Nonsense

Another week has passed.
How fast time flies.
I've been working for almost 8 months now.
Doesn't seem like it's been that long though.

If everything goes according to plan (i.e I am not extended) I will be finishing Ortho soon.
I can't believe I am saying this, but I think I will miss this department.
There are some really nice people in this department (although there are some I will not miss AT ALL).

A friend of mind pointed out - it's easy for us to say now that we kind of like the department, 'cos we are already leaving it.
I remember hating this department when I started out.
Eventually things turned out quite well.

Maybe it's because when I first entered the department it was an entirely new thing (trust me, Ortho and Paeds - 2 different world), and so it took me quite some time to adjust.
Maybe it's the different way the department is run.
Maybe it's the different people (Specialists, MOs, HOs) that I had to get to know.

Well, right now, it all doesn't matter.
All that matters - I'm leaving soon and I am looking forward to it.
(I have one week of holidays before my next posting :P)

One thing I am sure of though - I do NOT want to become an Orthopedic surgeon.
It's not that I hate it or anything, but I don't think that the job is meant for me.
My luck with ILNs is one proof.
By the way, today I assisted in another ILN - this time, the guide wire refused to go in for some reason.
Haih....

It was a rather slow day - went for passover, then breakfast, then OT, then waited for 5pm to go back to the hostel.
For the past few days, I have been going out here and there after work, and all of a sudden I felt like I had a lot of time on my hands since I came back right after work.

I finally cleaned up my cupboard, folded all my clothes and arranged it properly (after a long, long time).
I even had an urge to iron all my clothes and hang them up.
Thanfully, I managed to talk myself out of it.

This post is full of crap.
I wanted to write about a more serious topic, but my brain refused to co-operate.
Some other time, maybe.

Today, I would like to share a story/joke with you. It happened quite some time ago, about 5 years back (maybe more).
My cousin sister, who was about (?)5 at that time, was trying to get me to play with her. She wanted me to hold the end of a skipping rope.
Cousin : Chechi, hold here.
Me : Say the magic word first.
Cousin : (thought about it a while) Abacadabra!

Well, I then had no choice but to hold the skipping rope and play with her.

Do I Bring Bad Luck?

The Ortho department has two different types of surgeries - the emergency ones, and the elective ones.

Emergency OT is open 24 hours a day and as the name implies, caters for all emergency surgeries (surgeries that have to be done fast to prevent complications) like open fractures, laceration wounds, diabetic foot ulcers, compartment syndrome, etc.

The elective OT does all internal fixations - e.g. plating, screw fixation.

We have 2 elective OTs - short OT (8am-3pm) and long OT (8am-9pm). Both the OTs will consist of a specialist, an MO and a HO (and of course a scrub nurse).

I have had my fair share of elective OTs.
One of the surgeries done in elective OTs is the interlocking nail (ILN), usually for fractures of the femur or tibia.

This is an X-ray post-ILN of the femur

It is a relatively simple surgery (I have heard rumors that a specialist has the record of completing the surgery in just 20 minutes!).

I have assisted in a few ILNs.
Each time, there will be some problem which will delay the surgery - sometimes causing the surgery to take up to 2 hours to complete!!

One of the surgeries - we found out intra-op that the patient also had a patella fracture.
So, we had to do tension band wiring for the patella.

Another time, the 'jig' got stuck and it took us forever to come up with a way to get it out. The patient's bone was SO strong, my MO was suffering throughout the surgery.

Once, the patient's bone was SO osteoporotic, the guide wire kept puncturing out from the bone instead of going in the bone.

There was one time when the fracture couldn't be reduced properly with the traction. We tried adding on traction, releasing traction, and abducting the leg.
I forgot what worked, but it was after a long, long time that we managed to get the fracture reduced.

And just the other day, while trying to fix the nail with a screw, the screw somehow got lost inside the patient. My MO spent quite a lot of time trying to locate the screw and take it out.

What's with me and ILNs?
Why can't I have one simple ILN that finishes in less than an hour?
:(

Today I learnt that for multiple myeloma, the following investigations need to be done (if I remember correctly).
-skeletal survey
-plasmaphoresis
-24 hour urine for Bence Jones protein
-ESR

Friends Or Colleagues?

Yesterday, I had my first OT (operation theater) call.
It was quite a sudden thing - I replaced a friend of mine who took emergency leave.

It was quite interesting to note that the equipments used in an Ortho OT is similar to tools you find in a toolbox.
We have hammers, drills, screws, screw-driver-like-thingy, rods and pliers.

I don't have much to say about the OT itself.
It is cold.
Basically, as housemen, we just assist the MO or surgeon during the surgery.
Time passes by quite fast though, which is a good thing.

I was just thinking - I have quite many colleagues, but how many of those can I consider my friends?
Are all my colleagues my friends?
What is the definition of a friend anyway?
So, I do what I do best - I googled for the answer.

