Things you have to do, but can't because you are sterile (sneeze, itch, etc.)?

Q-Optics, surgical ergonomics - redefined
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Cheisu

Cheisu

Future Surgeon
10+ Year Member
15+ Year Member
Joined
Aug 26, 2007
Messages
179
Reaction score
0
What happens if you are in the operating room, with your hands holding a heart or inside someone's chest, and you have to sneeze, but don't want to make too sudden of a movement?

What happens if you have to itch a place or "adjust" (us guys)?

Like, if you have to itch and it's ruining your focus, do you ask a nurse to itch it for you (if it's in an appropriate place)? What if it's in an inappropriate place?

What if you have to go to the bathroom?

etc. etc., but the itching thing is what I'm wondering about most.
Members don't see this ad.
 
You learn to control/ignore what you can.

When you feel the urge to sneeze, you ask someone to take over for you and step back away from the table. Do not turn your head, as sneeze particles are more likely to escape onto the field. If you have a mess in your mask, you can either scrub out and replace your mask or ask someone to do it, although I can imagine that most nurses aren't thrilled about taking your snot filled mask off.

You'll have to learn to ignore those itches or "need" for adjustment that males somehow insist upon.:rolleyes:

I suppose you can ask a nurse in the room to scratch your itches, but this is frowned upon behavior and especially if in an "inappropriate" area, can get you saddled with a sexual harassment claim. Although I've seen it on tv, I've rarely seen an attending surgeon ask a nurse to wipe his brow or scratch his nose. If its your head or face that needs scratching, you can step away from the field and rub it the IV pole or something like that, but this is an advanced move and not recommended for the novice.

Finally, most of us don't have to take bathroom breaks because we have learned to ignore the cues and don't volume load before going into the OR.
 
Go to a sperm bank. Wait, uh different question.

After awhile, 10+ years in my case, you just ignore itches and live with snot, etc. I have even trained my bladder to think that 6 hours without peeing is normal, don't sweat for 10 or so and can make it to about fifteen hours before I really need to go.

As for eating, going without lunch is pretty much the standard in surgery. Or at least it is in neuro.

-Mike
 
Members don't see this ad :)
Kind of strange when I think about this. I drink gallons of coffee, and tend to go to the boys room often. But in OR, 12 hrs later never need to go. Maybe the hot lights or something.:confused:
 
sleeping said:
Kind of strange when I think about this. I drink gallons of coffee, and tend to go to the boys room often. But in OR, 12 hrs later never need to go. Maybe the hot lights or something.:confused:
Click to expand...

Its a common phenomenon. Its because your mind is focused elsewhere and you are attending to other bodily cues.
 
When I've watched surgeries, they scratch their nose to the IV pole, but mostly they stay in the same position until they are done with the surgery.
 
We learn to ignore it. Facial itches, runny noses, bladder pressure, sore feet/knees/back...all ignored! :)
 
If you have to sneeze, sneeze. That is what the mask is for. If you can step away from the table, great.

I have never had to break scrub for a bathroom break, but there are natural breaks in ultra-long cases (12 hr plus free flaps) to go.

Itches don't happen when you are focused on surgery.

I had a really bad cold a few years ago when I was stuck on a long case...absolutely miserable. Nothing worse than snot running down your nose into your mouth and you can't do anything but snort and sniff.
 
For the women, what about that time of the month? At some point, you must need to take a bathroom break in the super-long cases, no? :confused:

Forget the sleep-/food-/life-deprivation, that and migraines are my biggest fears about surgical residency. :scared:
 
I can add that the surgeries that I watched were made by surgeons that hade done the same procedure thousands of times, so they used to talk and joke during the surgery.
They could probably do the surgery in their sleep.
 
Eh, I've seen a chief get fed part of a candy bar by a nurse in the middle of a case. ;) I guess it depends who your circulators are, who YOU are, and what the general environment is around you.

As far as the "women troubles" thing - progesterone-only contraception may cause amenorrhea in up to 80% of women. Not that "I have long surgeries and I don't want to have to scrub out to change my tampon" is the best indication for such treatment. Off-label use, maybe.

