What’s up friends!? Happy Monday and happy Labor Day!
I actually have the day off from clinic today, but I do have 3 patients I need to see this morning as follow-ups, so I will be doing that, then I plan to relax, cook, workout, and go to bed at 7:30 pm. Ahhh the perfect day 🙂
Last week was our first week of call and so I thought I would share a little about how my first few days went!
As a first year ophthalmology resident, we hold the primary pager for the department all day every day, for 1 year. Whenever the ER calls with a patient, a patient from home calls with a question, or a hospital service consults ophthalmology, we get the call. Our group of residents (there are 4 1st years) decided to split call up every 4 days, and then one person will work the entire weekend so we all get 3 out of 4 weekends completely off. Since it’s the very beginning of call, we are doing every 4 days and not taking whole weekends for the first 2 weeks- just to get our feet wet.
My first day of call was Tuesday. So Tuesday morning, at 7:00 am I had the ophtho service pager transferred onto my pager. Luckily, I didn’t get a single ophtho call until after work was over, so I just went about my normal clinic day as usual. (I may have treated myself to an iced coffee since it was my first day on call.)
After work, we had a hospital consult I needed to go see, so I made my way from the clinic building to St. Mary’s hospital which is 1 mile uptown. On my way there, I got a call from the Mayo operator letting me know that a patient was calling in with a question. Instant panic.
I waited until I was near a computer so I could look the patient up and know a little background before talking to them on the phone. I didn’t want to sound like a total moron (although that was inevitable). Once I had the chart up on the computer, I called the operator back and was connected to the patient. Luckily, they just wanted to know if they could take their migraine medicine before having a biopsy procedure the next day. Phew- I can answer that! One patient down, 13 hours to go.
Shortly after that phone call, I got a call from the ED about a patient with “decreased vision.” Now here is the funny thing about ophthalmology. NO ONE, seriously no one, knows anything about the eyes (myself included.. .kidding- kind of.) You would never call a cardiology consult without knowing the blood pressure or heart rate. If you did that, the cardiology fellow would bite your head off! But, plenty of people call ophtho for “decreased vision” without ever actually checking the patient’s vision. Is the patient 20/20? 20/400? Hand motion only? No light perception? Who knows! And as you can probably tell, that information would make a huge difference in your thought process about what is going on.
So, I asked the ED to check the vision and they called me back saying, “the patient is seeing 20/20 so we don’t need you anymore.” Great! 2 down, 12 hours to go.
My second year resident joined me at the hospital and we went to see the hospital inpatient together. After completing a bedside exam and writing our note, I got another call from the ED. This one didn’t need to be seen urgently so I set up an appointment for them to be seen in clinic the next day. 4 patients down, 11 hours to go.
While wrapping everything up in the hospital, I got a hospital consult on a patient which also didn’t need to be seen urgently so I set up another clinic appointment for that patient. It’s so much better to see the patients in clinic when we have all our resources and tools for looking into the eye compared with seeing them bedside and doing a sub-par exam. So if it’s not urgent, it’s better to get them to clinic in a day or two. 5 patients down, 10 hours to go.
By 8:30 I got home (I had been in clinic since 7 am so it was a long day, but not terrible), I made dinner and went to bed. And guess what? My pager didn’t go off ONCE all night! I woke up at 5 am and went about my normal morning routine. Success!!
The rest of the week went by really smoothly. On Friday, I got to scrub into an emergency corneal transplant for a patient with a terrible fungal corneal ulcer. I wasn’t on call, but it was my patient from clinic, so I got to go to the surgery and I was in awe the entire time. I already think cornea is pretty cool, so getting to see a full corneal transplant was incredible. I scarfed down some dinner while Kyle drove me to the hospital and picked me up after surgery. What a nice husband 🙂
We literally removed the entire central cornea and replaced it with a graft. The suturing technique to get the new graft to lay flush with the old corneal edges is so specific!
On Saturday, I wasn’t on call but I did go in to see my corneal transplant patient post-op. They were looking great so I discharged them from the hospital and actually plan to see them again today.
Sunday was my second official day on call. I was at the hospital from noon-5 pm seeing patients, but after that I didn’t get a call all night! So far, so good.
I have 93 total days on call this year, so only 91 left! Yahooooo!!
Hope you all have a fantastic Labor day!