I found 2 definitions for a friend :

1. A person whom one knows, likes, and trusts.

2. A person whom one knows; an acquaintance.

Personally, I prefer the first definition - however, it is not easy to find someone that you can trust 100%. You can't just go spill your guts to every Tom, Dick and Harry, right?
But then the second definition is too common. What if you know the person but you don't like the person - is that person still considered a friend?

A colleague - A fellow member of a profession, staff, or academic faculty; an associate.

If I were to accept the second definition of a friend, then all colleagues are to be considered friends. However, if I agree with the first definition, then I can separate my colleagues into 2 groups - those whom I introduce as my friends (I like them) and those I introduce as my colleague (don't really like them).

Now, I think the first definition makes more sense than the second.

So, if I were to introduce someone as a colleague - paham-pahamla that I don't really like them. :P

I think I am crapping already. Must be the lack of sleep. Time to stop for today.

Today, I learnt that people will say/do anything to save their asses. Do your own work. Don't trust another person to do things for you. If something goes wrong, you are the one who will be blamed.

I HATE IT!!!!

26/04/09 - Pre-call (have to go to the ward that I'm going to be oncall in to get to know the cases there
27/04/09 - Oncall
28/04/09 - Post-call
29/04/09 - Pre-call
30/04/09 - Oncall
01/05/09 - Post-call (get to go back half day cos of public holiday)
02/05/09 - Passive call (since it's a weekend, I get time off from the end of specialist rounds up to about 7pm, but have to work until about 11pm).
03/05/09 - Oncall

What the %#@*!!

I HATE this department.
So far, I have not found anything that I like about this department.

Every morning, I have to go to work early just to try to finish the rounds.
Passover starts at 7.30am, and usually the MO rounds start right after passover.
Which means, your rounds have to finish before 7.30am.
On top of that, if you clerked any cases the day before that, you have to find the tickets of those patients to bring downstairs for passover.

Passover - if you clerked the case, you present the case in front of all the specialists and MOs and HOs.
If the specialists have any questions (regarding the patient) for you, they ask you.
If you can't answer, you are an idiot 'cos that is your patient.

So many times in Paeds, we, HOs were told that we are not clerks, but doctors.
But here, I feel like I am a clerk.
Nothing more.

So many times, I feel like I am unwanted in this department.
I feel like everyone hates me (and vice versa).
My colleagues are OK though, most of them are nice.
The specialists and MOs - the moment I feel that one of them is nice (or not bad), they will say something to make me hate them all over again.
ARGH!!

Everyday, there is a stress while going to work.
So far, I have not dreaded going to work.
But I think, soon, that is going to change.
I HATE ORTHO!!!!
I hope I am not extended.
I don't want this torture to be prolonged!
Already I am just waiting to get out of the department.

First Day In Ortho

Today I started my Orthopedic cycle.
First thing this morning, I had to attend the passover rounds.
It was extra long because it is a Monday.
Basically, you have to present whatever cases that you clerk at the passover rounds.
If it is a Monday, then you have to present all new cases from Friday up to Sunday.

After the passover rounds, the captain gave us a briefing about the department.
Then we met the HOD - who gave us a short 'lecture'. It wasn't really a lecture, but I can't think of any other words to use.

Then, I went up to the ward.
I was SO BLUR!
I didn't know any cases.
I didn't know how to clerk cases (taggers are required to clerk new cases).
I didn't know how to manage any cases.
I didn't know where the lab forms are.
I didn't know how things were done in that ward.

I tried reading through a few cases; trying to see how to clerk an orthopedic case.
The other HOs were doing their morning rounds.
I kind of managed to figure out how to clerk a case, but then to manage it?
I have NO IDEA!
The other HOs said that that will take time.
How much time, I wonder.

The whole day passed in a blur.
I clerked 2 cases (the MO/specialist was around and he planned the management).
I still don't know the name of the MOs and specialists.
I don't know how to manage any Ortho case.
I failed 1 line setting and succeeded another - which was a pediatric case.

I have 5 days to learn whatever I can before I am put oncall.
I can't imagine being oncall, clueless as I am right now.
5 days.
I have to work from 7.30am to 12am everyday with a break from 5pm-7pm.
When am I going to study?
ARGH!!!!!!
I should have chosen a different proffession.

I Am Nervous!!

I'm nervous!
I start my new department tomorrow - Orthopedics.
I know almost nothing about Ortho.
I don't even know all the parts of the bones.
I don't know anything about adult medicine.
All I have seen are children and more children.

I have to be at the passover room by 7.30am tomorrow.
I have to introduce myself to all the MOs and Specialists there.
I am nervous.
I hope I don't say or do anything stupid.

Tomorrow will be my 1st day of tagging.
Since it is my 2nd posting, I have to do a minimum of 5 days of tagging before I can off-tag.
Is 5 days enough for me to learn all that I need to know about Ortho?
Argh!!!!