JuniorDr Blog

I m waiting in the surgical mess. Im literally hanging around for a few swab results. So tedious its painful.

V. random , odd few days. Little jobs seem to be cropping up at odd unf. hours.

For example friday at 4.30 (official finishing time is 4.00 here) i happily walked to the medical  ward to see one of my teams patient. Home time finally i thought! :D

To my shock and confusion a "mysterious" surgeon/anaesthetist had prepped our patient wrongly for surgery again (twice in one week). Poor chap had been NBM on a insulin sliding scale all day with his fam nearby glaring .

I looked at the nurses and they looked at me frowning. The official undesputed fresh faced representative of the surgical team. This was going to be a ball game and someone was gona get hit. lol. Duck and hide!

Quickly grabbing the notes , the nursing staff realised no one had written in them. Oh well, no proof no blame.  Mysterious person saved by poor documentation.

Unf. i had the honour of explaining to his fam that the surgery had yet been cancelled and re-arranged for the following week. Fortunately, they had a similar ethnic background to me. So switching tongues, communicating, in the all too familiar language soon got me (and my team) out of trouble. Each culture have their own rule book. If you can communicate using that you might just save yourself a legal battle.

 Lucky for my team, our tongues in total cover 6 cultures:)

Peace.:P

---

Comment (0) Read More...

Its great ive found this site so i can moan and hopefully amuse you all. Il begin with my ASL (Age, sex, location). Yea right. :P

 But in short, im a Muslim female medic who has just begun her foundation training ; beginning with Vascular surgery.:)

 Im having a brill time, no jokes, med school was such a complete bore and am so glad to finally be doing something mildly related to medicine. Lets just hope this  joy lasts till the end of my year. I have to get up at awkward hours , but, im glad it finallyyyy gets me out of bed before mid day lol. My day usually begins at the crack of dawn and if im trying to pray Fajr in morning that would be near 5.00am.

 To be frank with you, surgery is the last thing i wanted to do on the earth as a med student, but now that ive been forced into a 8 month rotation ...

 You see the issue really lies in those half sleeved surgical scrubs that almost everyone walks very comfortable around in incl.  other muslim doctors..they laze around in them in the surgical mess, wear them on night shifts and on calls. They are as comfortable as night wear!

 Unfortunately as a muslim Female medic who observes Hijab i ammm determined not to bare any flesh unless its a diree emergency where im then religiously permitted to do so.

So now i am being constantly faced with the "technical" issue of what to wear  in surgery.. hmm....i thought today when my Fy2 suggested i come into theatre in the afternoon and assist as we had a full list.

Il be there as soon as ive done my jobs i said and had a coffee. I then went to the mess and sat there scheming how i would cover my arms as i had forgotten a top for underneath the scrubs. And even if i had managed to do that bit, how would i sucessfully get scrubbed in without showing my arms to any men before wearing the sterile gown. Asking the surgeons to allow me to scrub after them might make me look a little shifty.

Indeed, dilemas are many lol. Still happily determined to do both.

Result:

Went to surgery, asked the nurse to give me a surgeons gown. Now this is usually a battle and a half. She complained about the manager and the cost. I mentally begged God to make this less embarrasing for me. She finally handed me a gown. I quickly put it on, thinking , for future i could use just the sleeves and somehow just have to wear the sleeves under the scrubs. I looked around for a pair of sissors in the changing room. None found. 

Oh well i thought , taking this design a bit far! I looked like a space raider alien. But it looked cute. Blue is a pretty color. Now all i have to do is look for an orthapedic hat.

Now ive asked the staff to put one of those things in the female changing room but so far noone has bothered. Am tempted to make this an after hours mission of mine.

So walking into theater , everyone looks at me, a little shocked. Bless them. Im shocked too. But thats life for you. A nurse kindly asks me : are you cold? I say no i just need to cover my arms. Oh right she says.

My Reg calls me a space raidor. I laugh . No insults taken or meant. I state i need to cover my arms. Hes a joker generally. Nice guy.

