Thursday, March 29, 2007

Groggy

I am so knackered . Mentally and physically.HAd a busy 24h call - Luckily wifey called me up before coming to UMMC. I was still sleeping.. Susbh pun burn !! hahaha.. Its wifey's first day at work and I don't want to make her wait in the car for me. I'm taking back the car and will have to fetch her later in the afternoon.

The call was punishing because of the stress - having the adrenaline rush gushing throughout the anaesthesia for the operation we provide. It did not help that upon arrival in OT - Laparotomy for an 18 month old baby - for intusseption. Doing paediatrics anaesthesia is a bummer because of all the precautions one has to take in ensuring smooth running of the operation. So many things to consider , from those small tiny cannnulation to the risk of hypothermia. Very-very calculative proceedings which needs a lot of anticipation rather than resuscitation. In the middle of that , the surgeon received a call... ANOTHER LAPAROTOMY for a 3 year old child - sepsis 2o peritonitis. God !! hahaha... It was a struggle inserting invasive monitoring lines for him !!

I had a Mexican next.. yes . from Mexico.. Arriibaaa !!! He was involved in a brawl the night before ; resulting his hand tendons cut - Obviously giving a brachial plexus block was my preference !!! It was tricky though , he was muscular and had a big frame ; therefore his anatomical landmark was altered.I do pity him as i did take quite some time before successfully injecting my local anaesthetics. He was cool about it though.. macho man la katakan.. Having electrical current stimulating your forearm and hand muscles can be quite distressing if you keep repeating it !! Thank you Jose !!


Next was a 61 year old man , who suffered from an infected disc on his spine , that caused him to have severe leg pain and weakness. We had to insert a double lumen tube , as the surgeons requested us to collapse one lung so that they can reach the infected area.YES , We anaesthetists are good in manipulating your body during operations !! To top it up , he had features of difficult intubation and my .. did we struggle...


After 5 hours , somehow we manage to extubate the patient . Funnily , i expected him to have a lot of pain after the operation but he was so comfortable. I suppose , by removing the compression ; he must have felt so relieved after having the excruciating pain for the past 6 months ! Hady laughed at me before the Op actually , as i probed into his "sexual" activities during history taking !!

After that , a laparotomy for an 82 year old lady - she was bleeding like mad because she over warfarinised herself.. INR: 9 !!!! Gilller... Dahlah she had cardiomegaly with a metallic valve! Sakit kepala woo.. nak fikir the safest anaesthesia technique !! It was constant movement during the op for me , resuscitating the old lady who had a very loving husband.

Ooh.. typing this out makes me tired again... aahhh... tidur kejapla...

2 comments:

doctor@pj said...

As a HO, I was attached to UMMC paeds onco for 3 months. Eversince then, I would never look at paediatrics the same way again.

TriStupe said...

tuan, reading ur blog makes me feel my life is so boring la...