ahhhhhhhhh. the 6 weeks has finally ended. no more driving 140+ miles a day, no more pap smears on inmates, no more avoiding strange grabby doctor, and NO MORE A SHEETS. whew.
the last week has been exhausting– early mornings, traffic amundo, and call. poor ryan banged up his knee, so i’ve been home every day to take care of him.
tuesday’s high risk clinic was madness, but i got to see Ms. A for the last time– a woman with a history of 2 SABs, on her third pregnancy, and whose husband has recently died. i first met her up on the floor, in the middle of the night — her story woke me up from the sleepless daze i was in– i nearly cried after hearing her story (she tells it much better than i do). she’s working unbelievably hard to keep this pregnancy– probably the most compliant patient i’ve seen. i hope everything goes well for her.
wednesday morning, i arrived at the hospital parking lot around 5am,. as i made my way towards the hospital entrance, i was greeted by a nutty woman screaming,
“HEY! I like your skirt!”
(keep walking, don’t make eye contact)
“you have nice legs! they aren’t even bowlegged!”
(almost to the door)
“can i have your cup? i need more ice!”
(cupless, at the door)
“put your sweater on! you’ll catch ammonia!”
(walk, laughing, to the elevator)
gyn rounds was interesting. i had one patient with vulvar cellulitis, who was so red and swollen and in pain that we were giving her pain meds galore on top of her antibiotics. my next patient had menometorrhagia caused by uterine fibroids– she presented to the ER with a hemoglobin of 5, got a blood transfusion, ultrasound, and biopsy. poor lady. another woman had a giant tumor t(ovarian cystadenoma) that extended from her pelvis to her rib cage. she looked like she was pregnant. damn!
on ob rounds, we met a woman who was 8 weeks pregnant who was vomiting 3 times a day for the past 3 months and had lost 25 pounds. apparently, this kind of NV happened with her last kid, too, but she wasn’t hospitalized for it. poor girl– she looked so exhausted and pale.
on thursday, we pulled out a gigantic (4250 gms, but really short) baby girl through a mess of adhesions (from her previous c-sections). and the best thing? i finally learned to close up the skin with a subcuticular stitch on an early morning C-section/tubal ligation patient. woo! it is MUCH more fun than stapling. ::dances in the OR::
later on that day, we had this 300+ pound woman (carrying twins for the second time) come in for a BP check and PIH labs. we ended up sectioning her– in a very crowded operating room. it took a mess of people to tape up her enormous belly, (which, by the way, was all dimpled so that it looked like a massive orange when they covered it in betadine), there were NICU nurses standing by, an anesthesia student, NICU student, 2 OB residents, and random other nurses running around and sneaking peeks. i watched as they cut thru inches upon inches of fat until they finally made it to the uterus, where they pulled out a 7 pound boy in the vertex position, and then a slightly smaller boy who was breech. two tubal ligations later, the docs came out exhausted.
the rest of the night was uneventful– or i was so sleepy i don’t remember any of it… but now i’m home, happy, and needing to study for the upcoming exams.
poo.
life at the Medical Clinic is a far cry from that of my last adventures at County Hospital… g and i work with one doc, who’s amazingly laid back although he’s quite busy. we see a few patients at a time– at a nice leisurely pace– no screaming at nurses, no searching for equipment, no unhappy people!
yay for “pinkies up” tea today with ryan, annie, and maggie! we went to the tea rose garden in old town and gorged ourselves on teeny tiny finger sandwiches, scones, fruit, and of course, tea.