My sister texted me to let me know I need to post. So here it is.
This morning (or the smorning for some of you) I woke up early and Matt drove me to school two hours before classes started. I was in green surgical scrubs that I had quite the adventure finding yesterday (as it turns out, you cannot buy surgical scrubs in the school book store) and it was about 25 degrees out. But all of that was ok, because I was observing in the OR for the first time!
Our patient was a 40-something father of two from Chicago. He has Loeys-Dietz Syndrome, a disease of the arteries and presenting with cleft palate, wide-spread eyes and skeletal deformities. Patients with Loeys-Dietz have a high risk of death from aortic aneurysm rupture. Our patient had had a previous major surgery to repair some blood vessels and today the patient had a valve-sparing aortic root replacement for an aortic root aneurysm. (Here's a link to a video of the surgery in someone else.) This basically means that the surgeons opened his chest, cut out part of the aorta coming out of his heart taking the blood to the rest of his body, and sewed in a tube-like graft. Unfortunately, I didn't get to see any of the procedure because I had to go to class... but I did have a fabulous first glimpse into the operating room and started learning about anesthesia.
Our patient, V, was visiting with his wife and college-age daughter when Dr. M., his anesthesiologist and I walked in. Dr. M. explained what her part in the procedure would be, what it would feel like to "fall asleep," how many tubes he would have coming out of his nose and mouth when he woke up in the Intensive Care Unit after the surgery, and that the "margaritas" she would give him through his IV would keep him very warm and feeling good throughout his recovery. V didn't have many questions, but his wife wondered if the surgeons were planning to look at his other large blood vessels while they had him opened? No, they weren't. That wasn't on the consent form. V's daughter asked if he would have chest tubes in after the surgery? No, not like last time. This time he would have similar tubes coming out of his lower abdomen though. I started to feel sweaty and weak. The combination of the excitement of wearing the green scrubs and blue meshy cap, the fact that we were talking to V and his family, and the fact that it was rather warm in the pre-op space didn't really work for me at that moment. I took a second to take a few deep breaths and realize that my only job was to watch. I wasn't in charge of anyone's life, I wasn't the one who had no control over his life.
V asked to speak with the chaplain right after his wife and daughter went to the waiting room. While we waited for the chaplain to arrive I sat down next to V and learned that he was from Chicago, his son was still home finishing up his last week of high school before the holidays and that their flight was delayed several times on the way to Baltimore on Sunday. His daughter is studying journalism and wants to get involved in sports reporting.
Dr. M. is such a wonderful teacher. She was teaching Dr. B., a 3rd year resident who physically did most of the work under Dr. M's guidance and direction. When they were putting V to sleep she told me everything they were doing and made sure I could see at all times. When you're knocked-out with anesthesia you can't breathe for yourself, so you must be intubated with a breathing tube. This breathing tube went down into V's trachea, through his vocal cords and was attached to a ventilator. While they were getting things set, Dr. M. had me squeezing on the blue air bag to ventilate V manually. Dr. M. explained that I was breathing for V, that it was a very necessary part of the procedure to put his to sleep and keep him asleep through the surgery. "And all before my first class."
I watched everyone start draping and scrubbing V's body to prep him for the surgery while Dr. M. and Dr. B. administered drugs, sucked air and fluid out of his stomach and placed a central like in the large artery under his clavicle. I did not touch anything blue. Blue things are sterile and I'm not allowed to touch anything blue. Other than the air bag, I didn't touch anything at all.
Although I didn't get to see V's surgery, I am comfortable with the amount I did get to see today and I'm eager to go back and learn more. Dr. M. emailed me to let me know that the surgery ended at 5pm and was not without complications. They actually had to reopen his chest to address some ventricular fibrillation, quivering of the heart muscle instead of solid contractions. I'm eager to hear how V did coming out of the anesthesia and how his recovery turns out, and I'm equally eager to sign up for more shadowing... now that I have this school thing under control!
