Are You Sterile?

Heh.  Nothing about fertility here, it’s just a run-down on how the hospital I’m at likes you to scrub-in for surgery.  I’m blogging this because it’s fairly interesting (and a little convoluted), but also so you can get an idea about just how dilligent the surgical teams are about maintaining the sterile field.  Hopefully it makes you feel a little better.  Or not, whatever.

There are 3 scrubs in the process:

First Scrub – 2 minutes:

- Take a sterile surgical scrub brush and open the packet, careful not to touch anything inside it.  Sit it on the bench, and turn the water on (our hospital uses infrared-operated taps you don’t need to touch).
- Hold you hands above your elbows and let the water run over your hands and forearms down to the elbow.  From now on, your arms should remain in this position – never let your hands fall below the level of your elbows.  If they do, start again.
- Using your elbow, squirt some soap into your hand.  For the first scrub, use iodine-based soap – since it’s brown, you can see if your hands and forearms are completely coated.
- Carefully pick up the small plastic nail pick from the surgical scrub brush packet and clean under all your nails; discard the pick.
- Rub your hands together like you do when you normally wash your hands, then use the nailbrush side of the scrub brush to clean under your nails, over your nails, and the knuckles of your fingers.
- Once this is done, quickly coat your forearms down to the elbows with soap.
- Rinse under water.

Second Scrub – 2 minutes:

- Soap up again, using either iodine- or chlorhexidine-based soap – whatever you prefer.
- Spread the soap, making sure to work it in around the nails, knuckles, finger webbing and around the wrist.
- Use the sponge side of the scrub brush to go over these areas again.
- Once this is done, quickly coat your forearms down to just before the elbows.
- Rinse under water.

Third Scrub – 1 minute:

- Using soap, repeat the scrub process.  Do not use brush or sponge.  Clean only to the mid-forearm.
- Rinse under water.  Hold elbows over trough and let the water drain off.

Starting Gowning:

- Put your hands together as though praying and enter the theatre.
- At the gowning and gloving station, pick up the folded gown on the left-hand side – as this will be the inside of the gown.
- With one hand pressing either side of the folded gown, slide your hands forward and move them away from your body to let the gown unfold.  All going well, you should now magically have your arms inside the gown.
- At the stage, a scout will come and attach the adhesive strip at the back of the neck, and tie the internal string at the small of your back.
- Keeping your hands within the sleeve of the gown, start to glove up.

Gloving Up:

- Without actually touching the glove with your skin, pick up the first glove and lay it over the sleeve of your gown (palm up).  The way to do this is lie the thumb of the glove on your thumb, and the open end of the glove over your wrist.
- Then, carefully gripping the glove in your thumb and index finger (which are both still in the sleeve), use your other hand (still in the sleeve) to pull the open end of the glove over your hand.  This sounds hard, and is hard.  If you do it right, you should have half a glove on, and the sleeve of the gown should have been pulled back to show half your hand.
- Gently pull the sleeve of your gown so that the glove slides on easily, and the sleeve of the gown retracts so that your fingers are all free.  Be careful not to tear the gown!
- From this point, it is easier to put the second glove on, since yo now have a sterile hand to use.  Glove up in the same way.
- Put on another pair of gloves.

Finishing Gowning:

- Your trusty scout should now come back to help you finish gowning.  There is a cardboard colour-coded tag on the front of your gown which is connected to two ties.  Holding the left tie, pull the tag off.  It should still be connected to the right tie, which is long.  Hand it to the scout, careful not to touch the scout.
- Once the scout has the tie, spin in a circle (therefore wrapping yourself in the tie) and pull the tie away from the cardboard that the scout is holding.  You can now tie your gown up in front.  You are sterile!

Now that you’re all gowned and gloved up, don’t touch a scout – they’re dirty.

Theatre 23, #2

first_surgery_1

Surgery 6:     Right knee arthroscopy.  Repair torn medial meniscus; extensive calcification of entire knee joint.

Surgery 7:     Left knee arthroscopy.  Repair torn lateral meniscus.

Surgery 8:     Open re-exploration left foot, plantar aspect.  Morton’s neuroma removed.

Surgery 9:     Open tibialis anterior tendon repair. 

Surgery 10:   Left ankle arthroscopic and open fusion of talus and calcaneous.  Intraoperative complication: tourniquet not applied to limb, resulting in moderate blood loss through the bone.

Surgery 11:   Bilateral osteotomy of hallux valgus deformities in the first metatarsophalangeal joints, with sesamoid removal bilaterally.

 

8.5 hours in theatre today, and got to actually scrub in.  I’ll go into detail of the scrub-in process some other time – it’s rediculously complex.

Round and Round

memememe

Self portrait

Where it stops?  I wish I knew! 

Well, I’ve gone and done it again – I’ve starting talking to a guy.  Well – several, actually – but this one is smart and incredibly attractive.  It’s enough to make a boy suspicious…

…but let’s not go down that path of insecurity.

Anyway, I guess I said I wasn’t going to pass up any opportunities, and I’m staying true to my word there.  I just get the feeling that I haven’t learned anything from each previous encounter…we’ll see.

The Quarter Life

info_Info_Guarantee

I’m nearly 25.  Sort of.
I understand that we go through changes, and that there are stages where you can go through big changes (such as the red convertible and driving glove when you’re 50), but the thing is, I think I’m going through one now.

I’m not talking anything like the mid-life crises you see portrayed by Hollywood.  God bless those idiots in Hollywood.  I’m talking about a pervasive anti-Peter-Pan sensation….that feeling that you need to grow up, and grow up quick.

