surgery question... for women (TMI)

[swoopyswoop]

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[operaman]

Not a woman, but there's absolutely nothing wrong with taking care of your own needs during the rotation. Surgery has a reputation that may be slightly exaggerated. I've scrubbed into some really long cases and I just take breaks at appropriate times. If I'm not feeling well, I usually try to grab shorter cases and get other students to cover the longer ones. Depending on how things are set up at your school, you may be able to observe some cases and not scrub so it would be easy to step out briefly. Just make sure that you're a rockstar and consistently perform well clinically and nobody will mind at all if you need to step out for a minute (just come right back and be interested). Do make sure to inform people ahead of time so they don't have you doing something important when nature comes calling.

 

[darkjedi]

is you serial

 

[swoopyswoop]

i am 100% serial

 

[Serous Demilune]

I couldn't have picked a better title to get men curious enough to read this.

 

[Winged Scapula]

You chemically manipulate your period - either by using a Nuvaring or an OCP continuously, and don't skip a week.

 

[ksmi117]

You chemically manipulate your period - either by using a Nuvaring or an OCP continuously, and don't skip a week.

Mirena ftw.

 

[SouthernSurgeon]

You chemically manipulate your period - either by using a Nuvaring or an OCP continuously, and don't skip a week.

And, apparently, wear scrub pants with cuffed ankles

 

[swoopyswoop]

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[Winged Scapula]

I tried OCPs once in college and really didn't like them. Plus, I start next week so it's kind of too late, although I suppose I could salvage my second month.

Basically, let's say I don't have a choice in what surgeries I scrub in on since I'm assigned to 1 attending and I'm the only student. And the whole team is male. I guess they'll just think I have an overactive bladder... oh well!

Since the average general surgery case is around 90 mins long, unless your flow rivals that of the Ganges, you should be ok.

As far as not liking the OCP, there are many formulations and you may need to try another one. The Mirena is a good choice but it can increase flow in some. I liked the Nuvaring because I didn't have to remember to take something every day.

Finally these are adult medical professionals, they shouldn't be squeamish about you needing a menstrual related break.

 

[swoopyswoop]

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[Winged Scapula]

I think I'll be fine during Gen Surg, but I have transplant after. I know those cases are epic in length, but what's the average?

Depends. Renal transplants (which are by far the most common) are not very long (~ 2 hrs IIRC); livers? Well yeah those can take hours and hours (I scrubbed an 10 hr one once) and you and many of the staff will take breaks. You are unlikely to be doing small bowel and pancreas transplants.

Seriously get yourself a Nuvaring or use a menstrual cup (which doesn't have to be changed as often).

 

[Smurfette]

The liver transplants I've been involved with all allowed people to scrub out for bathroom and food breaks. I was told more than once in those cases to take a break, eat or whatever, and come back.

 

[swoopyswoop]

okay, i feel better about this now.

 

[Fluffy Pomeranian]

If you do decide to take an OCP continuously (skip placebo week), still wear a liner just in case. Whenever I've tried this, I've still gotten some light spotting, so you wouldn't want that to happen while wearing scrubs

 

[Kaustikos]

Hysterectomy. You're welcome.


I got a DaVinci opening if you need it.

 

[Instatewaiter]

Seriously get yourself a Nuvaring or use a menstrual cup (which doesn't have to be changed as often).

I'm not really sure what a menstrual cup is but it sounds disgusting. Does it look something like this?

 

[Kaustikos]

I'm not really sure what a menstrual cup is but it sounds disgusting. Does it look something like this?

Only because I can't get in trouble for using these images...

How to Use a Menstrual Cup

 

[masterwolfie]

So I'm starting the pill, but I can't start it until first week of my period, and I'll probably be on call at least twice during that time...anyone have any advice for that? I'm assuming I should just take really frequent bathroom breaks during downtime and use an extra large pad in case I end up in a 6 hour surgery? I'm really worried because my flow during certain days of my period does, indeed, rival that of the Ganges
(hi classmates who have identified me! how are ya guys?)

 

[Etorphine]

everyone reading this is going to be or is a doctor...what do you think happens when a pt tells a male doc about their period? male doc runs and hides?

 

[swoopyswoop]

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[Serous Demilune]

everyone reading this is going to be or is a doctor...what do you think happens when a pt tells a male doc about their period? male doc runs and hides?

