Sunday, August 20, 2006

Surgery Backtrack and a sneak peek at the San Lazaro Chronicles

On the prowl again here at the LRU.. Some things were never meant to change.. ;)

Just got back after duty at San Lazaro... you know, THE official infectious diseases hospital of the Philippines.. Good Lord, I just had duty at the dreaded Pav 10, the TB WARD... Tsk tsk... I can only shake my head at the state of things that I saw.. But I won't get ahead of myself and stick to the chronology =P

Surgery... What can I say? I'm really grateful that the teams agreed to slide for Neuro/Plastic and I'd like to congratulate our group for a job well done!

Shoutouts go to the Neurosugery team (Drs. Ranoa/Navarro/Pacia) and the Plasticman himself, Dr. Butch Mapayo! Astig kayo doc!

By the way, I forgot to mention the ORs I attended/observed at this service, so here's a brief list..

NEURO
Cranitomy (open up the skull to remove something from the brain)
Emergency Ventriculostomy (drill a hole through the skull to reach the ventricles and put a drain)

PLASTIC
Burn wound care (as in a VERY LARGE burn wound, encompassing the entire back, butt and some of the extremities)
Cheiloplasty (repair of cleft lip)

With Neuro-"toxic" behind us, we prepared to settle down to an easier time with Pedia/Uro, which was not really the case.. Urology is infamous for it's ultra-rapid turnover of patients, while Pedia referrals for Pedia Surg cases are at times toxic, to say the least...

Be that as it may, I really enjoyed this particular rotation, especially Uro (since my only patient at Pedia surgery was a case of a leg abscess which needed to be drained). The Uro ORs that I went to really rocked, although they looked pretty painful (well, from a guy's point of view anyway. I won't elaborate 'coz it might be too graphic...). I was able to observe a TURP and assist in an Anatrophic Nephrolithotomy and a Cystolitholapaxy.

Here are some short definitions to my dear uninitiated readers

TURP - short for Trans-Urethral Resection of the Prostate. Basically, you literally scape the enlarged protaste like wax from a candle though an acess port passing through the male urethra.. I won't explain how this is done.. You hafta research and imagine it nalang 'coz descibing it could make make some people flinch and my blog could lose what little readership it has. =P

Anatrophic Nephrolithotomy - you cut through the back to reach the kidney, cut open the kidney, and remove the stone trapped there. But believe me, its a lot harder than how I made it sound..

Cystolitholapaxy - another transurethral technique. You basically put a "nutcracker" into the urinary bladder by passing through the urethra, and use it to crush the stones trapped within. Then you aspirate the stone fragments via the same route.. Ouch...

It was times like these that made me grateful to the guy who invented anesthetic...

Thanks to the Urology team (Drs. Hipol III/Bisnar/Domingo/Ocampo) for making our stay as pleasant and interesting as possible, even though we screwed up big time with a particular patient. Thanks for not chewing us out even though you were really pissed off at what happened.

Also thanks to the Pedia surg people from GS (Drs. Dizon/Olalia/Alay-Ay/Nitisasmito/Manzo) during that time. You guys keep on rotating that it's hard to keep track with regards to who is assigned to what..

Moving on, we found ourselves at our last rotation at Surgery.. TCVS/Ortho, branded my some as the most benign rotation in all of Surgery. =D And it didn't disappoint one bit.. It was during this rotation that I was finally able to use the slippers I brought for exclusive use at the clerks room, and this was the time I got the most amount of sleep from any duty night I've been through so far... Not bad, not bad at all... =D

TCVS didn't have any ORs for me though. New TCVS patients are a rarity at the clinical division. But thanks to Dr. Jay Junio, the sole TCVS man of the hospital, we were able to observe at an Open-Heart Surgery there at the Pay division. He also let me assist during a bedside CTT insertion, and ako pa talaga yung nagpasok ng tube!!

*CTT - Chest Tube Thoracostomy. You cut a hole in between the ribs to drain whatever is in the cavity of the lungs which requires removal, be it extrapulmonary air, blood, or tissue fluid)

I also won't forget the times we went with him on rounds, and he gave me the power to write at the Physician's Order Sheets! Wow pare, parang intern! Astig!! =D It made me feel so powerful! Bwahaha! Wala lang...

For Orthopaedics naman.. I'm all praises for the Ortho team (Drs. Yumul/Tarigan/Angeles/Braganza). They made stuff seem light and interesting, especially Doc Braggy (who I happened to have already met a few years back when I was an MT intern and he was still in 3rd year med). Cool ka bro! Thanks for everything! I also had quite a bit of OR time at Ortho, assisting in an ORIF and arthotomy/synovectomy..

ORIF - short for Open Reduction Internal Fixation. Done for some types of fractures, it means opening up the patient, re-aligning the fractured bony parts, and applying internal fixation devices (like screws and plates) which are left inside the patient's body.

Arthrotomy/synovectomy - Literally means opening up the joint cavity/removing the lining of the joint cavity

Before we knew it, Surgery was over! And to think that at times it just seemed to drag on forever...

We held a sportsfest at the end of the rotation. Ang gagaling nung mga residents sa basketball! Tambak kami 30+ points!! =(

We also had a grand duty which I was unfortunately unable to attend.. Not that sobrang naghihinayang ako or anything, coz I heard that it was too loud for my taste anyway. =D

Alas, all good things must come to an end.. Id like to thank my surgery teammates for all the laughter we've shared and all that we've been through together, and I'd also like to say sorry for anything I've done (or not done for that matter)...

My Surgery groupmates...

Osang a.k.a. "partner"
Em
Rhyan
Leigh
Tricia
Marlon
Au

Thank you guys for everything!! I won't forget yung mga pinagsamahan natin!!

I'd also like to give a shout-out to my dutymates (the people from the other services na palagi naming ka-duty ni Osang, well, except for the time na nag-sliding kami.. (and nung nauso na rin ang sliding sa inyo) hehehe

Joanne/Mary/Maan
Braix/Dinah
Michelle/Ira/Jacky
Kathy/Aina/Grace
Lawrence/Christine

It was loads of fun despite the toxicity! I'm glad to have known some of you better during the bonding seesions. Thanks for the memories friends!!

For the next issue.. the SAN LAZARO CHRONICLES

"Don't you find it ironic that they call the place San Lazaro, but this happens to be where a lot of people end up dying or dead?..." - BraniaxMD

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