rtt2142
My dear OB,
There are seven steps before a catastrophe occurs. This is a basic tenet of economics. Today I got away by the skin of my teeth. I hate turps. They are always stressful and just so bloody compromised, and this boy goes really close to the muscle, beyond the capsule, always causing a large amount of fluid absorption. He believes in what he does, I believe in what I do. So we differ on this opinion. The patient came in from Madagascar, ethically Bohri, old baba with a heart rate on table of 45, bp 101/56, spO2 of 84. Cxr showed alot of fluff in his lungs, but he has taken aspirin 150 the day before. The die was cast. I had to give the case. Social reasons: he had flown here for five days just for the surgery. Scientific rationale: frequent UTIs because of the catheter, this was a sweet window in which we could go in. Htn, DM post cabg 28 years before. What threw me off was the vitals in the ward was recorded as hr of 74 and saturation of 98! This made me even more worried, because breach candy is sincere in their recording. I gave atropine, preoxygenated him just to make sure he was responding to treatments, and then put down an LMA. I then checked his HGT which was 42!!! 25D ran in immediately, and it came up. OB, I realised, in hindsight, he was at his most vulnerable at that moment. I should have had the courage to post pone the case. But essentially everything was suboptimal at the moment I put him under GA. By God's grace it all went off well, but I realised the first three steps of the catastrophe had already occured. Sure, I took corrective measures, but somehow physiologically, he was very compromised at that point in time, which wasn't the case before he came to OT.
I'm grateful that it all went well. I had three turps, all very high risk, and two stones. Came home feeling tired of that constant adrenaline that had washed over me for 6 hours straight.
How was your day? I feel you are very depressed? I know the world is an unfair, unjust, cruel place. But ours is not to reason why, ours is not to do or die.
Aai