August 21: Final Day of Surgery
Well here I am on the ward at 10:10 pm on the final day of surgery. However, it’s not because of a glitch in the half-day schedule. We had just 13 patients today, 12 adults and one 12 year old girl who was the daughter of one of the adult patients. Most patients had local anesthesia with a bit of IV sedation, and four, including the 12 year old, had general anesthesia. The last patient arrived on the ward at about 1:00 pm, and the plan was for most, if not all to go to shore on the 5:00pm Tender. However, only four patients decided to go home today as it turned out several of the patients live several hours by car from Santo Domingo. By the time they reached the shore and were transported home, it would have been quite late. Besides, the beds and food are great. The night nurses were disappointed to hear that patients were staying as there is a salsa dancing party tonight in the large entryway of the OR where we have muster. Bruce and I volunteered to take care of the ward patients for the evening until 11:00 pm so they could enjoy the party. We’re both happy to have an excuse to skip this event (without appearing to be antisocial,) and they’re ecstatic at the opportunity to flirt with the men in uniform.
Except for taking vital signs every four hours and making sure pain medications and fluids were being taken care of, it wasn’t very demanding for the first hour. At that point, a 34 year old woman had an allergic reaction to ibuprofen and a 53 year old man with recently diagnosed hypertension began having a rapid heart beat and chest pain. We had his pre-op EKG and his cardiologist’s letter of evaluation, clearing him for surgery, and a copy of his normal echocardiogram as well. The woman responded nicely to Benadryl and fluids, and the man’s EKG tonight was unchanged from pre-op. Nevertheless, we did decide to consult the Navy cardiologist who reassured everyone. He put the symptoms down to dehydration so I unplugged the monitor and handed over a jug of juice. Now we’re ready for the nurses to return and go back to being pediatricians.
Just before dinner, we trekked all the way down to the end of the ship to the Fantail to take our team photo. I took a couple of pictures of an amazing cloud formation and posted one on Picasa. It’s the first time I’ve been outside all week and made me very eager to return to land. Tomorrow, after we discharge the patients, they will leave on the 9:00 am boat. We have to be ready to leave on at about 9:30 when it returns. We'll arrive back on land about four hours before we can check into the hotel, so an excursion to a local craft market is planned.
The last day of surgery is always a half day and usually the patients are older and are having procedures under local anesthesia. I always enjoy seeing these patients who are leading their lives like anyone else. If the previous day's parents are still around, I often see them together, talking, looking at the babies' faces, pointing to their own scars. For the most part, I think it's very relieving to these young parents to see happy, successful young and old adults who started life with same challenges their babies are facing. Of course there are many adults with sadder stories, but in countries with developed or developing cleft programs, more and more infants are being seen early. so their are fewer older kids and adults left untreated.
I'll be up early tomorrow to do the discharges and then pack up for the trip to shore.
Well here I am on the ward at 10:10 pm on the final day of surgery. However, it’s not because of a glitch in the half-day schedule. We had just 13 patients today, 12 adults and one 12 year old girl who was the daughter of one of the adult patients. Most patients had local anesthesia with a bit of IV sedation, and four, including the 12 year old, had general anesthesia. The last patient arrived on the ward at about 1:00 pm, and the plan was for most, if not all to go to shore on the 5:00pm Tender. However, only four patients decided to go home today as it turned out several of the patients live several hours by car from Santo Domingo. By the time they reached the shore and were transported home, it would have been quite late. Besides, the beds and food are great. The night nurses were disappointed to hear that patients were staying as there is a salsa dancing party tonight in the large entryway of the OR where we have muster. Bruce and I volunteered to take care of the ward patients for the evening until 11:00 pm so they could enjoy the party. We’re both happy to have an excuse to skip this event (without appearing to be antisocial,) and they’re ecstatic at the opportunity to flirt with the men in uniform.
Except for taking vital signs every four hours and making sure pain medications and fluids were being taken care of, it wasn’t very demanding for the first hour. At that point, a 34 year old woman had an allergic reaction to ibuprofen and a 53 year old man with recently diagnosed hypertension began having a rapid heart beat and chest pain. We had his pre-op EKG and his cardiologist’s letter of evaluation, clearing him for surgery, and a copy of his normal echocardiogram as well. The woman responded nicely to Benadryl and fluids, and the man’s EKG tonight was unchanged from pre-op. Nevertheless, we did decide to consult the Navy cardiologist who reassured everyone. He put the symptoms down to dehydration so I unplugged the monitor and handed over a jug of juice. Now we’re ready for the nurses to return and go back to being pediatricians.
Just before dinner, we trekked all the way down to the end of the ship to the Fantail to take our team photo. I took a couple of pictures of an amazing cloud formation and posted one on Picasa. It’s the first time I’ve been outside all week and made me very eager to return to land. Tomorrow, after we discharge the patients, they will leave on the 9:00 am boat. We have to be ready to leave on at about 9:30 when it returns. We'll arrive back on land about four hours before we can check into the hotel, so an excursion to a local craft market is planned.
The last day of surgery is always a half day and usually the patients are older and are having procedures under local anesthesia. I always enjoy seeing these patients who are leading their lives like anyone else. If the previous day's parents are still around, I often see them together, talking, looking at the babies' faces, pointing to their own scars. For the most part, I think it's very relieving to these young parents to see happy, successful young and old adults who started life with same challenges their babies are facing. Of course there are many adults with sadder stories, but in countries with developed or developing cleft programs, more and more infants are being seen early. so their are fewer older kids and adults left untreated.
I'll be up early tomorrow to do the discharges and then pack up for the trip to shore.
No comments:
Post a Comment