NPO U

So, here's something new.
I had to look this up.
The Rad read this as "post maxillary LeFort BSSO".

A quick google -"Surgery to the maxilla is carried out at three levels named after a French Surgeon René Le Fort.

The Le Fort I osteotomy involves separating the maxilla and the palate from the skull above the roots of the upper teeth through an incision inside the upper lip. The maxilla is fixed in its new position with titanium screws and plates. Surgery time is around three hours. The operation is frequently carried out with the mandibular Sagittal split osteotomy when it is termed a Bimaxillary Osteotomy.

Bimaxillary osteotomies take around five hours to complete and may be carried out in conjunction with chin surgery and liposuction/liposculpture. On occasions bone grafting is required in the Le Fort I osteotomy to ensure bone healing and union across the bone cuts. The graft is frequently harvested from the hip. Bone graft material may be harvested from the chin or lower jaw in bimaxillary cases – leaving the hip intact.

Cosmetic improvement is startling for those individuals requiring these procedures, and with proper planning it is unusual for patients not to be delighted with outcome.

Interesting.....gross, painful, but very interesting.

Ouch.

NPO 4 U!!

El Bow

Saturday was a dislocated elbow night. Two in one night - how often does that happen?


This pt was very, very drunk. They gave her 8 of morphine and she was still writhing around on the cart. She also threatened to murder me if I touched her elbow and it hurt her. I couldn't really do a lateral (or an AP or anything that looked right), but I tried and she didn't kill me, so fairly successful.
This next pt dislocated and fractured his radius. He also wanted to kill me. The student I was working with said he looked like he was going to punch me when I was positioning his arm. Hey- if you come to the ER, you're in a lot of pain and you want x-rays done, it might hurt. Boo hoo. Would you rather not know what is wrong with you?
He wouldn't let me move his arm for the AP, so the x-ray below was done with tube/film angle magic. I was pretty close to AP all things considered.
Then I spent an hour in surgery workin' the C-arm.
And ta da- post op films. Looks a lot better, right? (ignore the yellow arrow-it's not pointing at anything)

Scrub Strut

I love
Strutting in scrubs
Ceil blue
Head bouffant
Mask round my neck
Models kill the cat walk
I rock the OR.

Surgery Sucks

I am soooo tired. I had to work a morning shift today. Last night I got off work at 11pm, drove home 30 mins., and then got up again at 5am and to drive back to work.
Started the day off with a mammogram. Did an awsome job - as always - nobody gets more breast tissue on a film than me! I get chest wall everytime, on every film.

At 9am I went up to surgery. The first case was a foreign body removal and the second one was a gallbadder. Easy-peasy, 2 hours tops, Right? Wrong! I was in surg. for four hours!!

Four hours wearing about 20 lbs. of protective lead. apron, thyroid shield, ect. Plus the ever stylish blue hair net and yellow face mask.

The for. body was a kid that was burning garbage, someting exploded and hit him in the cheek. Dr. T. dug around and around in the boy's cheek for like hours. Seriously, if anything happens to my face I'm going to a cosmetic surgeon. No scars for me! Thanks very much.

They usually use a magnet to suck for. bodies out of incision sites. The magnet looks like metal toilet paper holder with a metal tip on either end. They stick the metal tip end into the flesh, squish it around a little bit and sometimes that's all it takes. The for. body sticks to the magnet and sclushp it's out.

But not today. It wasn't ferrous. So it wouldn't stick to the magnet. And it was stuck it a chunk of tissue, so Dr. T just had to dig it out manually.
My job in Surg. is pretty boring. I stand there and push the C-Arm in and out of the surgical site. When the Dr. says x-ray, I press a button and take an x-ray.

The gallbladder took forever, because the Dr., thinking it was an artery, clamped a duct off and then tried to inject contrast. "Hmmm, the contrast isn't going anywhere?" "Maybe it's the big stain-less steel clip you just clamped there."

Most of the time I really like Dr. T.
He's quiet and he doesn't swear at me.
A+ Dr.!!