21.53

Yes, everyone that was my 5km time trial time, 21 minutes 53 seconds. My chest was burning a touch when I finished but I’m thrilled. The 1st lady did a 20.03 and I was 2nd. Think it will be a while before I’ll get close to her time. I went for a run this morning and my legs felt rather leaden eventhough the time trial was only 5km.

Chris did a free flap yesterday for a breast reconstruction and only got home at 11pm, I think as I was busy dealing with a vomiting child, yay. A free flap is when they take a muscle from a completely different part of the body, cut off the artery and vein and then re-attach it again to replace the breast tissue (or any other tissue) that was removed. It involves a lot of micro-surgery and it didn’t all go smoothly. Once he’d re-attached everything the flap stayed white which usuallly means that the artery isn’t working as no blood is getting into the flap so he re-did that anastomosis (what they call the join in the artery), it still didn’t work so he redid it again and it was still white. He then checked the vein and it was twisted, so he redid that and all was fine. He’s still not sure what happened as usually if it’s the vein then the flap will be blue not pink (as it should be) or white (as it was). The reason it goes blue is because blood is getting into the flap but not going out, so it gets engorged with de-oxygenated blood. The first time the anastomosis took 1 hour 20 minutes, the next time 40 minutes and the last time 30 minutes, so the Anaesthetist joked that at least he was getting good practice!! Each time he redid it, he had to cut out the previous anastomosis and start from scratch. The op started just before 3 and he eventually finished at about 9.30pm but kept the lady under anaesthetic a little bit just to check that the flap was okay. This morning he says that the flap looks okay and the patient is also doing well so fingers crossed it’ll continue to go well. He has another one tomorrow but he tells me that this flap isn’t quite as difficult as the one yesterday. Why, I have no idea. As far as reconstructive surgery goes, a free flap is about the most difficult thing you can do and although he’s done a lot over the years, it’s always rather nerve-wrecking stuff. He is a very calm person that never gets stressed but free flaps do make him a little nervous I’ve come to realise.

Here’s for the ironic bit. There’s another newish plastic surgeon in PE that is good but he works very slowly. Chris operates quite quickly (well so I’ve been told). This guy took over 8 hours to do a pedicled flap the other day (that’s when you don’t cut through the vein and artery, just reposition everything). If all goes well that would normally take Chris less than 3 hours but he says at the end of the day it really doesn’t matter how long you take to do an op, as long as it is successful, that’s what’s important. Next time we won’t make any comments about how long other surgeons take, although even with the couple of redo’s it still only took him just under 7 hours. Can you imagine standing operating for 7 hours with quite a large proportion of that time spent looking through a microscope while you’re operating, rather him than me. The main issue with a slow plastic surgeon is that it has a big influence on their cosmetic work. The hospital charges per minute for the theatre and so because the patient and not the medical aid is paying, time is money. Usually one charges a set price for a particular procedure, so if you operate quickly then you (as the surgeon) will get more money as the hospital fee will be less. If you are a slower surgeon then you could charge more for the procedure but you might not get so many people coming to you if you are way more expensive than everyone else.

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