self-care
Allergic Contact Dermatitis: A Surgeon’s Dilemma
In early 2014, I reluctantly made my way to the Dermatologist’s office as encouraged by my Fellowship Director. “How long have you been having these symptoms?” he asked. I thought carefully back to the first time I noticed that my hands blistered and started itching at least four years before that visit. By the time I finally sought help, my hands were raw under the cotton gloves I wore after applying steroid ointments or Vaseline. The problem had slowly worsened over time probably due to developing allergic contact dermatitis as well as increasing exposure to the offending substances. The Dermatologist recommended skin testing which involved placing numerous discs of various allergens on my back for five days. I was skeptical since I had performed my own latex avoidance trial using only nitrile gloves at the bedside and in the operating room for several months with no improvement. That avoidance test...
The Myth of the Young, Healthy Physician-in-Training
Surgical residents are in an often unrecognized position—encouraging and reminding patients to see their primary doctor for regular preventative health tests and cancer screening. Rotations on various surgical services provide an opportunity to discuss injury prevention and substance abuse issues (trauma), smoking cessation (vascular), obesity (bariatrics), and various cancer screenings, especially breast and colorectal cancers. Indeed, every rotation brings a new challenge of mastering the proper cessation and screening guidelines for a particular surgical patient population. Despite having an important role in preventative health for surgical patients, surgical residents are among the most at-risk young health professionals for neglecting preventative health care needs, at times delaying or even ignoring their own age-appropriate vaccinations and family history-directed cancer screenings. In a systematic analysis of resident well-being, residents were found to have lower self-rated mental health scores and well-being that the similarly aged population norm (Raj 2016). Residents were also found to...
Too Young to Have Colon Cancer?
We all have that anecdotal story that changes our practice. We read the literature and pretend we are data driven until we have a patient with a complication, or see the crazy zebra diagnosis that makes us paranoid or concerned, and changes our practice. For me, as a colorectal surgeon, it was a gastroenterology colleague who was anemic. A bit tired and run down, she eventually went to have a colonoscopy after several months. The cancer in her colon had already spread to her ovaries. But she isn’t the only story… How many times have I heard the story from a patient with rectal bleeding diagnosed with hemorrhoids without even a rectal exam? How many times did the change in bowel movements get ascribed to irritable bowel disease rather than getting a colonoscopy? How many times did I need to see a patient under the age of 50 who waited...
An Open Letter to AWS Members from Communications Committee
Two years ago, a friend and mentor approached me and asked me to help manage the communications team for AWS. Like I do with most things, I approached this with gusto. I got organized, made lists, set up accounts, and enthusiastically began to partner with my co-chair, Dr. Yeo. It has been extraordinarily rewarding to plan, communicate, and interact with the AWS membership in a very daily and contemporary way – on social media and our blog. But more has happened than just tweeting and sharing news. I’ve have learned much about our organization, and the enthusiastic, brilliant, and spectacular women that make up our membership. In the communications leadership, we really feel like we have our “finger on the pulse” of the women’s surgeons community. We see your comments, we share your triumphs, and we feel your pain on your down days. Through this process, we have come to...
Thyroid Cancer Awareness
In my training as a surgical oncologist, I certainly performed my share of thyroidectomies and node excisions for thyroid cancer. My practice quickly focused on breast cancer once in academic practice, given the demand in the community. Yet, my patients will report thyroid cancer frequently enough that I felt I should revisit this topic, to fill in the details of our growing knowledge. We should all be aware of this cancer. Not only is it the fifth most common cancer, it affects three times as many women as men! Only 2% of the cases will occur in children or adolescents. In adulthood, women present usually in their 40’s or 50’s, whereas men will present later, in their 60’s or 70’s. There can be a hereditary component; RET gene mutations are associated with the development of medullary cancer of the thyroid, which may be part of familial medullary thyroid cancer (FMTC)...
