The Freudian Slip Of A Bacolodnon

Today is my last day as a surgical PGI. I am perhaps the last to assist in the elective surgery for our group. I assisted along with Melvin a laminectomy procedure with Dr. Gustilo and Dr. Jingco (who is our Ortho resident while I was still a JI in CLMMRH). Melvin however was unable to finish the laminectomy because he had to scrub out to assist in Dr. Amante's AVF formation. So far I have assisted in the following procedures: 1. Appendectomy 2. Exploratory Lapartomy 3. Subtotal gastrectomy 4. Gastrojejunostomy 5. Cholecestectomy 6. CBD Exploration 7. Choledochojejunostomy 8. Craniectomy 9. Open reduction, internal fixation of various fractures including a communited mandibular fracture 10. Fistulectomy 11. Hemorrhoidectomy 12. Palatoplasty 13. Cheiloplasty 14. Modified radical Mastectomy 15. Herniorrhaphy (Liechtenstein and Posterior approach) 16. Herniotomy 17. Debridement of diabetic ulcers 18. Excision of mass(es) 19. Laminectomy Most of my OR procedures are appendectomy and ch...

I was on 24 hours duty last Thursday June 22, 2006 and it was to be considered a more benign duty than the one I had last Monday June 19. I only admitted 4 patients during the entire 24 hours, two for pediatric surgery (palatoplasty and cheiloplasty), one for orchiectomy, which was done earlier this afternoon, and the other was more of a psychiatric case, a patient with anxiety disorder, but was admitted under our department because the attending physician she prefered was a surgeon by specialty. She was later referred to the department of internal medicine. But how do you treat anxiety disorder? Not surgically of course but my personal approach would be to give the following therapeutics: a listening ear, a shoulder to cry on and 1 tab of Diazepam 5 mg if unable to sleep. I had the most interesting conversation with that middle-aged lady. And I felt fortunate to have admitted her under my care. Somehow, after the long conversation we had, I feel I have helped her somehow. She had been...

It was a weird day last Monday June 19. Along with the Santol Seeds Kid (see previous blog), I also admitted a young female, single, with no history of sexual contact, with a very distended abdomen. I had an animated conversation with her and her mom and during the course of my history taking, I discovered that she had been diagnosed earlier with a huge ovarian mass on her left ovary. The mass was said to be benign in nature. The mass had been growing in size for the past 5-6 months and she had been advised for surgical removal of the said mass. During the entire period, she had not experience any other signs and symptoms other than the distending abdomen and occasional abdominal pain. There had been no signs that would indicate an obstructive syndrome. Last Wednesday, June 21, 2006, I tried to catch up on her early morning exploratory laparotomy. I failed to witness how the ovarian mass was excised but I was able to see the specimen removed from my patient. It was huge! Perhaps twice ...

It was early 2:30 a.m. when the E.R. nurse called me up telling me about a patient from Himamaylan who was referred to BOLMSH with an initial impression of intestinal obstruction secondary to santol seeds. At first I wasn't really paying attention to the nurse's referral. I was still between dreamland and even farther-away-from-dreamland and the words intestinal obstruction due to ingested santol seeds didn't really strike me yet. So I went down the E.R. in my scrub suit tired and with heavy eyes. I have already admitted so far 7 patients half of which are scheduled for operation the following morning. I went to the E.R. and saw a young 12 year old boy with IV lines and an NGT inserted already. I introduced myself to the folks and asked a brief history of the patient. According to the folks, patient has been experiencing abdominal pain for the past two days after eating santol and swallowing its seeds. Since that time, patient had episodes of vomiting, anorexia and constipa...

