The Month of Vajayjays....

My name is Danelle Wilson and I have a problem.  I like all specialties!  How am I going to decide?  I always saw myself as a pediatrician, but then I was wooed by general surgery.  And now I'm thinking "I totally want to be an Ob/Gyn."  It's going to be very hard to choose a residency if I end up liking every specialty.  I guess next month on my Peds rotation will be the moment of truth.  Maybe I like Ob/Gyn so much because of the baby part.

Even though Ob/Gyn focuses on a small area, the specialty is so vast.  You get to make patient connections and see women of all ages throughout their lives.  You follow a pregnancy and then get to be the first hands to welcome that life into the world.  You get to perform surgeries and can actually make problems better.  You're not just treating symptoms which is very satisfying.  I have learned so much during this rotation.  It was a great combination of patient care and surgery, clinic time and hospital time.  I really like the diversity.

My attending was a super cool guy!  He is from Argentina and completed medical school there before moving to Chicago to complete an American Residency program.  It's real interesting the difference between the two countries.  In Argentina, you don't go to college.  At 18 you start medical school.  The first two years are in classroom and then the next three are in hospital.  And then you're an attending.  There is no residency.  So at age 23 he was a full fledged doctor.  And the best part?  It's all free!  You don't pay for medical school in Argentina.  I'm very jealous of that fact.  Anyways, he was really funny and joked around a lot.  He said he could get away with it because of his accent.

Delivering the babies, when things went right, was awesome.  But when things went wrong, they went really wrong really fast.  Unfortunately I saw miscarriages, fetal demise, and birth defects.  I had one day being on call that was just awful.  I went from a miscarriage to an emergency C-section for a 29 week old fetus of a teenager who already had 3 kids not in her custody.  This poor baby did not have a very good chance of survival and was immediately airlifted to Children's Hospital in Denver.  After the C-section we delivered a baby who immediately went through withdrawal since mom did heroin during the pregnancy.  The inconsolable cry of a baby was just heart breaking.  The worst part of the call shift though was an inter-uterine demise (IUD).  This means that for reasons we don't know, the baby's heart just stops beating.  At 38 weeks a lady came to the ER saying she hadn't felt her baby move all day.  She was declared IUD and an induction of labor was begun.  It was the hardest labor I've been a part of.  This woman, who had done everything right, had a healthy baby one minute and lost it the next.  She then had to give birth knowing she wasn't going home with a baby.  I was really proud of myself for not crying during the process but boy did I lose it later that night.  It was a really bad day and extremely difficult to get through.  That day was full of so much sadness.  I was just hit with it back to back to back.

Luckily that day wasn't the norm.  And the good definitely outweighed the bad.  One of my favorite surgeries was placing a bladder sling.  This woman was having a problem with incontinence for years and it was really making her miserable.  Using a super long, curved needle attached to a mesh ribbon, you thread it under the pubic bone and up through the abdomen.  The woman came for her follow up the next week and she cried because she was so happy with the fix.  I also had some pretty interesting...finds...  You'd be surprised what people stick up there.  I thought about starting a diary.  I would begin with Dear Diary, today I pulled a bag of cocaine out of a woman's vajayjay.  Another entry would be 'today I pulled a Polly Pocket out of a little girl's "secret hole"'  Her mom threatened to take it away if she didn't behave so she hid it.  Another treasure found was cloves of garlic.  The lady read on the internet that it would cure what ailed her.  FYI - it won't.  Don't Do It!  Other gems were carrots and sex toys.  All in all very interesting.  It appears there is a need for a list titled "Things that Don't Belong in Your Vagina".

Anyway...I loved this past month and am super excited for the next!                                  

The Hip Bones Connected to the...

It's hard to believe that another month has come and gone.  I spent it on an Orthopedic Surgery Rotation.  It was very interesting and so much fun.  Bones are so cool!  And joint replacements are just amazing!  The precision and technology that goes into each surgery is incredible.  Each cut is made after several measurements and a blade guide is set up.  I saw several knee replacements, a few hips, and even a complete shoulder.  It is really incredible that the next day these people are putting weight on and actually using their new joints.  The biggest risk with a joint replacement is infection.  Every precaution against infection is put into place.  My attending would even send all his patients to the dentist before the surgery.  For some reason that science doesn't know yet, bacteria in the mouth loves to travel to metal in the body.  This is why people with joint replacements must take antibiotics before any dental work.  Another precaution is the room set up.  Everyone in the room is in a special suit and hood that has positive pressure air being blown down the front of the face towards the floor.  This is like an air trap that germs can't get across.  There is also air blown from the ceiling and out towards the sides of the room at floor level.  These suits are nice for the patient, but a pain for the doctor.  They get very hot.  And its hard to hear one another speaking.  Also, if your scrub pants aren't tired tight enough, the battery weight pulls them down.  One assistant had to have the circulatory nurse pull up their pants and re-tire them.  I was just super happy it wasn't me!

One of my favorite surgeries was piecing together a shattered clavicle or collar bone.  It was just like doing a jig saw puzzle!  We had to be very careful placing the screws because the subclavian artery and vein lie right below the bone.  Knick one of those and the patient can bleed out in seconds.  Another favorite was pinning a broken femur.  Through the smallest incision at the hip, you drill a pin down the center of the bone.  That pin is used as a guide wire for all the drilling.  Xrays are taken throughout to check placement.  This means that everyone in the room wears lead throughout the entire surgery.  Again, really hot and heavy!  A reamer is then used to drill a big hole through the middle of the bone.  A metal bar is threaded down the pin, the pin is removed and the bar is held in place with two more screws.  There is something very satisfying about drilling into bone.  What is amazing is that the patient is weight bearing the next day!  There is no cast or anything like that.  Pretty cool if you ask me.
      
My attending is a younger doctor who is trained in some of the newer procedures and is very up to date on all the latest and greatest.  He was a lot of fun to work with.  Ortho is most definitely a boys world with 91% of all orthopedic surgeons being male.  Luckily my dad and brother trained me well and I can carry my weight with the boys.  After a few jokes and showing some knowledge of golf and firearms, I was in the club.  I was even invited to participate in a golf tournament.  Now I haven't golfed since I was 13 and my grandpa taught me one summer.  But I did well enough I guess since I was invited back.  I was shown that business is still conducted on the golf course.  I was introduced to many business people and doctors from the area.  I also realized that I enjoy golfing.  There is nothing quite like hitting a little ball as hard as you can and watching it soar down the drive.  All in all, Ortho was fun but not for me for the long term.  If I had to choose between General Surgery and Ortho, General would definitely win.  But now it's time to move onto OB/GYN.  Hello babies!