Let's Talk Shop

Today I am going to discuss my technical expertise and passion for cardiac surgery.

It's been a long journey. Unfortunately, because of what I do for a living, I have to show it 'as I see it' and this is literally. So if close up views of surgery are too intense for you, you might want to opt for a different blog post, okay?

The only thing that interested me in Medical School was the heart.

Everything else I learned as a requirement. But this? I couldn't get enough! I studied it. I drew it. I aced the anatomy section on the thorax. I went to the asian market and bought pig hearts from the butcher just so I could learn how all the valves and the muscles worked.

And the very first time I saw Stuart Jamieson, MD,  show us how to tell the difference between an Aortic Valve and a Pulmonic Valve in lecture? I was hooked!

I asked to do a cardiac surgery rotation during my surgery elective. I worked with Dr. Jamieson, and this is the view I had while I worked as a first assistant to the fellow to open the chest.

I enjoyed everything and all things about that specialty, and a surgeon, hopefully, a cardiac surgeon, I was to be.

This is what it looks like when you are in on the field. With my residency, my heart surgeon used to let me be the 'designated heart holder' and retract with my hand so he could see.

All the extra time I had spend closing the leg in the heart room as a medical student paid off! In residency I would race the senior resident on the other leg, and even learned how to harvest vein.

I also grew close to the heart surgeon at my hospital--he would be my best mentor I ever had.

Heart surgery training is a long, lonely road. There is internship, then residency--five years in training--just to get IN to a hearts program. Then there are three years after that.

I didn't make it.

A really bad rotation on Vascular had me decide this wasn't how I wanted to live my life. I was working from three in the morning to ten at night every day. So I finished my second year, and signed up for Anesthesia training. I did my second year twice, because that is where I had to begin in Anesthesia Residency. It was a good fit with my personality and lifestyle. I also made it to be Chief Resident for my class.

I still loved the heart room. There wasn't any place else I would rather stay. This was my new view, from the head of the bed.

I did a fellowship. I learned transesophageal echocardiography (TEE).

I even did perfusion for one week in fellowship--I ran the heart-lung machine--just like this--with the perfusionist. I set it up and made sure the patient was asleep when they were on bypass.

I returned to teach. I taught many an anesthesia resident how to do hearts safely. I had extra training in pediatric hearts in fellowship. When I was pregnant I wondered if my child would pick up the knowledge of the healing that went on in OR 1...

Later I was invited to start a heart program at a local hospital... which I did.

The state surveyor said my CV was the nicest one they had ever seen, with the most qualifications.

I was super excited to bring this healing to the community where I now worked.

But it wasn't easy. A heart program takes people with experience to make it happen. And every hospital has their own culture.

Not many women succeed in community practice.

I had been offered jobs on the spot at St. Michael's hospital in New Jersey (I went for a training program in off-pump CABG), Cedars-Sinai in Los Angeles, and also at a local trauma hospital. The first I didn't want to relocate, and the second, I had just bought my house which was too far to commute, and the third, well--some of the heart surgeons there didn't like women.

I had forgotten, but a surgeon at the hospital closest to my home also had offered me a job while we played a game of golf together at a conference on anticoagulants in Austin, Texas, too. He was amazing person, very forward-thinking, and did one hundred percent off pump CABG for everyone.

I was that good.

It's been four years since I did my last heart.

I try not to think about it.

The Reiki training wouldn't have been possible with the hours I was expected to keep doing hearts. (I took a lot of classes at night for the Psychic Development in addition to the Reiki classes on the weekends).

And I'd have never been able to drop my son off at school every day, like I do, which is an important bonding time for me. (Hearts cut at eight, so Anesthesia must have the patient in the room by six thirty, and the room set up starting at six at the latest).

You can't do hearts forever. With training I put in about ten years in the heart room. That's as long as most people do...

(That's what I love about heart surgery the most--patients get better. You can see the pink in their cheeks the very next day after repair of their heart...)

