{"id":1018,"date":"2013-11-17T21:17:34","date_gmt":"2013-11-17T21:17:34","guid":{"rendered":"https:\/\/surgerytoday.com\/education\/?p=1018"},"modified":"2013-11-17T23:18:05","modified_gmt":"2013-11-17T23:18:05","slug":"my-first-surgery","status":"publish","type":"post","link":"https:\/\/surgerytoday.com\/education\/my-first-surgery\/","title":{"rendered":"My first surgery"},"content":{"rendered":"

Back in the days of Surgery Residency<\/h2>\n

My first ever surgery: about 16 years ago (from 11\/17\/13), this (brachial basilic arterio-venous fistula) was my very first surgery I’ve ever done in my life. It was a strange way to start because the technical aspects of this surgery is high – I still consider it difficult. But I was a lowly surgical intern in Cleveland, and highly respected\u00a0transplant surgeon, Dr. James Schulak<\/a>, was doing the surgery. I was just retracting (Surgical Interns didn’t operate, they just held things), but during the case, Dr. Schulak was time-pressed and accidentally I got showered in the face with blood – blood dripping down my face, luckily it didn’t hit me in the eye (I love wearing glasses). He told me to get out, clean up. When I leisurely (I took my time getting all the blood off) made it back to the surgery after wiping off my face and changing. I saw that he was just waiting for me without having made any progress in the surgery. He was just sitting there without moving – bizarre. He said he had a policy: if he splashed a resident with blood, the resident gets to do the entire case. So, that’s how I did my first surgery. It took about 2 more hours, and I didn’t even know how to hold the specialized vascular instruments<\/a> (given that I hadn’t even done any surgeries at all), but he guided me expertly through it, I managed to do it, and the patient had a great result. In Modesto, the operation would have taken me about 30 minutes – but we all had to start somewhere.<\/p>\n

One stage vs. two staged surgical procedure<\/h2>\n

I sorta miss these cases (and my crazy method I personally innovated for laparoscopic peritoneal dialysis catheters). Now, with a cosmetic surgery practice<\/a>, I’m focused on my Modesto Botox Patients<\/a>, Veins and Acupuncture. \u00a0When I used to make these brachiobasilic AV fistulas, I did them in one stage which included a pretty long incision from axilla to antecubital fossa, my theory was that I would spare the patients two trips to the operating room. There’s a theory out there that separating the operation into 2 stage approach is better in case the fistula doesn’t mature. Stage One: make the anastamosis (connection between vein and artery), and Stage Two: mobilize the basilic vein to the surface (because it is deep and not easily accessible from a dialysis standpoint). Dr. Fung<\/a> of Modesto very kindly helped me improve my technique for these vascular procedures – he is the master.<\/p>\n

\"brachial<\/a><\/p>\n

 <\/p>\n

2 Degrees of separation from Mr. Quinton, inventor leading up to these surgeries:<\/h3>\n

My nurse practitioner<\/a> friend Jaimee wrote on 11\/17\/13:<\/p>\n

I was on a small-ship cruise a few years ago, and my family became friendly with this older couple. The woman asked what I did for work, and I told her I was an NP. She said her husband had created some medical devices – his name was Wayne Quinton<\/a>. He also invented the first dialysis machine. He’s up in his 90s now and still tinkers with inventions.<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"

Back in the days of Surgery Residency My first ever surgery: about 16 years ago (from 11\/17\/13), this (brachial basilic arterio-venous fistula) was my very first surgery I’ve ever done in my life. It was a strange way to start because the technical aspects of this surgery is high – I still consider it difficult. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1,6],"tags":[334,332,331,333,377],"class_list":["post-1018","post","type-post","status-publish","format-standard","hentry","category-uncategorized","category-veins","tag-blood","tag-first-surgery","tag-fistulas","tag-lit-fung","tag-modesto"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/posts\/1018","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/comments?post=1018"}],"version-history":[{"count":8,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/posts\/1018\/revisions"}],"predecessor-version":[{"id":1027,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/posts\/1018\/revisions\/1027"}],"wp:attachment":[{"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/media?parent=1018"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/categories?post=1018"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/tags?post=1018"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}