Night-time livers

I've been inspired to blog a little more both from my wife, who has a semi-professional blog that she actually gets paid for writing (based on ad-revenue stream of visitors) and another surgery resident whose blog I started following.

I've been meaning to blog on the day after being up all night or after an interesting case. Last Monday night on August 11th, we did a liver transplant. Actually, the case started at 1AM on Tuesday August 12th and finished around 7AM. The guy was a very sick frail gentleman who "appeared much older than his stated age" of 60 years old with end-stage liver disease from hepatitis C. He had around 6 liters of ascites in his belly and the case was pretty bloody. I was a good first assistant in a pretty big case and I sewed half of the portal vein anastamosis and half of the biliary duct anastamosis. I've scrubbed in liver transplants before where I've been able to do more of the case, and I feel pretty comfortable with the case and feel I could do more of it, but working with different attendings I just take what I can get.

More importantly, I think we did a great job of managing a pretty frail old guy post-operatively. We did a gentle management and now one week later he is on the floor and ready to go to rehab.

Not much else is going on. The service is pretty slow right now and we discharged most of the other patients and our census is now 3 patients and one is going home today. I thought we might "win the game" in discharging all of our patients today and thus wouldn't have to come in for rounds on Wednesday, but now I don't think that will happen.