Vascular Surgey

I absolutely love love love <3>

I learned so much from Mr Wolfe and Dr Ian Mackay.

ahaha they seriously rock ler!

It was very tiring I admit.
Waking up really early everyday to attend ward rounds at 8am!
and theatres/clinics after that which go on the whole day.
Scrubbed into surgery and standing for hours at the operating table..
But it was absolutely fantastic!

And got teaching everyday :)
But was shot with tons of questions everyday at theatres.
A lot of which the answers are not exactly found in the books, but the ones which you have to derieve from logical deduction, which unfortunately I am not capable of. The best part was they did not give me the answer straight away, preferring to ask me more questions leading me to the answers myself instead :)

I think I might have pissed them off a little, as they had to dig answers out of me.

I'm so sorry!! I don't really mean to be like that.....
Just that I was afraid of having the wrong answer and rambling on about it...

Anyway their method of teaching is really good, make me realize that I didn't understand some important concepts. for example why they need to make an AV fistula for haemodialysis.
and also the importance of categorising information so that I would be able to remember more easily, and not just memorising information blind which you would tend to forget easily later on.

All in all it was a good week, and I really appreciated the fact that I was lucky enough to be able to watch uncommon surgeries for example the brachial anuerysm.

Speaking about the brachial aneurysm....During surgery, Mr Wolfe was trying to clamp the brachial aneurysm further up and remove it later on, when suddenly the artery just snap and broke off, and blood was spewing out everywhere, and Ian had to compress the arm to try and slow down the bleeding, and the whole place was just flooded with blood, and at last Mr Wolfe managed to stich the artery up so it would stop bleeding.

Anyway during one of the surgeries, Ian was trying to teach me about stroke, and he mentioned that if the patient were to come to me in the early hours of the morning, there would be nobody around to perform a CT scan to differentiate between the diagnosis of whether it was an ischaemic stroke or haemorrhagic stroke, as the person in charge would be too tired to perform the CT scan, or can't be bothered to show up. Anyway, after he told me that, Mr Wolfe told him to be careful of what he said, and the anaesthetist was quite angry, and told him "not to talk nonsense to the medical student", and that the "radiologist will definitely come up to perform a CT scan". Then Ian was still quite adamant that this was what happened in various other hospitals but probably not in this hospital, and Mr Wolfe told him not to "dig himself into a deeper hole." Anyway, very scary experience being trapped in between the doctors arguing.


I managed to scrub into a carotid endarterectomy too, where they cut open the carotid artery and they dig out all the cholesterol bits from the artery, while maintaining the flow of blood by inserting in a tube to still allow the blood to flow to the other side bypassing the part of the artery where the cholesterol bits is being cut out. I went and clerked the patient the day before and took her blood. eeekk I had to take to take her blood twice cause her veins collapsed and I couldn't get any blood out. Anyway she's 70-80 plus years old, but she totally doesn't look her age, and she's still working. She was a really nice and friendly patient :) Anyway during the surgery, at first she was kept awake, as they wanted to assess whether she was having a stroke during the surgery, as having a stroke was one of the risks of carotid endarterectomy, but then she had to be put to sleep as she kept coughing (she blames it on her blood pressure tablets, but I checked and they've switched the tablets to the ones which won't make her cough). We went to see her after the operation and she was alright :) and she had quite a speedy recovery :)

Which comes to the part of how I kinda pissed the surgeon off.
By giving him stupid answers.
which ended up with him saying "Do you think we are stupid? okay maybe we are a little.."
ok not exactly stupid answers,
but more like correct answers which were vague.

hahhaha.
For example they asked me what happens after a stroke,
I answered "weakness"
and they were like "which part of the body."
and I said "the peripheral parts."
"for example?"
"err..."
"Which part of the body would you test for in a patient with stroke?"
"err...the hands and legs"

It must be so annoying for them to dig out answers from me...
I don't know what's gotten into me......

Cat got my tongue I think.......

The next bit contains some useful information about carotid endarterectomy. Skip it if you find it useless/boring. hahaa.

Anyway some interesting bits of information about the carotid endarterectomy. I got asked all these stuff during the surgery.

Well the artery which they dig out the bits of gunk from is the internal carotid artery which is a branch of the common carotid artery, and the internal carotid artery supplies the brain and it has no branches, unlike it's twin the external carotid artery which supplies most part of the face, thyroid etc. The indictations for the surgery include, a recent TIA or stroke, and if the artery is severely occluded by atherosclerosis >70% if I am not mistaken. The complications of the surgery include stroke, death, injury to nerves. On which the surgeon asked me, "Why would you perform a surgery to prevent the stroke, when the surgery itself might cause a stroke?"

Go figure!! oh yes, somemore anatomy stuff, the internal jugular vein is medial to the internal carotid artery, and below the internal jugular vein and the internal carotid artery is the vagus nerve. Also nearby there is the hypoglossal nerve. so need to be really careful when performing the surgery.

Also got scolded for giving one word answers.
haha not the first time actually.
okay need to elaborate on my answers next time.
and must remember to think logically and systematically.

This posts is getting far too long.
Shall go back to studying and continue writing another day.

On another note...finished all my free minutes already!
No more phone calls until Saturday as that would be the 1st of December.
No more phone calls anyway until exams are over.
Am spending too much time on the phone!! sheesh..
But at least I managed to find out some interesting bits of information.
Like the fact that my parents bought my brother a new camera...

I am so cluelesss about everything!!!
To all those people who think I know everything or have a "satellite"
All I can say is that's absolutely rubbish!!
am too far away from everyone!

oh yes, am totally getting addicted to coffee.

Cappucino, tiramisu, good conversation during the weekend :)