In women, coronary artery disease may be distributed uniformly throughout the artery wall rather than in sporadic areas of plaque, and may be accompanied by microvascular disease—a narrowing of the smaller vessels that feed into the coronary arteries. In women, persistent fatigue, flu-like symptoms and depression can also signal coronary artery disease.
If you have several risk factors for or symptoms of coronary artery disease, your doctor will take an electrocardiogram (ECG or EKG)—a test that records the electrical activity of the heart and detects heart muscle damage.
Antiplatelet medications, which reduce the platelets’ ability to stick together and cause clots.
Coronary angioplasty, in which a catheter is used to reduce the obstruction in the blocked vessel to increase blood flow.
Coronary artery bypass, in which a piece of a vein is grafted above and below the blocked area of a coronary artery, enabling blood to flow around the obstruction. Reference these links for information on how to prevent heart disease and how to live a healthy lifestyle. Worse is bringing the instrument into view ready to cut, and finding it’s been handed backwards, with the curve of the blades opposite to the curve of my fingers.
I continue the incision of the white line north and south: having cleared a portion of the space behind the colon, now I can easily see where I need to go.
All surgeons do that move: keeping an instrument in half a hand while doing something else, then regaining full use of it. I’m moving my left hand up or down the colon as I dissect with my right, providing my own counter-traction as my assistant holds the anterior abdominal wall up and away. Sid Schwab is a retired surgeon and author of Cutting Remarks: Insights and Recollections of a Surgeon. I was an OR nurse for nearly 20 years and prided myself on rarely being asked for an instrument and I slapped them all in (when appropriate).


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Knowledge of equipment sterilization, and the ordering, inventory, and stocking of medical supplies.
As a result, women may have different symptoms and benefit from different diagnostic procedures than men do. Some women will have no symptoms, while others might have pressure or pain in the chest, also called angina. If the ECG indicates heart disease, your doctor may recommend a stress test, in which you will walk on a treadmill or ride a stationary bike while your heart, breathing and blood pressure are monitored. Medications used to lower blood pressure can also make it easier for the heart to deliver blood to the tissues.
With my left hand I grasp the mid-portion of the sigmoid colon and pull it gently but firmly toward me, exposing the lateral mesentery. Leaving my ring finger in the handle of the scissor, I release my thumb and rotate the instrument 180 degrees, so the shaft is resting on my wrist and inside my forearm while I do a little finger work, further opening the space behind the colon.
My left index finger is working at the edge of the cut I’m making in the peritoneum, exploring and exposing. This page will help you to write a attention grabbing CV by giving you expert tips and practical resources that will show you how to address the needs of the employers and the requirements of the job. They will give you an idea of how to not only impress Hiring Managers with your experience and qualifications but also by showing off your writing skills and enthusiasm.
If you would like the fully editable MS Word versions of the CV templates below then you can purchase all of them for ONLY £5. If your stress test suggests heart disease, you may be asked to have a cardiac angiogram, in which x-rays are taken after a contrast agent is injected into your coronary arteries to locate the narrowing, occlusions and other abnormalities of specific arteries.


Treatment may range from making lifestyle changes to reduce your risk factors, to surgery to bypass an obstructed artery. If you need to change instruments you lay down the one you’re using, open your hand toward the scrub while keeping your eyes on the object of your effort, and want that new tool placed quickly and firmly. In a quick move, I spin the scissor back into my hand, cut a little more, use the closed blades as a dissecting tool. It all takes only a minute or two and the entire left side of the sigmoid colon is opened up, and I can elevate the bowel a couple of inches further than when I started. During angiography, you may have an intravascular ultrasound (IVUS) test to determine whether macrovascular disease is present, too.
Now I can begin to decide where I’ll be dividing it, having converted the S-shape into a C.
So you can feel it through your glove which, when your palm is open, makes a little trampoline between the bases of your thumb and pinkie. It means the whole loop can be removed, and the ends will be very near each other; which is one of the reasons I like sigmoid resection.
Mobilizing the sigmoid colon from its attachments along the left side of the pelvis is one of those areas.
Behind the sigmoid colon passes the left ureter (the tube carrying urine from the kidney to the bladder); causing it harm while working on the colon is a major transgression. Unless the area is distorted by infection or tumor, avoiding the ureter usually isn’t difficult.



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