what has happened since early ramadan?

lots of things..people come and go at the hospital...
1- going out a lot with shaker after the hard times with his girl friend has ended and he is now starting a fresh start..he came on friday to meet me at the ER in order to freshen up some old info about medicine, he was so much concerned about TPN!
2-first time ever for me to enter kitkat and drink tea,anis and 3ennab on an old coffee with 5 cats around me!-i was with shaker by the way
3- helping in the delivery of a baby girl over the bridge of the hospital..her mother gave birth to her in the taxi..we all ran to cut the cord..amina -the nurse that helps me in small surgical procedures at the ER and always pampers me and makes me feel relaxed by working with her ,she makes me work as if am working in the major operative field which is making me happy and relaxed- was the one who grabed the cord and cut it! damn !
4-we were wondering what name we will choose for this kid, i have chosen amany..others insited on laila
5-i had received one major trauma on the first day of ramadan, and the patient as usual came shocked and asking me for some water..whenever someone asks me for this i become dead sure that he is going to arrest in no time , i needed urgent admission to the ICU , i was not able to take the risk of managing him at the ER..i needed a central line and o neg blood..we ran at the ICU and started the central line with blood and hysteril and tons of fluids..my diagnosis was accurate thank god..a pelvic fracture with bladder tear and retroperitoneal extension with paralytic ileus..i was insisting on suprapubic and thank god i was right,the CT and other xrays confirmed my diagnosis..i hope he will complete well after abdominal exploration and surgical repair of the bladder with lots of drains..he was not feverish postop..i never added clexan to him as he is bed ridden but still the drains are bringing blood..i hope he will not develop ARDS!
6-the third day of ramadan,we were 2 surgical residents alone in the hospital..800 fully occupied beds with only 2 surgical residents..i had to do tons of things at the ward,the outpatient,the admissions and the clinic for follow up of wounds and major trauma patient..i was everywhere at the hospital and i had tons of surgical consultation and i was on call at the ER..Peter the other resident was also consumed at the hospital but at the operative theater..i was consumed all around the hospital..from early morning till around 2,30 pm..then i went up to the ward..to finish the papers of some patients and catch my breaths for a while and here we go , i had a neglected patient since yesterday-no one salemmni the patients and i started the shift all alone-,the patient was 39 c with vomiting and abdominal colicks..we never opened the gut as he had only rectopexy for total rectal prolapse..the patient is only25 and diabetic since he was 15..his RBS was 600! with acetone 3plus in urine..he was severly hypotensive and acidotic..i couldn;t take ABG'S due to hypotension and i asked for ICU consultation..i couldn't make it at the ward..we went directly to the ICU..CVP was negative 4!and ph was 7.1..he was about to arrest..thank god that we saved him and now he is improving and he is having positive fluid balance in his charts and his kidneys are oki
7- i had received on thursday- as i was on call all this ramadan as most of the surgeons are having exams these days except me and peter,one left the hospital , one had vomited blood coz of DU,one has rt scaphoid fracture and 3 new junior residents that we can never depend upon..even the newly married resident came to help with us-..any way..on thurday i had received an acute ischaemia in the rt leg of a 43 yrs old chronic heavy smoker..i made a lecture for the diagnosis and management of this limb to the new doctors in charge at the ER..while my patient was doing the duplex and was prepared for angio..it was acute embolisation and fogarty's was used..we never needed angio , duplex was enough..now he is fully heparinized with a second attack of arterial block by an embolus!..he is under investigations -cardiac for sure-we are thinking about old MI with mural thrombus that is showering..i have to follow this pt with the vascular section
8- i made a fight few days ago with the internal medicine ward coz there was a 30 yrs old female 28 weeks pregnant with acute UTI and they never wanted to admit her ! we made it quite clear that she must be admitted to be under observation and to take fluids and antibioticS IV..she eventually entered the hospital between the OBGYN ward and internal medicine ward..she developed red eye and proptosis while she is at the hospital..this was a cavernous sinus thrombosis..it was not UTI at all..it was fungal sinusitis-maxilla-that has spread to the orbit and from it to the brain..a major and first time to see medical case..full case scenario will be discussed tomorrow at the internal medicine ward..i hope she will pass with good prognosis..happy ramadan!