What to do when your Scrub Nurse’s relative undergoes CABG ?

The topic though seems simple but its a complicated thing to manage when you face it and need previous exposure. I was a resident and experiencing the same when our scrub brother’s uncle got admitted under one of our consultants.

It is an opportunity to help your scrub brother or sister when their relative got admitted under you. It is a time to pay them back, the all works they had done for your patient till now. It is a time to make them feel sympathised for you and a time to increase the relation between you two.

Our brother’s uncle got admitted with complaints of breathlessness and chest pain with history of previous PTCA stent to LAD and RCA. Initial thing was to stabilise the patient, as he had fever and his serum creatinine was high and we were planning to do Coronary Angiography.

Hospital stay was expensive and he had need long hospital stay to stabilise  first and later the recovery after the surgery. It was not possible for our brother to pay in an expensive hospital of Delhi. The first thing our consultant did was to convert the patient to General Ward Category. I was impressed, yes good work!

The patient improved, Coronary Angiography was done and the surgery date was decided. I have been helping the brother in all possible ways as I can do, but being busy in the department it was not possible for me to spent adequate time as i was thinking of along with brother and his uncle. I was assuring all the time- everything will be alright, don’t worry… Brother, you are in safest hand in the world- I was meaning to our consultant, who had Limca Book of World Record of performing 433 plus CABGs without any hospital mortality.

On the day of surgery, our brother was wandering here and there, much worried and thoughtful. He used to scrub everyday and assisted thousands of operations before, but this time, it was his family person… the attachment of blood, the affection of the care they had done for you. Brother was getting worried and anxious, time by time, when his uncle got shifted to the operation theatre.

It feel awkward when your own family member got admitted to hospital for an operation and you rove around there seeing them lying naked as a small child and getting catheterised and pricked at several sites for intravenous and intra arterial lines.

Brother was getting shaken from inside,  his heart beating for his own family members and enquiring every time- is everything going alright? It was his working area and he had free access to enter unlike other patient’s relative. His heart was racing. All the time, being a doctor or nurse is miserable, when it comes to your own family member.

I was assuring brother, my consultant,  who was about to enter the operation theatre come to me and took me to a side. I was looking at his face as he was wearing the facemark and told me with a voice of order while tying his knot on the back of his head-, ” Don’t allow Him to enter the operation theatre till the operation is over.” He passes aside, as I nodded my head in a thought of perplexity and pleasure. Good work again!!

Brother had not entered the Operation theatre as instructed except some wink from the  form glass door. The operation got over in hours with utmost success.  As the patient got shifted to the Recovery Room, I was sitting with all the staff and admiring the decision taken by my consultant. Good decision!!!

 

 

CABG in Pectus Carinatum Chest

Fig 1: Chest wound 4 days after corny artery bypass grafting

A 48 year old non diabetic non hypertensive patient came to hospital with complaints of intermittent chest pain since 1 month which was insidious in onset gradually progressive, increased on exertion and relieved by rest. His ECG showed ST changes. Coronary Angiography  done which showed triple vessel coronary artery disease.

He was a small stunted man with history of fall in childhood. He has short neck with pectus carinatum ( pigeon chest)-Fig 1 and Fig 2.

Sternum was short but wide. Left internal mammary harvesting was abnormal course but harvested well with precision and given to left anterior descending artery.  Rest of the grafts were Long Saphenous Veins.

Fig. 2: Chest wound 4 days after coronary artery bypass grafting. Side view with clearly seen short sternum with pectus carinatum chest.

Recovery was uneventful with normal wound healing. The photos were taken at the time of discharge.