seriously.

Today was my first day working in the labor and delivery at the hospital. A little disappointed because i happened to just miss all 3 of the vaginal deliveries, because i had to deal with a group of post-op and gyn patients. Overall today was interesting....

started off rounding a group of post-op patients, nothing too exciting. no complications, healthy babies. easy patients.

then things started getting interesting. We saw a patient with a nasty, disgusting, dry heaving infection. She is in quarantine, so we had to put gowns, masks and sterile gloves on before entering to change the dressing on her wound. It was my job to remove the existing covering and expose the wound. My jaw nearly hit the floor when i saw what we were dealing with (thank god for the mask). She has a MRSA infection of her c-section scar, that started to become necrotic and form a fistula. (describing this is tough....imagine a c-section scar across the lower pelvis, now imagine a circular HOLE above this open scar the size of a silver dollar that actually connects with the original scar. And then envision black/dying tissue inside this hole, deep enough to stick your hand up to your knuckles). basically a horrible looking wound with an even worse smell.

Even when i did autopsies i had never smelled anything this horrific. I wanted to dry heave each time we removed more dead tissue from the wound. We finally got finished, it was one of the most horrible experiences of my day. usually my stomach is pretty solid, but the smell alone nearly killed me.

another patient disturbed me today. This one is actually famous on the service.....she came in last week for abd pain, she thought she was about 20wk pregnant.

here is what actually happened......24yr old, 43 wks gestation, 12lb baby (overcooked, dead). She also weighed 580lbs, is diabetic, hypertensive and by definition severely morbidly obese.

its strange but the only part of that i found disturbing....is that someone actually had sex with her to get her pregnant! I had a hard enough time removing the Foley catheter and all i had to do is follow the tube to the vagina!! cleaning the incision was a team effort as well, esp because the pt stated that she is unable to wipe herself so you can imagine how much skin had to be held up to clean and bandage the incision.

one of the last patients gave me practice in giving information to the patient.....we had to tell a patient that she had a severe gonorrhea and chlamydia infection that has spread to the abdominal cavity....not to mention she is pregnant so clearly my treatment plan of choice is no good unless i want her kid to be deformed.

anyways.....things are still going well and i still love OB/GYN even if things are quite gross at the moment.....no OR yet, but maybe tomorrow i will get to see a delivery or be in the OR..i will keep you posted.