Nothing can make my day like watching a fractured clavicle being screwed back together. I finally got to watch some seikei geka (orthopedic surgery) today. I had been waiting for this for four months and it was certainly worth the wait. There were scews and titanium pins and electric drills and screwdrivers and wire cutters... They actually bored the grooves into the bone for the screws! Come on, how awesome is that?! Oh man, it was excellent. To quote Christina from Grey`s Anatomy, it was "like candy, but with blood, which is so much better!"
I love Seikei.
Showing posts with label surgery. Show all posts
Showing posts with label surgery. Show all posts
Wednesday, 26 December 2007
Monday, 10 December 2007
げか 2 - Surgery II
I went back into surgery on Wednesday. It was only the third time I have been in there but it felt like the hundredth. I feel like I have been watching surgeries all my life, but each one is still just as amazing as the first one I saw.
I watched two operations on this visit: a Cholecystectomy (removal of the gallbladder) and a skin graft.
Cholecystectomy:
This was an endoscopic (or laparoscopic) procedure. Several small incisions are made at strategic points on the patient's abdomen and then the surgeon detaches the gallbladder and pulls it out through one of the holes. This particular patient had a rather bad case of gallstones, so his gallbladder was very enlarged. It was about the size of a pear, and the incisions are roughly the size of grapes, so there was quite a bit of tugging and twisting when it came to pulling it out. It reminded me of birth, only the result isn't a cute baby but a diseased sac of bile. Oh, speaking of bile, the surgeons accidentally punctured the gallbladder while they were detaching it from the liver, and this caused some of the bile contained within to gush out into the patients abdominal cavity. It was quite a sight!
This procedure was particularly impressive because the surgeons can't see anything they are doing directly. They have various long instruments stuck into their patient, which they are enthusiastically moving around, thrusting them into the far corners of this poor man's stomach, all time while looking at a TV screen. It must take a lot of practice. Obviously.
Skin Graft
Now this one was very interesting indeed. Whereas all the other procedures I have observed have been fairly routine, a skin graft can never really be routine, can it? I mean, if you need some of your skin replacing... how often does that happen?
The patient had had a malignant melanoma on her foot. The cancer was very aggressive so the dermatologist had to remove a lot of skin from the foot around the tumour to ensure there wasn't a single cell of it left that would spread. That happened several weeks ago. Now, the patient was well enough to undergo a second surgery to repair some of the damage sustained to her foot as a result of the first surgery. A large section of skin was removed from the patient's abdomen – about the size of a mango, to continue the fruit sizing system – and while an intern and resident took to sewing up this huge hole, the chief of dermatology started preparing the skin for grafting. This involved carefully cutting off the inch of fat – which is a delicious, bright yellow colour by the way – that was present and then smoothing the underside of the skin by cutting away any imperfections. When she was finished, the skin looked so thin and shrivelled I was just hoping that it was stretchy, otherwise it would never cover the wound. It turned out to be remarkably stretchy; The skin really is an amazing organ, you know.
Once the skin was loosely attached with just enough stitches to hold it in place, a blue dye was injected into the tissue around the would, presumably to track the blood flow to the new skin over the next few hours/days. That's when it happened.... the foot moved!!! Ha! The surgeon stopped what he was doing and gave a rather amused look to the anaesthesiologist, who quickly made a few adjustments to the station at his end of the table. Aw man, the foot moved.... awesome :-)
I watched two operations on this visit: a Cholecystectomy (removal of the gallbladder) and a skin graft.
Cholecystectomy:
This was an endoscopic (or laparoscopic) procedure. Several small incisions are made at strategic points on the patient's abdomen and then the surgeon detaches the gallbladder and pulls it out through one of the holes. This particular patient had a rather bad case of gallstones, so his gallbladder was very enlarged. It was about the size of a pear, and the incisions are roughly the size of grapes, so there was quite a bit of tugging and twisting when it came to pulling it out. It reminded me of birth, only the result isn't a cute baby but a diseased sac of bile. Oh, speaking of bile, the surgeons accidentally punctured the gallbladder while they were detaching it from the liver, and this caused some of the bile contained within to gush out into the patients abdominal cavity. It was quite a sight!
