Saturday, September 06, 2003

Well, today I worked on some gifts (birthdays and christmas) for people I know and love. I figure if I start early I can take my time finding good gifts.
In other news, on monday I'm hoping to scrub in on a penis implant surgery. I would scrub in on a robotic lap partial nephrectomy but those take forever (laparoscopic procedures are much longer than normal open procedures but recovery time is usually much shorter and scars are minimal) and I have a stupid CT conference to go to. I swear, we spend more time in conferences (fancy word for "lecture") than actually seeing surgeries. Lame. The only cool things so far is the ENT conference where they lectured on Cochlear implants (my cousin has one of these) and Laparoscopic Skills Lab. The Lap Skills thing is part of a research project the Tulane Surgery Dept is conducting to see if computer simulation programs (VR) and the other training system improve lap skills and I guess justify the expense of such a system. If you ask me, by using medical students, the data will of course prove the system to be a good value since we have little to no skills and so most of us will have improvement by the end of the program. I would be more convinced if the study consisted mainly of docs who have been using the lap procedures and are using the system to refine their skills. But anyway...the first test was to try to cut a piece of paper between two lines and we had to cut the paper so far to get a point. There's a series of these lines and you try to cut the paper as many times as possible in 2 minutes but if you don't cut far enough or cut a line, you lose a point. My right hand was far better than my left hand - no big surprise there. It's really hard to judge the depth on the tv screen (they cover the bin so it's like a real lap procedure where you can't see through the skin). For some reason instead of training on the system that at least involves tactile feedback, I'm training on the computer and there's no tactile feedback but instead relies on my depth perception alone to complete these tasks. IN short, I suck. My right hand is better at completing the tasks but my left hand is better at economy of movements. I think the procedures take forever because you need to move so slowly to be 100% accurate. It was fun though. I hope to see at least 1 lap procedure. The most I'll be involved is holding the camera trochar - which is actually pretty important because if they can't see, they can't do anything in there safely!
Oh and I learned how to tie knots with one hand. And once I learned the 1 handed way, i forgot the simple 2 handed method! The instrument ties are not too hard either but pigs skin is not the easiest stuff to suture up.
~me~ at 11:31 PM

Thursday, September 04, 2003

Well today was the first day on the urology surgical service. It was alright. Quite scary since the pace was quite different from Family Medicine. Okay okay, family in thibodaux isn't the best thing to be comparing anything else to but that's all I've got. The resident seems cool as does one of the attendings. We got to see part of a procedure today but nothing to write much about - a circumcision on an older kid. And guess what time I'm getting up tomorrow! 4:45 am! Okay, I'm giving myself time to get my lazy tired butt out of bed and at the hospital to interview my patient and be ready for rounds at 6:15 am. Then there's something called walk rounds in the afternoon...as opposed to run rounds? Who knows! Hopefully, I'll get the swing of things and it won't be too bad. In clinic all I have to do is the Subjective part of a soap note since Dr. Thomas doesn't want us to do the physical exam on our own. Perhaps to cut down on unnecessary probing? In other words, my fingers have not been in nasty places yet. Tomorrow I have Laparoscopy Skills lab where we play with virtual reality simulator things to practice doing stuff with lap tools. I have 4 sessions of that. I'm looking forward to that - no patients involved there. Well, I'm going to study.
~me~ at 7:05 PM