I found my way down to the OR, and into the locker room, where I changed from my street clothes into the requisite blue scrubs, my super comfortable tennis shoes, surgical cap, and 2 pairs of shoe covers. I then entered the OR hallway, and found the main desk, and looked at the scheduling board to see what was up for the day. My preceptor had 6 procedures scheduled for the day, including a few arthroscopic procedures, and a total knee replacement. I met up with him in pre-op. to visit the first patient on the schedule with him, and to touch base on what the day was going to look like. At this point, I could hear my heartbeat inside my ear, and I was shaking beyond belief (and I had no coffee that morning, for fear that I'd get into a long surgery without the opportunity to leave to visit the ladies room). Once the pre-op visit was done and the patient was under anesthesia and ready to go, I left to go with my preceptor to look at the x-rays, and "scrub in."
Scrubbing in is quite a bizarre practice for anyone not in medicine, and even some of us in medicine. The ways in which we must move in order to get our gown, gloves, goggles, and other protective gear on without contaminating ourselves, the sterile surgical field, surgical tray, and the other sterile people in the room is quite mind-boggling. It sort of looks like an awkward, 90s-style club dance, in which you back into the room after scrubbing your hands and forearms, with the scrub nurse coming at you with your gown while you wriggle your arms through the sleeves, and someone comes up behind you to close the velcro enclosure at the neck. Then the scrub nurse holds your right hand glove out in front of you, and with still partially damp hands, you have to somehow dive your entire hand into the glove, and make sure all of your fingers find the appropriate home. The process repeats for the left hand, and then for another pair of gloves placed on top. Then, to tie the gown around the waist, you give one part of the sash on the gown to the scrub nurse, while you grab the other side, and twirl around (what is fondly known as the "surgical pirouette") until you meet on the other side, and you tie the 2 strings securely in a bow.
Seriously, between the process used to get scrubbed in and sterile (by the way, there is probably nothing that makes you feel more stupid as a student than scrubbing in for the first time...there is no way around it...you will look like an idiot, but everyone in medicine has had this rite of passage), and knowing that I was about to see someone's bones, I was proverbially sweating bullets at this point. And the surgery hadn't even begun yet. Oy. I was toast. But, I figured, as a student that was scrubbing into surgery for the first time ever, my precepting surgeon would probably just have me standing somewhere obscurely in the OR, observing. Nope. "Katie, stand right next the table right here; you'll get a better view that way." So much for obscurity.
Once the surgery had started, and he was down to the bone, my surgeon told me to take my gloved finger and place it into the surgical field, while he flexed the joint. Apprehensively, I did so, totally freaked out. But, once he started flexing the joint, I realized just how amazing it was that I was touching someone's actual bone, while it moved!!! This tiny joint in the foot, that had helped this person move, was the one I was touching right now in surgery! SO COOL!
Yep, and all of you naysayers out there can probably predict how the rest of the story goes: a few screws and stitches later, and I was hooked! Seriously, I fell head-over-heels in love with orthopedic surgery! And that was just with the morning surgery! A few arthroscopic procedures and a very quick ingestion of lunch later, I was getting ready for the afternoon's total knee replacement.
As a student, I had heard up until now that there is pretty much nothing more violent that we, as healthcare providers, can do ON PURPOSE, than total joint replacements. I knew that when my surgeon told me that I would need to don the surgical haz-mat suit for this one, complete with booties, gown, and a helmet with it's own personal cooling system, I knew the rumors weren't lying.
Once in there, I was told to again, stand right next to my preceptor, but this time, I was going to get the opportunity to not only observe, but serve as the 2nd assist! He wasted no time in deconstructing the joint (if you have a morbid curiosity, just look up "total knee replacement" on youtube; there's a plethora of live surgical videos that go through the surgery in detail). For all of you not in medicine, in a period of just over 2 hours, the knee joint is completely deconstructed, the patella is removed and retracted to the side, small pieces of the tibia and femur, most likely severely affected by arthritic change, are removed using a surgical jigsaw, the artificial end pieces (aka the new knee) are fitted, cemented in, and everything is sewn back and stitched up. Seriously, when I say violent, it's pretty fitting, although mostly bloodless.
Being a part of the total knee replacement was pretty much the most amazing thing I've done up until now. I was there to witness, first hand, as a surgeon completely tore apart someone's knee, again, on purpose, and used his skills and a bunch of surgical titanium to build a new knee that would not be riddled with the same arthritic issues as this patient's actual knee had been. It was SO MUCH FUN!!!! Again, if you have a strong stomach, watch it on Youtube; it's pretty cool!
