Tiger Board Logo

Donor's Den General Leaderboards TNET coins™ POTD Hall of Fame Map FAQ
GIVE AN AWARD
Use your TNET coins™ to grant this post a special award!

W
50
Big Brain
90
Love it!
100
Cheers
100
Helpful
100
Made Me Smile
100
Great Idea!
150
Mind Blown
150
Caring
200
Flammable
200
Hear ye, hear ye
200
Bravo
250
Nom Nom Nom
250
Take My Coins
500
Ooo, Shiny!
700
Treasured Post!
1000

YOUR BALANCE
In physical pain this morning
storage This topic has been archived - replies are not allowed.
Archives - General Boards Archive
add New Topic
Replies: 21
| visibility 1

In physical pain this morning


Nov 3, 2020, 8:23 AM

I started a case yesterday at about 12:30, a Type IV paraesophageal hernia on a 50 some odd year old guy with a BMI around 30. His whole stomach, transverse colon, omentum, duodenum, and tail of his pancreas were all in his chest. He had pain every time he ate, shortness of breath, and had lost about 40 pounds in the last six months. I spend about 4.5 hours on the robot and it just was not coming down. The hernia sac was stuck all to both lungs, the heart, and the aorta. So I decided to open him and called my senior partner to come help. I am in utter shock that the old heads used to routinely do this case open, it is physical and back breaking labor. I had by elbow at this mans hiatus with my entire forearm in his right chest pulling down incarcerated omentum to finally get it all to pull down. Took us another hour to clear all the hernia sac off the hiatus and get it exposed, then I used about 8 pledgeted ethibond sutures and sewed it back together in the deepest hole I’ve ever had to work in, way harder and tighter space than all the rectal cases, pancreas, liver transplants, etc. Did a suture and tube gastropexy and closed up around 830-9. Hands down the hardest case I’ve ever done. Feeling this morning like I ran a marathon and did some qweer crossfit routine.

Did not get to cook the salmon that was on the menu last night. The whole week’s menu is now thrown off.

2024 orange level member flag link military_tech thumb_downthumb_up

Eeewwwwww!


Nov 3, 2020, 8:27 AM

Hope there was no Rona in there!

flag link military_tech thumb_downthumb_up

I read all that and came away with.......


Nov 3, 2020, 8:27 AM

damm his menu for the week is screwed.

#GoodJob

2024 orange level memberbadge-donor-10yr.jpg2011_nascar_champ.gifringofhonor-celti_tiger-110.jpg flag link military_tech thumb_downthumb_up

.


Re: In physical pain this morning


Nov 3, 2020, 8:27 AM

did you remember to check the lint filter?

badge-donor-05yr.jpg flag link military_tech thumb_downthumb_up

Re: In physical pain this morning


Nov 3, 2020, 8:38 AM

Dang it! I knew I forgot something

2024 orange level member flag link military_tech thumb_downthumb_up

I feel for you, but on the flip side, I bet


Nov 3, 2020, 8:28 AM

you made what, $200? $250 from that procedure? Some people don't make that much in a week!

2024 orange level memberbadge-donor-20yr.jpgringofhonor-obed.jpg flag link military_tech thumb_downthumb_up


Re: I feel for you, but on the flip side, I bet


Nov 3, 2020, 8:31 AM

Dude even though I get to practice independently here, I’m still paid like a fellow. I didn’t earn dickall. My reward is the sweet satisfaction of a learning opportunity

2024 orange level member flag link military_tech thumb_downthumb_up

LOL wut?


Nov 3, 2020, 8:32 AM

If you'd left a rubber glove in his chest I'm guessing you wouldn't get indemnity for doing the job gratis, no?

I mean, I get it, but it doesn't seem right. Medical career pathing is just bizarre.

2024 orange level memberbadge-donor-20yr.jpgringofhonor-obed.jpg flag link military_tech thumb_downthumb_up


Re: LOL wut?


Nov 3, 2020, 8:36 AM

Just did some quick math, if I did this case next year at a pretty standard rvu conversion factor for private practice, it would be about a $1800 case. My malpractice is covered by the hospital here, but if I’m named in a suit or even if it’s settled, I have to put that on all future license applications.

