Dreams and Dramas

A teenage girl was referred to one of our doctors for some serious correction of her back problem - a dextro-scoliosis of T4 to T11 with an 80 degree Cobb angle of the curve. This is my first time to assist a spine surgery and yes, it was a heck of an experience with continuous shots of C-arm fluoroscope. 

Patient’s X-Ray result before the surgery.

Exposure had to be done such that all the intrinsic muscles were stripped off the thoracic vertebrae & posterior-most proximal rib surfaces.

Pedicle screws were used for moving & correcting the curved thoracic segments particularly in T3, T5, T9, T10, T11, L1 and L2. The surgeon later removed the L2 pedicle screw & simply shortened the left rod to match the right. The really tricky thing was the fact that the sizes of the pedicles of the thoracic & lumbar vertebrae were sub-normal & assymetric, making pedicle screw fixation a real pain in the neck.

The former 80-degree thoarcic curve is now nearly straight. The surgeon did a wake-up test before finalizing the correction - the anesthesiologist cuts down on the anesthetic gas, wakes the patient up & asks the patient to move both lower extremities in order to assess whether the spinal cord inside the bony vertebral column has not been over-distracted (& thus rendered partially or fully paralyzed). In this case, patient was able to move both lower limbs with vigor, so the surgeon accepted the correction. Closed the incision and was transferred to recovery room.

It was an 8-hour long surgery. Both my feet and eyes ached after the whole thing but I left my mind in the operating table wondering how did the team managed to deal with this case. Thus, Orthopedics is not for the weak-willed individuals. I see myself performing such surgeries in the near future. 

A 19-year old cheerleader from one of the biggest universities here in the country landed on the pavement instead of in her catching team’s human net during cheerleading practice. She managed to prevent her head from smashing on the pavement by sticking out her left lower limb. However, she twisted her left ankle badly and bruised it prominently. 

As it turned out, she had a fractured ankle - particularly a Lateral Malleolar Fracture.

A contoured 1/3 mini  tubular mini plate was screwed onto the fractured fragments in order to firmly keep them locked together.

She can be a cheerleader again after three months with only a month of physical therapy and continuous pain medications. 

The X-ray result a week after the surgery. It turned out that the surgery was a success. The screws are intact and the incision site shows no sign/s of infection.

This is what I have been doing for the past month - working as a nurse trainee and an orthopedic operating room nurse of two of the greatest surgeons in the country. This is also the reason why I haven’t been posting lately. Sorry though for this gross-but-educational comeback post. 

I can use my Filed! planner starting today. 2012 is my fourth year in organizing my thoughts and keeping it in a journal. Anyway, work resumes tomorrow so goodluck to me because i’ll be the nurse-reliever of Dr. LCL, the most sought-after orthopedic surgeon in the country.

Someday, I’ll perform miracles by making the cripple walk again.

I started training in their OR since last August. It wasn’t really that hard to get in since they sponsored my college tuition fee. In short, I was their scholar so they have no choice but to get me into their training grounds. I don’t have backers or whatsoever other nurses call it nowadays. 

When I started, they assigned me into the private counter part of POC which is Philippine Orthopedic Institute (POI) in Makati near Makati Med. The focus was obviously to render care to patients with masculoskeletal problems. Though given phisical therapy and administrative tasks, the staff there were kind enough to let me practice my profession - they assigned me to assist in Orthopedic surgeries in different hospitals affiliated with POI. But first, I have to familiarize myself with different orthopedic-surgical instruments which I find a bit easy because ortho has always been my forte. 

Casts, splints, tractions, exercises, therapies, walkers and crutches are just some of common words i use in my work place. I also enjoy assisting in arthoscopy, arthrocentesis and arthroplasty. Orthopedics is an interesting sub-specialty of medicine if and only if you are interested with motion and ambulation. 

I also assisted some of the country’s best orthopedic surgeons but I can’t forget when I first assisted the world-renowned orthopedic guru, Dr. Gustilo. He was so humble, very gentle but strict. His aura upon entering the OR theater, sets the mood up. He is a genius and he knows his staff very well. He told me that it was nice seeing me again because the last time that he did was when I a little kid, playing and swimming with his grandchildren (now in the US). My dad and Dr. Gustilo are best friends anyway. 

All in all, my experience in the Operating room of POC was one of the most memorable times in my starting career plus, it was also my first time to practice my profession with my own license at stake. It was remarkable and I wouldn’t forget a single learning I had in that institution. 

My 3-month training ends this coming friday (November 25). And if I were to be asked if i’d like to stay, I’d answer no. Because people grow roots from where they stay. And I don’t want my career to be encased in a single specialty alone. I want to learn more. I want to explore every single aspect of nursing. 

Thank you POC! I really learned a lot. ‘Till I see you again, Banawe!