Fainting - should I quit surgery?

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useyourmint

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Hi! I'm a 2nd year med student and I don't really know what I'm going to do in the future, so right now I'm just trying different things and I'm really enjoying surgery. However, I'm afraid I might not be suitable for it due to my problem with fainting. In my free time I got involved with one of our university's surgical research groups. It's really great, I learn a lot from it, I love reading about medical conditions and surgical techniques, the doctors share their knowledge and let us participate in their research. And I get a chance to be in the operating theater just about whenever I want to and assist during operations. I love being in the operating room, I'm always excited to scrub in and see different cases up close, and listening to the surgeon when he describes different aspects and techniques does help in understanding the things you read in books. I'm not grossed out by the sight, sound, feel nor the smell of blood, burnt flesh or intestinal contents. I'm never hesitant to stick my hand wherever the operator needs me to, clip a vessel shooting blood like a fountain or stitch up some skin. Those things never bothered me.
But I sometimes have a problem with feeling light-headed while in the operating room. The first time it happened, I wasn't even scrubbed in (luckily), I was just observing a liver transplantation. I wanted to see as much as I could, so I kept standing on my toes on top of that little platform that lets you see over the surgeon's shoulder. It was like the third time I was present during the surgery, and the first time I wasn't assisting. About 3 hours into the surgery, I started feeling hot and sweating, then I got a little light-headed. I thought it'd pass if I took a few steps around the room, but it got worse. It was too hot, I couldn't breathe even though I took off my mask, the lights were too bright and I couldn't hear anything. It felt like all of the blood had escaped from my head. I sat down on a stool and lowered my head but it didn't help and I lost consciousness for a second or two, and the next thing I was on the floor and the anesthesiologist was by my side, asking if I was alright. The whole thing lasted about 2 minutes and I can't think of anything that might have triggered it. I've never been more embarrassed in my life. I promised myself that I would prepare better before operations, eat, sleep and drink more.
After that, I was at a few shorter surgeries and everything was fine. I was happy it must've been a one-time accident due to dehydration. But yesterday it happened again. I was assisting during a particularly messy surgery. Every now and then an artery would burst open, the surgeon got in a fight with the nurse, the large intestine got punctured, **** was leaking everywhere, we had to change scrubs like 3 times in 3 hours, and on top of that the bottle in the suction machine literally exploded, it was exciting to say the least. But I never felt grossed out by any of that. But about 4 hours into, when the surgeon has already started closing the wound, I felt extremely hot again. I was sweating and I knew what it meant. I tried to fight it but it wouldn't go away. So I asked the other student, who was observing, to scrub in and step in instead of me. But I couldn't stand there long enough for him to come back, I didn't want to risk fainting in the field so I told the doctors I was starting to feel unwell so they told me to step back and lie down, which I did. It made me feel better in a minute but there was no way I could come back to assist after that, so I just sat there watching the rest of the surgery, feeling ashamed. It was strange because when all the gross things were happening, I felt good, but when the surgery was just about to end and nothing was happening, it was all clean and calm, my body betrayed me.
I'm starting to think it might have something to do with me being physically too weak to stand still for this period of time or that I might have some circulation problems. I'm thinking about going to the doctor and joining gym. But I'm afraid I'll never get over it and that I'm just not suitable for the operating room. I'm afraid I'll be forced to stop going to surgeries, which I really enjoy. I'm afraid I wouldn't be able to become a surgeon even if I wanted to and my grades allowed it just because of this stupid fanting.
What should I do? Sorry for the long post, but it's really bothering me right now and I can't stop thinking about it.
 
Thank you for your reply! I'll definitely try not locking my knees, I hope I'll manage to remember that when I'm focused on what's going on in the field 🙂 As of eating and drinking, I'm pretty sure I was hydrated yesterday (I made sure to drink 2 liters of water that day before the operation, that is before 2pm) and I ate breakfast, so I'm not sure that was the case. And when I couldn't see over the doctor's shoulder, I was already standing on a stool (I'm sorry if that message didn't come across, English is not my first language so I didn't really know how to call it). The second time though I could see everything as I was assisting.
See, the thing is, it's not just something I have to live through and forget, like clinics during studies. It's something I'm quite interested in and going to surgeries is something I'd like to do quite regularly if I have a chance. That's why I'm worried if I'm even physivally suitable to do it. Even if I feel bad 1 in 10 times I'm assisting, that's still a risk for the patient, an inconvenience for the staff and an embarrassment for me. And I don't want the doctors to think I'm an inconvenience.
 