I cover my ears and scream I CAN'T HEAR YOU until she runs away.

 

[Winged Scapula]

So I'm starting the pill, but I can't start it until first week of my period, and I'll probably be on call at least twice during that time...anyone have any advice for that? I'm assuming I should just take really frequent bathroom breaks during downtime and use an extra large pad in case I end up in a 6 hour surgery? I'm really worried because my flow during certain days of my period does, indeed, rival that of the Ganges
(hi classmates who have identified me! how are ya guys?)

I'm telling ya: Nuvaring. You don't have to remember to take something every day and you can start whenever you want.

But if you insist on the OCP, wear a tampon and a liner and ASK for a break if you need one. It's not that big of a deal, just don't ask if the ****s hitting the fan. You're a medical student; you are unlikely to be playing a significant role in the operation where you can't excuse yourself for a moment.

 

[Fluffy Pomeranian]

So I'm starting the pill, but I can't start it until first week of my period, and I'll probably be on call at least twice during that time...anyone have any advice for that? I'm assuming I should just take really frequent bathroom breaks during downtime and use an extra large pad in case I end up in a 6 hour surgery? I'm really worried because my flow during certain days of my period does, indeed, rival that of the Ganges
(hi classmates who have identified me! how are ya guys?)

Taking birth control should hopefully make your period lighter and shorter eventually. Atleast you have that to look forward to!

 

[Fluffy Pomeranian]

I cover my ears and scream I CAN'T HEAR YOU until she runs away.

I once asked my male med school professor a question about my vagina. He was a doc....is that awkward?

 

[Serous Demilune]

I once asked my male med school professor a question about my vagina. He was a doc....is that awkward?

Not if you were flirting

 

[Fluffy Pomeranian]

Not if you were flirting

No it was medical question.

 

[Brain Bucket]

No it was medical question.

he's joking. unless he's a gyn, it's an odd thing to do, though. I remember peppering my MS-1 anatomy lab-group instructor about acl care every time my knee acted up. Now, every time we cross paths, he always asks about it. I hope yours doesn't XD

 

[Kaustikos]

I'm telling ya: Nuvaring. You don't have to remember to take something every day and you can start whenever you want.

But if you insist on the OCP, wear a tampon and a liner and ASK for a break if you need one. It's not that big of a deal, just don't ask if the ****s hitting the fan. You're a medical student; you are unlikely to be playing a significant role in the operation where you can't excuse yourself for a moment.

Truth.
Also, this discussion sounds like there are no bathrooms in hospitals or it's forbidden to go to one. This must explain my failed evaluations.... "Student goes to bathroom... completely unprofessional. Recommend remediation."

 

[swoopyswoop]

True story: I went to the bathroom today and when I came back my intern asked me if I was bored.

 

[Brain Bucket]

There's no excuse for dudes to run to the bathroom during most surgeries.

 

[Psai]

I'm not really sure what a menstrual cup is but it sounds disgusting. Does it look something like this?

That cup will probably help prevent menstruation, yes

 

[starstarie]

Does this conversation seem a little overly dramatic, or is it just me? Have you ladies really been going to the bathroom every few hours while menstruating for your entire post-pubescent lives? You really need to get on that. Buy some OB ultra tampons and get a dam* Mirena/NuvaRing/whatever already! (Although I am one of those unfortunate few who have had increased bleeding with the Mirena- still love it tho!)

Also, mentioning your period should not make anyone at all be grossed out. It's a natural process for half of the world's population, and for those who don't have it, the majority of them live with people who do. You don't necessarily have to explain to all men that you are about to bleed out of your vagina everywhere, but ANYONE- doctor, med student, or average person- needs to be able to handle a woman asking to be excused to the bathroom if it's necessary.

 

[starstarie]

Ummm, yeah, when I have my period I definitely need to attend to that situation at least every other hour. More like every hour for the first couple days, despite the super plus tampons. I don't know what happened to my uterus, but ever since having my babies I basically hemorrhage every month. I'm thinking about just wearing a diaper to the OR. I'll wear a bigger scrub size and with the gown, I doubt it would be noticeable. Nuvaring makes me a crazy bitch so unfortunately that's not a viable option. Hopefully I'll have female surgery preceptors...