Yes, I understand that I’m a graduate student studying a medical degree which takes centre stage in my life, and that everything will change when I start to earn some money - etc, but here are the cold facts:

  • I’m 24 and I own a dying hand-me-down car.  A car that isn’t even registered under my name.
  • I’m 24 and I have no savings.
  • I’m 24 and have not had a meaningful relationship.
  • I’m 24 and I room with two guys from uni.
  • I’m 24 and I’m a slob who barely does laundry and doesn’t keep his room clean.
  • I’m 24 and don’t own anything much of value except for my health (which, okay, is a lot).

Basically, I feel like a 24-year-old little boy. 
Anyway, I’m living a life that really isn’t me, which is okay, we do that a lot – make the sacrifices for the pay-off later on.  I think I’m just finally getting really impatient with the whole thing. 

I want to get a place outside the city, by myself (or preferably, with a guy).  I want a dog, comfortable digs and a decent kitchen.  I don’t feel like being articulate right now, so I’ll just say this: 

I want a life, already!

Limbs Akimbo

No, I know it conjures up images of the lusciously leggy ladies from Lipstick Jungle or something, but limbs akimbo – in this case – is merely in reference to the lower limb examination we did today in clinical skills.

Boring?  Maybe.

Actually, it was okay but there was nowhere near enough time to really practice the examination techniques.  This is musculoskeletal (known herein as MSK) we’re doing, and it’s all very mechanical.  We needed the time to practice, but anyway.  It’s not like I can really see much of the world around me since my glasses bit the big one a week ago.  I feel sorry for people who get headaches all the time.

Oh, and blind people.

In any case, this is my last week of uni before we get a whole week off.  I’m so excited I could poo.  Really.  My plan for the holiday is to get in a photo shoot at some stage.  If I do, you will obviously hear all about it.  Lucky you.

Anyway, back to squiting at my facebook page.

Real Control

Seriously, it scares me.  I can deal with not getting what I want, for the most part.  I really can.  But there are some things I can’t deal with not having.  The big stuff.  The stuff that isn’t an iPod or a car or something.

There’s only one way I want it all to work out, and there’s a good chance it won’t work out that way – doesn’t God laugh at our plans?  On this, I am decidedly inflexible, but I have no real control.

Theatre 23

 

Okay, so I’m just going to write it down here so I don’t forget:

 

Surgery 1:      Right knee arthroscopy.  Repair right lateral meniscus tear and remove multi-nodular cyst deep to the iliotibial band.

Surgery 2:     Left knee arthroscopy.  Repair left medial meniscus tear and articular cartilage (stage 4 osteoarthritis).

Surgery 3:     Left knee arthroscopy.  Repair left medial meniscus tear (with synovitis).

Surgery 4:     Left anterior-cruciate ligament (ACL)  autograft (arthroscopy).  ACL graft made from patient’s own hamstring tendons.

Surgery 5:     Left shoulder stabilisation (arthroscopy).  Reconstruct superior labrum at glenohumeral joint post dislocation.

 

Surgery is awesome.  Five surgeries in five hours.  Depending on the surgeon next week, we may see some laminectomies – spinal surgery.

Buzzin’ like a motherfucker today.

Quick Gay Rant

Why oh why are all the other gay bloggers absolutely saturating their blogs with pictures of almost-naked impossibly hot men, even when the subject of the entry is what they had for dinner?

STOP STEREOTYPING YOUR DAMN SELVES!

All the Drama of the Theatre

Operating+room+1938

Okay, so I get that I don’t know anything, and won’t be able to do anything, and will probably actually reveal just how much I don’t know about my supposed chosen profession – but I don’t care.  I’m going into theatre!

I’ll be scrubbing in for a surgery tomorrow morning at 8, and given the travel time will have to wake up at 5 (worst luck).  I don’t know what the procedure will be, and it could be something lame, but since it’s orthopaedics – it’s bound to be gruesome.

Gruesome is good.

This will be my first time in a surgery, and I’m excited.  Not because I’ll get to do anything incredible or prove myself in any way, or because I’ll get to wear scrubs for a reason other than going on a pub crawl or a jog (okay, it’s a little about the scrubs), but just because it comes at such a good time.  I’m so disenfranchised with academic life; it’ll be nice to do something more practical.

Anyway, I’m looking forward to it.  There’s costumes, lighting, cameras, performers, and all the drama of the theatre.

That is why they call it theatre…right?

Let the Rain Fall Down

and_the_rain_came_down_x_b

Winter now.  Everything is a little colder, a little darker, and a little more comfortable.  I’m in a period of not looking, for the time being.  I’m not looking for anything, just trying to stay comfortable in my little corner.  It’s not that hard, because as always, things are changing.

I’ve been spending a lot more time with my sister, lately.  We get along so well, it’s just such an effortless relationship.  The fact that we share a love of the finer things in life – so long as you can eat and drink them – also helps. 

I’m sort of getting into the study, a little more.  I think I’m happier now we’ve started the musculoskeletal block.  I dunno.  Life is random.

I’m taking a break from boys – I don’t know how to do the whole dating thing and I think I make a bit of a mess of it when I try.  I won’t close myself off to the possibility, but I’m not sure I’ll actively persue it for now.

########

I’m sitting here in the learning centre of the medical school, looking out at the rain that seems to have set-in for the day, trying to think of what to write.  It’s so much harder when there’s no drama, I’ll admit.  No drama is a nice thing, but it’s easy to write about.

Anyway, come back again soon.  The drama is never too far away.  For now I’m kinda happy to just sit and watch the rain fall down.

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One Version of Things

I'm a 24 year old gay medical student living on the Gold Coast in Australia. This blog started as a way to blow off steam (ie procrastinate) during the tedious med-entry period, and snowballed into a sort of outlet of self-therapy. It's my way of pulling back to look at the bigger picture. So here it is - the bigger picture. Or one version, anyway. I hope you enjoy it here.

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