After the total knee, there was just one more surgery, and 15.5 hours after I had arrived that morning, I left the hospital for my bed, blissfully knowing I could sleep in a bit the next morning, since the day only involved rounding on the post-op. patients, and checking on their progress.
Wednesday involved rounding, and Thursday was another busy day of seeing patients in clinic. Surgery, like Diabetes Camp, feels like total immersion. Orthopedic surgery is a world unto itself, with an entire breadth of terminology, physical exams, pathologies, and techniques, and surgical tools (including to my amusement, an ugly looking tool called a "mother-in-law," most likely named by someone who thought his mother-in-law was scary) to know and master. Since this is only a 2-week rotation, I cannot possibly learn everything, but I have been fervently studying every night after clinic, in the hopes that some of what I see in clinic and surgery will stay with me.
Next week is another busy week of clinic patients, rounding, and most importantly, SURGERY on Tuesday and Wednesday. Seriously, if you had talked with me just a week ago, you're probably totally flabbergasted that I'm actually excited for more surgery. It's kind of addicting, actually...like chocolate, only better.
I am already anticipating scheduling more stints in orthopedic surgery throughout my clinical rotations, including, hopefully, another, longer rotation with this same surgeon. I have learned so much, and am so grateful to have such a patient teacher, and overall, so far, amazing experience.
Stay tuned for all of the nitty gritty details of orthopedic surgery, week 2. If it's anything like this past week has been, I'm sure I'll have plenty of fodder for another interesting post.
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Sunday, July 24, 2011
Beyond the broken bones
Considering my life is currently dominated by all things orthopedic surgery, I felt it appropriate to change the picture on my blog, to that of a post-op. x-ray of someone with total knee replacements, a surgery that is not uncommon in ortho.
For those of you who, at times, know me better than I know myself, you know that I am an EXTREMELY stubborn person, and, sometimes to a fault, I am very set in my opinions, and my feelings on what I like, and what I dislike (or think I dislike).
Such was the case coming into my required surgical rotation for the summer. Months ago, back in January, we all had to fill out an inquiry form for our surgical rotations, indicating our preferences for surgical specialties (general, GI, urologic, trauma, orthopedic, etc.). I just remember that, when I did fill out the form, I ranked every other specialty above orthopedic surgery; the idea of ripping apart joints, using tools seemingly better suited for a carpentry shop, and operating on bones really freaked me out.
So, much to my dismay, when we received our assignments for the summer, I saw that not only was I placed in Greeley, but in orthopedic surgery...what, was this the universe showing its hatred toward me?!?! In the weeks leading up to the one I just completed, I tried fervently to find positive things about my assignment ("well, this should make it easy for me to realize I don't like surgery;" "I'll reinforce what I don't like, which will inevitably help me know what I do like when it's time for me to pick a specialty," etc.) Seriously, there was no one dreading a rotation more on the planet than me, last Sunday night, as I went to bed before my first day in the ortho. clinic.
I must admit, my first day of the rotation was a little uneventful, since it was a clinic day. My preceptor operates 2 days out of the week, and sees new consults, pre- and post-operative patients the other 3 days in clinic. A lot of range of motion testing, special tests, and trying (and failing most of the time) to interpret x-ray and MRI studies to determine what caused pain, swelling, redness, limited motion, etc. All throughout clinic on Monday, I was thinking about (and dreading) Tuesday, because I knew that would be my first day in surgery, and when I finally had to encounter all of the creepy things that made me think I hated orthopedic surgery. I was terrified that at the moment I heard the revving of the jigsaw used to remove small pieces of bone, I'd pass out cold on the OR floor.
I didn't sleep a whole lot on Monday night...too nervous to calm down and sleep. I got to the hospital at 6:30 am for the scheduled 7:30 am start of the first surgery. I found my way down to the OR, and into the locker room, where I changed from my street clothes into the requisite blue scrubs, my super comfortable tennis shoes, surgical cap, and 2 pairs of shoe covers. I then entered the OR hallway, and found the main desk, and looked at the scheduling board to see what was up for the day. My preceptor had 6 procedures scheduled for the day, including a few arthroscopic procedures, and a total knee replacement. I met up with him in pre-op. to visit the first patient on the schedule with him, and to touch base on what the day was going to look like. At this point, I could hear my heartbeat inside my ear, and I was shaking beyond belief (and I had no coffee that morning, for fear that I'd get into a long surgery without the opportunity to leave to visit the ladies room). Once the pre-op visit was done and the patient was under anesthesia and ready to go, I left to go with my preceptor to look at the x-rays, and "scrub in."
