barefoot in the OR...

May 15, 2010

I think the last place I had left off, Scottie and I had spent the day exploring the city. That night a few of us went to the english pub down the street which is apparently our new favorite hangout. Afterwards I went to bed early because I had to work day shift the next morning. I know weird right...when is the last time I have worked that early in the morning, haha.

Friday actually went relatively fast at the hospital. A little one month old baby girl occupied most of our time in the morning. She is a DORV with TET like physiology who got a BT shunt on Thursday evening. She looked awful when we got there!! She was super dusky and pale and freezing cold. She was also having pretty low pressures and her gas was 7.1 with a CO2 or 27 and a BE of -19!! We came to the conclusion that her shunt was probably working a little too well!! So we restarted her Epi for awhile and started her on some Milrinone, gave her some fluid and blood, paralyzed and sedated her, and increased her PEEP on the vent. After awhile she was doing much better, still a nasty color but slowly improving. Her poor mom was so sweet. Every time she came in to see her she would have tears just rolling down her face. I wish I could have talked to her, but the language barrier makes it so hard. I tried to do what I could to make her feel better, but it didn't feel like enough. You can tell that making family feel comfortable is not a priority here in the hospital. At home we would be talking her through what was going on with her child, but here it seems like they are pretty much kept in the dark.

Another patient on Friday was a 24 year old girl named Natalie who had an aortic valve replacement on Thursday. She was really sweet and spoke pretty good english. She was talking to me and Scottie and started crying when she was talking about her kid (or so we thought). Towards the end of the conversation we figured out she was actually talking about how she missed her orange and red cat, haha. Her and Julia both went to the floor otherwise known as "the ward." Yay Julia, I will miss taking care of her, she was soooo sweet and adorable. I am glad she is doing so well though!

The lunch they feed you at the hospital is sooo good. The cook is this old lady who will make you eat, I dont care if you want to or not haha. We had Ukranian Borscht which is a type of soup and sooo good. They had fresh sour cream you added to it and these pancakes that were to die for. They were so good we even came back later and had some with our tea.

The first case Friday was an older man who got a triple bipass. Luckily we weren't in charge of taking care of him cause that is a little out of my comfort zone, haha. Chris Gilbert, the surgeon who is with us likes to do one adult surgery each trip. At the same time this case was going on, Olga the surgeon from here performed a PDA ligation on a cute little 6 month old Down's kid. She came back still intubated and while they were assessing to see whether she was ready to extubate they just unhooked her ETT from the vent and just left it flopping in the breeze, basically using it as an oral airway....weird!! When it came time to extubate I got to do it!! So cool :) Igor, basically the director of the cardiac program here in Kharkiv did a cath on a 5 year old complete AV canal who previously had her PA's banded. They thought they saw some left ventricular disfunction and that it looked a little small on echo so they were cathing to check everything out. They decided that she looked good and was ready for her complete repair which will be one of our cases for next Tuesday. The last surgery was a 17 year old who had a sinus valsalva fistula. They repaired this and closed her PFO. When coming off pump they thought they heard a thrill and because they don't have a TEE here they went back on pump just to look around and make sure she didn't have a VSD or something else. Sergei the anesthesiologist who is from Belarus but now lives in Canada was telling us about this and was saying since they don't have a TEE here they have to go by just their eyes and hands. Everything looked fine and she came off pump easily!! During this case I went up to the gallery and got to watch some. It was funny seeing an OR with the doors just hanging wide open and the scrub nurse was barefoot!!! So all in all it was a successful and pretty busy day! We even got to buy icecream for some of our patients that are now on the ward...they are so cute :)

After coming back from the hospital a bunch of us went back to the English pub for dinner. I had a really good meal of grilled chicken with pineapple and vegetables, sort of like a stir fry. Everyone ordered some vodka and I figured I should try it since that is the thing to do here. I normally hate vodka but it was actually pretty smooth. Eugene, the intensivist from Minsk was leaving this morning so we all had to say goodbye to him after dinner! I found out that he actually came to Cincinnati for a month back in 2004 and spent 3 weeks as a visiting physician with Dave Nelson! I will have to ask Dave if he remembers him! When we got back from dinner everyone went down to the bar in the hotel, called the Gold Lion. I was tooo sleepy so I just went up to bed and slept like a rock until morning! Katie, Scottie, and Michelle all got back from the hospital around 9 am so I got up and ate breakfast with them. We have the weekend off to explore so when they wake up in a couple hours we are going to do just that! I think we might even take a gandala ride...no joke.

-Lindsey