Ah colorectal surgery, what an interesting month.
If you have never had to meet a colorectal surgeon, you may not know about all the services offered. In colorectal surgery we operated on anuses, rectums, small intestine, and large intestines. When people have inflammatory bowel diseases like Crohn's or Ulcerative Colitis the colon can get abscesses or obstructions, or just die and in that case you may need to remove part of the colon . Some cases you need to allow healing and for the inflammation from the disease to "cool down" so we create an ostomy to divert the poop from passing through inflamed colon for a few months and then can go in and reconnect it later once inflammation is down.
An ostomy is where you cut the colon and sew one end shut and put it back in the abdomen and you bring the other open end out to the skin and sew it into the skin so bowel movements pass through that end of the colon and catch in a bag. You can do this type of procedure with colon but it can be done in a similar way with small intestine. These can be reversible in some cases, but sometimes they are not. When do you need these? If you have a bad colon cancer , if someone is paralyzed and continues to get wounds around their anus that can't heal due to frequent bowel movements passing in wound, if inflammatory bowel disease has become severe, if you were severely obstructed/constipated and perforated a whole through the wall of the colon, etc. These procedures are not as scary as they sound and are tolerated well.
Other surgeries we do include those on the anus or rectum. For whatever reason (it's not the patient's fault) some people get fissures or abscesses around their anus and these take a long time to heal. They are very painful for people and so frequently we go in and drain them. Sometimes we put permanent drains in them. We also managed hemorrhoids and warts.
We arrived around 5:30 or 5:00 a.m. and reviewed the patients on the computer overnight.
From 6:00 a.m. - 7:00 a.m. we visited all the patients on our list in the hospital and checked their surgery sites and helped form a plan for their diet for the day.
Then we went to visit patients in the preoperative area of the hospital and talked with them before surgery to discuss the procedure and the medications they'll be on in the hospital. Throughout the day we answered many pages from everyone who is a team member taking care of our patients (nurses, physical therapy, occupational therapy, speech language pathologists, pharmacists)
Operations occurred in the morning and sometimes went through to the afternoon.
Afternoons were spent in clinic seeing patients who had a recent surgery, needed an in office procedure done like draining a cyst or hemorrhoid banding, wanted to have their wounds examined, or were getting worked up for a new surgery
We would have transfers from outside hospitals with emergent cases either during the day or nights
By 5:30 p.m. on days we weren't on call we handed off our patients to people on call for the evening and they would handle the events that came up in the night
When "on call" you manage all of the surgery teams' patients (thoracic, vascular, oncology, endocrine, colorectal) and I'm don't want to say just how many patients that was but it was definitely overwhelming on the weekends . There are fellows around for difficult cases and assistance with those! You also manage the phones for the surgery call centers, so anyone wanting to call about a possible emergency or needing advice from a doctor on the surgery team I would answer their phone calls and questions and sometimes help them decide if they did or did not need to come in and visit me personally at the hospital in our emergency room. If a patient came into the emergency room for any of the services you would go visit them there as well.
It was a busy, busy month but I had fun with my coresidents and that makes all the difference!