Scrubbing in is quite a bizarre practice for anyone not in medicine, and even some of us in medicine. The ways in which we must move in order to get our gown, gloves, goggles, and other protective gear on without contaminating ourselves, the sterile surgical field, surgical tray, and the other sterile people in the room is quite mind-boggling. It sort of looks like an awkward, 90s-style club dance, in which you back into the room after scrubbing your hands and forearms, with the scrub nurse coming at you with your gown while you wriggle your arms through the sleeves, and someone comes up behind you to close the velcro enclosure at the neck. Then the scrub nurse holds your right hand glove out in front of you, and with still partially damp hands, you have to somehow dive your entire hand into the glove, and make sure all of your fingers find the appropriate home. The process repeats for the left hand, and then for another pair of gloves placed on top. Then, to tie the gown around the waist, you give one part of the sash on the gown to the scrub nurse, while you grab the other side, and twirl around (what is fondly known as the "surgical pirouette") until you meet on the other side, and you tie the 2 strings securely in a bow.
Seriously, between the process used to get scrubbed in and sterile (by the way, there is probably nothing that makes you feel more stupid as a student than scrubbing in for the first time...there is no way around it...you will look like an idiot, but everyone in medicine has had this rite of passage), and knowing that I was about to see someone's bones, I was proverbially sweating bullets at this point. And the surgery hadn't even begun yet. Oy. I was toast. But, I figured, as a student that was scrubbing into surgery for the first time ever, my precepting surgeon would probably just have me standing somewhere obscurely in the OR, observing. Nope. "Katie, stand right next the table right here; you'll get a better view that way." So much for obscurity.
Once the surgery had started, and he was down to the bone, my surgeon told me to take my gloved finger and place it into the surgical field, while he flexed the joint. Apprehensively, I did so, totally freaked out. But, once he started flexing the joint, I realized just how amazing it was that I was touching someone's actual bone, while it moved!!! This tiny joint in the foot, that had helped this person move, was the one I was touching right now in surgery! SO COOL!
Yep, and all of you naysayers out there can probably predict how the rest of the story goes: a few screws and stitches later, and I was hooked! Seriously, I fell head-over-heels in love with orthopedic surgery! And that was just with the morning surgery! A few arthroscopic procedures and a very quick ingestion of lunch later, I was getting ready for the afternoon's total knee replacement.
As a student, I had heard up until now that there is pretty much nothing more violent that we, as healthcare providers, can do ON PURPOSE, than total joint replacements. I knew that when my surgeon told me that I would need to don the surgical haz-mat suit for this one, complete with booties, gown, and a helmet with it's own personal cooling system, I knew the rumors weren't lying.
Once in there, I was told to again, stand right next to my preceptor, but this time, I was going to get the opportunity to not only observe, but serve as the 2nd assist! He wasted no time in deconstructing the joint (if you have a morbid curiosity, just look up "total knee replacement" on youtube; there's a plethora of live surgical videos that go through the surgery in detail). For all of you not in medicine, in a period of just over 2 hours, the knee joint is completely deconstructed, the patella is removed and retracted to the side, small pieces of the tibia and femur, most likely severely affected by arthritic change, are removed using a surgical jigsaw, the artificial end pieces (aka the new knee) are fitted, cemented in, and everything is sewn back and stitched up. Seriously, when I say violent, it's pretty fitting, although mostly bloodless.
Being a part of the total knee replacement was pretty much the most amazing thing I've done up until now. I was there to witness, first hand, as a surgeon completely tore apart someone's knee, again, on purpose, and used his skills and a bunch of surgical titanium to build a new knee that would not be riddled with the same arthritic issues as this patient's actual knee had been. It was SO MUCH FUN!!!! Again, if you have a strong stomach, watch it on Youtube; it's pretty cool!
After the total knee, there was just one more surgery, and 15.5 hours after I had arrived that morning, I left the hospital for my bed, blissfully knowing I could sleep in a bit the next morning, since the day only involved rounding on the post-op. patients, and checking on their progress.
Wednesday involved rounding, and Thursday was another busy day of seeing patients in clinic. Surgery, like Diabetes Camp, feels like total immersion. Orthopedic surgery is a world unto itself, with an entire breadth of terminology, physical exams, pathologies, and techniques, and surgical tools (including to my amusement, an ugly looking tool called a "mother-in-law," most likely named by someone who thought his mother-in-law was scary) to know and master. Since this is only a 2-week rotation, I cannot possibly learn everything, but I have been fervently studying every night after clinic, in the hopes that some of what I see in clinic and surgery will stay with me.
