Sunday, October 22, 2006

Surgery, While Awake

One of the fun parts about our surgery procedures is that the patient is awake the whole time. Unlike the controlled operating room setting, where the patient is out cold, you never know what can happen.

Like the time when the patient reached his arm up to scratch his nose, right next to the gaping hole we were trying to sew up. Very sterile field, I tell you.

Or when you're working next to the mouth, and a talking patient means a moving target for the suture needle.

You know you're good when the patient starts snoring. Or is that just a sign of old age and chronic sleep deprivation? Probably just good local anesthesia.

The best is when a patient falls asleep and wakes up in the middle of the procedure with no recollection of what they are doing on the table. Classic.

The really neat part, though, is the amount of time you get to spend per patient. Unlike regular dermatology clinics, where you've got at least four patients scheduled per hour, once you've started to cut, time is no longer an issue. You take as long as you need to close up.

Some patients have quick procedures. Others have more bleeding because of their medical conditions or because of blood thinners. Whatever the case, you still have a good half hour to hour with each patient. Who can talk back to you. So assuming the area of interest isn't right next to the mouth, you can learn a lot about that person and their life in that hour. Talking to them helps distract the few really nervous patients, but it's also fun to learn more about what who these people are. You learn that Mrs. X was one of the first women in the air force. And Mr. Y was a famous costume designer for Vegas showgirls before retiring rich. Or that Mr. Z used to be an Alaskan who would winter in Australia. Such a wonderful variety of patients come through our doors, and it's a pleasure to get to learn from them all.

photo credit


Blogger ipanema said...

Oh my God, I still remember when I had my first born. I gave birth through CS and I woke up in the middle of everything. I saw the thread and needle! They were stitching me. After that, I'm always afraid being on the table. It gives me creeps.

Something I have no recollection was during the time I had my a herniated disc operation. So, It was general anaesthesia. I woke up in the recovery room.

What I'm afraid is the anaesthesiologist. I'm afraid the dosage might be too much that I won't be able to wake up. Or too little that I can feel when they do incision. :)

Just sharing. Your post reminds me of my personal experience. I dont want to stay awake. :)

11:25 PM  
Blogger always learning said...

Ipanema - Wow. I hope you didn't feel the stitching!! I think most people are afraid of the operating table. I'm terrified of the thought of one day being a patient in the OR and having general anesthesia. Gives me the heebie-jeebies. I'd take local anesthesia any day. Or perhaps accupuncture. :) Apparently if you do it right, you can have great pain control for certain procedures.

9:59 PM  

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