Bring on the Smelling Salts!

My attending had no cases today (surprise, surprise - I don't know what he does most of the time...), so I decided to go in on the case with the Chair of the Vascular Surgery department. The case was an ex vivo renal artery bypass to repair a renal artery aneurysm. The renal artery supplies blood to the kidney. An aneurysm is a big 'ol in an artery (like a balloon), where the artery is weak and can rupture. "Ex vivo" means that they dissect the kidney out, and pack it in ice and preservative material so that they have more time to work on the problem.

This was actually the first big, open abdomen case I've worked on. Most of the things I've seen with my attending have been endovascular - meaning, all I see is a TV screen showing x-ray images of what is going on inside the body. Good for the patient, boring for students to watch... Well, boring for me anyway.

Okay, before I start complaining (cause I'm gonna complain), let me just say: the abdomen - the inside guts part - is pretty! The colors are, I mean. Kind of like this color scheme (don't worry, Lindsay, this isn't a picture of actual intestines). Very pastel-y and pretty. I'd decorate my room in the colors of 'intestine.' Especially if you could add a little spleen for accent. (this one is, so don't click it Lulu)

Did everyone know that Lindsay's new nickname is Lulu? Well, it is. So say I.

ANYWAAAAY. On to the complaining. Well, maybe not so much complaining as...okay, really, it is just complaining.

The operation started at about 7:30 - the first incision, that is. I was helping to prep the patient by 7:10. Let me set the scene:

1. Head of the Vascular department.
2. Who liked asking me questions.
3. Whose answers I did not know. Gerota's fascia for future reference.
4. It was hot. At one point, Dr. Surgeon said: "The patient's temperature is under control, let's turn the thermostat down to 75." Down to 75.
5. I had a granola bar and some coffee for breakfast. At 5.
6. My 'monthly' started today.
7. I had taken four Advil. At 5.
8. The Advil wore off. Cramps. Ugh.
9. There was nothing for me to do but stand there.
10. Until they turned the heat back up, and wanted me to do something with stitches - I'm still not quite sure what...
11. My back hurt.

I lasted until 3. I started feeling bad around 1pm, and awful at about 2. I'm surprised I lasted as long as I did. I decided that I should break scrub when I started kinda blacking out... The annoying thing was that they were done 40 minutes later. I almost made it! Grrr. The anesthesiologist did tell me that the patient had more color than I did...generally not a good thing...

They say it happens to everyone. So far, 2 of the 3 of us on vascular have had to break scrub. We'll see if the other one holds out!

And, as a side note for the girls - if you're ever in a situation where you find yourself saying: "Well, it is only the first day of my period, and this pad is pretty absorbant; plus I'll be standing, not sitting, so less likely to get leaks; plus these scrub pants are enormous, so how could it leak thru to them anyway? And how long can an ex vivo renal artery bypass take? Surely not over 7 hours" Just say NO. And go find the nearest tampon dispenser.