It's been a busy couple of days! Let's see, where to start...
On Tuesday, I saw my first delivery (and my second)! The actual delivery went way faster than I thought it would, and even though it was pretty bloody I managed not to pass out, throw up, or get emotional! My preceptor let me clamp the cord so the dad could cut it, and then he showed me how to deliver the placenta. Pretty incredible! During the second delivery, he let me deliver the placenta on my own. That one actually happened at around 6pm, after we had all left the office for the day, but my preceptor called me after he got the call about the delivery and I went in to see it and help! The rest of our patients on Tuesday were mostly prenatal visits, which are pretty straightforward if the mom doesn't have any problems to report.
Wednesday was surgery day! I got to the hospital at 7:15am, ready to scrub in on the first surgery of the day at 7:45. When we learned how to scrub in at school, the whole process took 10 minutes and was very thorough... but I am quickly learning that real life is nothing like the textbooks! I had about a five-minute head start on my preceptor at the scrub sink, and he was done scrubbing in before me! The surgeries he did yesterday were two laparoscopic hysterectomies, and one TVT-O placement (basically a sling to hold the ureter in place for people who have stress urinary incontinence). The hysterectomies were really cool, because the way they do it is to actually put gas in the abdomen to blow it up like a balloon so there's room for their instruments. Then, when they put the camera in, the abdomen looks just like a textbook picture! For some reason I thought it would be more messy-looking or something, or more like the insides of a cadaver, but it looked just like everything I had seen in books. For the first one, I just watched, but for the second one I got to hold the uterus in place for a little while so the doctors could cut around it, and then help suture and put steri-strips on at the end. During the TVT-O, I mostly just watched, but also held some things in place for my preceptor while he did all the work. There was also a delivery that day, so we were pretty busy! The delivery took longer than the ones the day before, because this was the first birth for the mom, but it went well and I got to deliver the placenta by myself again. When I got home at 4:30, it felt like I had been to war! I didn't have anything to eat or drink all day, and was standing pretty much the entire day as well. I think I fell asleep at like 6pm that night!
Today was a more routine clinic day, lots of prenatal visits and a few consults for other problems. My preceptor has started to send me in on my own for prenatal visits, and I feel pretty comfortable doing everything he wants me to do for them. Our last patient of the day had had a C-section about three weeks ago, and was coming in because her incision site hurt really badly and was red. She had a pretty serious infection, and we ended up draining it and packing the wound. At first, it seemed like there would just be a little pus, but then my preceptor started pressing along the incision site and more and more kept coming! It smelled pretty terrible and there was a lot of it ... about 200 mL, which was the most my preceptor said he had ever seen in his 20-year career. But the worst part was when he was packing the wound later, because he had to stick the packing material deep into the wound with a Q-tip, and it was pretty gross. But the patient felt so much better afterward, even though she was in pain while we were draining it. So that was rewarding! Sorry if that was too gross of a description :)
So, I'm having a great week! Tomorrow is another clinic day, so it should be relatively calm. I'm excited for the weekend so I can explore the town where I'm staying!
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