Clean Hands Deserve Two Thumbs Up
The Hungarian obstetrician and a father of modern antiseptic techniques, Ignaz Semmelweis, risked his reputation when he took to stage at the Vienna Medical Society’s meeting on May 15, 1850. He was beseeching his colleagues to participate in a simple but a provably effective method of diminishing disease transmission: hand washing. The rates of puerperal fevers on wards covered by medical students, whose morning autopsies on women who died from the fever preceded examinations on the day's laboring women, far outnumbered the rates on wards monitored by midwives, whose responsibilities did not include autopsies. Semmelweis attributed rates of the former group to poor hand hygiene. Ever the scientist-at-heart, he implemented a protocol whereby students and physicians washed their hands with a chlorinated lime solution after dissection. The results were groundbreaking: mortality rates of mothers seen on those wards covered by students and junior physicians plunged. Despite the evidence, Semmelweis’s conclusions...
United We Are Stronger
FuerzaMéxico #19S Thirty-two years ago, Mexico City was hit by a devastating earthquake that left thousands dead, hundreds of buildings collapsed and became uninhabitable. It was an event that united us as a society and helped to implement a culture of prevention. The regulations for the construction of buildings in the city were modified and since childhood we were taught how to act and protect ourselves during an earthquake. Earthquakes cannot be predicted, but we can prevent many of their terrible consequences. On September 19th, a new earthquake struck the country on the anniversary of the 1985 earthquake. Two weeks after another strong earthquake shook the coasts of Chiapas and Oaxaca. What a terrible coincidence! That morning the City had participated in acts that commemorate the events of 1985. At the time of the earthquake (13:14 CMT), I was in the emergency room with several surgery residents when we felt...
Lessons About Healing After Hurricane Harvey
By Jackie Olive I hail from the foothills of Los Angeles County, where natural disaster comes in the form of forest fires and droughts. Having lived in Houston for over four years for college and now medical school, I’ve learned that disaster here comes in practically the opposite form. Hurricane Harvey was the first significant tropical storm that I have experienced. Initially, my colleagues and I hadn’t predicted the magnitude of the devastation that our city and neighboring Texas coastline would ultimately face. I remember we first became worried when we heard of friends who were leaving town and grocery stores that had completely empty shelves. We later became shocked when we couldn’t leave our homes because the water levels had dangerously risen and cars had been deserted in the middle of streets. The immediate aftermath of the hurricane was devastating, as homes were destroyed, families relocated, and stress levels...
Hand ties & Heartbreak: My Experiences as a Puerto Rican Surgical Residency Applicant during Hurricane Maria
By Mariela Martinez News channels have been flooded with images of the devastation caused by hurricane María in Puerto Rico. There are numerous stories about the damages to the health system, infrastructure and economy of the Island. Yet, have you wondered what it was like for Puerto Ricans who experienced this devastating storm? I am a medical student from Puerto Rico and this is my story. Hurricane Maria made Landfall in Puerto Rico It was 4:00am and I was wide awake for the fourth day in a row. My mind filled with despair as images of the beautiful island I call home were replaced with destruction. I made another frantic attempt to call them one more time. No success. Calling my loved ones had become a stubborn attempt to restore some normalcy in my life and to re-establish a sense of balance, to pretend this disaster never happened. I was...
When Disaster Strikes
By Dr. Minerva Romero Arenas #HoustonStrong #HurricaneIrma #FuerzaMéxico #PRstrong #VegasStrong Our world has been in the midst of what seems like an endless series of tragedies. This blog started out as an idea to write about how I was inspired and proud of the goodwill shown by my fellow Houstonians (and other Texans and neighbors) in the aftermath of hurricane Harvey. Much like this love letter. Much like my colleague’s reminder to look for the helpers when disaster strikes. However, it quickly became a seemingly insurmountable task. Just as I was trying to pen a few lines, another disaster was brewing in the Atlantic. Then the earthquakes hit México. Another set of hurricanes. Yet another mass shooting. Staying safe. Trying to help. Then trying to keep up with everyone’s safety and figuring out how to help in the aftermath. Donate. Volunteer. Meteorological maps seemed like something that could only have...
