Oh and Merry Christmas :)

I am tired today. My feet ache from standing in one place for so long. Today's surgeries went well and there is always a feeling of accomplishment when you know you did the patient right or at the very least they are better going out the door than what they were coming in. We had such an interesting case of a man with an inferior vena cava (IVC) aortic fistula. His IVC had a diameter of about 9cm and he was pumping literally liters of blood into it from his aorta which caused heart failure and pulmonary congestion. His belly sounded like a very loud machine and made you wonder why this had gone undiagnosed for so many years. Well, his belly is quiet (other than the gurgle and burps of bowel sounds) now and it was nice to have a surgery go so smoothly and with so little blood loss.

I know that I work in vascular surgery but I still have a hard time with large quantities of blood. It just makes me rather anxious to see the blood dripping on my feet and pooling in front of me as I remove sponge after sponge from a bleeding cavity. I know that we could do a better job at hemostasis. hmmm .... perhaps this is a bit graphic for the average reader. Still, this is what I do every day and most of the time it is exhilarating.

Actually I don't think it is the blood per say but the way that the surgeon seems to have so little mind of it and of other very scary things. For example, we ended up having to remove part of a rib during a very complicated case a few days ago and I was literally holding this mans lungs down so that the saw wouldn't open the pleura and cause some real problems. Not only were we in the middle of the brachial plexus (which for the average reader is a complex webbing of nerves in the arm that if disrupted could destroy the arms function completely) but there were arteries and veins and lungs and lots of other vital things. It was stressful. I really do love my job.

Oh and Merry Christmas :)