Saturday, June 27, 2009

ok, ID is getting better...

so ix-nay on the STD clinic, but i've still managed to enjoy ID a bit more than earlier this week. i think that mostly had to do with not being around a certain fellow, but then i saw how crappy he got treated by his attending...i felt sorry for him. no wonder he's a grumpy guy...he was getting bossed around by a woman younger than him (i assume). and i also believe that where he's from, men don't get told what to do by women, so i can just imagine...

one thing i have noticed...out of all the doctors that i've been around, the ID ones are the folks who don't wash their hands as much as they should. not ALL the ID folks, but just 2 of them off the top of my head, i have witnessed bad behavior! (trust me, i am ALWAYS washing hands and using the foams and gels and whatnot...i keep a bottle in my pocket.) for example, one of them was examining a patient's diabetic foot ulceration, poked his finger all up in it, and then GRABBED MY STETHOSCOPE TO USE. he didn't even ask. he just took it out of my pocket with his nasty gloved hand, used it, and gave it back to me. i was wearing gloves, but now omg my stethoscope was contaminated with freaking MRSA. i used copious amounts of antibacterial gel on it, let it dry, and then alcohol rubbed the hell out of it. ugh. so i suppose it's clean now, but i'm still pissed. and yes, the doc took off his gloves and didn't antibac-gel his hands. i guess it doesn't really matter, but i'm grossed out.

and now my friend K has convinced me that i need to go volunteer at the free clinic today. so i should get ready. egads!

Tuesday, June 23, 2009

infectious diseases, or maybe not so infectious?

so now i've been on ID for 2 days...and let me say...i wish i were still on neurology!

don't get me wrong, it's been interesting seeing patients in the various clinics. i've seen patients with HIV, osteomyelitis, and hepatitis C. pretty cookie-cutter stuff. it seems like most of the treatment plans follow standard algorithms. i signed up for this rotation because i thought it would be good to get to see patients that i really haven't been able to see yet, plus i would learn some useful things. but honestly, i'd rather be doing something else.

it's all part of the process. i enjoy clinic, but i also enjoy consults. i like to get in on the action, but then i like to just step back as well. alas...this blog is here to help me sort all my thoughts. i would be very surprised to see myself as an ID doctor...it's just not going to happen! but i am learning very useful things that i can apply to my future patients...

ok, going to do some reading and then repot my plants...they are growing so well!

Sunday, June 21, 2009

the end of neurology...

today i was on call for neurology, and let me tell you, sitting on my ass for 5 hours in the hospital is NO FUN. ok, i take that back...me and A went to the VA for an hour or so to visit our patients and read some updates. why did we do that? i dunno...nobody would have known if we hadn't. we have nobody to report to about it. but it was the RIGHT thing to do. i wanted to tell my patient goodbye and check on his progress. (it's amazing at how much recovery can happen in a stroke patient in just a few days.) what really gets to me is how much my "patient" looked to me for answers...some of the stuff was common sense, etc, but really it was just the fact that he looked towards me for answers to his questions. i guess i look like i know what i'm doing sometimes, or that i sound competent...ha. when i first walked in the room he goes "i thought i was never going to see you again!" i just laughed and said that there were a few more things i wanted to check out. and then i told him that after today i hoped i never had to see him again, because that would mean that he was getting better. he agreed. he sure does like to talk though, and was a great patient to learn from. i told him to keep exercising like the physical therapist said to and NO CHEATING. i wish him as full a recovery as he can get. he's got a lot of people depending on him back at home.

well, in the end the resident we were on call with was like "the weekends are boring and nothing happens". well, it might be boring to you mr doctor man, but to us students, we think ANYTHING is something exciting. oooh, our resident is calling another doctor up to do a phone consult! ooooh! another patient in the ER with a mysterious drug-seeking headache! fun! ooh, he's filling out paperwork! let me look so i can learn! so yeah, he was trying to spare us the "boredom", so we just sat on our butts and twiddled our thumbs. i wonder how much money i spent on tuition to do that. probably at least a $100 or so...ugh. that really pisses me off. i see where he was coming from, but i'm still at that "excited to do anything" stage. blah.

