Thursday, December 07, 2017

Hello darlings how are y'all doing?? I swear writing this post took me time. Was not really in the mood to so, sorry in advance if this ain't as detailed as it ought to be. The department was so disorganized.

So, I talked about moving to the department of Surgery in which I started with orthopedics in this post HERE. In the department of surgery, we all are expected to do some minor postings one week each and the major posting for six weeks which makes it a total of 3months (12weeks) in the department.
All postings are important for us to do and i'll just list out the minor postings:
Ophthalmology: A branch of medicine that deals with the anatomy, physiology and diseases of the eyeball and orbit
Otolaryngology: A surgical sub speciality which deals with conditions of the ear, nose, throat and also deals with related structures of the head and neck. Its also known as ENT.
These two minor postings don't do calls which involves you working and sleeping at work overnight. Surgeries are done on some days and some other days were for clinic: following up on old patients and seeing new ones
Casualty/Emergency: This is where we get to attend to patients as they present at the hospital. We get first hand information here and stabilize  the patient by providing the necessary first aid before deciding on the managing team or if the patient has to be referred to another hospital which depends on the severity of the disease and the specialists needed. Didnt really like this minor posting because sometimes the influx of patients can be crazy. You get somedays off though during the one week. You also get the opportunity to provide first aid, learn to suture, etc.

So for the major posting, you get to do one for 6 weeks which could be one of the following:
Urology: Known as genitourinary surgery which is a branch o medicine that focuses on surgical and medical diseases of the male and female urinary tract system and the male reproductive organs.
They specialize in issues like Benign prostatic hyperplasia, erectile dysfunction, cystitis, prostrate cancer, urethral stricture, prostatitis

Pediatrics Surgery: A subspecialty of surgery that deals with the surgery of fetuses, infants, children, adolescents and young adults.
General Surgery
From the beginning, I always wanted general surgery. I didn't see myself in Urology especially after finding out the on their clinic days they tend to change catheters eww. So disgusting and I was so sad when they were short of house officers and they had to come and borrow me from my own unit to work in theirs. Pediatrics surgery wasn't also on my mind because I just wanted general surgery and wasnt prepared mentally to start working with kids setting lines for them and just wanted to save everything kids for my pediatric posting.

Before I start talking about my experience in General surgery, from the first day I got there they were so disorganized. Some units were short of house officers and along the line and towards the end of my posting, I was the only house officer in my unit and it was so horrible coupled with the fact that I was in the HOD's unit.
Every day of the week, we do our rounds in the morning as house officers and then the Consultant decides to do his rounds whenever he chooses to which means you must always be on ground irrespective of where you stay. So inconsiderate!! There was a day my Consultant fixed a surgery for 6am it wasn't even funny despite being at work till 10pm the the previous day. I managed to get to work around 6:35am I was threatened with extension. Extension means spending extra week(s) during your posting. Very funny!!
My Medical House officer was nice to work with. He was always available and knows so many procedures. He also doesn't wait or depend on house officers, he does his thing.
Mondays: Major Surgery days where we do cases like:
Appendectomy: which is the surgical removal of the appendix. Some times, they are managed conservatively.
This was a very interesting surgery. The appendix was discovered to be gangrenous during the surgery and even my consultant had to ask for a picture as it was his first time seeing such during all his years of practice.
Exploratory Laparotomy: Involves the opening of the abdominal cavity and examination of the abdominal organs in cases like intestinal obstruction, chronic vomiting, Abdominal pain, abdominal masses etc. There was a particular patient who had cancer of the sigmoid colon and we had to do what is called Resection and anastomosis for him.
Mastectomy: The surgical removal of one or both breasts in case of Cancer.
Herniorrhaphy: Surgical repair for correction of a hernia which is a bulging of internal organs or tissues through the wall that contains it.
Tuesdays & Fridays: We start by doing our ward rounds as house officers which involves checking on our patients especially those that had surgery to inspect their wound, check if they are getting their medications and if they have any complain and when our Consultant or Medical Officer is ready, they do their own rounds and we document for them. Unlike my Medicine posting, we usually get less patients. After the rounds, we do mop-ups which involves taking blood samples and making sure instructions given out by our superiors are carried out.
Wednesdays: Special and only day for clinic also our permanent call days. After attending to patients at the clinic in which most of them are for follow up from surgery, those with new complaints and those to book for the next surgery day, we then go tho the emergency room to start our call. Sometimes we are lucky enough not to have patients waiting for us. On our call days, we see all surgical cases irrespective of if it has to do with kids or not. As house officers, we clerk them, work them up, stabilize them and hand over to the main unit that should be in charge. For instance, any pediatrics case is handed over to the pediatrics surgery unit the next day or any case that has to do with the male and female urinary tract is handed to the Urologists. Same goes for other units on call. they hand over a general surgery case from their call for proper management the next day. Most general surgery cases I witnessed were usually emergencies which means we had to start working them up almost immediately and move them to the theatre. Some patients are also transferred to the wards for conservative management. We also do some procedures like passing catheter, passing chest tube & nasogastric tube.
Common cases we see on call days are Hernia, Acute Appendicitis,  Ruptured Appendicitis,Intestinal Obstruction, Burns, Head Injury, etc.
Thursdays: Minor surgery days where we do procedures like excision biopsy, Incision & drainage incase of abscess, Debridement, Incision biopsy
Fridays: We do our rounds, mop-ups, and draw out the list of patients going for surgery on Monday. The list is submitted in the theatre, patients ward and also given to the anesthetist who reviews to see if the patient is fit for surgery.

Saturdays & Sundays: This was the best part. We usually had our weekends to ourselves and unlike medicine, it wasn't a must to come and see the patients as most of them are usually stable unlike Medicine where patients can just die anyhow :(. My MO was also nice enough to check up on the patients weekends since he doesn't stay too far from the hospital.

During the 6 weeks posting in surgery, theres something called weekend call which means you start you call Friday till Monday morning and then do your unit activity for that Monday then go home after which also depends if your permanent call days are Mondays or not. For those that had their permanent call days as Mondays had to work from Friday till Tuesday which is not something funny.
We also get consults from the Medical team for procedures like venous cut down which is an emergency procedure in which the vein is exposed surgical and then a cannula is inserted into the vein, insertion of chest tube done to remove air, fluids or pus from the intrathoratic space, passage of Naso gastric tube which can be used for feeding, administering drugs to patients and also use to drain the stomach's content( gastrointestinal secretions and swallowed air).
I tried my best for this post guys. It wasn't so interesting for me. I don't think I will ever consider doing surgery.
Thanks for visiting and see you all in my next post. Cheers!!

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