Thursday September 13, 2012

Today my frustration is at an all time high. It is our last full day of operating, and once again patients who have not been mentioned to us have been placed on the OR schedule, as well as an older man with a hernia. We specifically agreed that we would not do hernias today, as we had too much else to do. We arrived in the OR to find we have 6 cases scheduled, including the acute abdomen, a boy for an ileostomy decommissioning, a mastectomy, an axillary dissection, and a hernia ! Our first case was the acute abdomen admitted yesterday. Anesthesia finally put him to sleep around 9:30; the length of time from patient in the room to induction of anesthesia seems to have lengthened exponentially on this trip, for reasons that are unclear. Anyway, he turned out to have an unresectable gastric cancer with carcinomatosis, so Jonathan and Moses just closed him up. I went to the Out-patient Clinic and saw patients of what seemed to me to be at least an hour and a half. When I came back up to the OR, they were just starting the second case, which was the ileostomy decommissioning. Of course nothing is simple today, and that is taking a long time. Meanwhile, the lady for the axillary dissection is getting antsy, and the man with the hernia is up here wondering when he will get done. I asked about opening a second room, but there aren't monitors for that room or there isn't staff or there is some reason they can't. It's now almost 1 PM, and we still have a lot of work to do. I'm irritated to say the least. On the good news side, young Joshua with the huge mass on his back returned to the clinic today. His chest xray looks fine, as do his labs, so Konneh is arranging for him to be admitted and have blood for surgery tomorrow. Josephine Reece, the Chevron/Baylor pediatrician, was kind enough to allow us to take a Pedi ER bed for him as there are no pedi surgical beds available to us currently. I'm hopeful that we can excise it rather than just biopsy it. I forgot to mention that Tubman's revenge ( Tubman being the West African cousin of Montezuma) struck me last night with full force. I was a bit shaken, but seemed okay this morning. While we were doing the mastectomy this afternoon, I started sweating and got dizzy and nauseous, I think due to dehydration. I thought I was going to faint, so I asked Moses to scrub in with Jonathan and finish the case. I went to the lounge, and Percillar was kind enough to get me a couple of bottles of water. I felt well enough to do the axillary dissection on Ms. Johnson, but I am sitting out the last case of an acute abdomen. My GI tract feels fine, but I'm feeling achy and feverish, and I'm looking forward to going home to rest. We were supposed to go to Jonathan's aunt place again, but I think I will give that a pass. He might too depending on how late it is when they finish. There was a significant delay in starting the last case because they needed someone from Pharmacy to come up and man the OR Pharmacy room; that room not only dispenses drugs, but also sutures, gloves, and IV fluids among other things. I am reminded that after our first visit, Colleen compiled a list of the Top 10 hurdles to getting an operation done at JFK; over the intervening 3 years, I think some of the hurdles might have changed, but not too many. After we left the hospital Jonathan went to see his relative; I chose to come back to the apartment as I have no desire for food or anything other than my bed and some water. I'm hoping this is gone tomorrow !