Random Tuesday in September

It was a pretty good one. Local weather nice.

Rounds 7am not quite sharp, but thereabouts (small team, all human). Not much on. Patients that were on death's door a few days ago are going home, and are impatient for their chest X-rays to be confirmed and their discharge prescriptions to be filled. So it goes on a thoracic surgery floor, as elsewhere.

One patient has gone back into atrial fibrillation after esophagectomy, so cardiology will have to reasses him, though his blood pressure is stable and his rate is between 80 and 120. He feels fine and doesn't know what we're so fussed about. We're worried about an anastomotic leak, and his swallow test is today. And we want to be able to anticoagulate him so he doesn't get a stroke.

We contact oncology and ENT for other patients, prepare discharge papers, chase path reports, check today's bloods and chest X-rays. Clinic in the morning to follow up post-surgical patients. I meet a lady who survived when her esophageal cancer and subsequent radiotherapy caused a diverticulum into her left atrium which led to near exsanguination. She was saved by a gastroenterologist who had his wits (and a Blakemore tube) about him, and by a lot of luck. I meet a gentleman with renal call cancer who has had all sorts of things resected and is still going for cure.

Result of our patient's swallow test? No leak. Cardiology says rate control, and we can anticoagulate now.

And then OR. Paraesophageal hernia repair. Did you know your colon could migrate into your chest? I bet this guy didn't either.

Music chosen by the surgeon: Scar Tissue, by the Red Hot Chili Peppers.