Placement 3 - Week 2

Pretty straight forward week...well except for Wednesday. I had to wake up early to attend a whole day of theatre. Saw a TEMS procedure to remove an early cancer in the rectum. Also got to do my first PR on a patient...which I was trying to avoid like no tomorrow. It isn't exactly the most pleasant thing to do. I mean I got to feel the cancer which was quite small. But yeah...really didn't enjoy doing the PR. At least the patient was asleep though (as it was right before the start of the operation). Finished the TEMS procedure quite quickly and then we found out that the next patient will be late coming down to theatre. So I had a bit of a dilemma because I had a meeting to go to at 12pm to meet another consultant. Essentially when it was time to do the next operation, I had to leave for my meeting. Grreatt...I was kinda excited for it as it was an APER procedure to remove a late rectal cancer.

If I remember correctly, this involves the removal of the sigmoid colon and the entire rectum.  The surgery is done in two parts - first part is to do key hole surgery in the abdomen to separate the sigmoid colon from the rest of the colon.  The second part is to turn the patient over into a prone position to remove the sigmoid colon and rectum. Sounds pretty interesting right...so I was pretty bummed out that I had to miss a bit of it.

Anyways rushed to meet another consultant only to find out he was late. I sat outside his office and ended up falling asleep in the chair. Next thing I know, the consultant comes out to meet me and I was snoozing with my phone in one hand. Awkward. He said my name and the first thing that went through my mind was the synonym of crap. Opened my eyes and saw a really confused consultant. Mind you I have never met this consultant before..so great first impression. Had a really great chat though and it was really relaxed. I was pooping myself (before I fell asleep) as I wasn't sure if this consultant was going to be mean or super serious. By the end of the meeting I didn't even know why I was so nervous. It turned out fine and I managed to sort some things out for next year (that's for another blog entry later in the year). I was really happy with how the meeting went and quickly went back to theatre to watch the APER.

Apparently I didn't miss too much of the APER but I did miss the chance to scrub-in. I also realized my consultant has some pretty dodgy camera skills as the abdomen bit of the procedure was laparoscopic. There were times where he would shake the camera so much, everyone would start feeling a bit sick. Oh well. After the first part, we took a 5ish minute break and then went on to the second bit. I must say...this bit was a lot more gruesome than I imagined it to be. Incisions were made around the anus and you would keep cutting in to access the rectum.  Because the colon has been separated, all the surgeons had to do was remove the sigmoid colon and rectum and close up the anus. One of the incisions went too deep and there was quite a lot of blood. At one point blood spurted out and luckily I dodged just in time as I was right in its path. My consultant was really on the ball though and quickly stopped the bleed and we continued on with the procedure. Removed the sigmoid colon and rectum (which was quite a large specimen). Unfortunately, I had to leave early from the surgery so I missed the part where they closed everything up. Either way it was a really interesting operation to watch and I enjoyed it quite a bit.

Thursday - day-case surgery. Not going ever again. It was pretty boring as we just did a bunch of procedures to fix anal fissures/fistulas/etc. I didn't really enjoy it and my consultant did pretty much no teaching either. I was pretty excited to just go home and get ready for the epic Medics Fancy Dress Pub Crawl. Obviously that meant I couldn't go into placement on Friday. The registrar told me to go to clinic on Friday morning and I told her "I don't think I'll make it." She gave me a really confused face and I just smiled and laughed nervously. My consultant picked up on my nervous laugh and he was really cool about it and was like "Yeah....clinic will be boring so just sleep in and I'll see you next week *wink*" The registrar was pretty clueless. Pretty sure everyone else got the gist of what I was saying, except for her. I guess she would find out if she ventured out to city centre that night. Haha.

Anyways pretty slack and uneventful week. Wednesday was definitely the highlight of my week though.