This procedure was particularly impressive because the surgeons can't see anything they are doing directly. They have various long instruments stuck into their patient, which they are enthusiastically moving around, thrusting them into the far corners of this poor man's stomach, all time while looking at a TV screen. It must take a lot of practice. Obviously.
Skin Graft
Now this one was very interesting indeed. Whereas all the other procedures I have observed have been fairly routine, a skin graft can never really be routine, can it? I mean, if you need some of your skin replacing... how often does that happen?
The patient had had a malignant melanoma on her foot. The cancer was very aggressive so the dermatologist had to remove a lot of skin from the foot around the tumour to ensure there wasn't a single cell of it left that would spread. That happened several weeks ago. Now, the patient was well enough to undergo a second surgery to repair some of the damage sustained to her foot as a result of the first surgery. A large section of skin was removed from the patient's abdomen – about the size of a mango, to continue the fruit sizing system – and while an intern and resident took to sewing up this huge hole, the chief of dermatology started preparing the skin for grafting. This involved carefully cutting off the inch of fat – which is a delicious, bright yellow colour by the way – that was present and then smoothing the underside of the skin by cutting away any imperfections. When she was finished, the skin looked so thin and shrivelled I was just hoping that it was stretchy, otherwise it would never cover the wound. It turned out to be remarkably stretchy; The skin really is an amazing organ, you know.
Once the skin was loosely attached with just enough stitches to hold it in place, a blue dye was injected into the tissue around the would, presumably to track the blood flow to the new skin over the next few hours/days. That's when it happened.... the foot moved!!! Ha! The surgeon stopped what he was doing and gave a rather amused look to the anaesthesiologist, who quickly made a few adjustments to the station at his end of the table. Aw man, the foot moved.... awesome :-)
Wednesday, 5 December 2007
Truffles & Blood Clots
With too many truffles to handle even between the two of us, May and I decided to hand some out to a few of our friends at the hospital. This included our friends in Pharmacy and Radiology, Kimura-san, Kumiko-san, Oka-san and Nakashima-sensei. Everyone was really impressed, exclaiming "Oishii!" ("delicious"), and I think they they won us a few brownie points too. Now we're not just the GAP volunteers, we're the GAP volunteer who give them confectionery. Who couldn't love us?!
*
Ide-san, the woman who met all of the Gappers in Tokyo back in September, came to visit Nagasaki last week to check on May and me. Since everything is fine, it was a short, concise visit, only lasting for more than an hour because we broke for lunch. She gave us a piece of advice though that has really stuck with me: be less shy and more active when it comes to asking for more things to do. She said this in the context of asking to watch a birth, but I have already applied it at work in a different context. Yesterday in the Test Department I asked if I could help take the clots out of centrifuged blood - something I see the other lab tech's doing scores of times a day. They didn't even hesitate and handed a blood-filled test tube and a tooth pick each to May and me. They were so impressed they gave us our tea break early and then let us leave for lunch early too. Ide-san's advice really worked! I wonder what else this could lead to? With less than three months to go now, I really have to try to make the most of this.
*
I watched surgery again last week. I didn't mention it before because I took May in with me so we only stayed for an hour. She was very impressed but said that once was enough. Me? I'm going back in this afternoon. It will never be enough :-)
*
Ide-san, the woman who met all of the Gappers in Tokyo back in September, came to visit Nagasaki last week to check on May and me. Since everything is fine, it was a short, concise visit, only lasting for more than an hour because we broke for lunch. She gave us a piece of advice though that has really stuck with me: be less shy and more active when it comes to asking for more things to do. She said this in the context of asking to watch a birth, but I have already applied it at work in a different context. Yesterday in the Test Department I asked if I could help take the clots out of centrifuged blood - something I see the other lab tech's doing scores of times a day. They didn't even hesitate and handed a blood-filled test tube and a tooth pick each to May and me. They were so impressed they gave us our tea break early and then let us leave for lunch early too. Ide-san's advice really worked! I wonder what else this could lead to? With less than three months to go now, I really have to try to make the most of this.