Cardiac Anesthesiologists train in Thoracic Anesthesia too. I am very good with a bronchoscope. So when a colleague had trouble with a double-lumen tube, a nurse asked me to come in from the Doctor's Lounge into that OR to help.

I saw the problem immediately--it was a tight fit between the bronchoscope and the endobronchial lumen of the double-lumen tube. Instead of silicone, the team was using cetacaine spray, which is not flammable, but it not a lubricant either. Head of nursing had made the switch.

The surgeon was frustrated. So I held the tube, backing it up and advancing it with the surgeon who had taken over the placement (One I know, not this one, actually BILLS for it, placing the tube!).

My colleague was like, 'If you are just going to hold the tube I can do it...' and reached for the tube.

I didn't let them. I held my ground, and did what the surgeon asked me to do. It got placed perfectly.

My colleague challenged me.

I said, 'I have known this surgeon ever since I was a resident. It has been over twenty years (I stretched it  a little). I was calming him down. We have been through a lot together and we work well as a team.'

The other surgeon, the assistant, had been watching and listening. He was taking it all in. He is Sri Lankan. I enjoy working with him on thoracic cases. He always is respectful and level-headed.

After tube placement, we were both in the Doctor's Lounge.The patient needed to be prepped before he could assist.  I was post-call from a very long call, and on my way home. When we are post-call, our 'filters' don't work so well.

We were talking bronchoscopes, and somehow the conversation to a turn in a direction I normally don't discuss, especially in front of a heart surgeon.

It was like my heart spoke without my being able to stop it.

'When I started the heart program here, there was nothing. It was so hard. Do you know what happened? For example, once I was placing a double-lumen tube and I had requested a bronchoscope the night before. Do you know what they got me? A GLIDE scope from the E.R.!!! How was I supposed to check placement with that? (bronchoscope is long and thin fiberoptic, a glide scope is a shoe-horn type thing for intubation)'

And much to my dismay, I kept going, and under my voice I said, 'I get almost violent when someone threatens the care of my patients...they thought I was a total bitch and they freaked out and they never wanted me in there again.'

And he looked at me.

He listened. And he understood exactly where I was coming from.

Later, as we were talking Singapore restaurants in the area, he said, 'Give me your number' and he texted me a link to the restaurant he recommended. I took his contact information, his photo, and sent him the link to the new one I was sharing with him.

His acceptance and offer of friendship validated me as a healer, as a cardiac anesthesiologist, and as a patient advocate (of which I am a total bulldog! Just last week, I overheard some staff talking about how they have never heard me raise my voice in the OR but they did that day and it surprised them. The table was beyond its weight limit, and when unlocked for a turn, it started to tip. With the patient on it!!! So I said STOP as loud as I could, and got the lock back on. One inch more and the patient would have had his head hit the ground as the unbalanced table would have immediately fallen over)

He wished me Happy Mother's Day today. He sent a text. He even put a little smiley face at the end of it.

.
I wouldn't have changed a thing with how it all turned out. Reiki is the way of the future. Energy Healing, Quantum Healing, and addressing Dis-Ease will one day be more important that anything that is the standard of care at this time. I look forward to helping to align the healing of the future with those who are the healers of today--both in mainstream medicine, and other healing arts.

I hope that the photos were not offensive to you in any way. They are technical, and are my expertise. They are not for everyone. But they are unfortunately totally normal for me, now that I have been in this field for as many years as I have...


Aloha and Mahalos,
Namaste,
Peace,

Reiki Doc


P.S. The heart symbol with the hands is a Seraphim symbol for Love. When I saw the Seraphim in October 2012, in meditation, it made that symbol and several others--harmony, Light....it was very nice. So now you know one Seraphim symbol...

The New Consciousness Of The Divine Feminine

I live in a masculine world.

I work in one that is even MORE masculine.

Last week, I got assigned to a thoracic room. 

