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!
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