IMG_9423

Daily Kaylee // 1.6.17

The past 3 days I have spent in the plastic surgery department and I have been fortunate to see quite a few surgeries, round with the doctors and work in out patient. Oh the 5th, I went into the hospital early to observe a surgery for a patient that got a breast augmentation 7 years ago. She was complaining about her right breast. It is protocol to test for a rare lymphoma because although there have only been around 40 cases, it is very severe. Biopsy was sent to lab in hospital as well as outside the hospital to be sure. Papageorgiou has never had a case. The head of the department performed operation. After any breast surgeries— they place a tube to drain any fluids.

More about the condition we’re testing for: Breast Implant-Associated Anaplastic Large Cell Lymphoma. BIA-ALCL is a rare type of T-cell lymphoma that can develop following breast implants. BIA-ALCL is not breast cancer. It is a cancer involving cells of the immune system. BIA-ALCL is generally found next to the implant itself and is usually contained within the fibrous capsule that the body forms around the implant. Most of the breast implant patients found to have BIA-ALCL were diagnosed after they sought medical treatment for implant-related symptoms such as pain, lumps, swelling, or asymmetry that developed after their initial surgical sites had fully healed. In most cases, the BIA-ALCL was treated with surgery to remove the implant and surrounding scar tissue. Some patients also received radiation therapy, chemotherapy or both. The risk of developing BIA-ALCL is low.


Surgery Time Table

10:29 second surgery of the day. Patient just went under. He was injected with a radioactive substance so that we could use a navigator to detect cancer cells.

11:04 main surgeon scrubbing in

11:06 begin using navigator to find cancer.

11:08 first cut

1:27 we had to take a huge chunk of his lip out due to a tumor. Now they have cut a flap of neighboring skin and will use it to help gill in the hole and preserve nerve endings.

2:00 continuing to stich open wounds on face.

Patient was in great condition one day post op. He is being fed through a tube but his lip looks normal considering yesterday we removed such a large chunk of skin.

 

IMG_9411

Daily Kaylee // 1.3.18

I

started the day begging other doctors for their patients in the plastic surgery out patient clinic. Very grey’s anatomy. The doctors here are very collaborative. I asked one of the doctors why they chose to go into plastics. His response was something I had never considered. It involves the whole body, you can perform plastic surgery on any part of the body in contrast to say neurosurgeons who really only focus on the brain and spine. Every situation is different, you have to always have a plan B. As opposed to general surgery where you may consistently do appendectomies— removing a mole will always be slightly different in location, size and behavior. In plastics you really cover a wide variety of issues. From removing cancer to elective/cosmetic surgeries. In Greece, plastic surgeons must attend 6 years medical school and then 6 after. This is 2 years general surgery and 4 in plastics. Right now, you can practice anywhere in Europe because of EU— may not be able to in the England soon because of brexit.

People don’t seem to mind if there are a bunch of people in the room and if people come in and out. Lots of skin cancer removal and reconstruction. Burns and skin grafts.

Patient came in with burn covering most of one arm and part of other. Blistering, skin red and purple. Skin is raw. Injured from something hot at work. Does not want to get better. Had burns for 3 months and is now at risk of losing function in his hands. Doctors have referred him to psychologist and physical therapist. He did not go to either— showed him excersizes and he did not do them. Helpless wants doctors to do everything for him and doesn’t seem to want to put in the effort to get better.

When admitted to the hospital he was next to a man with similar burns but also had burns on his legs and that man was out after 3 weeks with function.

Ended my day in a surgery on a patient with a hand infection. It was very cool to be able to see all of the muscles, tensions and bones in his hand as they rinsed the infected flesh.

My past few updates have been more medical related. Let me know if you prefer updates like today’s that are more like field notes or if you’d rather hear about what I’m doing outside the hospital and see pictures.

 

IMG_8947

Daily Kaylee // 1.2.18

Saying 2018 feels so weird.


11:57 

I just got out of a c-section surgery. To start the day off I watched a dilation and curettage. A d&c is a procedure to remove tissue from inside the uterus. Doctors perform d&c to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion. The patient was 55 years old and had an abnormally thick uterine lining and was experiencing bleeding despite having gone through menopause, so we took a biopsy to make sure it was not cancer. Initial appearance suggested it is likely benign but tests will take 5-10 days to come back.

I watched back to back births, one a natural and after a cesarean section. I officially never want to have children. Watching a woman literally being ripped open has permanently scared me. A c-section is the delivery of a baby through a surgical incision in the mother’s abdomen and uterus. It is very hard on the body of the mother as layers of skin, fat and muscle are cut open to remove the baby directly from the mothers uterus.

In Greece, similarly to the United States, once a woman has a c-section, every birth after must also be a c-section. Much of Europe allows women to have natural births after c-sections. NOTE: If you’ve had only one previous c-section, with a horizontal uterine incision, you may be a good candidate for a vaginal birth after cesarean, or VBAC.


12:24

Going into another c-section. This mother had spinal anesthesia as opposed to epidural anesthesia. For spinal anesthesia the medicine is injected using a much smaller needle than an epidural, directly into the cerebrospinal fluid that surrounds the spinal cord. The area where the needle will be inserted is first numbed with a local anesthetic. Then the needle is guided into the spinal canal, and the anesthetic is injected. She then played down and we waited a few minutes for her to be unable to move her legs. Then, the surgery could begin.


13:40

Closing her up. Final set of sutures are being done to close up the incision. They sew up the mothers uterus first.

It was a very fun day in the hospital today. I am now headed off to dinner.