*
I watched surgery again last week. I didn't mention it before because I took May in with me so we only stayed for an hour. She was very impressed but said that once was enough. Me? I'm going back in this afternoon. It will never be enough :-)
Wednesday, 14 November 2007
げか - Surgery
Phew! What a week it has been. My first surgery was awesome, as was the Kumamoto trip, although for drastically different reasons. I'll talk about Kumamoto in a later post, I promise.
So there I was, last Wednesday, the day of my first surgery. I was met by one of the female surgeons who took me into the changing room to get into my surgical scrubs, cap and mask. Even that part was exciting. She then took me through the surgical floor to O.T. 5, where I had a few minutes to just look around in awe at all the cool equipment and medical stuff. Nakashimasan (the vice-president of the hospital, who took May and me to the Viking restaurant back in October) arrived and he told me a bit about the patient: 6 year-old male; blood type AB+; suffering from sleep apnea, difficulties eating/gaining weight, a concave chest and heart problems as a result of this; will undergo tonsillectomy and adenoidectomy. Basically, his tonsils and adenoids were so big that he couldn't swallow, that's where most of his medical problems were coming from. This tiny little boy was brought in, obviously pretty scared, but the anaesthetists were great and soon calmed him down. It took quite a long time for him to fully fall asleep though. Nakashimasan explained that they were being particularly careful with the anaesthetic because he was a child.
With the patient under general anaesthetic, the surgeons got to work. The main thing they were worried about was bleeding. They don't use sutures for a tonsillectomy so they have to be certain that they have stopped all the bleeding (using what is essentially a soldering iron) before they wake the patient up. I was a little surprised at how rough they had to be to get the tonsils out. They used a 'snare' (wire loop) and pretty much just pulled them out. From start to finish, it was about 1 hour 30 minutes. That's 90 minutes of pure enthralment from my perspective.
After the little boy was moved out and taken back to his Mum, Nakashimasan gave me a proper tour of the surgical floor. I got to peek inside the other four operating rooms, all of which had surgeries going on in them. I also spent a few minutes observing a skin tumour being removed from a woman's scalp, which was very cool. I wondered how something like that gets noticed though. I mean I could only see it because her head had been shaved. Ordinarily her hair would have covered it, right?
Anyway, we headed back to OT5. A second patient was brought in. Two surgeries in one day – I couldn't believe my luck! This patient was a middle-aged man with a visible tumour in his neck: a tumour of the lymph gland. As you probably would have guessed, he was in surgery to have it removed. The doctors didn't know if it was malignant or not, but regardless, nobody wants a lump the size of a golf ball sticking out of they neck. This second procedure was way cooler than the first. The point at which I realised this was when the surgeons were in the process of cutting out the tumour, tying off blood vessels as they went – something that looked very satisfying to do indeed – and a wonderful gloop of lymph oozed out of it. Imagine really thick cream, but more yellow, and you've got lymph. It was disgusting but so, so interesting. Apparently, this tumour was actually contained within a lymph-filled sack, hence the seepage. Cooool.
The second surgery only took about an hour and after that, alas, I had to leave. I was really tired though, after standing up concentrating for three hours straight. My body was tired, but my mind was buzzing. It really was amazing. It all felt so natural, you know, like it was natural for me to be there. This wasn't just some once-in-a-lifetime experience; I could see myself doing this every day as my job. Ah, I am still so excited about it a week on. I might being going into surgery again this afternoon but Nakashimasan is at a conference so I need to find the female surgeon from last time. I'll let you know as and when I make it back in!