Today is Father's Day; a day when all the Men of the House find reason not to do the laundry and dishes for the entire day for the first time of their married life. I am a proud father myself and I was greeted earlier in the day by my wife and kid and my co-workers at the hospital, including friends through SMS. Sunday at work wasn't really an eventful day, except for a stat Appendectomy with one of my favourite Surgeons, Dr. Hinolan. Melvin and I assisted in the Operation and he allowed me to cut the mesoappendix and close the subcutaneous and skin with Melvin. Right after work, I immediately went to my parents' computer shop where I was to meet Roann and Rien. We had our lunch there and went to the mall after a quick rest. I had to go back to the Mall and play once again at the arcades. These arcade games are perhaps the new Casino slot machines. All you need is a peso coin and you can drop them in any game machine available to win tickets. The many tickets you win, the b...

I had a bad toothache last night so, while I only had two admissions during my entire 24hours duty, I stayed up late nursing a whacked tooth, took two tabs of Tramadol, Mefenamic acid and Ibuprofen and fell asleep at around 5 a.m. already. I had to cut my sleep short because I had to wake up for a 7:30 a.m. cholecystectomy with Dr. Mogul. So, without even bothering to comb my hair and eat my breakfast, I dragged myself to the O.R., just when my patient was already being wheeled in by the orderlies. THe Anesthesiologist was already inside but Dr. Mogul wasn't yet so I was hoping Melvin, who was on call today, could come on time for the O.R. so he could assist instead of me. He did come and I was able to salvage some time for me to continue my sleep. My toothache was already subsiding by then but I still need to see a dentist and have this tooth pulled out. Easier said than done considering that I got no time to excuse myself from the hospital. But I should talk to Clarissa's mom...

Ever wonder what happens in a 24 hour duty of a PGI in BOLMSH? 24 hour duty starts as early as 7:30 a.m. and ends the same time the following day. However, everyone stays inside the hospital until 5 p.m. So, it isn't really strictly 24 hours duty. I happen to share a 24 hour duty schedule with Gerard, Ken and Gabby. We are not an all boys' group though. Ken and Gabby are girls. They were named as such thanks to their parents so frustrated enough to have boys of their own. Gerard a.k.a Gesper is currently rotating as a OB-GYNE PGI. Trivia: he is the only PGI in BOLMSH who is single and available and not because he wanted it to be so, if you know what I mean. Strengths: has loads of talents in singing and webpage design. Weakness: nulliparous women. Toxicity level: neutral. Gerard can be benign but sometimes toxic in his 24 hour duty. Role: He mans the Delivery Room and if need be the operating room if there are C-sections to be done. What he loves about his job? The Internal ...

So far, a month has passed and I can fairly say that my rotation as a surgical PGI is swell. The following have been the many operations I have attended to, most of which I was First Assist: 1. Appendectomy 2. Cholecystectomy 3. Exploratory laparotomy 4. Adhesiolysis 5. Common Bile Duct Exploration 6. Choledochoduodenostomy 7. Palatoplasty 8. Rhinoplasty 9. Herniorrhaphy 10. Open reduction and internal fixation of fractures 11. Debridement of diabetic foot 12. Craniectomy 13. Modified Radical Mastectomy 14. Excisions of cysts I am a "benign" PGI, with an average number of admissions of 4. The longest Operation I attended to was a Craniectomy and an ORIF of right mandibular fracture (closed, comminuted), done on a single patient. Oepration lasted 6 1/2 hours. The patient was a victim of a hacking incident, sustaining most of his injuries on the face and skull. The second longest operation was a CBDE with choledochodoudenostomy done on a patient who already had her gallbladder ...

It was supposed to be a case presentation regarding appendicitis and appendectomy but an hour and a half later, we 14 PGIs realized no consultant was coming so we spent the moment at the Board Room photocopying our I.D.s (for our application for a savings account) and taking pictures of ourselves. Using MacMac's state of the art cellphone, all 14 of us posed before the camera a la telenovela primer. Boys Line (L-R): Pax, Melvin, Gerard, Bayen, Mark A., Mark J.,Andy. Girls Line (L-R): Joanne, Gabby, Leah, Bel, Tin, Con and Ken. Bayen Trademark Same Serious Moment, with the girls on the seats this time. Bayen Trademark So after all the formalities, it's to play! Bayen Trademark Right after the "pseudo-conference", we all went upstairs in our On-call room and continued the photosessions. hmmm... what's up with Leah?? Bayen Trademark Today we also celebrated Bel's birthday (who is unfortunately not in this pic but just worth mentioning. oops...she's right t...