And as a migraine sufferer myself, the few times I got one during my surgical clerkship I popped some imitrex and they seemed to take care of things. If not, caffeine tended to at least mitigate the rest. . . idk if triptans help you or not, bruinrab, but they damn sure work for me 9 times out of 10.
 
TheThroat said:
I had a really bad cold a few years ago when I was stuck on a long case...absolutely miserable. Nothing worse than snot running down your nose into your mouth and you can't do anything but snort and sniff.
Click to expand...

The only time I've been asked to leave the OR was for this very thing; my attending told me to step out, blow my nose and then return, as my constant sniffing was getting on his nerves.
 
if you need to itch/scratch/adjust you can always get a sterile swab from the scrub nurse and use it to do the job and act as a barrier between you and your fingers, then hand it to someone who is unscrubbed to discard it. If what you need to do requires a bit more dexterity, you can always use your hand and then change your glove (let the surgeons know that you need to do this). Anything more complicated then this and you should probably scrub out if you cant ignore it.

Most surgeons don't seem to mind as they would prefer you to focus on the operation and not let anything get in the way of this.
 
Members don't see this ad :)
bruinrab said:
For the women, what about that time of the month? At some point, you must need to take a bathroom break in the super-long cases, no? :confused:
Click to expand...

Do yourself a favor and get a Nuva-ring or at the very least one of the newer OCPs which you can take continuously.

The advantage of the former is that you do not have to remember to take a daily pill, nor rely on taking it at the same time every day. Goes in once a month and you change it out for a new one without having a period. Most female surgical residents I knew had given up on the pill and either used the patch or the ring continuously to avoid the problems you are concerned about.

Forget the sleep-/food-/life-deprivation, that and migraines are my biggest fears about surgical residency. :scared:
Click to expand...

I too am a migraine sufferer and I made sure:

a) I took Excedrin extra strength at the first sign of a headache
b) made friends with the SICU pharmacist who would give me Imitrex and Phenergan if I didn't have any of my own

I made it through residency with only a couple of occasions in which I was really incapacitated. As long as you are a hard worker and don't try and slack off because of the headaches, most of your colleagues will understand (and some of them also may be sufferers).
 
SocialistMD said:
The only time I've been asked to leave the OR was for this very thing; my attending told me to step out, blow my nose and then return, as my constant sniffing was getting on his nerves.
Click to expand...

Hah! Same thing happened to me but with allergies. My constant sniffling was getting on MY nerves....it was pretty gross when I changed masks.:scared:
 
See, but some guys go commando in their scrubs and forget that the "flop factor" can be pretty noticable. We're not blind, guys.
 
at least we're not seeing castro's sausage encased in pink scrubs
:rolleyes:
 
Kimberli Cox said:
Do yourself a favor and get a Nuva-ring or at the very least one of the newer OCPs which you can take continuously.

The advantage of the former is that you do not have to remember to take a daily pill, nor rely on taking it at the same time every day. Goes in once a month and you change it out for a new one without having a period. Most female surgical residents I knew had given up on the pill and either used the patch or the ring continuously to avoid the problems you are concerned about.
Click to expand...

Hmm...Both combined and progesterone-only ocps gave me major problems. Will look into the nuva-ring.

I too am a migraine sufferer and I made sure:

a) I took Excedrin extra strength at the first sign of a headache
b) made friends with the SICU pharmacist who would give me Imitrex and Phenergan if I didn't have any of my own

I made it through residency with only a couple of occasions in which I was really incapacitated. As long as you are a hard worker and don't try and slack off because of the headaches, most of your colleagues will understand (and some of them also may be sufferers).
Click to expand...

Between prophylactic meds and getting rid of one major stressor in my life, mine have improved considerably. Hopefully they stay that way once I start residency. But I will definitely make friends with the pharmacists. :laugh:

Thanks for the advice. :)



Edit: OK, looked into it, probably won't try the ring since it's combined, and combined ocp's are contraindicated in migraine with aura (something my ob/gyn didn't know about, and I found out after being on them for months :p). My migraines were downright scary with seasonale, not an experience I want to repeat.
 
gasnewby said:
at least we're not seeing castro's sausage encased in pink scrubs
:rolleyes:
Click to expand...

