Friday, 13 September 2013

Blood, plaque and clogged arteries

I had one of the most enjoyable days so far yesterday, shadowing nurses in the cath lab for a full 7 hours. Early on, the head nurse, Laden introduced me to Iman, who quickly took me under her wing. In her early 30s, Iman had worked in the cath lab for 4 years. She was born in Qatar but her family came from Palestine. During our shift, she showed me pictures of her sister's wedding, last month. She had to make sure there were no men around when she showed me because her religion prevents males who are not family members from seeing women with their heads uncovered (in the photos, her and her sister were both uncovered). It's nice to know that nurses in Qatar are just as keen to talk about and show pictures of weddings (and babies) as nurses back home! That's definitely one thing we have in common.

She asked what area of nursing I'd like to get into. I still don't know for sure but I told her I really liked the renal (kidney) unit when I spent a semester there last fall. She told me, in broken English, that, like cardiac, "If you choose renal, you will be like a DIAMOND [big emphasis on diamond] and everywhere you go, you will work." I think she was saying that renal would be a great place to begin my career.

Iman patiently answered all of my questions and explained everything to me, part of the reason why yesterday was so enjoyable. Again I'll reiterate how exciting it is to be in the cath lab, with a new patient coming in everyone 45-minutes or so and doctors rushing the find out if and where an artery is blocked. I was able to watch the chief cardiologist at Hamad perform several angioplasties today. He welcomed me into his lab and told me to step closer as he punctured a patient's femoral artery.

"You're OK with blood, right?" he asked me.
"Uhh....yeah..I think so," I replied, giving him a puzzled look. I always tell people that I'm OK with blood but I've never actually had to see a whole lot of it, at least until now. A little bit of blood, sure no problem. Actually the first time I got to watch a wound dressing change back on the renal unit I unexpectedly felt faint and had to run outside to the nearest chair before I fainted. Now granted, this was no normal wound, there was some tunneling and...well you get the picture. Since then I've had no issue. But you can't always predict how you're going to react in certain circumstances, sometimes the body just takes over. Getting comfortable with the icky stuff in nursing  is sort of like stepping into a cold swimming pool: just a little bit at a time and eventually it gets easier. I felt my heart rate speed up in the seconds before I saw him stick a needle into the artery. Instead of watching the doctor,  I secretly looked down at my shoes and took a deep breath). No problem!! Eventually, curiosity got the better of me and obviously I looked (how could I not?). Yep, that's an artery alright. You can tell by the way the blood pulses out with every heartbeat. Fascinating!

I don't know why this doctor felt like he needed to quiz me but he did.
"Are you familiar with the anatomy of the femoral artery?" he asked me.
"Well yes, sort of," I replied, knowing this was going to end badly. I hadn't studied arteries and veins for over a year.
"And what is the anatomy of the femoral artery?"
"Well, I know it's in the leg," I said, smiling. DOH!
"Well now you have some homework," he said.



 By far the most common procedure yesterday was angioplasty, where they unblock arteries of the heart using a fine wire and a balloon which pushes the artery open and improves blood flow.
Atherosclerosis is the term used for hardening of the arteries caused by a build-up of plaque (cholesterol or fats) that eventually impede blood flow or can rupture and go for a road trip in the body, destination unknown.  Believe me when I say those clots can cause some serious damage! Hmmm....so there's a reason doctors eternally preach about diet and exercise? Seeing the fatty clots on the x-ray machine in the cath lab yesterday was eye-opening/scary to say the least. Maybe doctors should carry a picture of a clogged artery in their pocket and show patients when they want them to start exercising? Something like this:




 BAM!!! Pretty disgusting eh? I think it gets the message across.  I'll get off my soapbox now.




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