I cant seem to keep up with my blog these days. There seem to be plenty of things going on, from disturbing illnesses in the hospital, to countries in peril. I just don't got the time!
I had 2 weeks of being in the ER almost everyday. I'm not a fan. Too tiring, and it is just non-stop work, with maybe two 15 min break to eat throughout a 12 hour day. (I'm sure I've bitched about this before). It's probably because our ER is the busiest ER in the North East U.S., and it shows. Pain. You do see some crazy shit though. I don't work in trauma at all, so no gunshots or stab wounds (occasionally though), but all kinds of other problems, ailments, and diseases. I had this one guy come in.... Well. This story may be a little grotesque for some of you, so go ahead and skip the paragraph if you don't want to hear gross disturbing stories. Anyway, this 54 year old guy came in with a complaint of not being able to urinate for 3 days. When talking to him, he also revealed he has this swelling and pain in his penis for the last 3 months. (Skip down now unless you are ready....) On his exam, he had a very assymetrically swollen and enlarged member more towards the tip. It was even quite hard in certain points (probably a bad choice of words). He also had a phimosis, which is why it was more painful and he couldn't pee. But what the hell was going on? So we called the Urology resident. They came down, put him into a room, gave him some sedation (thank god), and performed a penile block (so the nerves down there get numbed...) Then (you ready?), they took a scalpel and they sliced upon along the top of the shaft, from the tip, to releieve all that tension, get rid of the skin, to try and find the tip of the glans. While they were cutting all sorts of blood and pus was oozing out (he was clearly infected as wel). It was almost difficult to delineate the actual arcitecture of the normal glans. But out came this fungating, angry, hard mass, that pretty much encompassed the majority of the poor guy's manhood. For months he has been ignoring a terrible penile cancer. It was definitely one of the grossest things I've seen, (even the Urologist said so). So they cut it open, sent a biopsy, but in a foley catheter, and sent him to follow up in a day. The guy pretty much is going to need a total penectomy/orchiectomy (everything is coming off), and an aggressive inguinal lymph node dissection, which cuts into the guy's groin and his lymph nodes, which will leave him not only without the goods, but with chronically swollen and screwd up legs from hacking away at all those lymphatics and vessels. He probably has a pretty poor survival given that its likely metastatic. Wow. Terrible. Poor guy. Talk about quality of life for your remaining days. Makes you think twice about complaining about any ailments that you get on a yearly basis!
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