Plastic bread-bag clips: the saga continues

Susan McDonald and Con Rusnak
General surgery resident (McDonald)
General surgeon; Capital Health Region; Victoria, BC (Rusnak)

We read with interest the recent report of plastic bread-bag clips in the gastrointestinal tract.1 We were recently consulted regarding a patient whose small bowel was ultimately found to have been perforated owing to an impacted plastic bread-bag clip.

The patient, a 39-year-old man, had been experiencing intermittent episodes of colicky abdominal pain for about 5 years. He had previously been admitted to hospital with signs and symptoms consistent with a small bowel obstruction. He had undergone several investigations, including CT scans and a small bowel follow-through, but no cause was identified.

He presented at our hospital with severe pain and a recent onset of nausea and vomiting. This followed several weeks of increasing crampy pain, associated with at least 1 episode of rectal bleeding. He was admitted to the GI service and over the next 36 hours developed signs of peritonitis, for which the surgical service was consulted. In the meantime, he had undergone both an ultrasound and a CT scan, which showed a small amount of free fluid but nothing else.

He underwent a laparotomy, and the clip was found in the distal small bowel, where it appeared to have attached itself and slowly eroded through the wall, as described by Ken Newell and colleagues.1 He underwent a resection and primary anastomosis, from which he has recovered well. Unfortunately, the "best before" date was no longer visible on the clip.

In contrast to most of the patients in the study by Newell and colleagues,1 this patient was young and had his own teeth. However, he is a single parent of young, active children and said that he often eats in a rush and does not chew his food well.

The findings in this case support the authors' recommendation that the clips be made of a radiopaque material to allow early identification of the foreign body.

(From Canadian Medical Association Journal, Vol.163 Issue 1, July 11, 2000, p.16).


Can you imagine?

It's gonna be FUN!

So, in the past 10 minutes, I ran into 3 people I know that will be starting University here this year...two of my youth girls from Ebenezer, and my cousin (whom I didn't know was attending here this year!).

I told them all where I work and told them to stop by for lunch or coffee or a visit now and again.

These were seemingly random and chance meetings, but do you ever get the feeling that there's something more to come, that somehow this fits into a bigger picture?

These meetings, and the possibility of being there for these girls as they navigate their first year in the "real world" ignited something in me. Now, it's always been my passion to help people, especially at that age in life, to navigate life's challenges, changes, and difficulties. Perhaps this is a chance to put that into practise.

It's one of the things that makes me feel so alive and purposeful when I get a chance to do it. Something that makes me look beyond myself and reach out to try to make others' lives more fulfilling. I guess we'll see what the next few months hold.

Mwa-ha-ha-ha!

You are a GRAMMAR GOD!


Congratulations! If your mission in life
is not already to preserve the English tongue,
it should be. You can smell a grammatical
inaccuracy from fifty yards. Your speech is
revered by the underlings, though some may
blaspheme and call you a snob. They're just
jealous. Go out there and change the world.


How grammatically correct are you? (Revised with answer key)
brought to you by Quizilla

Sorrow and Celebration

Some of you may have heard of Dwayne Harms, the pastor of Living Hope church, and a 38 year old husband and father.

Today, after a 3 month battle with cancer, he passed away. His story (from his own words and his wife's words) is here.

http://dhjourney.blogspot.com

Pray for his family, and for his flock.

i've been doing a lot of thinking lately, and less blogging and talking. Other than a few outings, i've been content to sit at home, not even thinking of calling people or making plans to socialize.

It's different for me, but i think it's my way of slowing down a bit.

I thought i had written this story here before, seems that i hadn't, so here goes.

I was going to post an update to a story that happened to me post-accident, and then when I went to look for it, I realized i hadn't posted it in the first place! So here it is.

On one of my particularly bad days at home after the accident, my coworker Maxine thought I could use some cheering up. So she decided to get me some ice cream, popcorn, a couple good movies, and some flowers to help cheer me and help me pass the time at home. She thought Anthony was working late and knew how bored I was...

However, she was working, so she sent her boyfriend Tony over to deliver the goods to me...I had no idea he was coming or that she was sending anything, so I was laying up in my bed. Anthony had just gotten home, and so when the doorbell rang, he went down to answer it.

Well, Anthony opened the door to find this man standing there with flowers and ice cream, and Tony turned red and stammered a bit because he had forgotten my name (having never met me)...so finally he was able to say "these are for ... um....Lynette" and then he realized how this all looked and was quick to add "From Maxine. She sent me. I'm Maxine's boyfriend"...

We all had a good laugh over this, Maxine almost died laughing when she heard the story....she was so concerned with helping me feel better that she hadn't even thought about how it would look, this mystery guy coming to the door with flowers for me.

And as for the postscript I was going to add today.....does anyone out there remember the acappela group Streetnix? Turns out Tony sang bass for them for 10 years!!! So the story is even a bit more twisted than the original. Wow! Don't i feel lucky, having the streetnix guy bringing me flowers while my husband is supposed to be at work and i'm sick at home!

it's gonna be a FUN afternoon!

i just bought 1,100 stamps. Now i get to stick them all on things.

Gotta love mail surveys!

anyone interested in fringe-ing this weekend?

(if you reply after 5pm Friday, just call me 'cuz i won't be on email or internet after that)