- On Monday, I got to assist in delivering my first baby. It was one of the most incredible experiences of my life. It was a beautiful baby girl. Happy Birthday Beautiful!
- On Thursday, I did the history and physical on a patient who was being admitted for the delivery of her first child. I spent a lot of time with her and got to know her just a little bit. On Friday morning, the nurse said that she was delivering and so I ran into the room to watch the delivery. The doctor let me assist again! Another beautiful baby girl!!
- Friday morning, I got to scrub in and assist in my first surgery. The patient was having a hysterectomy because she had a uterus full of benign leiomyomas (uterine fibroids), which can cause increased bleeding and a ton of pain. I have felt benign leiomyomas during pelvic exams and seen in the cadavers during anatomy. The leiomyomas themselves basically feel the same in all three situations; however the uterus feels different in a cadaver than it did freshly removed from this patient. Obviously, the cadavers are processed and they are very similar but a little tougher/harder. There are some medical schools who are no longer using cadavers to teach anatomy. I cannot imagine how they learn the anatomy (it is all so twisty and it is in 3D). In ways, watching the surgery was like being back in the anatomy lab because I have seen the insides before. There are little things like the thickness of the vessels (even just feeling the vessel) tells you if it is an artery or a vein. I think there are somethings that are best learned by touching and doing rather than reading. Anatomy is one of those things, despite how much I hated the anatomy lab.
- Also on Friday, I got to scrub in and assist in my first cesarean section. Happy Birthday Baby Girl!
- Had a patient with premature rupture of the membranes (PROM). PROM is one of those things that is all over my OB/GYN text book so it was interesting to see a case. I know that sounds horrible, but this mom is close to term so they are just having her hold off delivery for a few more days. Both Mom and baby look good. I have had a chance to see a patient with PROM, which makes remembering the syndrome and remembering how to treat it much easier. For the rest of my life, I will remember this woman's face and her name. These patients make such an impact on medical students. I wonder if they know how much they mean to us.
- Saw a cerclage removed. A cerclage is a super stitch that is placed in a pregnant woman who has cervical incompetence. I had read about cerclages and wondered how a regular old stitch would hold together a cervix. I was wrong: a cerclage is no regular stitch. It is a super stitch. Watching a stitch being removed may not sound exciting, but I am glad I got to see it.
- I saw not one but two patients with polycystic ovary syndrome! This is another syndrome that we hear a lot about in school, not just in the third year OB/GYN and endocrinology text books but in the second year pathology. I even had a question about polycystic ovary syndrome on my boards last November.
- I saw a diabetic and hypertensive pregnant lady. These are major problems in the United States and again it was a great learning experience to see how the doctors managed this lady's problems. Last night I was reading in my OB/GYN book about pregnant ladies with diabetes and hypertension and it was so helpful to have seen a patient with those problems. It just makes things make more sense.
I have always had OB/GYN on my radar, but I've never known if I could handle the surgery. I just don't think I am cut out for surgery. I was a little grossed out by the first few surgeries that I saw. Just observing the room and watching the surgeons, who have to be rather aggressive to perform surgery, is a strange feeling. It is sort of like watching a surgery on t.v. I kept thinking about the surgery from the patient's prospective--Thank God for Anesthesiology! Anyway, once I was actually at the table, my perspective on the surgery completely changed. It was amazing! During the surgery, I was trying to figure out what and why the doctors were doing what they were doing (In medical school, one doesn't learn how to perform surgery step by step like a surgical resident. In medical school, we learn to stitch and staple, proper technique for scrubbing into surgery and similar things). When I say I assisted, I really mean that I held retractors, gave tension to the thread when the doctor was stitching and suctioned blood out of the field. All in all, I was surprised how much I liked the surgeries.
On the other hand, I knew that I would love delivering babies. I have got to say that it is one of the most exciting things I have ever done in my life. Once the little heads are out, it takes a little bit for the shoulders to come out, then the babies quickly arrive, like a ketchup packet being stepped on. I have cut the umbilical cord in both deliveries that I assisted and I am here to tell you that the umbilical cord feels a little rubbery. For those of you who do not know, the deliveries are not that bloody until after the baby is born. The uterus has lots of blood in it as does the placenta so during the delivery of the placenta things start to get bloody.
I am still very interested in hematology and oncology, but this OB/GYN rotation is making OB/GYN seem like a very viable option for me. I am still not 100% sure I want to do surgeries nor am I sure about the crazy hours that OB/GYNs work, but I love this rotation.
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