Have you tried a Mirena? Very low hormones, which do not have as many documented systemic effects. I had terrible experiences on numerous systemic hormonal contraceptive methods. If anything with Mirena it has controlled my hormones better. I' d really try something because I think you can improve your quality of life significantly, although if it doesn't usually bother you, to each her own. Have you gotten those OB ultra (purple color) tampons. They are hard to find nowadays (guess not that many women had to deal with such a heavy flow as me!) but when I used to have a really heavy period they were the only ones that would give me an uninterrupted 3-4 hours.

 

[colbgw02]

That cup will probably help prevent menstruation, yes

You're not getting enough credit for this post.

 

[VivaLaVida]

Love how people are telling you to change your body instead of just taking a bathroom break. It's ok to step out of surgeries and scrub back in. Has anyone taught you how to gown and glove by yourself yet? That is a skill I would learn for occasions just like these to minimize interruption to the others in the case.

 

[enterthepanda]

I don't know if it's just my school, but throughout my surgical rotations, I never saw or heard of anyone scrubbing out to go to the bathroom, even on really long, 8hr+ cases. People told us not to drink anything in the morning, especially not coffee, so that we wouldn't have to scrub out. Anyway, highly recommend the menstrual cup, even if it sounds gross; it rocks! Takes some getting used to, but once you've got the hang of it, you never again have to worry about a tampon leak! Hooray for menstrual cups! The Mirena is also awesome...no periods at all for some people!

 

[Prncssbuttercup]

I had progesterone only pills, and they were horrible, and I am glad I didn't have mirena. I ended up having periods every 10 days. $%^& THAT! I would personally not recommend women jump into a hormonal IUD with no idea how the hormones will effect them...
My first surgery rotation is going to be urogyne, and I have no idea what that's going to be like, I have no idea how long it takes to repair a pelvic floor or put in a urethral sling.... hoping my feet, knees, bladder etc will all be fine...

 

[SouthernSurgeon]

I don't know if it's just my school, but throughout my surgical rotations, I never saw or heard of anyone scrubbing out to go to the bathroom, even on really long, 8hr+ cases. People told us not to drink anything in the morning, especially not coffee, so that we wouldn't have to scrub out. Anyway, highly recommend the menstrual cup, even if it sounds gross; it rocks! Takes some getting used to, but once you've got the hang of it, you never again have to worry about a tampon leak! Hooray for menstrual cups! The Mirena is also awesome...no periods at all for some people!

It's funny. We explicitly tell all our students it IS ok to take a bathroom break. And in a long case, I usually try to remind myself to tell them to take a break at some point.

Med students aren't that vital to the case that they can't take a bathroom break.

Also med students are more likely to faint/pass out so I'd prefer that they not intentionally dehydrate themselves on top of it.

If you're having to go to the bathroom three times during a lap chole we are going to look at you a little funny. But if we're doing a whipple or a lung transplant I want you to take a break.

Love how people are telling you to change your body instead of just taking a bathroom break. It's ok to step out of surgeries and scrub back in. Has anyone taught you how to gown and glove by yourself yet? That is a skill I would learn for occasions just like these to minimize interruption to the others in the case.

I think the advice people were giving to the OP were just directed at the heavy flow issue itself which is bothersome to a lot of women.

 

[DermViser]

you've been warned. turn back, men & queasy people.

what do women do on surgery rotations when they have their periods & need to use the bathroom frequently? assume that this is the case even with a pad + tampon.

 

[starstarie]

I had progesterone only pills, and they were horrible, and I am glad I didn't have mirena. I ended up having periods every 10 days. $%^& THAT! I would personally not recommend women jump into a hormonal IUD with no idea how the hormones will effect them...
My first surgery rotation is going to be urogyne, and I have no idea what that's going to be like, I have no idea how long it takes to repair a pelvic floor or put in a urethral sling.... hoping my feet, knees, bladder etc will all be fine...

