Wednesday, July 06, 2005

Circadian Arrhythmia

Woke up late today. And by late I mean 5:25am. Ridiculous. Almost didn't have time to preround on my patient before it was time to present to the chief for real rounds. The problem is, I refuse on principle to rise before the sun. In general, I don't live by many self-imposed irrational rules. The only other one I can think of right now is that I must eat breakfast food as my first meal of the day, whatever time that may be. Of course, I'm the one who defines "breakfast food" for myself, but this is just part of the illogic that goes along with the illogical personal rule. (Incidentally, I will truly get to test this in a few weeks when I start obstetrics night float and have to wake up in the afternoon for my 5:30pm-5:30am shift...I'll keep you posted) Anyway, back to waking up. I've been stirring at around 4am, and then again at 5am, fearful that I'll oversleep--but then I feel obligated to lie in bed until my window lightens enough that I know for sure the sun is up. And then I realize how late it is, jump out of bed, and run around like a chicken with its head cut off to make it to the hospital in time...

Speaking of chickens, I clearly counted them before they had hatched yesterday, with my premature self-congratulations on making through my first surgery unscathed. This morning I was in a rush to get to the 9am hysterectomy and didn't have time to eat or drink much of anything beforehand. Note to self and others: bad idea. But the surgery was supposed to be a quick 'n easy laparoscopy, so no worries. That is, until the surgeon realized that the patient had too many adhesions (things stuck to each other from past surgery or infection) to do it laparoscopically, and *I* realized that I was now committed to spending the next 3+ hours standing on a stool under the hot lights, contorted into some inevitably uncomfortable position while my kidneys grew increasingly sullen with my lack of additional hydration. Ugh.
Three and a half hours, multiple ligated arteries, two ovaries and a uterus later, I was still standing on a stool perched under the hot lights, over the patient, in my paper gown and mask, trying to alleviate the incredibly painful cramps that had unfortunately chosen today for their monthly arrival. I had that icky dry taste in my mouth that I usually only get during the latter hours of Yom Kippur after fasting without food and water for a full day. Luckily, the surgeon and my resident were all done and about to suture up the incision, my second successful hysterectomy....when suddenly, without warning, I felt strange. "Am I feeling what I think I'm feeling?" I thought to myself. "Nah, couldn't be--we're almost done!" I responded to myself. Before I could get another word in edgewise with myself, I felt a tap on my shoulder, a whisper in my ear asking if I was feeling ok. Luckily, she didn't wait for my answer. The scrub nurse deftly slipped a wheely stool behind me as she gently shoved me down onto it, and within moments I was leaning over the sterile garbage can while the nurse wiped sterile alcohol pads on the back of my neck to cool me down. Given that I didn't actually have enough of anything in me to throw up immediately, the nurse turned back to her more important conern (that of maintaining sterility) and promptly wheeled me straight out of the OR before I could contaminate a single thing.

It all turned out fine in the end. I didn't technically pass out or vomit, and I certaintly didn't fall to the ground and bump my head on a machine and end up in the ER like one of my classmates did on our very first day three weeks ago; but it still felt demoralizing to be the one who had to get wheeled out on a stool and fed apple juice and crackers while the rest of the team got the job done. Guess there's nothing to do now but chalk this one up to experience and make sure to drink well before surgeries in the future. Of course, therein lies the dilemma--need to hydrate, but if too much hydration, may need to pee. And there are no potty breaks in the operating room. Hmm...maybe I could wear some Depends just in case. Or maybe catheterize myself beforehand and then drink as much water as I want. Riiight.


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