What has been my first week like as a PGI? It has been a week-long roller coster ride for me personally. After a month of furlow from work and pressure, it's back to the factory again, but this time only in a much better suit. Not only that, you get three free meals a day, have time to take a bath in the morning and still look OD(on duty) even if you're FD (from duty). But it has to take at least one week for the body to re-adjust and shift from vacation mode to work mode. We were criticized for choosing the more lenient hospital as our hospital for training. Among the leading hospitals in the city, BOLMSH is perhaps less "toxic" when it comes to work load and pressure. CLMMRH is bluntly likened to the fiery shores of Hell, where souls experience beyond mortal torments and tortures. Riverside Medical Center is almost like CLMMRH but you get paid for the tortures they give you. BOLMSH is Paradiso! We PGIs may not remember every admitting orders we need to remember but ...

Day 4 - I was on call and as an on-call intern, my post is at the OR. Being true to my benigness in the OR, I had no scheduled OR in the a.m. Instead, I assisted in an open reduction, internal fixation of a fractured left humerus, (closed and segmental) in the afternoon. The rest of the morning was left making rounds with my patients. After the OR, I went to check the histories and progress notes of the clerks (4th year medical students). I wasn't able to attend their regular afternoon didactics so I wasn't able to give the quiz I prepared. The topic was on thyroid. Today is a good day. Perhaps a much better day than yesterday. I slept the moment I arrived home but woke up to answer a phone call from my uncle, Tito Lorenzo. My cousin Angelie has this benign bone growth on her knee area and she is scheduled for an OR. X-ray findings reveal osteochondroma, a benign bone cyst. She was initially scheduled this June but her father wanted it much earlier so it won't be a hassle f...

Day One - I entered the hospital with that feeling of apprehension, weighing much more than the sentiment of thrill and excitement. I cannot understand it but I have this awkward feeling just surrounding me. I really cannot explain it. I am kind of happy to be with friends and in a new hospital and earning at last. However, I cannot help feel weird about the whole thing. The day passed by uneventfully. It was Orientation day and all the usual stuff and preliminaries were done. At around 12 noon I went home. It was a half-day work because today is Labor Day, a holiday. I decided not to eat lunch and I really don't know why. I went to my parents' store, asked for dough to buy me some new polo shirts and pants for work. I went to the mall, bought me 3 polo shirts, a long-sleeved t-shirt and 2 pairs of pants. I then went to buy a new penlight. I really was planning to buy me a new stethoscope, the quite expensive one (Littman) coz mine was kinda old. But my cash wasn't enough s...

The schedule is in and as of May 1, 2006 I will be starting my PGI-ship at Bacolod Our Lady of Mercy Specialty Hospital. From May to June, I will be rotating at the Dept of Surgery. July to August, I will be rotating at the Dept of Pediatrics. Sep't to October, I will be with the Dep't of OB-GYNE. November to December, I will be working with the City Health for my Community Exposure. January 2007 to February, I will be at the Dep't of Internal Medicine. March to April 2007 will be electives. So far, everything is okay. We have our own quarters, fully air-conditioned. I'm planning to bring my pc. I am teamed up with Con-Con and Melvin. I just actually came from the Fellowship dinner for the incoming interns and it was really a casual occasion. I was congratulated by my Pediatrician who happens to be my son's pediatrician too. Work is 24 hours a day every 3 days. The rest of the days are from 8 to 5, unless if it's a holiday which is only until 12. Weekends are h...