A vascular surgeon posting (mostly) about vascular surgery.
*my views (especially political)are mine alone and do not represent any organization I am a part of.
Anatomy in action. Deep peroneal nerve, distal anterior tibial artery, then anterior vein (lateral to medial). Anterior tibial artery is "blue" because it is thrombosed
#Vascular
#Anatomy
@CMA_Docs
Your inability to stand alongside a humanitarian crisis, advocate against the murder of Healthcare workers, destruction of hospitals, and targeting of ambulances, is shameful and utterly disgusting. You don't represent medicine in the slightest.
@QaaliHussein1
@JAMA_current
Health professionals who are afraid to speak out against crimes of genocidal magnitude need to look in the mirror and ask themselves why they went into medicine. It's been despicable.
@MrAhmednurAli
@uche_blackstock
The further these 'muslims' are away from Islam, the more profound your statement. Muslims need to remember Bilal ibn Rabah, this is reminiscent of his struggles. Slavery in all its forms has no place in Islam, nor in any "free democracy"
#GeorgeFloyd
Retrograde iliac to SMA bypass. Had to scrub out to check
@Royal_College
exam results. I passed, I cried, I closed the abdomen, I phoned my mom and wished her a happy birthday. What a day. Grateful. Love this job
@VascularSVS
@CanadianSVS
Under-diagnosed, mis-managed and poorly understood. First rib resection for nTOS, need to extend surgical indication beyond just arterial. Some of my most grateful patients.
Vascular surgery is Beautiful. Venous TOS, costoclavicular space can be a hostile one for the subclavian vein. Subclavius muscle was resected, anterior scalene was resected and the first rib was removed
@JVascSurg
The apology is a good start, but the medical system is broken and the surgical culture needs to be repaired. I would start with addressing the unprofessionalism junior trainees and surgical interns, especially in the US, face. This should have never passed the eyeball test.
@LianaHwang
@Albertadoctors
Should have read this thread in high school. I would also add:
Recruiter: oh, one more thing. You don't get a pension for your service to the public. Start saving
@Schadi_CRS
Nicely sad bro. My children are too young to understand too, and I also hope by the time they are older positive change would have been enacted
“Not a single major medical professional organisation in the US has come out against the acute-on-chronic genocide of Palestinians in Gaza, let alone rallied their substantial lobbying power to oppose US lawmakers’ active support for it.”
By
@_Eric_Reinhart
et al
Posterior approach to popliteal thrombectomy. Did a longitudinal arteriotomy in TP trunk. Peroneal and PT can be seen, AT takes off anteriorly so cannot be fully visualized. Patch repair with short saphenous vein.
@CanadianSVS
@farkomd
@VascularSVS
@EJVES_ESVS
@SVM_tweets
Dr Brar, a vascular surgeon in the UK, being arrested for standing with Palestine. Society has it all backwards it seems as doctors now being arrested for standing against genocide. No words.
@trklou
@QaaliHussein1
@omarsuleiman504
The true face of 'western democratic values'.
This is the third time our comrade Dr Ranjeet Brar has been arrested as a result of his solidarity with
#PalestineFree
. On the two other occasions the police were eventually forced to pay damages for wrongful arrest and mistreatment
Thank you all for your tips and tricks. Tackled this CTO with a glide and a kumpe. Right slipped right through, but left needed patience and a whole lot of wire spinning. (Biggest lumbar I've ever seen..)
@farkomd
@vascularIR
@AWBeckMD
@westleyohman
@thesurgerylife
Juiciest GSV I've seen in a while. CEAP 4a disease. VenaSeal should do the trick.
@VascularSVS
@VeinsandL
@TheVeinBoss
thoughts? Do you have a size threshold? Plan for ankle access in that juicy segment near the malleolus.
So my
@Royal_College
exam is on my wife's birthday...in the hotel where we got married...suuuuuper weird.
Good luck to everyone writing this week. We got this!
I pursued a career in GIM in no small part due to inspiration by the amazing
@jddneary
. He remains an inspiration today, showing true leadership & fierce advocacy at the
@Royal_College
special meeting to discuss spring examinations
Is it not a HUGE red flag that not a single graduating resident (to my knowledge anyways) has supported the way the
@Royal_College
has handled this? Or are they patting each other on the back for it behind closed doors thinking "we know best". Or they simply don't care?
@QaaliHussein1
If we can't, as physicians stand against oppression of the most blatant kind, I feel bad for our patients who im sure are oppressed everyday
Province of Ontario is delivering online examinations for university students. Certification exams for
@Royal_College
are much more urgent. No reason they cannot be delivered using a similar platform
@ConcResidents
"Daddy you're home early!" Exclaims my 5 yo as I walk in the door at 6 pm after a 7 am start (inpatient rounds then clinic).
Something didn't quite feel right about that 😕
#vascularlife
#vascularsurgery
#medtwitter
@MichaelChaikof
@Royal_College
@smoffattbruce1
Thank you Michael for eloquently phrasing the thoughts, fears, concerns, anxieties of the graduating cohort. I'm at a loss for words at this point. This meeting was done to appease, and say "look, we tried". Clearly that is not true, no amount of apology will right this.