Those cases are done by heart surgeons, at least where I am.

And those surgeons like to 'cut at eight'.

Well, on Fridays, our cases are booked to begin at eight. I don't show up until seven-thirty. And I forget that all heart surgeons, everywhere on the globe, like to 'cut at eight'. This is because they like to finish their cases by noon, eat lunch, and go to their clinic after their cases, or perhaps to another hospital for another case that is booked.

Heart surgeons are busy people.

I am a single mother who used to do hearts. I don't do them any more because of a personality conflict with someone who was dangerous and has since been let go from the system--a surgeon who has killed people, fortunately not mine, by not making sure without a doubt the cardioplegia was actually going IN the right place. (this isn't the point of my story).

My surgeon showed up early and berated me and my colleagues for 'being late', when in fact, I WASN'T.

My friend, a mom of twins, set things up and offered to do the arterial line.  She and the others reminded me of some surgeons who book cases for when they like to cut, not when they 'go in the room' like ninety percent of the rest of our surgeons. 

I was rattled.

I was really fighting my emotions.

Emotions rattled are not a good thing for anesthesia.

Luckily the case went well. And although the surgeon did his best to annoy me and distract me and rattle me and humiliate me, I stood strong. I also fought the urge to defend myself and to engage.

I made sure to let them see my face over the drapes and watch their work when I was caught up with my charting and orders in the computer.

Let me say this guy is NOT the one that booked the case, but he likes chest cases more, and the other guy let him do it. He was telling me how to do my job, literally. But I took it with a grain of salt, and accepted it as 'constructive criticism'.

Something weird happened as I was watching...I realized this is his crack!

Doing cases and having control and his schedule be on time is his crack that gives him pleasure and he can't deal with it if he doesn't have it RIGHT AWAY...

Well that re-started my consciousness!

Who am I to get in the way of him getting his crack? At least his crack helps patients!

(the next case had such an incredibly fast turnover--because of me--that the surgeon thanked my anesthesia tech. And I also got him to confess he has a love for Paris and all things French--when he said my last name out loud. I started speaking French and he was impressed. He did TWO cases by noon and was quite happy.)

Shhhhhh.

Right now my son is watching Captain Phillips on pay-per-view.

I can't stand it.

But 'action' is for most males, a form of 'crack'.  As he is embracing his masculinity, who am I to get in the way?

As a matter of fact, yesterday I made him attend Martial Arts (he wanted to skip), and he gave his best effort in a long time.

I also put him in a kayak and told him to enjoy his freedom, he was welcome to be near me on the paddle board, but where else can you enjoy doing exactly what you want to do as a kid?

My Divine Feminine is ENCOURAGING the Divine Masculine that is around me to explore, to be safe, and to do what Spirit is telling it to do...

This goes for my son, my surgeons, my coworkers, Ross, the Galactics, my fellow Lightworkers...even my pets.

You may not have known, but I have been tending to a snake injury I inadvertently caused in my son's pet, a six foot ball python named Cecil. He's three, and while I was helping him peel, it was like the skin of some on steroids when you remove tape--a top layer came off. I've been doing everything I looked up on the internet, and it's been working beautifully. Today, I soaked him and helped him shed his skin on his head. There was an eye cap that got stuck. And I had to remove it. You know, that snake trusted me the most he ever has, and let me take care of it?

Even snakes can learn when you are tending to their needs with your heart...

And for that?

In the Garden, as I sent Galactic Reiki, a new sign came in. This is the sixth one, and has a name, which means 'see the offspring' in Igbo (it's close). Igbo is the native language of southeast Nigeria, on the coast (these Galactic symbols are Sirian)--and it is Right Next To The Congo!!!

The meaning is to see the fruits of our labors, to resolve differences and problems peacefully, to work together to build a new future for us all.

