Monday, February 1, 2010

Flexing the fiberoptic power!



let me buzz...

Having taken a well deserved break from the eternal strife that marital bliss made him endure , the pompous and glad senior citizen married to this  formerly incessantly chatting middle aged lady, guided her into the doctor’s office. The reason for his absolute bliss, evident from his unusually silent wife, was a traumatic jaw fracture which needed corrective surgery.
Fathoms of gossip yarn ,spindling out from her seasoned mouth into a mobile phone had distracted her while driving their 4 wheeler. The resultant minor blip on the local terrain where she pummeled her car into 4 others ,had led to her jaw moving quite out of place. The power of speech taken away, our lady had to make do with moans and aahs to get the message across. The  constantly ringing mobile phone in her bag made the irony so evident that surgery was planned as soon as fitness for surgery was obtained.
After a brief review and examination with inch tape science, our plan of anesthesia comprised awake nasal fiber optic intubation  for securing airway besides the routine protocol.  Spindles transmitting light have woven quite a niche for themselves in medical science. Our ever evolving branch called anesthesia was benevolent to weave itself a new illuminant device, the fiberscope!
Talking about first impressions that always come to mind, my senior consultant perched on top a small stool ,probing a zonked out dude’s throat with a fiberscope searching for an elusive larynx hidden in a pinkish brownish whitish zone of upper airway did seem quite a feat! If you smudge out the scope in his hands, a lot many years younger, and he would have passed for a poor school kid punished by his stern teacher, by being made to stand on the bench with hands held up. “styand up on dee bench!”, my class teacher would say. Each day with pending homework  would be revved up with the shrill retort that she used to train us with. Having done my ‘up on the bench’ time ,many times over, having to do the same for securing airway seemed like a  crude little joke life played on me if not déjà vu!
Fresher year was spent assisting the scope laden seniors while second year promised a date with this new weaponry to master. Up goes the lever to move the tip back, down goes the lever to move it forward.. white balance? turned on!!.. Magnification? Check!!… suction? Check!!… and there you go prodding some guy’s throat. Glycopyrollate IM before intubation made sure the throat did not have cob webs of mucus lining our batman cave! Oral versus nasal, airway preparation for awake intubation, liberal use of lignocaine were the soft skills we picked up.
Our middle aged lady was wheeled in after preparation to the OR. The entire procedure being explained in quite grotesque detail by my funny resident made sure her heart rate was alive and kicking big time! After a short session 1 on 1 with the patient, the stage was set for the scope to take limelight. ‘Difficult intubation’, meant only seniors could do the procedure. The senior resident climbed up, picked up the scope and the snake charming began. Insistent cajoling by the consultants notwithstanding, the poor guy managed to lever down the tube the right way in a short span of time just clocking a little under 30 mins! Its tough when the limelight is on you, they say.. so true!
Our motormouth lady got her mandible set right and her husband's peaceful existence went wrong all over again. The irony of a normal wife with a mended jaw might give him a lot to hear and a lot less to think about.
Our resident, in the process of needling an anesthetised throat, had committed to a lunch treat soon after to celebrate the achievement. Party vibes simmering through the doctor’s room, the fiberscope set was wheeled out and the food wheeled in. its still a long way to go for me to set my hands on the magic torch but the process of getting there has been pleasant, gastronomically indeed!
Till all of us get versatile with the scope to ‘bend it like beckham’, here is me signing off to savour a treat!
Cheers!! Keep them coming, I say!

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