i got to do a tracheostomy today!

ok so ive been doing this elective attachment for abt 2 and a half wks now..and for the first 2 wks, ive been seeing lots of cool cases but never really got to do anything..i would be able to scrub in for all surgeries but if im ever doing anything, it's likely gonna be retracting or cutting sutures..which i already do back in nz..and then recently i got to remove stitches in clinic..woohoo..one step up..

head and neck is quite a highly specialised field so i kinda half expected not to be able to do anything anyways..but even my resident was complaining how he doesn't get to do much and dat he too is doing wat im doing, which is retracting..but he does get to close and do suturing..he got really excited when he got to raise flaps for neck dissection..

so yesterday all of a sudden, i was given a chance to actually stitch! i was shocked! and then the fellow just passed me the needle and didn't really give me any instruction..i kinda knew wat had to be done..which was to close the underlying tissues just before the skin..and it was pretty much doing a basic interrupted stitch..im sure the fellow was watching me intently..i managed a couple of stitches but i was soo much slower than them..hahaha..but i got there in the end! except the fellow redid one of my stitches..but i was quite happy after dat..

and then today..the fellow asked me to put in the urinary catheter..again i was shocked..i was like oh ok then..so i did it..except i hadnt done it in a while so i didn't fully set up rite but got there in the end again with some assistance..

then the same pt was undergoing a neck dissection with a glossectomy and mandible reconstruction..so he needed a tracheostomy first..so i scrubbed in with the fellow to do the trach..i had seen a few of these done already so my job was pretty much to retract once again..and then the fellow tells the scrub nurse to hand me the knife (aka scalpel)..i was like HUH? so i got to make the cut..i was like oh cool i get to make the cut..but not just the cut! the fellow then hands me the cautery! so i was buzzing away cutting thru subcutaneous fat, muscle until we got to the trachea..and then i get to make the mark on the trachea with the cautery and then cut the trachea with the scalpel! it was the first time i had ever done anything like dat! i never got to do anything like dat in nz! the most i ever got to do in surgery in nz was to close..and dat was like the last day of my TI surgery run..and then my fellow puts in the tracheostomy..and then he sewed on one half of the trach and i got to sew on the other half..

and then later on when we were doing the neck dissection, the attending is now present (he wasn't present when the trach was put in)..and he asks me do u kno how to tie? and i said no..then he says i want u to learn how to tie before the next surgery..which means i'll get to tie next wk! now i just gotta learn how to tie..no one ever teaches u how to tie, esp in nz where we hardly get to do anything..so now i gotta figure out how to make knots with one hand..hmm..

it's amazing..i was thinking the other day how this elective is good in terms of seeing cool operations but not great in terms of doing stuff..and today i got to do a tracheostomy..wow..surgery is awesome..