tag:blogger.com,1999:blog-30499448.post4335655856706486035..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: BleederSid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger17125tag:blogger.com,1999:blog-30499448.post-74667444886685949482007-11-03T12:55:00.000-07:002007-11-03T12:55:00.000-07:00I do laparoscopic radical prostatectomy . Yesterd...I do <A HREF="http://www.laprp.com" REL="nofollow"> laparoscopic radical prostatectomy </A>. Yesterday, I operated on a cardiologist with coronary disease who recently got a stent. His cardiologist asked to start Plavix, aspirin right away, even as we had him on Fragmin throughout. What is the risk? How do we know how much is safe to anticoagulate after major pelvic surgery? What are the rules?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-6090812914851898652007-11-03T08:57:00.000-07:002007-11-03T08:57:00.000-07:00Interesting post on bleeding. I recently had two ...Interesting post on bleeding. I recently had two lumpectomies for breast cancer (they didn't get clear margins the first time) and the surgeon told me my blood is "thin and oozy" and I bleed all over the place. It causes quite a mess in her operating room, from what I could gather. I take low-dose aspirin but I had stopped that a week before. I also take venlafaxine, which supposedly has an antiplatelet effect. I wonder if it could be from that.<BR/><BR/>MarilynUnknownhttps://www.blogger.com/profile/16193362190826548025noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-37033434572820388822007-11-03T06:03:00.000-07:002007-11-03T06:03:00.000-07:00Apart from the initial embarrassment of getting sq...Apart from the initial embarrassment of getting squirted in the eyes with a bleeder myself during a pneumenectomy case, as i was peering over the shoulder of a scrub nurse, I soon realized the punishment for my transgression. Being a sales rep, 1000kms from home that day, i had to hang about for the obligatory blood tests that friday night. Lesson learnt.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-41646120237545980962007-10-28T20:29:00.000-07:002007-10-28T20:29:00.000-07:00lights: I'm sure it'll be fine. You clipped the ap...lights: I'm sure it'll be fine. You clipped the appendiceal artery, right? It'll be fine. I'm sure you threw enough knots on the mesoappendix. It'll be fine. Well away from the inferior epigastric, right? It'll be fine. Go to sleep. It'll be fine.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-55994251901225278512007-10-28T20:16:00.000-07:002007-10-28T20:16:00.000-07:00Oh man. Great. I *was* going to try to get some sl...Oh man. Great. I *was* going to try to get some sleep tonight, if the opportunity presents itself while I'm on call. But I did an open appy on a kid this evening. Now I may be waiting for the other shoe to drop...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-73224925162809876242007-10-28T12:51:00.000-07:002007-10-28T12:51:00.000-07:00Oh, good! ;) Injured eyes/hands means no work/$.Oh, good! ;) Injured eyes/hands means no work/$.FetchingGalhttps://www.blogger.com/profile/12725479087572080780noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-19336417723530205882007-10-27T14:15:00.000-07:002007-10-27T14:15:00.000-07:00I'm pretty sure the picture is a set-up, and the "...I'm pretty sure the picture is a set-up, and the "blood" that's squirting is silly-string.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-24537322602003593462007-10-27T13:52:00.000-07:002007-10-27T13:52:00.000-07:00Is it just me, or is only one person wearing a bit...Is it just me, or is only one person wearing a bit o plastic to protect the eyes from the bleeder in that photo? :-o Glad I got my Oakleys...FetchingGalhttps://www.blogger.com/profile/12725479087572080780noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-66063573178023586562007-10-26T20:56:00.000-07:002007-10-26T20:56:00.000-07:00The uterus is evil for postop bleeding. It gets h...The uterus is evil for postop bleeding. It gets hemostasis by contraction, so it is possible to miss a large venous sinus while closing the incision (because the myometrium is so contracted, it's not really actively bleeding at the time), and then if the tone lets up a little bit, it can start bleeding, a lot.<BR/><BR/>You can usually see it when you go back.Midwife with a Knifehttps://www.blogger.com/profile/04309579302399381913noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-13092945383514094992007-10-26T20:22:00.000-07:002007-10-26T20:22:00.000-07:00Well, I must say that's my experience, too. In the...Well, I must say that's my experience, too. In the case I mentioned, it was, in fact. Still, the point that we typically don't close when there's bleeding, and the mechanism of bleeding post-op applies whether it's an obvious bleeder or not.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-35977314082032579912007-10-26T19:06:00.000-07:002007-10-26T19:06:00.000-07:00Bongi, I too have never found the bleeder when I h...Bongi, I too have never found the bleeder when I had to take someone back for bleeding--the blood was all clotted. Very humbling, even when you know you "had hemostasis" when you left the OR the first time around.rlbateshttps://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-30769396132543413472007-10-26T14:39:00.000-07:002007-10-26T14:39:00.000-07:00IT'S AN HONOR TO ME TOO.IT'S AN HONOR TO ME TOO.Dr. Robhttps://www.blogger.com/profile/01871792467587364512noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-49668959636445233872007-10-26T14:37:00.000-07:002007-10-26T14:37:00.000-07:00i thank you!i thank you!Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-35286424582468363342007-10-26T14:09:00.000-07:002007-10-26T14:09:00.000-07:00Bongi: it was an homage to you.Bongi: it was an homage to you.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-12886069793244927902007-10-26T13:56:00.000-07:002007-10-26T13:56:00.000-07:00not to be the one to criticize but shouldn't rob b...not to be the one to criticize but shouldn't rob be with a capital letter?<BR/><BR/>taking someone back for bleeding was for me always very frustrating. i nearly never found the bleed. they had usually stopped bleeding before theater.Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-42381019082029621582007-10-26T10:00:00.000-07:002007-10-26T10:00:00.000-07:00Rob: think that's cool? Watch this: röb rób rôb r...Rob: think that's cool? Watch this: röb rób rôb rõb<BR/><BR/>Generally, however, I like to deëmphasize my brilliance.<BR/><BR/>Ω ≈ ç √ ∫ µ ≤ å ß ≈ ƒ © ˙ ∆ ˚ ¬ … œ ∑ ® † ¥Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-90451394113212186462007-10-26T09:11:00.000-07:002007-10-26T09:11:00.000-07:00Hey Sid, How did you get those little umlauts over...Hey Sid, How did you get those little umlauts over the letters? Pretty cool, but I was not aware that was a correct way to spell "deëmphasizing" and "Reöperation." Dang you are smart. Even re-do punctuation. <BR/><BR/>Can I be like you when I grow up?Dr. Robhttps://www.blogger.com/profile/01871792467587364512noreply@blogger.com