Surgery= the never-ending rotation

[vtucci]

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Hi all.

I was wondering if anyone else is in the same place I am. I am five weeks into my surgery rotation and have 2 weeks and 4 days left and it seems like an eternity.

Don't get me wrong. My teams have been fantastic. I appreciate their interest and their patience. Our clerkship director is genuinely interested in making the clerkship as usual for people like myself who are not planning to enter the field of surgery as a career.

My problem is that I get sick in every surgery I go into. I had bariatric surgery in 2006 and ever since then, I have a very adverse reaction to the heat and rebreathing warm air when fully scrubbed has made me sick each and every time I am in the OR for any extended period of time. My attendings have sent me out of the surgeries because I have almost collapsed on numerous occasions. My body then seems to take all day to recuperate and I go home collapse and wake up in the morning and repeat. I have been completely unable to study so only God knows how the shelf exam is going to go.

Ironically, I might have enjoyed the rotation if it was not for these physical issues.

 

[smq123]

I was wondering if anyone else is in the same place I am. I am five weeks into my surgery rotation and have 2 weeks and 4 days left and it seems like an eternity.

Don't get me wrong. My teams have been fantastic. I appreciate their interest and their patience. Our clerkship director is genuinely interested in making the clerkship as usual for people like myself who are not planning to enter the field of surgery as a career.

My problem is that I get sick in every surgery I go into. I had bariatric surgery in 2006 and ever since then, I have a very adverse reaction to the heat and rebreathing warm air when fully scrubbed has made me sick each and every time I am in the OR for any extended period of time. My attendings have sent me out of the surgeries because I have almost collapsed on numerous occasions. My body then seems to take all day to recuperate and I go home collapse and wake up in the morning and repeat. I have been completely unable to study so only God knows how the shelf exam is going to go.

Ironically, I might have enjoyed the rotation if it was not for these physical issues.

Wow, I'm so sorry. 🙁

I really enjoyed my surgery rotation, and was extremely sad that it was over. I loved the OR, and particularly enjoyed the longer oncology cases.

But this level of comfort only came after being in the OR day after day for weeks - it took me a while to figure out how to keep myself comfortable. I also easily vasovagal in extremely hot and stuffy environments, so putting on the surgical mask made me feel mildly claustrophobic at first.

Have you tried adjusting your mask so that a little fresh air comes in with each breath? I know it isn't easy (it took me a few weeks to figure it out), but keeping the bottom mask ties loosely tied can allow some fresh air in. Also, don't wear masks that come with face shields - they can make you feel even more uncomfortable.

Before each case, and in between cases, I would also go to the bathroom and wash my face, neck, and arms with freezing cold water - as cold as I could stand. That way, if the OR was warm, I still felt somewhat cool and comfortable for a while.

Also, are you eating well and (sort of) sleeping well? And not drinking coffee? It sounds counterintuitive, but I think that drinking coffee while on your surgery rotation saps your energy and can hurt you in the long run.

Good luck! I'm sorry that it's turning out to be such a physically difficult experience for you. 🙁

 

[dilated]

Also, don't wear masks that come with face shields - they can make you feel even more uncomfortable.

this makes a huuuuuuuge difference. full face mask = uncomfortable sauna with fogging (yes, even with all the tricks to reduce it). no face mask = cool and comfortable. unfortunately sometimes you need one (bleeders) and sometimes they'll make you wear one.

I realized the glasses-wearing attending looked pretty comfy so I got a pair of nonprescription glasses and I was in the comfort zone. You can get safety glasses too (a la lab gear) but the one intern I met who did that got incessantly mocked, even by murses.

Plus you can pick emo glasses to get a massive empathy score with your patients. 👍 😛

 

[vtucci]

Wow, I'm so sorry. 🙁

I really enjoyed my surgery rotation, and was extremely sad that it was over. I loved the OR, and particularly enjoyed the longer oncology cases.

But this level of comfort only came after being in the OR day after day for weeks - it took me a while to figure out how to keep myself comfortable. I also easily vasovagal in extremely hot and stuffy environments, so putting on the surgical mask made me feel mildly claustrophobic at first.

Have you tried adjusting your mask so that a little fresh air comes in with each breath? I know it isn't easy (it took me a few weeks to figure it out), but keeping the bottom mask ties loosely tied can allow some fresh air in. Also, don't wear masks that come with face shields - they can make you feel even more uncomfortable.

Before each case, and in between cases, I would also go to the bathroom and wash my face, neck, and arms with freezing cold water - as cold as I could stand. That way, if the OR was warm, I still felt somewhat cool and comfortable for a while.

Also, are you eating well and (sort of) sleeping well? And not drinking coffee? It sounds counterintuitive, but I think that drinking coffee while on your surgery rotation saps your energy and can hurt you in the long run.

Good luck! I'm sorry that it's turning out to be such a physically difficult experience for you. 🙁

I am in week 6 and counting down the remaining days (as you can see-LOL).

I have used the green masks (supposedly non-foggable for those of us who wear glasses) when permitted but have had cases that I was required to wear the face shield. I have also done the cold water trick but it never lasts long enough.

Can't drink coffee since the bariatric surgery- too acidic. I always try to eat something and drink something before going near the OR but it does not matter. 🙁

After being sick all day, I go home eat dinner, take a shower and go to bed. I cannot study and just sleep but it is never enough. I feel so crappy all the time that even 8hours does not let my body adjust.

Thanks for the support and letting me vent.

 

[SoCuteMD]

Hi all.

I was wondering if anyone else is in the same place I am. I am five weeks into my surgery rotation and have 2 weeks and 4 days left and it seems like an eternity.

