friday.

I can't believe it. Winterim is over. It went by so fast. I had an incredible last day. Everyone loved the cookies I made! Today was a long day. We had  3 cases (almost 4, but the facelift canceled!!). I started the day off with watching a breast lift and then a breast lift/aug and a tummy tuck. You would think I'd get bored watching the same procedures, but I don't. I get trapped in this trance. It's so cool watch Dr. G alter someone's body and make them look great. I think we really clicked. It was fun hanging out with her and watching the everyday problems she is faced with as a doctor. This has been better than any tv show I will ever watch and more educational than any class I'll take in school. I  really appreciate this opportunity and I'm glad to have been able to work with Dr. G. Later that day, I saw a colonoscopy. It's a procedure where they stick this long flexible pole with a camera at the end up your bottom and push it up all the way to your colon. It was...interesting. On the tv, all I could see was a long tunnel with fleshy walls and green/yellow goo dripping from them. The doctor suggested that there should be a colonoscopy video game where you try to navigate your way around someones large intestine and destroy any unusual growths :) I wasn't really hungry for lunch after that, but I knew that was the only time I could eat. The last case was a breast lift/aug and lipo. One of the nurses showed me what all the doctors have to do to scrub in. It's really meticulous, but I guess you would have to be. Dr. G and I talked about my future  and how my music would play into all of it. It was great being able to talk to someone who has been through it all before. I now know what colleges are great for what I'm looking for and now have a better idea of what this profession requires of me. I hope to stay in contact with her as I embark on this journey of higher education. Thanks for this opportunity.

thursday.

Today was my last day in the office :( I wish winterim was a bit longer. I did it. I wore heels!! and they didn't even hurt. These Tahari thigh-high suede boots are like walking on a cloud. Anyway, it was amazing to see some of the patients I had met the 1st day. For some people, I was able to see their pre-op check in, surgery, and post-op check in. Everyone in the office has been so kind and I hope they all enjoy the cookies I'm currently baking for them!! Today,  I saw a lot of post-ops and consultations. I never knew how colorful bruises were (mine just tend to be darker brown). Since everyone is different, people react differently to surgery. One patient came in with really neat bruises on her legs from a recent surgery. They will go away soon, but it was kind of awesome to see something like that before I go. I also just learned that Dr. G is one of the doctors who take in residents from Vanderbilt, That is why Rubble is always in surgery with her. I hope that one day I'll be able to work along side her as a resident as well :) Dr. G and I sat down and talked for a while. She gave me amazing advice about being in medical school. When she was a student, she was a minority. Only a small percentage of her colleagues were women.  She told me that as a minority, every battle isn't worth fighting. You just have to leave ignorant people alone. If someone doesn't like you for who you are, that is their problem. Work hard and don't let silly things phase you. Soon enough you will come out just as good or even better than your classmates (the guys, in her case). I also learned about medical school and residency. She told me to keep my options open and not declare a particular medical field just yet. I really appreciate the fact that she let me follow her around for a month. This has been an amazing experience and has strengthened my love for medicine. Tomorrow will be a bittersweet day in the OR. We have two big cases and one is a facelift...a full one with incisions around the eyes O_o What a great way to end a great experience.

gerbil love.

more pictures ^_^

the menace checking the fat level

Dr. G and Rubble in the middle of a liposuction case

The menace and me :)

"melted" and liposuctioned fat !!!

I (along with a bunch of random people) am spotted wearing "gerbil love" sticker that one of the nurses suck on me this morning

wednesday.

