Sometimes all you need is luck...

This is going to be a quick post. I'm exhausted and need to head to bed. I know, its only 8:30, but I ran my tail off today.

I wanted to give everyone an update about my girl with Ulcerative colitis. She ended up going to the operating room today. The procedure ended up taking about 6 hours. I wasn't in the OR (I tried to stay away, as I really don't want involved in whatever comes out of this mess). I guess my attending had everyone document that there was no way that anyone could cause this colitis with medications, etc. and to proceed with surgery. Very sticky situation if you ask me. I think she did fine and that is what matters in the end :)

One thing that really bothers me with parents is when you have a child that is old enough to understand, i.e. 8 years old, and you lie to them about the procedure they are having done. We had a little girl today in for precocious puberty. These kids start puberty too early. Periods at age 7-8 for the girls, etc. (one of the girls today had more hair in her armpits then I have on my head, she was 10). Anyways, this girl today, was told by her parents that she was having a mole taken off because her parents didn't want her to know what they were doing and that she was having something inserted in her arm. Basically for these kids we put in a hormone implant in their arm right under the skin (similar to the old norplant birth control sticks). It releases hormones for a year and then we take it out and replace it with another. Not a big deal. I just don't understand why this kid had to be lied to. Like she isn't going to feel the implant when she wakes up. Ughh.

OK..so I thought this post was going to be short. HA HA!!

I got a call first thing this morning for a boy who was transferred in overnight from another hospital. He had symptoms of appendicitis but the CT scan did not show his appendix or appendicitis. I got the lovely task of seeing him this morning. After admission, he wasn't having very much pain but definitely was tender when palpated (pushed on) in the right lower quadrant. A few of the other things we look for were positive so I took the CT to review with our radiologists. After looking at the scan for 30 seconds, he said, I don't know what the other radiologist saw, but his appendix is definitely inflammed and needs to come out. Anyway, I book him in the operating room as a laparoscopic case (with a camera and tiny incisions). The specific surgeon on call today sometimes does them laparoscopic and sometimes the old fashion open way. His incisions (cuts) are really the same size no matter what way he does it. Anways, I book him and am telling the surgeon the run down. He is like, Ill do it open. I'm like OK, I booked it as laparoscopic but I will change it. We kind of go back and forth for a second. Then, he is like no never mind, Ill try it laparoscopic. No big deal. We get him to the operating room and find his appendix. It is an cute appendicitis. So yeah, my clinical exam was correct :) But, the best part was, because he did it laparoscopic, he found another problem in the kids bowel (intestines). Its called a Meckels diverticulum. It is an outpouching of the colon, seen in 2% of the population that has stomach lining in it. These can be serious problems to those people that have them, bleeding, etc. So, he took it out. No big deal. But, if he would have chose to do it open, he would have never seen the Meckels and the kid could have come back in a year or two with a serious problem. After the case we were walking down the hall, and my surgeon says to me, ya know, you have to have talent to be a surgeon, but sometimes its about the luck. Something was telling you this morning to book it laparoscopic and then me to change my mind and do it this way. It was a nice ending to the day, as I felt like I helped this 15 year old boy today. He doesn't have a clue or wont ever appreciate it, but we saved him from potentially having an emergency operation at some point down the road. Oh, the simple things!

Ok now im really going to bed.