Don't get me wrong. My teams have been fantastic. I appreciate their interest and their patience. Our clerkship director is genuinely interested in making the clerkship as usual for people like myself who are not planning to enter the field of surgery as a career.

My problem is that I get sick in every surgery I go into. I had bariatric surgery in 2006 and ever since then, I have a very adverse reaction to the heat and rebreathing warm air when fully scrubbed has made me sick each and every time I am in the OR for any extended period of time. My attendings have sent me out of the surgeries because I have almost collapsed on numerous occasions. My body then seems to take all day to recuperate and I go home collapse and wake up in the morning and repeat. I have been completely unable to study so only God knows how the shelf exam is going to go.

Ironically, I might have enjoyed the rotation if it was not for these physical issues.

I had a particularly miserable surgery rotation, and it sounds like yours is difficult for very different reasons. Just remember, "They can't stop the clock."

Don't worry about studying for the shelf. You'll pick up more than you realize during the day. Round on as many post-op patients as you can, and volunteer to do consults in the ER for the next couple weeks. You'll learn a lot from seeing patients from the moment they step through the door, your residents will love you, and everyone wins. No one ever has the energy to study for the surgery shelf except for the superstars, so don't stress too much.

 

[Ashers]

...
Have you tried adjusting your mask so that a little fresh air comes in with each breath? I know it isn't easy (it took me a few weeks to figure it out), but keeping the bottom mask ties loosely tied can allow some fresh air in. Also, don't wear masks that come with face shields - they can make you feel even more uncomfortable.
...

Also, are you eating well and (sort of) sleeping well? And not drinking coffee? It sounds counterintuitive, but I think that drinking coffee while on your surgery rotation saps your energy and can hurt you in the long run.

Good luck! I'm sorry that it's turning out to be such a physically difficult experience for you. 🙁

I enjoyed the OR for my surgery time. I didn't like my rotations though, so it felt like my 8 weeks dragged on and on. I also didn't like it that everyone said I should enjoy general surgery because I want to do something surgical. ARGH! (sorry, pet peeve.)

smq has some good suggestions here. I'll add some hints that I did.

As for masks, I always wear the So-Soft white masks. Others bother my face and make me feel claustrophobic. I only wear those colorful goggles with replacable plastic shield thing for very short cases -- they give me headaches, they fog up, and they fall off my face. What I started doing is taking the shield mask, folding the mask part, and tying it to my forehead. I might've looked stupid, but I was able to breath, and it has more coverage than those goggles. (I didn't make it up, I stole the idea from an ortho resident.) If you try it, put it on well before scrubbing, I found for me, if I didn't have it adjusted just right, it'd fog up.

I also have food in my pockets at all times... generally snack bars and protein bars. If I knew I had a really long case, I'd go to the bathroom, grab water, and eat a protein bar. I have a bad habit of nearly fainting when I get hypoglycemic and i'm standing in 1 place. I cut down my tea intake too and drank lots of water instead.

Good luck! You don't have that much time left on surgery.

 

[smq123]

I am in week 6 and counting down the remaining days (as you can see-LOL).

After being sick all day, I go home eat dinner, take a shower and go to bed. I cannot study and just sleep but it is never enough. I feel so crappy all the time that even 8hours does not let my body adjust.

When you start feeling faint in the OR, what do you do? Do you try moving around a little bit (if possible)? While scrubbed in, are you just staying still in one place?

Sometimes pumping your legs up and down can help increase preload and stave off syncope. (Sometimes. And I know it can be hard to move around when scrubbed in and retracting!) I also know that some residents use TED stockings to keep up blood return, but I don't know if it would help - they're bulky and hot stockings.

It sounds like you're having really tough time on surgery. I'm sorry that you're having such a hard time recovering from each episode. Good luck - hang in there!

 

[MossPoh]

As a continuation of the more airflow recommendation, many of the ORs I've been in have a selection of masks. As suggested by the orthopedic surgeon, I took the one where you bend the nose piece each time. You can bend it so it still rest on your face but leaves a little more air gaps. That combined with a slightly loose bottom half of the mask helped me get some cooler air in there.

 

[Ashers]

When you start feeling faint in the OR, what do you do? Do you try moving around a little bit (if possible)? While scrubbed in, are you just staying still in one place?

Sometimes pumping your legs up and down can help increase preload and stave off syncope. (Sometimes. And I know it can be hard to move around when scrubbed in and retracting!) I also know that some residents use TED stockings to keep up blood return, but I don't know if it would help - they're bulky and hot stockings.

It sounds like you're having really tough time on surgery. I'm sorry that you're having such a hard time recovering from each episode. Good luck - hang in there!

Totally forgot about stockings and moving. I do that, as long as I wouldn't get yelled at for "moving." Try to shift your feet or bend a knee at a time, or even contract your calves. I've found as soon as I start feeling faint (especially if it's because I locked my knees -- did that when I was in charge of the camera during a ex-laparoscopy), if I start moving, nothing's gonna help, and I just keep on spiraling down until I have to break scrub. I have some compression stockings that my mom found that go up to my knee and are nylon, but just a lot stronger. I think she found them at Nordstroms.

 

[Medikit]

I like my surgery rotation a lot more than I thought I would, it seems to move fast for me, almost too fast, I have a lot more reading to do!

 

[teh t]

our is 12 weeks long, 12 weeks!!

 

[vtucci]

UGH 12 weeks.

Our clerkship director has been great and really tries to make it as painless as possible. I doubt it could ever be completely painfree as it is surgery.

I am just crossing my fingers till I see the shelf results and make sure I at least have a pass (hopefully, it will be higher but a pass at the minimum) and can not worry about this anymore.