So, everyone in the OR room read my blog while I was out doing stuff. Now they all want nicknames. Ok, We have Dr. G, Rubble, The Menace, Clyde, Ghost and Jimmy (that's already his nickname). I started the day with a breast lift/reduction and a tummy tuck. Here's one thing you should remember, when dealing with bodies, you can always take more off, but you can't always add more on. With that said, the procedure went wonderfully. I sat in on one of Dr. T's knee scopes. He minimized the pocket of a loose knee cap! Jimmy was his NA and showed me everything he does during a case. He showed me the various tubes, what the machine readings meant, and all the narcotics and pain killers they use (he let me hold everything). I was afraid I was going to drop the Propofol (or whatever it's called) so I put them back. Today, Dr. G had very limited time to do two cases and had to do one right after the other. So, I picked up lunch for everyone in the room. I had to walk to Jason's Deli (since I don't have a car), but it was great exercise. I met a really nice hobo on the way there. We talked for a while about random stuff.  He was selling those newspapers (lol, the nurses told me to say hi to him on my way there).  I ended up bringing the lunch back earlier than expected (yay) and was proud that I didn't get lost, hypothermia, or kidnapped :) The second case was liposuction in various areas of the body. So I didn't get bored, Dr. G let me watch Dr. M (a fellow plastic surgeon) perform a nipple reconstruction. Remember when I saw those breast cancer patients postop? I was able to see the type of surgery they had undergone. It's really incredible to see something made for absolutely nothing. Dr. G finished up the lipo and took be back to the office where I chilled until it was time for me to leave. Btw: I  remembered to take photos today!!!

the anesthetist and her monitoring station 

Dr. G working on a patient (not shown for obvious reasons)

tuesday.

This morning I was in the office. I spotted another male patient. That gives me a grand total of...four :) Anyway, this guy came in to correct a condition called gynecomastia. Ok, what is that, you may ask? Well, "gyne" or "gyneko" means woman or female. "Mastia" means breasts. So, basically they are man boobs (like an underdeveloped woman).

  

Obviously, this can be very embarrassing for a man, so Dr. G does some lipo around the area. It was a pretty light day in the office. In the OR we had a breast lift and tummy tuck. During the procedure, we got into this huge discussion about tv and how crazy it's getting. The resident that usually works with Dr. G and I were talking about skins and the American remake. He seems to keep up with pop culture more than the others. I'm gonna call him Rubble (tehehe) because that it what his name reminds me of :) He is in his last year of residency and has been really fun to work with.  The snacks in the break room never seem to stop. You can always find something to munch on. Also, being able to access coffee whenever you feel like it has been a lot different than school. The coffee in the break room (which has a slight floral aroma) has kept me from totally passing out from tiredness. It's really incredible to see the great lengths doctors go through to keep everything sterile. I used to think is was tricky navigating through the sterile fields (I've totally gotten the hang of it now!), but I think it's even harder to move around the room and not get contaminated. We went through about 3 pairs of gloves, 2 of those light handle covers, a ton of those towels, and 2 suction tubes (?). Dr. G has been pretty lax about this (because she knows I can handle it); but, when I visit other OR rooms, I sometimes have to stay in one spot for the whole procedure (thank God for coffee) so I don't accidentally contaminate stuff. I'm sad this will be the last week I get to work with her. I'm having a great time.

friday.

I love Fridays. The whole atmosphere in the OR was pretty chill today. Dr. G started up the day with a perfect breast augmentation. It's kinda funny how much I learned about bras and breast sizes by just listening to the nurses answer all of the patient's questions.
1. Victoria's Secret runs really small (no, you are not a D cup)
2. Their bra sizes are actually the size of what your 'assets' will look like in a shirt (that means they are padded)
3. A 36c is equivalent to a 34d  (so I guess you are a D)
4. Older women tend to want smaller breasts (I've noticed they get more reductions)
5. There is such a thing as getting your implants too small (they look painfully obvious because they are completely visible)
This morning I was a bit upset because I had forgotten to pack my lunch (and I have no sense of direction to locate the hospital cafeteria); so, I ran into the grocery store and bought something as fast as I could only to realize another doctor had paid for Jim & Nick's BBQ for the break room. After my rather delicious lunch, the next case included UAL (ultrasonic assisted liposuction). UAL is different from regular liposuction because the probe vibrates extremely fast sending ultrasonic sound waves that 'melt' the fat before sucking it up. This results in a less aggressive, bloody, and tiring procedure. After that case Dr. G let me sit in on some other surgeries. Remember that doctor I was talking about in the last post (the one with the son)? Yeah, I spent the rest of the day watching him to a shoulder scope, knee scope, and bicep surgery. We're going to call him Dr. E. His room was a completely different atmosphere.  Dr. G's room is very chill with alt-acoustic music humming through the speakers and a crew mainly comprised of girls. When I walked into Dr.E's room, it was dark (so we could see the scope tv), hard rock (and the occasional hip-hop) was blasting through the speakers, and I (along with a spunky, older female nurse) was the only girl in the room. It was definitely fun to experience the change in scenery and profession  (Dr. E is an orthopedic surgeon), but I prefer the mellow, estrogen pumped, plastic surgery of  Dr. G. Don't get me wrong. I thoroughly loved hanging with the guys and hope to see them next week.