I will teach the symbols of Galactic Reiki when the time is right for it. In the meantime, I will continue to sent them to you every day as Spirit suggests, in the free Reiki healing I send to all who read this blog (or have ever once read it), follow Doctors With Reiki on Facebook, and follow on Twitter (@usui2102).


Aloha and Mahalos,
Namaste,

Reiki Doc

Why Thoracic Anesthesia Is Fun

Thoracic Anesthesia, or the anesthesia that is given for lung surgery, when everything is going well, it feels like sailing to me.

I adore sailing.

With the open sky and the sea and the wind in my face it is just about one of the best things to do on Gaia. And you are one with the sea and with the vessel. You move automatically with the lines, the sails, the team, as One.

In the O.R. there are many task to do, all in quick succession. There are fine adjustments to make, just as do when setting your course on the water....sail and tack...sail and tack....sail and tack...

There is more invasive monitoring than in the average case, but not so much as a heart. It's doable.

After induction, which is a big deal because you insert a breathing tube that is adapted to allow to ventilate one lung independently of the other, you place your lines.

You need two very big i.v.'s just in case your surgeon gets into trouble, and there is bleeding. The blood flows thick and fast when something happens, and you have got to be prepared ahead. There isn't time to set up after a hemorrhage. Fortunately, this part is very rare.

Another thing you insert is an arterial line to monitor oxygen, ventilation (CO2 output), and blood pressure. The last time I put in a line, the anesthesia tech blurted out, 'wow! Did you see how fast that line just went in? Yesterday in the other room it took an HOUR!' I had gotten it on the first try at the same rate someone would put in an i.v. I laughed and said, 'That's because I used to do hearts!'.

My surgeon took notice.

Speaking about him, there was the following conversation in the O.R.:

me: (as we were preparing to turn the patient lateral and nurse was putting in foley and I was bronching patient to verify tube position) Would you mind getting me three blankets from the warmer? (I pointed to the equipment)
surgeon: (gives me the look, acts like he doesn't notice, then blurts out) Are you talking to me?
me: Yes. When we turn I am going to need to support the head more than this gel pillow. Three flat blankets will do nicely.
surgeon: I can't. I don't know where the equipment is!
second surgeon:  Here, let me get that for you. (goes to the warmer, takes out three blankets, and hands them to me)
me: Gosh, I am sorry if I was rude in asking the surgeon for help by getting a blanket in front of you. I've known him for like, ten years, since I worked with him someplace else. Everyone else was busy, and I was trying to save time by thinking one step ahead...
second surgeon: You know you're not allowed to think!


circulator nurse: (we are alone and she is prepping patient while surgeons both scrub)
That was the PERFECT answer to that situation. He literally said, 'are you talking to me?' Perfect tone, perfect reasoning, perfect timing, perfectly said.
me: You know I almost dated him?
circulator nurse:  You could have done better!
me: I'm serious! When he came to our hospital and was new, and single, the other heart surgeon tried to set us up. I saw that he was dark and handsome and exotic, and seemed nice...but something made me think work and dating might not be a good idea. So I never did. It's a good thing that I listened to my 'hunch'--it turns out he has a terrible temper, as you can see.
circulator nurse: (gives me an approving look,, and surgeon walks back into the room, and she lifts her finger to her mask as a warning for us not to talk on the subject)

Why do I share with you all of this?

Some people asked me what Thoracic Anesthesia is. And why I love it.

Besides, I always liked to work in the thoracic cavity--my goal at one point was to become a cardiothoracic surgeon! Not a cardiac anesthesiologist. The lifestyle was horrible! That is why I gave that first dream up.

We move on.

I love it when a case asks much of me. It is so fun and really feels like I am One with my equipment and my purpose and my team...is there much time for Reiki? No. But I do what I can <3

Aloha and mahalos,
Namaste,

Reiki Doc

Cardiovascular Surgeons versus Anesthesia

There are two docs in my hospital I do not like to work with. One, who bullied me in the heart room so much that I am loathe to work with him, had booked a case in the Main O.R. instead of the Cardiac O.R. My heart and breath quickened, and I hoped I would not have to work with him.