No. In fact, this study showed that patients who were not shunted had a lower risk of stroke.
Is shunting necessary ever? No. Others will disagree, but I will die in on this hill until I see real evidence to the contrary.
@farkomd
@canuc_57
@ahmedkayssi
@VascularSVS
Residents and THEIR FAMILIES make great sacrifices to 1. Compete their residency, and 2. Even more so to buckle down for the exam of their lifetime. Please factor that into any equation
@Royal_College
. It is not right to put ourselves and families through studying for this 2..3x
Amazing how much value Ontario puts into postgrad students during this time, but
@Royal_College
still can’t find a way to certify trained physicians in an online format when we need it most. We need
#allthedoctors
now.
@cpso_ca
Why does the CPSO require a license with supervision, but the CPSA is willing to issue full independent license that expires June 30, 2021? Why the disparity? Why make our lives unnecessarily difficult? Why put up roadblocks during a global pandemic instead of easing your rules?
There's something about leaving the hospital after rounds in the morning just as everyone else is walking in that gives a sense of accomplishment to the day, and for moat, the day hasn't even started yet.
One of my favorite operations, open repair of a 4 cm CFA aneurysm,.followed by antegrade access and repair of pop aneurysm with a Viahbahn.
@VascularSVS
#aneurysmrepair
@CanadianSVS
@OGdukeneurosurg
Shout/yell: never. Surgeons who do this are compensating for defects in their skills and/or personality.
Showing emotion is human. Stay away from the surgeon that lacks emotion.
"nearly anyone can withstand adversity, but if you want to test a [person's] character, give them power" - Abraham Lincoln. No degrees beside his name. Education is self-taught, not granted. The ultimate form of power is the one over your own vices. Control it. Channel it.
Severe rest pain right leg. Couldnt even have it up for a minute for me to examine him properly. An aortobifemoral would have been...challenging in this patient.
Instead, CERAB and home same day. Love this job. 😀
#aortaed
@VascularSVS
@csvs
@_backtable
#vascularsurgery
@MichaelChaikof
@Royal_College
@smoffattbruce1
I only hope we can do better for our future colleagues as future voting members, and possibly, as members of the executive committee. I look forward to it. For now, I must suck it up and deal with the harsh reality thrown our way
Thank you
@Royal_College
and
@smoffattbruce1
for listening, and adapting. We know it's a big deal to scrap the oral exam. Thank you for allowing us to realign our priorities. We still need to study, but seems like we have at least 5 months to ace this thing!
Final answer: superior laryngeal nerve. This nerve will divide into internal (sensory) and external (motor to cricothyroid) branches. It should be preserve. If you can't name it, don't cut it!
56 yo with retained IVC filter. Percutaneous attempts at retrieval have failed. He has been anticoagulated with Warfarin for thromboprophylaxis due to the retained filter. He has not experiences any filter related complications. Remove surgically or leave in place and follow?
@yipengGe
@CMA_Docs
Dr Ge, you have the support of many of your colleagues who fought against the systemic oppression and bigotry that has gone rampant in our healthcare system. Your resignation letter sends a clear message to those who elevate their political biases over the sanctity if human life
Dear
@Royal_College
I'm at loss for words. You must do better...we have worked too long and too hard for you to put our life on hold. If you want us to contribute to patient care during this crisis, delaying our exams accomplishes the opposite. Please re-consider
@MichelleOnlock
Neglected is how I feel. No one from
@Royal_College
college has taken the time to assess how this has affected us at a personal level. I spent 5 years training for this, I'm ready. My wife has a PhD and has put her life on hold for me to finish so she can look after our 3 kids..
Patient with neurogenic TOS (consented to pics). Note the tight scalene triangle, which is a common finding in patients with TOS. There is no space between the two muscles where the trunks of the brachial plexus run
@VascularSVS
@CanadianSVS
@JVascSurgVI
@JVascSurgCIT
Becareful dividing the IMV in open aortic procedures, especially in someone with occlusive disease. Something treacherous may be lurking beside it...Moskowitz would be very upset with you. Mind the meandering mesenteric artery!
To stop myself from going insane 7 days before my Royal College exam I will be creating exam-studying riddles. Here we go: I'm young, idiopathic and never ulcerate. I have normal nails. What am I?
#medtwitter
Quite a disappointing 'update' from the
@Royal_College
today. We have been eagerly anticipating a big announcement of some sort so we can prioritize our life. Instead, we receive an update that we will be updated in 2 weeks by
@smoffattbruce1
.
@Royal_College
There is nothing positive about this. Positive means we can be recognized for sacrificing family time, physical and mental health, and overall well-being while putting in 10 hour days for the past 4-6 months to be certified. Not to mention the 2-7 years of training. Certify us.
@Ronindoc
@DrDanica
@Royal_College
We are not beginners doc. We were trained to thrive and to support our community during crises. We will never 'thank you later'
Patient with neurogenic TOS (consented to pics). Note the tight scalene triangle, which is a common finding in patients with TOS. There is no space between the two muscles where the trunks of the brachial plexus run
@VascularSVS
@CanadianSVS
@JVascSurgVI
@JVascSurgCIT