P.S.  I completely forgot to mention I was able to view a laparoscopic cholecystectomy which is the removal of a gallbladder. It was so cool. Dr. L pulled it out and cut it open for me to see all of the Gallstones. (it's smelled really bad but it was still awesome to see!!)

thursday.

Sorry about the lack of OOTDs. My camera has been m.i.a. I think it's somewhere around the house.

Today was pretty great day. It was a full office day and I met a lot of really sweet people. I've spotted another male patient and a couple of minorities. It was interesting to see how darker skin reacts to scaring as apposed to lighter skin. So far, the men don't really come in for life altering, body changing surgeries like the women tend to do -- just a little here and there. I also saw my first breast cancer patient. Since I was unaware of everything a breast cancer patient has to go through, Dr. G filled me in on what chemotherapy had to do: remove the breast and insert a port. It's amazing how Dr. G can restore a breast from nothing. What she has to do is take muscle and skin from either the back or abdominals and place it over the remaining breast tissue. This will help the breast tissue expand. She then inserts a tissue expander which is like a hard refillable implant. This stretches the skin out to the size of the other breast and makes it big enough for an implant. Once the implant is in, the patient has the choice of getting a nipple reconstructed or not. The only negative side I can see to having a nipple reconstructed (from skin on darker parts of the body) is that the muscle controlling the nipple is gone. That makes the nipple always "pointy". This experience has really made me think about WHY I wanted to go into this field. I had always been interested in medicine. It's in my blood; but, why plastic surgery? I think Dr. G's nurse said it the best. (paraphrasing)" In all other medical professions, your patients are there because they NEED to be. In plastic surgery, your patients WANT to be there." I would get to make people feel better about themselves while getting to use my creativity and science skills. The giggles, tears of joy, and exclamations of astonishment as a patient removes the surgical garments are moving. My favorite types of  office visits are of patients who are about 6 mo to a year out of surgery. I get to see the before pictures and the completely healed results. It's so cool to see them side by side. Even if the person doesn't have the 'perfect' body, the drastic change from the before picture is enough to make anyone squeal with joy. Next up: full surgery day ^_^

wednesday.

I was in surgery all day. I started the day with a surprisingly mellow mini-facelift. Last night, I felt it was necessary to youtube some facelift procedures so I would  know what I was getting myself into. BAD IDEA. I had forgotten Dr. G was only doing a mini facelift (which doesn't include incisions around the eyes, I think) and ended up watching a 30min facelift video. I sat in extreme discomfort as this person made incisions in the eyelid and below the eye. After about 5min, my own eyes started watering uncontrollably as my thespian personality started channeling the pain this person must be in. I successfully finished the video as I prepared to face the limit of my surgical tolerance the next day. One word to describe the day was tiring. I had overslept a bit this morning and headed into the OR with a bad case of yawning. My sleepiness quickly subsided when I overheard a couple of nurses talking about the upcoming season of Survivor and how an OR doctor's (rather attractive ^_^) son was already back from filming it. Anyway, I was really fascinated  by how squishy and jiggly the patient's cheek was after the skin had been lifted. Lunch was really fun because one of the doctors decided get everybody Swett's (southern soul food, yum!!). After our bellies were utterly full, Dr. G's team prepped for a complex surgery. One of the nurses (Bonnie's mom) taught me how to insert a catheter just in case the patient had to...relieve herself. As the surgery progressed, everyone started getting super tired. People were yawning and really quiet. We realized the soul food was to blame. To get everyone back in the groove of things, I found some dubstep and pumped up the volume. It seemed to help a bit. After about 15 min of that, we went back to alternative acoustic station and finished up the 3-part job a little later than scheduled, but hey...you can't rush perfection!

my beautiful mommy

Dr. Michael Alexander Salzhauer, M.D. actually wrote a children's book on teaching kids how to deal with their mothers' plastic surgery. ^_^ The pictures are from Amazon.

tuesday.