2024 orange level member flag link military_tech thumb_downthumb_up

I'm assuming that for cases like you just described,


Nov 3, 2020, 8:38 AM

that would generally be your only surgery of the day? Or would you have to scrub up and move to the next one?

2024 orange level memberbadge-donor-20yr.jpgringofhonor-obed.jpg flag link military_tech thumb_downthumb_up


Re: I'm assuming that for cases like you just described,


Nov 3, 2020, 8:41 AM

No, with the way OR block time works you usually will have 3-4 cases a day. Just before this one I did a sleeve on a woman with an LVAD to help her get a heart transplant. Fortunately those were my only two cases of the day, but yeah if something goes off the rails and you have more work to do... go take a leak, have a Diet Coke, and go get back to work. It’s hard to mentally clear the slate after a hard case, even worse when something actually bad happens and a patient gets hurt or isn’t doing well.

2024 orange level member flag link military_tech thumb_downthumb_up

Oof that hurts to even think about.***


Nov 3, 2020, 9:08 AM



2024 orange level memberbadge-donor-20yr.jpgringofhonor-obed.jpg flag link military_tech thumb_downthumb_up


Re: In physical pain this morning


Nov 3, 2020, 8:46 AM

That brings back a lot of memories. My dad and I did that to a lot of female hitchhikers growing up in the 80's. Good times. Miss you Dad!

flag link military_tech thumb_downthumb_up

Sounds like the time I helped my animal science major


Nov 3, 2020, 8:46 AM

roommate pull a stuck calf. We were both shoulder deep in there trying to turn it. Wound up using a strap and a come along. My wrists and shoulders ached for 2 days after. If I’d had any thoughts about changing my major to AS, that cured me.

Mom and calf were find btw.

2024 orange level memberbadge-donor-15yr.jpgringofhonor-cu85tiger.jpg flag link military_tech thumb_downthumb_up

“Anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that my ignorance is just as good as your knowledge.”
Isaac Asimov


“You should see the other guy”***


Nov 3, 2020, 8:55 AM



2024 white level memberbadge-donor-15yr.jpg flag link military_tech thumb_downthumb_up

null


Lost 40 pounds and was still BMI 30


Nov 3, 2020, 9:01 AM

####, just ####.

badge-donor-05yr.jpgringofhonor-aero.jpg flag link military_tech thumb_downthumb_up

^^^loves to spend his entire day inside of other dudes' guts***


Nov 3, 2020, 9:06 AM



badge-ringofhonor-clemsonsteve02.jpg flag link military_tech thumb_downthumb_up

You said a bunch of words, made me think of this


Nov 3, 2020, 10:15 AM

https://www.youtube.com/watch?v=lBp5ag6SJH4

Also, well done man, glad someone like you exists.

2024 orange level memberbadge-donor-10yr.jpg2011_pickem_champ.jpgbadge-ringofhonor-soccerkrzy.jpg flag link military_tech thumb_downthumb_up

Cole @ Beach Cole w/ Clemson Hat


TLDR version here for anyone interested:


Nov 3, 2020, 10:35 AM

Didn't have seggs.

Worked.

Has salmon in fridge that needs to be cooked.

flag link military_tech thumb_downthumb_up


After all that, maybe you should think about a hiatus.***


Nov 3, 2020, 12:38 PM



flag link military_tech thumb_downthumb_up

"*About* 8 pledgeted ethibond sutures"?


Nov 3, 2020, 2:58 PM

That sentence seems inexact and a bit worrisome.

(Just kidding, I don't shive a git)

2024 orange level memberbadge-donor-15yr.jpg flag link military_tech thumb_downthumb_up

"Every man is my superior, in that I may learn something from him."


Re: "*About* 8 pledgeted ethibond sutures"?


Nov 3, 2020, 3:06 PM

Eh who’s counting

2024 orange level member flag link military_tech thumb_downthumb_up

Replies: 21
| visibility 1
Archives - General Boards Archive
add New Topic