Well, we have done it. We took our last exam, and now, after 22 years in the making, my academic career is finally OVER! Thank God! I have to say, I could not have been happier when that day rolled around, I felt like a kid on Christmas morning. And although we still have boards part II to study for for next year, the feeling of not having class, or having to study after a long day of clinic is one of the greatest feelings EVER! As I was cleaning up my post exam week mess and putting away the countless powerpoint presentations I have studied over the past year, I had to share this picture.
Thats a lot of information that somehow found its way into my brain...and this was suppose to be the easy year..
Now, I am sure a lot of you are wondering, what does a medical student do now that their studying career is over? I have one word: R-E-L-A-X!!!!! It has been wonderful not only to have a three day weekend but to be able to lead a somewhat normal life. We get up, go to "work" (although, they aren't paying me, I am paying them... funny how that works) come home cook dinner and watch tv!!! So this is what I have been missing out on?! This is fantastic. I can not wait til I actually do get a paycheck for this!
So on top of leading a somewhat normal life, the month of March also started my surgery rotation. This is the rotation where we get to start using the surgical skills that we have been practicing in the classroom and get to apply them to real life. No, they do not let us loose on a patient in the OR (although..I wish they did) but rather we get to watch the surgeons do their thing while they quiz us on the procedure they are doing, the steps to doing the procedure, anatomic structures that he is pointing out and identifying, asking us what type of sutures we would use for this patient and what we would do for a post operative plan for the patient. Still more exciting then sitting in a classroom listening to some guy lecture about the Kreb Cycle if you ask me. I got to go into my first surgery of this rotation on Monday and it was very exciting. Although, we did not get to scrub in, we did get to watch the entire process from the pre operative planning to the operation itself to the post operative notes that the doctors have to write.
So, a little history on this patient. The patient had a big wound on the front of the ankle due to being run over by a car. Thankfully (and amazingly) there were no fractures involved. The patient had a big wound on the front of her ankle that needed a skin graft. So thats the main history of why the patient was in the OR. We were debriding the wound (aka. cleaning up the wound, taking off all the dead tissue and preparing the area for the skin graft) and applying a skin graft to the wound. Pretty cool right?
The first thing we had to do after the patient was under was to clean up the wound. We do this not only so that the skin graft has a good "wound bed" to adhere to but also because of infection. Bacteria LOVE dead skin, so we don't want to leave that bad stuff on the area. The doctor used what is called a Versa Jet to debride the wound. What the versa jet is is basically a high powered but very small pressure washer for the skin. Water comes out of the end of the instrument and takes off layers of skin one by one. The benefit of this is
a. you use saline solution which is sterile and cleans the wound and
b. this allows you to take single layers off at time, making sure you do not cut any important nerves, arteries etc. So its a pretty cool toy to use for these types of injuries.
Versa Jet..the surgeons version of a power washer
So after the area is cleaned up, we apply the skin graft. Now there are a whole bunch of skin grafts on the market all of them saying and claiming they do different things. Depending on the wound depends on the graft you use. The doctor I was watching was using a graft called Theraskin. After doing some pre operative research and looking up some information about this graft, I really like it. The graft is taken from a donor (in the same way as an organ donor) very soon after the patient has died. This allows the graft to still have all the "good stuff" (cells that help the body heal and fight of infection) that the skin needs to help heal itself. It is taken soon after the patient dies and is frozen so the cells in the graft don't die. When the graft is needed, it is defrosted and applied to the patient. At that point and over the next few weeks, the graft helps the healing process by "reactivating" those "good things" that the bodies needs to repair itself. Very very cool. Not all skin grafts are taken from cadavers, some are man made, it all just depends. The studies I did review however, showed very good results.
Theraskin..headquarters and where most of them are manufactured...LifeNet in Virginia Beach. I love a good hometown hero.
After the graft is placed on the wound it is held in place with sutures or staples. We then applied a wound vac to the area. The idea behind a wound vac is that is applies suction to the wound so that the area does not stay too saturated, which in turn, promotes an optimal healing environment.
So there is the surgery in a nutshell. It was a fun surgery that allowed me to ask a lot of questions and learn a lot of things. I am excited to see how this patients outcome is in the weeks to come.
Other than surgery and relaxing, its been a little bit of wedding planning here and there. I have my last dress fitting soon, and seating chart is starting to come along as well as the programs. Less than two months til the big day people. Time to get excited.
I hope you all are doing well. I will see a lot of you soon:)
xoxo
Shout Outs
~My father, he turns 60 this month! Woop Woop
~To all of my friends and family that have helped with my bridal showers. I can not wait to spend it with all of you.
~To my best friend, Lindsay, good luck with starting grad school this month!!!
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