Lucky for me everyone else is scrubbed in so the scrubbing area is free for me to take the gown off and scrub up without having to worry too much about having men walk in.

Lucky escape No 2.

Going to sew me a few long sleeved tops :P

Till the next time.

Peace :P

---

Comment (3) Read More...

We often wonder how it must be blissful to live without the gnashing pangs of pain. Pain is a terrible feeling that we want to avoid at all cost.  Yet, would you give up this feeling that saves you in more ways than one?

Congenital Insensitivity to Pain and Anhidrosis

“Look Ma, I poked my eye” happily exclaims a girl with congenital insensitivity to pain and anhidrosis (CIPA). It is otherwise known as hereditary sensory and autonomic neuropathy type IV (HSAN IV). Living free from pain sounds enchanting but patients are not as invincible as they appear to be. In fact, they live a fairly difficult life. They are prone to injuries that would have been otherwise prevented by feeling pain.These kids playfully self-mutilate. Guardians have to be on a constant watch.

Pathophysiology

It is an autosomal-recessive disorder with a genetic mutation in the neurotrophic tyrosine receptor kinase type 1 (NTRK1) gene that prevents the formation of nerve cells that signals for pain, heat and cold to the brain. Mental retardation has been associated in some cases, as well as impaired corneal reflex. They tend to play a lot with their eyes, introducing foreign bodies which causes infections and corneal ulcerations. Anhidrosis, on the other hand, is caused by the loss of innervation of exocrine sweat glands.

Signs and Symptoms

The earliest manifestation is extreme hyperpyrexia caused by anhidrosis. Half of the CIPA population tend to get killed by overheating during episodes of high grade fever before reaching the age of 3. I used to tear up the sofa with my teeth when I was a child but these kids bite their tounge for past time. By the time they reach the age of 2, their taste buds are destroyed. It may be doubly difficult to feed them because they aren’t capable of feeling hunger pains either. Infections and scarring of the tounge, gums and lips are common. Bone fractures and dislocations are often encountered, which may lead to osteomyelitis.

Treatment

Naloxone may be useful in cases where there is overproduction of endorphins but this does not always work. Anesthesia still has to be administered on them during operations because their tactile sensation is not impaired.

Prognosis 

Infections, bleeding and hyperpyrexia are a few of the threats to these patient’s lives that  come without a warning. If they survive past the age of 3, many do not live past 25 years old. Now we know why pain is an essential element in our lives.

http://en.wikipedia.org/wiki/Congenital_insensitivity_to_pain

http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=256800

http://www.edoj.org.eg/vol003/00301/05/01.htm

---

Comment (0) Read More...

Today is my one clinical day. Angio suite all morning where things go smoothly. I'm  doing them on my own now and that includes balloons and stents. A consultant has to be nearby but as I've worked here for two years now they just let me get on with things. I've only had one near miss so far. You have to be very careful when you're moving wires around insides someone's coronary arteries.

I spend a few hours on the ward and do consults in the afternoon and one of them needs an echo. It feels good to actually work on real people for a change and is something I'm  missing more and more as my time in research goes on.

I drop by the lab to pick up some papers and someone tells me that James is out for dinner. Which is strange as I'm  sure he told me he had a lot of work to do tonight. I try calling his phone but decide against leaving a message when I get voicemail. I go home and go to bed early.

---

Comment (0) Read More...

Meetings all morning. I smile at James during one of them but he pretends to ignore me. The grant proposals for the entire department are being finalised and everyone is getting worried about their jobs. I'm lucky as the funding from my doctorate comes from outside but I pretend to be nervous like everyone else.

I spend the afternoon catching up on my data analysis. I have all these numbers from my experiments and the hard part is actually trying to make sense of them and working out if they are relevant or not. We have a statistician on our team but talking to him is like getting an explanation from a computer.

I leave at five and meet James in town for a drink. We have dinner at a small Italian place where he seems to know the waiters very well. I wonder who else he's taken there? We go onto a bar for drinks but leave early as he recognises someone from the lab. We end up back at his and don't do much sleeping.

---

Comment (0) Read More...