Progesterone only pills are not even close to the Mirena. Clearly you didnt do enough resaerch. The Mirena has the least amount of hormones* (equiv to a fraction of a mini pill/mo) out of any hormonal birth control method and the least hormone related side effects. The mini pill is notorious for being the worst kind of birth control (except maybe the patch) so I don't know why you would be on it unless you specifically asked for it or had some adverse reaction to the estrogen. Personally I think any form of daily birth control is obsolete.
*besides the new IUDs that have even less

 

[Prncssbuttercup]

Hormones cause different side effects in different people. Some people take progestin-only pills and have the same results as mirena, some don't. My doc was concerned about my age (clotting risk), and that is one of the reasons I stopped seeing him, and because he's a *******. I don't want an IUD because I don't want to have something in my body that has to be removed if I want to get pregnant, so it doesn't matter to me if it's progestin or not. Thanks for the insulting tone though...

 

[starstarie]

Hormones cause different side effects in different people. Some people take progestin-only pills and have the same results as mirena, some don't. My doc was concerned about my age (clotting risk), and that is one of the reasons I stopped seeing him, and because he's a *******. I don't want an IUD because I don't want to have something in my body that has to be removed if I want to get pregnant, so it doesn't matter to me if it's progestin or not. Thanks for the insulting tone though...

That's a completely valid reason for not wanting an IUD. However, you implied above that the hormonal side effect of an IUD would be worse than taking the minipill, which is not at all the case, for many reasons.

 

[ihazquestionz]

Does this conversation seem a little overly dramatic, or is it just me? Have you ladies really been going to the bathroom every few hours while menstruating for your entire post-pubescent lives? You really need to get on that. Buy some OB ultra tampons and get a dam* Mirena/NuvaRing/whatever already! (Although I am one of those unfortunate few who have had increased bleeding with the Mirena- still love it tho!)

Also, mentioning your period should not make anyone at all be grossed out. It's a natural process for half of the world's population, and for those who don't have it, the majority of them live with people who do. You don't necessarily have to explain to all men that you are about to bleed out of your vagina everywhere, but ANYONE- doctor, med student, or average person- needs to be able to handle a woman asking to be excused to the bathroom if it's necessary.

I don't know how I stumbled upon this but glad I did. 1 classmate of mine was too nervous to tell the attending she got her period...the pt ended up having adhesions on adhesions and finished 10 hours later. When she scrubbed out, blood literally all down her scrub pants. The attending just stared at her like..."uh...you are um, free to go and do anything you need to" hahahaha.

A resident I scrubbed in with once got her period halfway through a whipple. She goes, "I just got my period and the med student will assist while I am scrubbed out" and left for 10 mins. It was great for me to be on the operator side of the whipple for 10 glorious minutes!

I think I would opt for the second approach-hard to focus when cramping/bleeding out. Some people have awfully painful periods too. Comes down to patient safety. But also-residents should not feel like they have to take a specific type of birth control if they don't feel comfortable with it. 10 mins away during a quiet part of a procedure does no harm most of the time.

 

[Crayola227]

So I'm starting the pill, but I can't start it until first week of my period, and I'll probably be on call at least twice during that time...anyone have any advice for that? I'm assuming I should just take really frequent bathroom breaks during downtime and use an extra large pad in case I end up in a 6 hour surgery? I'm really worried because my flow during certain days of my period does, indeed, rival that of the Ganges
(hi classmates who have identified me! how are ya guys?)

I'm telling ya: Nuvaring. You don't have to remember to take something every day and you can start whenever you want.

But if you insist on the OCP, wear a tampon and a liner and ASK for a break if you need one. It's not that big of a deal, just don't ask if the ****s hitting the fan. You're a medical student; you are unlikely to be playing a significant role in the operation where you can't excuse yourself for a moment.

I would point out that combined oral contraceptive pills can be started at any point in one's cycle - the key thing is if you don't start the first day of your period they are NOT immediately effective against pregnancy. One can use a back up method. However, it's more likely to have some irregularity with your period if you start them mid-cycle.

I would point out that NuvaRing carries a higher risk of BV compared to any other method. However, that risk is still very low.

The issue I had with NuvaRing was sex. My partner could feel it, which wasn't a big deal, but we frequently had "ringers" - where it comes out around the penis, and of course then you need to put it back in. At some point, it was just easier to take it out for intercourse and put it back in. Of course, this creates the issue of where to put it, and not forgetting to put it back in (or losing it entirely!). No big deal if you're always at home, but if you're as spontaneous as I am, finding a good spot for it can be a challenge. Plus I didn't really love all the in and out and handling of the damn thing. You can wash it off with water, not soap. I ended up getting wicked BV on it, too.

