Interesting day...

I started a little late, 6:30am for rounds instead of 6:00am. Got done by our 8:30am, but it ended up being a hernia repair instead of a planned colonoscopy. We repaired the guy's hernia last week. It was a huge one he had had for years with pretty much all of his bowels in front of the remains of his abdominal wall. He had lived a hard 61 years.

Well, we had hernia repair wound dehiscence. So our surgical Attending started the week in a foul mood. At least he doesn't take his anger out on personally. Still, everyone tends to tiptoe around the OR on days like this. The patient's tissue was so bad that he tore the sutures holding the mesh down. He had an elastic binder and staples holding his guts inside, so we had to rush him to surgery before they spilled onto his bed!

The surgery was very extensive. We put down two layers of mesh this time, and huge pieces sutured almost to his sides. If they tear out this time, he may have to live with the result because there won't be enough good fascia left to suture.

Then we had a radioactive labeled sentinel biopsy and mastectomy. It was another hard life case. She had a tumor as hard a rock encompassing most of her breast. It must have been palpable for years. The lymph nodes came back metastatic. So in addition to losing her breast, she's going to get at least radiation treatment. That's best case, if we don't find any metastasis.

Then Jason and I grabbed a quick dinner and saw a new consult in the ER (inguinal and scrotal abscesses) before rounding on our patients with our Attending. It was pretty quick, but we didn't get done until 7pm so it was a long day.

Now it's time to start studying!