Its 4.30 am now , I've just finished my second caesarean section. Both were uncomplicated. I/m not feeling sleepy though ; had two epidural referrals at 1 am before the 2 cases ; contemplating to proceed doing them now. Informed the nurses during the caesarean to give them the usual IM Pethidine if they are really in distress. Labour pain is the greatest pain of all !!
The first case done at 2am was a worrying case initially , as the triplets decided to come out to the world today. She was planned for elective caesarean on Tuesday but her contractions were very strong and they had to do it ASAP. She is also thrombocytopaenic of unknown cause ; the bad news being symptomatic. i.e. she has spontaneous bleeding especially on her gums and nasal bleed. Her latest platelet was 74 k , normal being 150 k - 300 k . ANother bad news was she just had her meal at 10pm and she is not for regional anaesthesia ( spinal ).The risk of aspiration is very high upon intubation.Gulp... time-time cuti selalu macam ni lah !!
Luckily she was not obese. Her airway was fairly straightforward but i did had initial difficulty in viewing the vocal cords. It was anteriorly placed and slightly oedematous. I definitely don't want to cause any trauma or bleeding from those areas as they will not stop once began ! SMO Kamal was around and everything was under control. SHe bled a bit and it did not help when they had to syringe out almost 500ml for the stem cell cord blood collection. With good fluid resuscitation , her haemodynamics ( blood pressure . pulse rate ) were stable. Managed to extubate her well.
I guess i will wait for the Subuh azan before going to sleep. Feeling a bit worried too in facing my aptitude assessment in 2 weeks time. I have not been a keen studying student in the past six months. Most of my seniors just laughed at us on our serious attitude towards this exam ! It will not count but still.. exams will always be exams..
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