So there I was, last Wednesday, the day of my first surgery. I was met by one of the female surgeons who took me into the changing room to get into my surgical scrubs, cap and mask. Even that part was exciting. She then took me through the surgical floor to O.T. 5, where I had a few minutes to just look around in awe at all the cool equipment and medical stuff. Nakashimasan (the vice-president of the hospital, who took May and me to the Viking restaurant back in October) arrived and he told me a bit about the patient: 6 year-old male; blood type AB+; suffering from sleep apnea, difficulties eating/gaining weight, a concave chest and heart problems as a result of this; will undergo tonsillectomy and adenoidectomy. Basically, his tonsils and adenoids were so big that he couldn't swallow, that's where most of his medical problems were coming from. This tiny little boy was brought in, obviously pretty scared, but the anaesthetists were great and soon calmed him down. It took quite a long time for him to fully fall asleep though. Nakashimasan explained that they were being particularly careful with the anaesthetic because he was a child.
With the patient under general anaesthetic, the surgeons got to work. The main thing they were worried about was bleeding. They don't use sutures for a tonsillectomy so they have to be certain that they have stopped all the bleeding (using what is essentially a soldering iron) before they wake the patient up. I was a little surprised at how rough they had to be to get the tonsils out. They used a 'snare' (wire loop) and pretty much just pulled them out. From start to finish, it was about 1 hour 30 minutes. That's 90 minutes of pure enthralment from my perspective.
After the little boy was moved out and taken back to his Mum, Nakashimasan gave me a proper tour of the surgical floor. I got to peek inside the other four operating rooms, all of which had surgeries going on in them. I also spent a few minutes observing a skin tumour being removed from a woman's scalp, which was very cool. I wondered how something like that gets noticed though. I mean I could only see it because her head had been shaved. Ordinarily her hair would have covered it, right?
Anyway, we headed back to OT5. A second patient was brought in. Two surgeries in one day – I couldn't believe my luck! This patient was a middle-aged man with a visible tumour in his neck: a tumour of the lymph gland. As you probably would have guessed, he was in surgery to have it removed. The doctors didn't know if it was malignant or not, but regardless, nobody wants a lump the size of a golf ball sticking out of they neck. This second procedure was way cooler than the first. The point at which I realised this was when the surgeons were in the process of cutting out the tumour, tying off blood vessels as they went – something that looked very satisfying to do indeed – and a wonderful gloop of lymph oozed out of it. Imagine really thick cream, but more yellow, and you've got lymph. It was disgusting but so, so interesting. Apparently, this tumour was actually contained within a lymph-filled sack, hence the seepage. Cooool.
The second surgery only took about an hour and after that, alas, I had to leave. I was really tired though, after standing up concentrating for three hours straight. My body was tired, but my mind was buzzing. It really was amazing. It all felt so natural, you know, like it was natural for me to be there. This wasn't just some once-in-a-lifetime experience; I could see myself doing this every day as my job. Ah, I am still so excited about it a week on. I might being going into surgery again this afternoon but Nakashimasan is at a conference so I need to find the female surgeon from last time. I'll let you know as and when I make it back in!
Monday, 1 October 2007
ばんごはん – Dinner
It turned out that I had nothing to worry about with our dinner invite on Friday. It was as far from the whole-hospital-invited party that I feared it might be as you could get.... only five of us: the hospital vice-president, a nurse from the ENT department, Kimurasan, May and me. I am embarrassed to admit that I have forgotten the names of both the vice-president and the nurse. Shame on me, I know!
That's the vice-president sat on the left of the photo, Kimurasan in the middle, and the ENT nurse on the right.
From the hospital May and I were taken by street car to the Best Western Premier Nagasaki Hotel, which, as you might imagine with a name like that, has a five-star rating. The restaurant (called 'The Kitchen') was on the 15th and top floor. The view was amazing. Just amazing. I had heard that Nagasaki has one of the best night views in Japan and now I can believe that unquestioningly. I took pictures but they really didn't capture it, so I won't bother posting them here.