Thank you for your reply! I'll definitely try not locking my knees, I hope I'll manage to remember that when I'm focused on what's going on in the field 🙂 As of eating and drinking, I'm pretty sure I was hydrated yesterday (I made sure to drink 2 liters of water that day before the operation, that is before 2pm) and I ate breakfast, so I'm not sure that was the case. And when I couldn't see over the doctor's shoulder, I was already standing on a stool (I'm sorry if that message didn't come across, English is not my first language so I didn't really know how to call it). The second time though I could see everything as I was assisting.
See, the thing is, it's not just something I have to live through and forget, like clinics during studies. It's something I'm quite interested in and going to surgeries is something I'd like to do quite regularly if I have a chance. That's why I'm worried if I'm even physivally suitable to do it. Even if I feel bad 1 in 10 times I'm assisting, that's still a risk for the patient, an inconvenience for the staff and an embarrassment for me. And I don't want the doctors to think I'm an inconvenience.

Quit being your typical neurotic med student --- just because you felt a little light headed during your surgery rotation doesn't mean that you can't be a surgeon -- settle down, quit worrying and just go with it. Heck, given the level of nervousness you're displaying, you may be psyching yourself out -- relax....I've actually had attendings faint into the surgical field during my training -- it happens.
 
Some possibilities:
You could totally have an underlying vestibular disorder that's just getting exacerbated when you're in the OR
You could be dehydrated (maybe try drinking lots of water throughout the day...and eating saltines to prevent yourself from peeing too much?). Make sure your nutrition's good/well-balanced.
There's a few different things you can do in the OR when you're feeling lightheaded that are positional- going up and down on your knees, legs apart, going up and down on your toes, etc
Perhaps there are certain operations you can't stand (i.e. I can't stand watching video-camera guided surgeries as those make me dizzy)
Maybe try those orthostatic stockings

Also, like the posters before me, I agree that you shouldn't cross out surgery because of this. There could be a lot of underlying reasons you're struggling with this. A lot of my female classmates have the same issue with fainting-- doesn't hold them back, and hopefully this won't hold you back either!
 
Thanks a lot for your tips! I have to say you did manage to calm me down a lot. I don't know if I want to be a surgeon, and if I do eventually, there's still a long way to go. But it's comforting to know that this is not something that should stop me if I decide to go into that field.
In my country, it's still pretty unusual for a woman to be interested in surgery. According to statistics, 90% of surgeons here are men. There's a pressure on women to do well or else we're not treated seriously. When a male student meets a doctor for the first time, he gets asked questions about his interests and plans for the future. When I meet a doctor for the first time, I get asked what I'm doing in the surgical ward. I think some of my insecurities might originate from that.
 
Thanks a lot for your tips! I have to say you did manage to calm me down a lot. I don't know if I want to be a surgeon, and if I do eventually, there's still a long way to go. But it's comforting to know that this is not something that should stop me if I decide to go into that field.
In my country, it's still pretty unusual for a woman to be interested in surgery. According to statistics, 90% of surgeons here are men. There's a pressure on women to do well or else we're not treated seriously. When a male student meets a doctor for the first time, he gets asked questions about his interests and plans for the future. When I meet a doctor for the first time, I get asked what I'm doing in the surgical ward. I think some of my insecurities might originate from that.

Tell them you're from the infection control department and need to do a penile swab for gonorrhea and a rectal for HPV infection on all male surgeons per new hospital policy -- that'll shut that up....or you could always move.....
 
What you are describing sounds like syncope, which can be triggered by dehydration but also by stress or strong emotions, not just by being grossed out. In addition to this it could be caused by a medication you’re taking or even an arrhythmia. It would probably be worth discussing with your doctor especially if it recurs and is impacting your life.
 
Tell them you're from the infection control department and need to do a penile swab for gonorrhea and a rectal for HPV infection on all male surgeons per new hospital policy -- that'll shut that up....or you could always move.....

Thank you all for your support! It really does mean a lot to me that you went out of your way to write words of support. I've tried your methods and I didn't have another incident yet. I'll see how it works out in the long run.

I have yet to try out the infection control department method - I'm really curious as to how it'd work 😉 Seriously though, I know I shouldn't let people treat me like this. In other specialties there's already place for women, but surgery is still very male-dominated here. Maybe I'll have to work on how to politely demand to be treated with respect, too. Not that I think anyone should have to do that.
 
The steps stack on top one one another and there is no shame in asking for two of them so you’re not on your toes the whole time... says a short Surgery resident with firsthand experience :whistle:
 
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