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Saturday, August 20, 2011

Surgical Oncology: Day 15, 16, 17, 18

Apologies for not keeping up with the posts! It's been another busy week...I've been working my normal hours, plus had a presentation for Thursday, and did a 26-hour shift from Thursday 6a-Friday 8a. I've also been studying when I get home after work, as I have oral exams coming up soon as well as my shelf exam. Not an excuse, I'll try harder to keep up.

Tuesday: was in from 6a-6p. We were in the operating room all day, with a resection of the 3rd section of the liver, and then we removed 2 melanomas from a little old lady, one from her leg and one from her nose. After removing the spot from her nose, there was missing skin at her ala of the nose, so we did a rotational flap of skin to cover it. Pretty cool. I got to put an IV in, impressed that I got it in considering she was quite old and her veins were thin and it was also my very first one!

Wednesday was in from 6a-5p. We were in the clinic all day, which made it pretty enjoyable. After work, our attending took us out to eat at an Indian restaurant, which was really nice. I didn't get home until after 9:30, so I didn't get to spend any time with Mike before my on-call shift.

Thursday/Friday was in from 6a Thursday - 8a Friday. We were in the OR with a patient who had a large melanoma mole on his forehead. We excised that, then took the sentinal node in for frozen section. Deciding which node is the sentinal node can be done by injecting a radioactive dye into the main lesion, in this case it was into the forehead at the place of the melanoma. This dye will drain into the sentinal lymph node. We can find that node by either the color (if using a blue dye) or by the radioactivity via the use of a gamma probe. This patient had radioactive dye injected, so we got to use the gamma probe to find the sentinal node. We took that lymph node out, then went down to the frozen section room and looked at it though a microscope. We didn't find any suggestion of melanoma in the node, which means that it probably hasn't spread and we don't have to continue to dissect more lymph nodes out of his neck. Good news all around! It was hard to close the skin, as it was a big hole that we took out of his face, but we managed to do a rotational flap instead of a skin graft, and it turned out alright. I might also add the fact that this young man did not have insurance, and our attending was doing this surgery pro-bono. I love doctors that love their patients more than themselves - you'd be surprised by how few of them there are out there!

Got home on Friday morning, slept a few hours, then did some things around the house...went to the grocery & made a nice dinner on the grill before watching a film with Mike. It's nice to have a chilled-out night after a long week of work!!

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