The meal itself was great. It turned out to be an authentic Japanese buffet. The Japanese word for buffet is, believe it or not, Viking (pronounced Biking). You can see how May and I got so confused when beforehand we were told it was a 'Biking' restaurant we would be going to. Anyway, the food was sensational. My favourite thing by far was the sashimi (thin slices of raw fish, in this case in a light marinade). The salmon sashimi was particularly good. Mm, sashimi.
To top off the wonderful food, we had some really great conversation with our hosts. It was during a dessert of ice cream, tiramisu and sesame seed cake that it happened. We were talking about what May and I wanted to do in the future, as in what careers we wanted to pursue, when the vice-president turned to me and the following words came from his mouth: You know, you can watch a surgery if you want to...
...My jaw dropped....
...I seriously could not believe it for a second. I had to ask him twice if I had heard him correctly. Me? Watch a surgery?! 'Yes, yes, yes, I would love to!' I was so shocked that I forgot to ask for details: When? What procedure? Which surgeon? From the gallery or - *gasps* - inside the operating theatre? Oh man, I'm getting so excited just thinking about it. I feel like Meredith Grey. No, actually, probably more like George O'Malley. (Sorry, for the non 'Grey's Anatomy' fans, I feel like a surgical intern, that's all you need to know).... Awe.Some.
We wound things up around 8:45 and May and I got a taxi home with the nurse. We didn't spend a single Yen all evening – the vice-president paid for everything. Of course we were incredibly grateful for this and showed our appreciation in the traditional Japanese way, by saying gochisou sama deshita (“that was a lovely meal”). We have been invited to another dinner in a few weeks; I am not nervous at all about this next one now :-)
That's the vice-president sat on the left of the photo, Kimurasan in the middle, and the ENT nurse on the right.
From the hospital May and I were taken by street car to the Best Western Premier Nagasaki Hotel, which, as you might imagine with a name like that, has a five-star rating. The restaurant (called 'The Kitchen') was on the 15th and top floor. The view was amazing. Just amazing. I had heard that Nagasaki has one of the best night views in Japan and now I can believe that unquestioningly. I took pictures but they really didn't capture it, so I won't bother posting them here.
The meal itself was great. It turned out to be an authentic Japanese buffet. The Japanese word for buffet is, believe it or not, Viking (pronounced Biking). You can see how May and I got so confused when beforehand we were told it was a 'Biking' restaurant we would be going to. Anyway, the food was sensational. My favourite thing by far was the sashimi (thin slices of raw fish, in this case in a light marinade). The salmon sashimi was particularly good. Mm, sashimi.
To top off the wonderful food, we had some really great conversation with our hosts. It was during a dessert of ice cream, tiramisu and sesame seed cake that it happened. We were talking about what May and I wanted to do in the future, as in what careers we wanted to pursue, when the vice-president turned to me and the following words came from his mouth: You know, you can watch a surgery if you want to...
...My jaw dropped....
...I seriously could not believe it for a second. I had to ask him twice if I had heard him correctly. Me? Watch a surgery?! 'Yes, yes, yes, I would love to!' I was so shocked that I forgot to ask for details: When? What procedure? Which surgeon? From the gallery or - *gasps* - inside the operating theatre? Oh man, I'm getting so excited just thinking about it. I feel like Meredith Grey. No, actually, probably more like George O'Malley. (Sorry, for the non 'Grey's Anatomy' fans, I feel like a surgical intern, that's all you need to know).... Awe.Some.
We wound things up around 8:45 and May and I got a taxi home with the nurse. We didn't spend a single Yen all evening – the vice-president paid for everything. Of course we were incredibly grateful for this and showed our appreciation in the traditional Japanese way, by saying gochisou sama deshita (“that was a lovely meal”). We have been invited to another dinner in a few weeks; I am not nervous at all about this next one now :-)
Subscribe to:
Posts (Atom)