Today was pretty great. I was a bit tired, but that just means I need to get into bed earlier. Tuesdays for Dr.G are in the office during the morning and in surgery during the afternoon. I sat in a few consultations and a nurse pre-op debriefing. I also got to play with the implants!! The silicone ones are the most fun. They are so soft and squishy. Being the nerd I am, I ended up organizing the implants by size. It's amazing how just a small decrease in breast size (about 50cc) can make you look a lot slimmer. You meet a lot of interesting people plastic surgery offices. Dr. G says from her experience, a majority of plastic surgery patients have a history of depression. Some people even have a form of body dysmorphic disorder (BDD). This is why Dr.G has to review her patients before they get surgery. She does not want people to be unhappy or unsatisfied with their appearance after the procedure. The one thing she dreads the most (other than dictations and face-lifts) is having to deal with a patient who has a skewed perception of their body and the results of the surgery. Some people will just keep getting work done and never be fully happy. Dr.G said it would be helpful to minor in psychology when I get in college because people expect more of a sympathetic, nuturitng, and overall honest attitude and opinion from female plastic surgeons. They expect you to relate and agree with them, however that is not always the case and sometimes the patient may be a bit stubborn. You have to be very persuasive as a surgeon because people may not always know the best operation for themselves. The rest of the day was spent doing a tummy tuck, which wasn't as bad as I had anticipated. After Dr. G left, I was able to watch a hand surgery being done by a neighboring surgeon. It was so interesting to see how different their methods were. After that I chilled in the break room and got to know a couple of nurses. Everyone is really friendly!! However, I am really gonna dread this face lift tomorrow. Anything on the torso or legs is so impersonal because the person's face is all covered up; but, this time, Dr. G will be slicing up someone's face which is a whole other animal to tackle. Thank God she won't be messing with the eyeballs...for now!

infographic of the day.

I find it very difficult to agree with many of these facts. Tell me what you think ^_^

friday.

I can now say I have seen a person's body being sliced up in an operating room. This morning I was so worried something bad might happen. The RN kept asking me if I had eaten breakfast or was prone to feinting. Everyone was reassuring me that if I passed out, they would understand. Those comments made me freak out even more. However, once the 1st incision was made, it was hard NOT to sit down. I wanted to see every thing. Dr. G was impressed with how well I was handling it. The RNs were very nice and explained to me what their jobs were. Good thing I like the color blue because EVERYTHING was blue and no one really knew why. Dr. G was scheduled for a breast reduction and liposuction, so nothing was particularly gory. I learned that communication with the nurses is extremely important. They set up everything while the surgeon is scrubbing in and if the surgeon performs an unknown procedure, they won't have the correct utensils in time. I also learned what each utensil is for and how they use it. There is this one probe, which I forget the name of right now, that sends an electrical current that will burn the flesh in that one particular spot which stops the blood flow. I'm guessing plastic surgery was a really bloody job back then because only now to they have all these methods and chemicals to decrease the blood flow during surgery. It was really cool to see the nurses prep the body before surgery. They had this really colorful iodine solution that they scrubbed on the patient's body to clean it.  It was so odd seeing the lady I had met yesterday just knocked out and completely naked with Dr. G's incision markings and doodles on the operating table. The nurses go through great lengths to make sure the body is completely comfortable using various pads, braces, blankets, and even turning the temperature of the room up and down depending on how the body was reacting. The NA (nurse anesthetist) could see the lady's vitals and how she was feeling depending on her monitor. Many times she turned the heat up, while the doctors where burning up, because the body was freezing cold. Dr. G popped out her iPod and set it up on the room's sound system so that we could all rock out while we were in surgery. Another funny thing was how she blessed each and every breast implant she put in a person with a goofy chant. Overall, the OR was incredibly fun and I'll be back there on Tuesday for a tummy tuck I believe. Also, I enjoyed wearing whatever I wanted to work because I would just change into scrubs when I got there.

ootd:

needs a reality check...

thursday.

