Day 6
Carmita, a 39 year old primigravid, presented with 2 months of progressive left abdominal pain. An exam confirmed the ultrasound diagnosis of a 7cm simple cyst. No worry about cancer here, but a cyst that size can twist and pull and be the source of significant pain. At home, a laparoscopic approach would have meant a faster recovery (because of a smaller incision), but she did well and the operative findings confirmed a benign cyst. The tube was wrapped around the cyst and had to be carefully dissected away from the cyst, which was removed intact after about 180mL (about 3/4 a cup) of clear fluid had been aspirated. A damaged tube can increase risk of an ectopic pregnancy (a pregnancy fatally stuck in the fallopian tube), but though removing the tube (to eliminate this risk), it also decreases chances of conception. The ovary without a fallopian tube would still takes turns ovulating, but the egg would have to travel to the other fallopian tube. Possible, but unlikely.
The other post-op patients have done well, more pain than expected, partly because it is hard for a surgically naive patient to anticipate the extent of postop pain, and partly because the patients receive significantly less narcotics than they would in the EE.UU.
23 outpatients seen, two surgical candidates, but today was the last day of surgery, so they couldn't be scheduled. The others were mostly a mix of chronic pelvic pain and patients seeking reassurance about treatment programs from local doc's.
At night a closing party; using a non-commissioned officers club with a military band. Too loud and food that looked liked it was catered by Safeway, so I left early, caught a cab home, and packed. My roomate for the week didn't go at all: "I'm 11 years AA and plan to keep it that way."
No comments:
Post a Comment