Next week is another busy week of clinic patients, rounding, and most importantly, SURGERY on Tuesday and Wednesday. Seriously, if you had talked with me just a week ago, you're probably totally flabbergasted that I'm actually excited for more surgery. It's kind of addicting, actually...like chocolate, only better.
I am already anticipating scheduling more stints in orthopedic surgery throughout my clinical rotations, including, hopefully, another, longer rotation with this same surgeon. I have learned so much, and am so grateful to have such a patient teacher, and overall, so far, amazing experience.
Stay tuned for all of the nitty gritty details of orthopedic surgery, week 2. If it's anything like this past week has been, I'm sure I'll have plenty of fodder for another interesting post.
For those of you who, at times, know me better than I know myself, you know that I am an EXTREMELY stubborn person, and, sometimes to a fault, I am very set in my opinions, and my feelings on what I like, and what I dislike (or think I dislike).
Such was the case coming into my required surgical rotation for the summer. Months ago, back in January, we all had to fill out an inquiry form for our surgical rotations, indicating our preferences for surgical specialties (general, GI, urologic, trauma, orthopedic, etc.). I just remember that, when I did fill out the form, I ranked every other specialty above orthopedic surgery; the idea of ripping apart joints, using tools seemingly better suited for a carpentry shop, and operating on bones really freaked me out.
So, much to my dismay, when we received our assignments for the summer, I saw that not only was I placed in Greeley, but in orthopedic surgery...what, was this the universe showing its hatred toward me?!?! In the weeks leading up to the one I just completed, I tried fervently to find positive things about my assignment ("well, this should make it easy for me to realize I don't like surgery;" "I'll reinforce what I don't like, which will inevitably help me know what I do like when it's time for me to pick a specialty," etc.) Seriously, there was no one dreading a rotation more on the planet than me, last Sunday night, as I went to bed before my first day in the ortho. clinic.
I must admit, my first day of the rotation was a little uneventful, since it was a clinic day. My preceptor operates 2 days out of the week, and sees new consults, pre- and post-operative patients the other 3 days in clinic. A lot of range of motion testing, special tests, and trying (and failing most of the time) to interpret x-ray and MRI studies to determine what caused pain, swelling, redness, limited motion, etc. All throughout clinic on Monday, I was thinking about (and dreading) Tuesday, because I knew that would be my first day in surgery, and when I finally had to encounter all of the creepy things that made me think I hated orthopedic surgery. I was terrified that at the moment I heard the revving of the jigsaw used to remove small pieces of bone, I'd pass out cold on the OR floor.
I didn't sleep a whole lot on Monday night...too nervous to calm down and sleep. I got to the hospital at 6:30 am for the scheduled 7:30 am start of the first surgery. I found my way down to the OR, and into the locker room, where I changed from my street clothes into the requisite blue scrubs, my super comfortable tennis shoes, surgical cap, and 2 pairs of shoe covers. I then entered the OR hallway, and found the main desk, and looked at the scheduling board to see what was up for the day. My preceptor had 6 procedures scheduled for the day, including a few arthroscopic procedures, and a total knee replacement. I met up with him in pre-op. to visit the first patient on the schedule with him, and to touch base on what the day was going to look like. At this point, I could hear my heartbeat inside my ear, and I was shaking beyond belief (and I had no coffee that morning, for fear that I'd get into a long surgery without the opportunity to leave to visit the ladies room). Once the pre-op visit was done and the patient was under anesthesia and ready to go, I left to go with my preceptor to look at the x-rays, and "scrub in."
Scrubbing in is quite a bizarre practice for anyone not in medicine, and even some of us in medicine. The ways in which we must move in order to get our gown, gloves, goggles, and other protective gear on without contaminating ourselves, the sterile surgical field, surgical tray, and the other sterile people in the room is quite mind-boggling. It sort of looks like an awkward, 90s-style club dance, in which you back into the room after scrubbing your hands and forearms, with the scrub nurse coming at you with your gown while you wriggle your arms through the sleeves, and someone comes up behind you to close the velcro enclosure at the neck. Then the scrub nurse holds your right hand glove out in front of you, and with still partially damp hands, you have to somehow dive your entire hand into the glove, and make sure all of your fingers find the appropriate home. The process repeats for the left hand, and then for another pair of gloves placed on top. Then, to tie the gown around the waist, you give one part of the sash on the gown to the scrub nurse, while you grab the other side, and twirl around (what is fondly known as the "surgical pirouette") until you meet on the other side, and you tie the 2 strings securely in a bow.