I think today was a pretty great start to an amazing winterim experience. I was definitely not prepared for the array of body parts I would be viewing; however, I quickly grew accustom to them. Today was an office day, meaning Dr. G (referring to the plastic surgeon) would be checking up on her patients and not performing surgery. I met tons of people who had received (or wanted to receive) everything from breast augmentations to tummy tucks to face lifts. It is hard writing this without describing some specific cases, but I feel as though the patients deserve some confidentiality. That being said, I learned the complications smoking can cause during surgery and the healing process. Smoking restricts the amount of blood that can reach the tissue in your body. While getting surgery done, it is necessary for the tissue to be able to heal nicely and if there is a restriction in the blood flow there is a higher risk of infection, inability to heal completely, and even death of the tissue completely (as I had witnessed on one patient). I have also picked up on a lot of the lingo used around the office. Dr. G really takes time to help me understand what has actually been done to each patient and what each incision is for. The nurses were really kind and always made sure I was comfortable. Before Dr. G would come in and speak with the patients, the nurses would ask if it was alright if I watched the visit. I was surprised at how many people were willing to let me in and just whip off their clothes. Fortunately, the majority of her patients were  female and the men only came in for face lifts, so I had not seen anything particularly scaring. ^_^ Actually, I realized I was not as squimish as I had thought. One patient came in who had previously had some work done on her abdomen; however, during the healing process, she contracted a staff infection in the incision and Dr. G had to re-open part of it. I walked into the room and in front of me was a woman whose lower side of her abdomen was sliced open and completely exposed. All I could see was the raw, blood red, freshly cut meat on her stomach and what amazed me was that I was actually intrigued and not somewhere puking in a bag. I now think I am prepared for the operating room tomorrow. Having lunch in the office was a bit awkward because I hardly knew any of the nurses and when we did try to have a conversation it was full of long pauses while people chewed their food. Also, I kinda burnt my popcorn a little so the whole kitchen smelled of it. Glad to get back to the patients, I quickly finished my lunch and got back to shadowing. I also read a lot of magazines today. When a patient preferred to not have me in the room, I was met with a lovely stack of Us Weekly, People, and Lucky. Note to self: Bring reading material next office day and absolutely no heels (ouch). Overall, I had a great time in the office and cannot wait to see what it is like in the hospital operating room. I loved seeing the different types of body shapes and how accepting Dr. G was. Plastic surgery is always cast in a very superficial, vain, and overall negative light by the general public. It was nice to see how positive it actually is and how it truly made people feel better about themselves. Dr. G made it a priority to stress how this surgery should be for nobody else's benefit but the patient's and how having unrealistic expectations can be really unhealthy.  I love working with her. She is very laid back and chill and the overall office style is very chic but not overly formal. I will try to post some OOTD as I come up with some professional outfits from my overtly causal/ hobo chic wardrobe. Also, I doubt I will be taking a lot of pictures around the office because of the nature of this profession. I can't wait for tomorrow!!

wednesday.

i start tomorrow! i honestly don't know what to think of this whole thing. the only thing i really know about plastic surgery is what the media bombards me with: dr.90210, nip/tuck, and tons of celebrity before & after pics. the reason i chose to intern in this field was because i seriously consider this as an option for my career. hopefully, by this experience, i will get to see the everyday life of a plastic surgeon, the actual nature of the job, and the demand my city has for this profession. 

intro.

hello world (mostly me). this blog/journal is to record my experiences over winterim. for the month of january, i will be interning with a local plastic surgeon. i cannot wait to get started. i will be writing daily posts about my day and what not. sooo...enjoy