Saran wrap in the nicu???

Seems a little out of place to see an industrial size roll of Saran wrap in the nicu. What do they use it for??? Wrap up the little babies on styrofoam plates like in the meat department? Wrap their little arms and legs so they can get a little more water weight off when they're doing their cardio??? No. They put a big piece over the top of the warmer to keep the heat in. I would take a picture of that but I can't put that on my blog. Legal reasons.



-- Post From My iPhone

My office for the day

We are doing stereotactic breast biopsies today, but we don't have the machine here--we're using the mobile unit.


-- Post From My iPhone

Stabbed in the Back.... Literally

This was our 4:30am trauma alert. Steak knife to the back by the wife. This is the 3rd time she's done it. He says it will be the last......

It didn't get anything. We just pulled it out and sent him home.

He was ready to get it out because he was lying prone and he had to pee really bad, but we wouldn't let him roll over until we had the x-rays to know if we could just pull it out.

Gross work pictures

Don't worry they're not laid out here for all the world to see. I have considerately hidden them in this post.....
So if you want to see what buckshot does at close range, click here and here.
What ha' happened wuz this man shot his pregnant stepdaughter and her boyfriend (the baby daddy). This is the boyfriend.
To orient you, what you are looking at is the right armpit (or axilla as I have to say at work). The arm is sticking out toward you, his head is to the left, and the rest of his body is to the right. If you will notice, there is some clear-ish looking plastic sticking out of the wound. That is the "wadding" (I think that's what it's called) that holds the metal pellets that comprise buckshot (I'm definitely showing my vast knowledge of ammunition). We also found the "plug" when we were digging around in the wound. He had to go to the operating room because he completely destroyed his axillary artery and vein, and some nerves (brachial plexus stuff--for those of you who know what I'm talking about). The clamps are on the severed ends of the vessels. We tried to just repair the holes in the vessels, but they were too far gone, so we called in the Vascular surgery people and they came in and did a graft to bridge the gap(s).

What I did at work tonight....

I'm almost a real surgeon!

Last night I celebrated my first belly case without an attending scrubbing in with me!  That's a big deal for us residents.  We do little cases here and there without an attending, but rarely a belly case (opening the abdomen) without an attending scrubbing, much less just sticking his head in the room to check on us periodically (which he did).  The person scrubbed with me is Philip Cole, a 3rd year resident.  Great guy.  We have a good time at work.  

Yeah!  This training is getting me there after all.  I've doubt frequently over the years that I would ever get to this point.  Cross your fingers that he makes it out of the hospital alive ( ;)  --just kidding!).

Compromise

As I found out from my poll, most of you are curious about the things I see here at USA Medical Center. A few wusses don't want to see the pictures, and lucky for you few, I've found a way to post pictures from work that you would have to click on to see.
So, if you want to see what a 12 gauge shotgun will do to a human leg, click here, here, here and here. He says he was squirrel hunting and somehow just accidentally bumped his gun and it went off. He went to the operating room right after he arrived because he had an arterial injury that we repaired with a saphenous vein graft. The orthopedic team came in after we were done to put on the ex-fix (external fixator---metal bars that keep the leg from moving.... like a cast....). However, due to the angle the leg was fixed at, the graft got kinked and clotted off. Even after that he still had ok blood flow to the leg, but he ended up needing to have an AKA (Above Knee Amputation).
Lots of people think, "Oh, things like that don't really ever happen," or "I'm very safe and careful, so it won't happen to me," but I am telling you---it happens every day no matter how safe, careful, and attentive you are. This also pertains to motorcycles (Jared and PawPaw Harden), which is why Porter will never have one. ;)

Tomorrow morning....

I have a 7:30 case tomorrow morning that would make for some very interesting pictures. If you want to see them, you'll have to vote "Yes" in my poll. I'm not going to ruin the suprise for anybody that wants to see them.....
Let's also discuss something that has come up at work recently. Don't be mad if your doctor changes his or her mind about advice they give or your treatment. It is not because they don't know what they are doing, but because they have been thinking about you and contemplating the best thing for you. It means that when they left the room you were in, you were still on their mind. It also means that they are not so arrogant that they think they are perfect or right all the time, but admit that they may not know all the answers. This allows them to go find the right answer or the best thing for the patient. I'm now stepping off the soap box.

Another sunrise

This is another sunrise from work. It's prettier than the one the other day.
I'm going to have to bring my real camera to work one day and see if I can get a good picture.

Sunrise at USA Medical Center

I drive to work in the dark, go to room 722 for checkout and then head to the patient floors to get started. When I walk out of room 722 and go toward the stairs, this is what I see most mornings. We have a beautiful sunrise. It always makes you feel a little better. I've taken lots of pictures of this view for the last 3 1/2 years, but none of them ever come out as pretty as the real thing.