Seriously, between the process used to get scrubbed in and sterile (by the way, there is probably nothing that makes you feel more stupid as a student than scrubbing in for the first time...there is no way around it...you will look like an idiot, but everyone in medicine has had this rite of passage), and knowing that I was about to see someone's bones, I was proverbially sweating bullets at this point. And the surgery hadn't even begun yet. Oy. I was toast. But, I figured, as a student that was scrubbing into surgery for the first time ever, my precepting surgeon would probably just have me standing somewhere obscurely in the OR, observing. Nope. "Katie, stand right next the table right here; you'll get a better view that way." So much for obscurity.
Once the surgery had started, and he was down to the bone, my surgeon told me to take my gloved finger and place it into the surgical field, while he flexed the joint. Apprehensively, I did so, totally freaked out. But, once he started flexing the joint, I realized just how amazing it was that I was touching someone's actual bone, while it moved!!! This tiny joint in the foot, that had helped this person move, was the one I was touching right now in surgery! SO COOL!
Yep, and all of you naysayers out there can probably predict how the rest of the story goes: a few screws and stitches later, and I was hooked! Seriously, I fell head-over-heels in love with orthopedic surgery! And that was just with the morning surgery! A few arthroscopic procedures and a very quick ingestion of lunch later, I was getting ready for the afternoon's total knee replacement.
As a student, I had heard up until now that there is pretty much nothing more violent that we, as healthcare providers, can do ON PURPOSE, than total joint replacements. I knew that when my surgeon told me that I would need to don the surgical haz-mat suit for this one, complete with booties, gown, and a helmet with it's own personal cooling system, I knew the rumors weren't lying.
Once in there, I was told to again, stand right next to my preceptor, but this time, I was going to get the opportunity to not only observe, but serve as the 2nd assist! He wasted no time in deconstructing the joint (if you have a morbid curiosity, just look up "total knee replacement" on youtube; there's a plethora of live surgical videos that go through the surgery in detail). For all of you not in medicine, in a period of just over 2 hours, the knee joint is completely deconstructed, the patella is removed and retracted to the side, small pieces of the tibia and femur, most likely severely affected by arthritic change, are removed using a surgical jigsaw, the artificial end pieces (aka the new knee) are fitted, cemented in, and everything is sewn back and stitched up. Seriously, when I say violent, it's pretty fitting, although mostly bloodless.
Being a part of the total knee replacement was pretty much the most amazing thing I've done up until now. I was there to witness, first hand, as a surgeon completely tore apart someone's knee, again, on purpose, and used his skills and a bunch of surgical titanium to build a new knee that would not be riddled with the same arthritic issues as this patient's actual knee had been. It was SO MUCH FUN!!!! Again, if you have a strong stomach, watch it on Youtube; it's pretty cool!
After the total knee, there was just one more surgery, and 15.5 hours after I had arrived that morning, I left the hospital for my bed, blissfully knowing I could sleep in a bit the next morning, since the day only involved rounding on the post-op. patients, and checking on their progress.
Wednesday involved rounding, and Thursday was another busy day of seeing patients in clinic. Surgery, like Diabetes Camp, feels like total immersion. Orthopedic surgery is a world unto itself, with an entire breadth of terminology, physical exams, pathologies, and techniques, and surgical tools (including to my amusement, an ugly looking tool called a "mother-in-law," most likely named by someone who thought his mother-in-law was scary) to know and master. Since this is only a 2-week rotation, I cannot possibly learn everything, but I have been fervently studying every night after clinic, in the hopes that some of what I see in clinic and surgery will stay with me.
Next week is another busy week of clinic patients, rounding, and most importantly, SURGERY on Tuesday and Wednesday. Seriously, if you had talked with me just a week ago, you're probably totally flabbergasted that I'm actually excited for more surgery. It's kind of addicting, actually...like chocolate, only better.
I am already anticipating scheduling more stints in orthopedic surgery throughout my clinical rotations, including, hopefully, another, longer rotation with this same surgeon. I have learned so much, and am so grateful to have such a patient teacher, and overall, so far, amazing experience.
Stay tuned for all of the nitty gritty details of orthopedic surgery, week 2. If it's anything like this past week has been, I'm sure I'll have plenty of fodder for another interesting post.
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love the post. look forward to reading more.
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