Also, if you're not done with your period by the time you have to put it back in, you can't use tampons, which I hate.

I think OCPs get too much of a bad rap - I've tried every method there is except IUD, and I've always come around to OCPs. I did have to try 4 or 5 formulations to get on the one I'm on now. It's fairly easy to research the different types or for a gyn to help determine which might be best. Some women do really well with the estrogen.

If it were me, I would use a menstrual cup or the most absorbent tampons I could find. I would put a fresh one in right before a case. I would wear the super super super diaper pads out there. I mean, get an incontinence pad that can take like a liter of fluids, if you must. They make these strange underwear that look like boycut panties that are meant to be leakproof and have your period in with nothing else! Wear those. Then wear some boxer shorts on top. Then 2 pairs of scrub bottoms, maybe one size larger on top of the pair underneath.

I bet if you do ALL of the above you can avoid bleeding all the way through.

 

[Psai]

I would point out that combined oral contraceptive pills can be started at any point in one's cycle - the key thing is if you don't start the first day of your period they are NOT immediately effective against pregnancy. One can use a back up method. However, it's more likely to have some irregularity with your period if you start them mid-cycle.

I would point out that NuvaRing carries a higher risk of BV compared to any other method. However, that risk is still very low.

The issue I had with NuvaRing was sex. My partner could feel it, which wasn't a big deal, but we frequently had "ringers" - where it comes out around the penis, and of course then you need to put it back in. At some point, it was just easier to take it out for intercourse and put it back in. Of course, this creates the issue of where to put it, and not forgetting to put it back in. No big deal if you're always at home, but if you're as spontaneous as I am, finding a good spot for it can be a challenge. Plus I didn't really love all the in and out and handling of the damn thing. You can wash it off with water, not soap. I ended up getting wicked BV on it, too.

Also, if you're not done with your period by the time you have to put it back in, you can't use tampons, which I hate.

I think OCPs get too much of a bad rap - I've tried every method there is except IUD, and I've always come around to OCPs. I did have to try 4 or 5 formulations to get on the one I'm on now. It's fairly easy to research the different types or for a gyn to help determine which might be best. Some women do really well with the estrogen.

If it were me, I would use a menstrual cup or the most absorbent tampons I could find. I would put a fresh one in right before a case. I would wear the super super super diaper pads out there. I mean, get an incontinence pad that can take like a liter of fluids, if you must. They make these strange underwear that look like boycut panties that are meant to be leakproof and have your period in with nothing else! Wear those. Then wear some boxer shorts on top. Then 2 pairs of scrub bottoms, maybe one size larger on top of the pair underneath.

I bet if you do ALL of the above you can avoid bleeding all the way through.

This was a bad time to be eating...

 

[ihazquestionz]

If it were me, I would use a menstrual cup or the most absorbent tampons I could find. I would put a fresh one in right before a case. I would wear the super super super diaper pads out there. I mean, get an incontinence pad that can take like a liter of fluids, if you must. They make these strange underwear that look like boycut panties that are meant to be leakproof and have your period in with nothing else! Wear those. Then wear some boxer shorts on top. Then 2 pairs of scrub bottoms, maybe one size larger on top of the pair underneath.

I bet if you do ALL of the above you can avoid bleeding all the way through.

Yea but what if you're not expecting your period? Can't just scrub in with diapers every 4 weeks even if no period.. overkill + uncomfy.

 

[Crayola227]

Yea but what if you're not expecting your period? Can't just scrub in with diapers every 4 weeks even if no period.. overkill + uncomfy.

As we say in medicine, you gotta do what you gotta do. That's another benefit of combined contraceptives, they tend to make getting your period controlled, regular, and lighter, easier.

Otherwise, maybe you do wear a diaper while on your surgery rotation.

 

[valid username]

As we say in medicine, you gotta do what you gotta do. That's another benefit of combined contraceptives, they tend to make getting your period controlled, regular, and lighter, easier.

Otherwise, maybe you do wear a diaper while on your surgery rotation.

Another option: look up "period panties" -cheap Ebay knockoffs are fine. Use them WITH pad/tampon instead of alone. It does the trick. Even witn thosr show everything scrubs.