Category: Work

And baby makes Three

Well actually it’s four, given that Jack is such an integral part of the family.

Today Simone had her first (12 week) ultrasound of our first attempted child. Apparently all is well to date with bones being where they should be and the like. Another 2 months before we get to the good scan (with fingers and brains and heartbeats etc) but it’s still a significant milestone. According to or reckonings it should be cooked and ready on about the 20th of April next year, although for those inquisitive souls out there you may have to wait until then to find out a sex, as we think we’re going to let it be a surprise.

In other related news Simone is planning on taking next year off work, and since Cairns have offered me a non-training job doing Orthopaedics we’re going to be staying in Cairns for another year, which obviously wasn’t the initial plan when we decided to come up, but as they say, life is what happens when you’re making other plans.

Abroad

Right. I’m off to NZ (Dunedin to be exact) on sunday for the next 6 weeks.

I’m going in order to attend an exam preparation course for the Surgical Part 1 exam, and then to sit the exam in October.

It’s going to be great to be back in my old undergrad stomping ground, but I don’t think I’m going to get to have as much fun as I would really like to.

It will also be interesting how cold it really seems, after my 6 years in Queensland.

More news will follow once I get there.

And red cells for all!

Well I’ve just finished my week relieving on the Haemotology and Oncology team, and have become quite blase about dealing with patients with no blood.

Hb 90? sure, I’ll organise a transfusion (although only 90… that’s not trying very hard). Hb 50? Better make that 4 units. Platelets of 13? That’s better than yesterday, but I suppose we’d better give you some irradiated platelets anyway. White cell count of 2? Well you’re fine to go home! Nausea post chemo? Lets start with 8 of ondansatron and go from there.

Before you do it you think that these patients are REALLY sick and delicate. Afterwards it just seems like another group of people who require amusing while nature (and chemo) cure/hold off the disease.

I did this!

To quote the famous Shelly poem: “Look on my works, ye mighty, and despair!”

A few weeks back I got the opportunity to fix my first ankle. Now seing as I can’t lay my hands on the pre-op xrays (they must have been private films, and went home with the patient), you’re just going to have to take my word for it that on the side of the ankle joint where you can see the screws going in, there was a fracture, and the pointy tip of the tibia (the big bone) was floating free. Now this is important because that tip stops the tibia shifting side to side on the top of the foot, so if it’s broken the ankle can become unstable.

So seing as I was being keen and hanging around late to help with the operation, my reg actually let me do it (under closely watchful eyes and with numerous pointers of course). Getting down to the fracture was easy. Getting the fractured tip shifted back into the right spot was easy. Holding it there with a clamp was easy. Getting the first (upper) screw in was easy. Getting the second screw in (which stops the fragment rotating around the axis of the first screw) was a monumental pain in the arse, and I eventually had to get the reg to put it in for me. Still it was loads of fun. Whheeeee. I wanna go again!!!

So behold my glorious handiwork (and make plans not to break any bones in any proximity to me, lest I try my skills out on you 🙂

(click on the picture to see a larger version)

Inside my skull

Things appear to be getting to me a little.

I’ve been studying hard, and to put myself to sleep at night, reading my way through the harry potter books (reading fiction while lying down = dave asleep in 10-15 mins, which is a good system really).

Anyway, the last few days I’ve been having some odd dreams while I’ve been resetting my body clock after a week working overnights.

Firstly I woke up the other day from an afternoon sleep with a strange sense of foreboding, and a non-specific feeling of concern for Neville’s wellbeing. I explained this to Simone, who said “Neville who?… … Longbottom?”, and I said yes. She wasn’t sure which was more wierd, me dreaming that Neville needed help, or that she immediately knew who I was talking about.

Then yesterday morning I awoke after a dream where I was reading through my anatomy book, and found 4 pages that I had somehow missed, which in really tiny print listed the names, nerve supplies, actions and attachments of about 200 muscles in the arm, and I suddenly realised why I didn’t understand how the arm worked, and that there was no way I could possibly learn all those muscles. And then I woke up…. sweating…

No beer and no TV makes David something something.

Job satisfaction

This evening I spent the last 4 hours of my shift working very hard to fix one patient.

She came in following a fall with angina (heart pain). We found she had a low haemoglobin (bad), an acutely high creatinine (bad – means kidney failure), a very high blood potasium level (bad – can cause heart arrhythmias) and a metabolic acidosis (quite bad – means blood pH has become acidic which stuffs up all the chemical reactions that rely on a steady pH balance).

I spent the 4 hours doing all manner of things, in order to slowly move her from our initial assessment of “Oh crap, this lady might be going to die” to “Well, she looks better, and feels better, and her blood test results have improved. She might be able to go home after a few days in hospital”.
And she was a kindly and deserving old lady (not that most patients aren’t deserving, just some you can’t help feel are more deserving than others), which makes the suspicion that you may have earned her a few more months or years to spend with her family and friends all that more satisfying.

I found myself quietly grinning all the way home. This is what I love about my job.

(In fact I ended up seeing an uncharacteristicly small number of patients this shift, but they were all more-than-averagely-deserving individuals with interesting and non-straight forward problems, so the whole day was pretty satisfying – I even got to give a kid a piggy back ride up to the kids ward).

The proud, the few…

Following the Black Caps’ victory over the south africans the other day I decided to display a bit of patriotism and wear my Beige Brigade shirt to work.

Now since I’m working nights the change in dress formality level was hardly noticed, although one patient did see the emblem and joke that perhaps he sould be asking for another doctor, one who supported the right team…

Violent green flashback

When I was summering in Canberra one of the refreshment options at the hall of residence we were in was this lurid green cordial. We referred to it as “violent green”, as in, “would you like a glass of green?”, or “violent green anyone?”.

Since starting my ED term I have discovered that the hospital also stocks violent green, and I have found that every time I have a glass of it I have the most vivid olfactorily mediated flashbacks to the fun and games that was my superb summers in Canberra.

Who would have thought something so simple (and bad for you) could have such powerful effects.

Caffeine, panadol, and the 4am breakfast

Well I’m back in ED and back working the overnight shift again for a week.

I actually came up with the title for this entry last year when I found myself surviving my overnight stints in ED with a combination of (carbonated) caffeine to stay perky, regular panadol to stave off the inevitable headache, and wierd eating habits, particularly having dinner at 9 or 10pm just before you go to work, and breakfast at 3 or 4am when you get peckish.

Tonight we managed to get all our patients sorted out by about 3am, so since then we’ve been in the unusual situation of finalising the last few extra-for-experts jobs on our remaining patients, chatting about the kinds of incessant crap that you talk about at 3am, and reading novels/trashy magazines/new scientists (depending whether you’re the intern, the head nurse, or myself (respectively)).

Luckily (or unlickily depending on how you look at it) the sun is starting to think about peeking it’s head up as I am writing this, and that means that it’s not too long until the morning staff come on and we can go home, but also not long before everyone starts waking up and realising that they’re sore/sick/bored and need to come up to the hospital.

That’s probably enough early morning incoherence for the moment.