Wednesday, July 22, 2020

Lingular Tonsil

Well it's been a while. Not two years, but certainly longer than I intended. Just made it through the middle of a call week, and there are reasons to celebrate. First of all, I got a text from Melody on the way home - she texts the Baptist systemwide Covid info every day. Baptist Little Rock went from 48 inpatient yesterday, 14 in the ICU, to 37 inpatient today, 11 in the ICU. North Little Rock got two out of the unit. Hard to know if it's a trend since we've been going up for a bit, but encouraging.

I was doing late frozens tonight for John Sims - the new ENT guy from Mayo who has increased our frozen monthly count by like 25% but is so gosh darn nice (I bet his ears were burning when Laurie and Jessica and I were talking about him in the gross room waiting on the specimen) it's hard to be mad at him about it.  I simultaneously learned that an organ procurement that was going to start at 8 was bumped to midnight, yikes. John came in the gross room to chat about the case. Melody had diagnosed cancer in a lymph node but the origin he was hunting for at the base of the tongue was elusive. I told him the second specimen was also negative. "We are in the lingular tonsil right?" He replied "The lingual tonsil, yes. I'm not too worried, because I've seen 2mm primaries in this area. And it makes a difference if you find it or not, for neoadjuvant therapy. Make sure you sample thoroughly. And I want p16." Oops. I got the lingula of the lung and the lingual tonsil all mashed up in my head, LOL. I told him, "We can do the p16 on the lymph node, if we cannot find the primary. Yes of course I'll put it all in and relay this info if I don't get the case."

Two funny things happened last week I kept trying to write about. Last Monday was chaos in the micro lab. Of the 48 patients scheduled to go to surgery that day only one had a Covid result from AEL. Turns out AEL lost 40% of their testing supplies from Roche - it's happening all over with the surges. We had to re-order the tests and do them in house. On MyChart there is a place the patient can check their Covid result. It says if you have questions, call this number. The number is to the front of the lab and that person was forwarding it to the micro lab all day. So patients were calling THE MICRO LAB FOR RESULTS!! That never happens. It was so hectic trying to get all the tests done that it wasn't until mid-afternoon that director Amy sat down to e-mail the head of the lab. She started it with HELP!!!!!!! Finally they stopped that still anon to me person from forwarding those calls. Surgeries and procedures were crippled for about three days last week, but it picked back up.

Another funny phone story. Jessica was sitting down with me talking in the back room of the gross room problem solving and there was a phone call. She said, "That's HIM!! UGGHH! Room 532!" I wondered who. Apparently there was a patient that was a little demented and had been calling the gross room all day long for three days asking various questions. "Is my wife there?" "Is this the kitchen?" It was getting so crazy - this was when surgery had started picking back up - she got the nurses to take away his phone. But then there would be a shift change and he would get it back from the new nurses. "I'm going to have to talk to those nurses and get it back again. Savanna, what did you say to him when he called?" Savanna is a new hire - hybrid gross room deaner and histotech. She's amazing. "I just picked up the phone and hung it up." I haven't heard any more about him this week, so I guess he was either discharged or lost his phone privileges permanently.

Jessica texted me on the way home that the organ procurement was moved back to 5am. Yay! Now I can have a drink in peace. The nurse at the front desk in the OR told me that midnight was probably wishful thinking, because it was a full organ procurement and to get that many surgeons and recipients coordinated in surrounding states would take a lot of time. She gave me a number to call before I went to bed to check the status. Now I don't have to worry about it. Whew.

Here's to after work cocktails and more Covid decline - we need some good news around here. My kids are happy (for the most part) and healthy - Jack's at camp for two weeks and Cecelia is loving spending money she is making from her new job babysitting a former Camp Aldersgate camper. I'm looking forward to next month - two weekends in a row are already booked up with birthday fun and I've got a doc mom book club to schedule. Hope you are doing well. Much love, E

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