Happy and merry Christmas to you and all you love!
Oh. My. God. I just worked. 60 hours this week, five days in a row. Three days in the PICU, two in the hem-onc ICU. Today, at the eleventh hour (actually, the 57th hour, but who's counting?) my patient turned his stable, perfusing sinus rhythm into an atrial flutter, two-to-one conduction. Which means that his atrium squeezed about 300 beats per minute, and the ventricles squeezed 150 times per minute. That's pretty fast if you're my 100 kilogram 62-year-old male, and not my 5 kilogram 9-month female patient. An EKG was done, cardiology was called in, and excitedly decided to cardiovert the patient. They were super excited because he was already anticoagulated thanks to coumadin treatment for an aortic valve replacement ten years ago. It's not advisable to cardiovert the heart of a patient who may have been in this unstable atrial rhythm for a while without anticoagulation, because there's a risk they may have formed a clot in the atrium which would then be sent elsewhere in the body, plugging up important spaces in the lungs or brains or whatnot. Anyhoo, we sedated the patient, shocked him, and finally started an amiodarone drip which actually converted him. What I'm trying to say is that the last few hours of my excessively long stretch of working were filled with much too much activity and business and now I am so freakin' tired. And I have no idea why I'm telling you all about cardioversion instead of sitting back and watching the BBC and letting my brain melt away.
Santa decided I was a good girl this year, because a shiny white Macbook showed up two days ago on my doorstep! It is just so cute that I invited it inside and I think I'll keep it.
More later, as I recover. So, to sum up, in case you're wondering, working five twelve-hour days in a row sucks a lot.