Sure enough, it manifested. There was a case switch to another room. I arranged for a colleague and I to trade so I would not have to take the case.

At the right moment, I realized I would not be able to 'get back on the horse' after falling if I did not take what was coming.

I looked at this case through Reiki eyes.

The patient was a technical challenge. For these cases, thoracic ones, a big tube needs to be placed. It is  hard to fit in people whose mouths don't open very well. There was a struggle, but I got a smaller tube in, with a bronchial blocker as the plan. But it had trouble going in to the right mainstem bronchus.

I saw firsthand how cardiac surgeons think. They think they are better than the rest of us. They jump to conclusions. And they want to  'see proof'.  Instead of seeing a board certified cardiac anesthesiologist and trusting her judgement about what is going to work and what doesn't, the Minor one said, 'do this it will work!' Well, maybe at another hospital. But in mine, with our equipment, guess what? It didn't. Back to what I had in, with a bloodier airway.

The Major on went behind my back and brought in another anesthesiologist. This one pulled out the airway, which is not good because you can lose it. And he tried a bigger one. It would not fit. (Duh! I was thinking.). Then another, smaller one would not go in. He had to shove it. There was trauma. But it worked.

Did I get angry? No. I fought back with higher principles. I 'learned'. I 'learned' about the attitudes of my surgeons. I 'learned' a fully-grown man has to lift a head one foot off the bed and shove a breathing tube forcefully to get it in. I 'learned' it was perception on their part, and not me. I also 'learned' that by doing my work, with Purpose, and then doing my Work--asking for Divine Peace Healing for the room--AND asking my angels, guides and deceased Loved Ones, to 'fix it' from The Other Side through me as a channel, a GREAT DEAL of energy flowed. I was Tingling the whole time I worked. And my 'Partners in Healing' let me know when it was time to 'close the circuit'. Job was finished (it was before the end of the case).

The level of Consciousness of your typical Cardiac Surgeon is on the Lower End of the Spectrum.

Yesterday I made a stand, in Spirit, with Spirit to back me up, to REFUSE to play the I AM THE CAPTAIN OF THE SHIP AND I CAN BULLY YOU GAME. I learned to hold my ground, on a spiritual level, and change the tone of the whole room. Without saying a word. It takes TWO to play. And everyone has a choice whether to get 'sucked in' to that Drama, or to withstand it like the rock on the beach that is like a boulder in the crashing waves.

Due to my telepathy, I knew that my Heart Center was connected to everyone in the room including the patient. And as the surgeon went to leave, the man I refused to acknowledge outside the OR for one year, and who stubbornly refused to acknowledge ME, thought, 'I was kind of hard on her.'

I felt it. I knew it. And when he saw me eating my Hawaiian Caramel Corn in the Doctors Lounge because I was starving, he approached me and asked it the patient was extubated and did all right. I saw that he had been setting others up to fail, by not being proactive on explaining the needs of his patient. I also saw, on a deeper level, that this man had been coddled so much by his O.R. Heart Team of nurses that he did not KNOW how to interact in any other way like 95% of all other surgeons do on behalf of their patient. I reassured him, keeping my energy GROUNDED, and directed him to the right bed in the recovery room and nurse who was taking care of him just in case he wanted to see the patient himself.

I have to admit, this was a hard thing on me. It was painful. It was a challenge to my well-being. And a choice. Looking back, I saw that this 'surgeon' is a vehicle to help me 'Dissolve' illusions about who I am, and what my skills are in the Operating Room. Nasty as it was, it was a gift from God and Spirit, in order to help me grow.

So, if YOU have one of those surgeons in your OR, or one of those Major or Minor Nasty people in your life, take the chance and ask the Guides on Earth and Heaven, to back you up, and help you Heal your World one A**hole at a time.

Namaste,

Reiki Doc