Seriously, though, I don't get it.

I know as a man, I'd love it if a female colleague were walking around without a brassiere and it was obvious that there was a bit of a "flop factor" along with it.

Why isn't it the same with you people?
 
Well said! :)

This is quickly becoming a great, classic surgical thread. :thumbup:
 
Castro Viejo said:
I know as a man, I'd love it if a female colleague were walking around without a brassiere and it was obvious that there was a bit of a "flop factor" along with it.

Why isn't it the same with you people?
Click to expand...

because the other females would go nuts.

castro, i'm a little disappointed. you don't have any cheesy comebacks about your "footlong kielbasa"? come on.
 
Well, truth be told, I was holding back, but since you asked for classic surgeon-type discussion as in the OR...

At work they call me "The Tripod.". =)
 
Castro Viejo said:
Seriously, though, I don't get it.

I know as a man, I'd love it if a female colleague were walking around without a brassiere and it was obvious that there was a bit of a "flop factor" along with it.

Why isn't it the same with you people?
Click to expand...

Personally, its probably because I'm a bit of a control freak...keep everything locked and loaded!

(women just aren't as visual as men, in terms of sexual arousal, but you already knew that)
 
Castro Viejo said:
Well, truth be told, I was holding back, but since you asked for classic surgeon-type discussion as in the OR...

At work they call me "The Tripod.". =)
Click to expand...

We'll all be comparing glove sizes and Dansko shoe sizes in a day or so...
 
gasnewby said:
at least if you ever lose a limb...
Click to expand...

Yeah, but wouldn't I have to rub it all day to make sure I'm standing upright? :confused:

:laugh:

Heard a great joke from a urologist the other day about a mohel and his leather gifts. :)
 
Blade28 said:
We'll all be comparing glove sizes and Dansko shoe sizes in a day or so...
Click to expand...

45 Danskos (that's like 11 or so in the US).

8.5 greens under 8 whites for the gloves up top.

Hell yeah!
 
I'm glad I read the surgery forums too from time to time. Dr. Cox I have a whole new view of you!
 
I was told my double 6 hands were pretty desirable....

for pedi surg
 
gasnewby said:
are you sure? maybe you should double check.
Click to expand...

I'm sure...from the base of my middle/long finger to the distal wrist crease is 9 cm. Doubling it you get 18 cm...if we're talking about measuring from medial chest wall to lateral, 18 cm is not a very big breast, if you're taking into account the "arc" of the breast, rather than just straight across.

I'm no Dolly Parton, but c'mon 18 cm is probably an A cup.
 
Kimberli Cox said:
I'm sure...from the base of my middle/long finger to the distal wrist crease is 9 cm. Doubling it you get 18 cm...if we're talking about measuring from medial chest wall to lateral, 18 cm is not a very big breast, if you're taking into account the "arc" of the breast, rather than just straight across.

I'm no Dolly Parton, but c'mon 18 cm is probably an A cup.
Click to expand...

Hmmm... Back to the books then.

OK, OK. Here's a Snapple fact. The fruit a woman desires most is usually directly proportional to the size of her breasts.

Kiwi? Apple? Orange? Grapefruit? Watermelon?
 
you know they all want the banana
 
You must log in or register to reply here.
Next unread thread

Similar threads

BonezBonezBonez
What is the favorite thing about your chosen subspecialty?
Replies
9
Views
3K
akwho
A
I
Research Experiences vs. Posters/Pubs/Presentations/Etc. and Competitiveness
Replies
3
Views
2K
Dr. Foresight
D
Thanatos
The aftermath: Covid, Mortality, and where we go from here. But are you really surprised?
Replies
14
Views
4K
ThoracicGuy
ThoracicGuy
M
Can't find a job...
Replies
6
Views
4K
HighPriest
HighPriest
Lem0nz
Book/Reference for Sutures, Instruments, Etc. in 2020
Replies
6
Views
2K
swoopyswoop
S
Top