yesterday me and H went kayaking on a 7 mile trip. it was a ton of fun. mini-vacations are always great and i was really thankful that he planned that trip for us. it was wonderful to get out of town and do something in the outdoors.

also, the school is pissing me off because i have yet to receive my loan moneys. nobody else has gotten their loans either. we are all without money. ugh. i'm going to be so pissed if july 1 comes around and i still haven't gotten my loan money...this is something that should have already been worked out. i just hate inefficiency. blah!

and tomorrow i start my 2 weeks of infectious disease. STD clinic, here i come! woo!

Wednesday, June 17, 2009

what a day

neuro so far is going really well. i'm really enjoying myself. things that have surprised me:
  • i say answers to questions that are CORRECT. wow, i know stuff!
  • i'm not as afraid of old people as i thought i was.
last night was my first night on call. resident let me and A leave at about 7 pm, so we retired to the neuro library and in some sort of divine inspiration, finished all of our required neuro "modules" by 9:00 pm. H was incredible and had made coconut chicken curry for a late night dinner. i'm sure i talked his ear off because yesterday was just so jammed packed. here's a recap:
  • went to sign-ins. listened to residents and attendings "academically debate" about when to treat stroke in various situations. actually followed along.
  • went to nephrology class. wish i hadn't been talking so loudly on the way there in front of the chief medicine resident, who definitely called me out during class...but in a good way.
  • went to the VA and sat around for a while. and sat and sat.
  • finally rounded on our *2* patients. one was asleep. the other was not. i got to witness my attending with her patient in a very poignant moment...patient was having some talk of depression and the doctor just tackled it head on in the best way imaginable. it was so sad though...when i'm at the VA i just feel so SAD for all those little old men. (to sum the patients up, just imagine "old man who used to be totally independent and taking care of their families until they have a stroke. then they can't do anything and they're stuck at the awful VA where time stands still." it's just heartbreaking.) the whole time i'm thinking "wow, i want to be like HER if i ever am in this situation."
  • went to try and get free lunch. vendor cancelled last minute. aaah!
  • went to afternoon stroke clinic. really cool stuff there. saw some nice patients who wanted to get back to work and lead full lives. saw a hypochondriac/overreacting patient. saw one who was milking her pathology for all it was worth. (complained of "neck pain" and whatnot, but as soon as she got comfortable and distracted around you, she seemed to have no problems moving her neck around.) and then i saw another physician "tough talk". this time the patient was basically dicking his life away with beer and cigars. umm, can't really do that when you are in heart failure and expect to live 10-15 years more. the doc did a great job of "this is your problem, this is how we can fix it, however we CAN'T because you are doing x, y, and z. so you have to stop." it was said firmly but respectfully. another great teaching moment.
  • then call. we just saw one ER patient. migraines!
ok, and with that, i think i'm going to eat some breakfast and head on to the hospital. i think i'm going to be taking a long nap when i got home today because i woke up and do NOT feel refreshed. ugh!

Friday, June 12, 2009

yay for neurology!

today was great! it started off kinda hairy...i realized now that instead of leaving my apartment at 6:30 to be in morning sign-ins by 7:00, i need to leave no later than 6:15. yes. 6:15. such is the life of a med student. class at 8:00 was weird...switching from neurology to delve into a boring ass lecture of nephrology? ugh. spare me. i hate kidneys.

after class A and i hopped on over to the VA to do our neurology fun times. lucky for me, the attending i am with is a personal acquaintance and is SUPER nice and and awesome teacher! it was great to be with someone that i know outside of all things medical, and we were able to catch up on a few things. during rounds we saw 4 patients. one was sort of a "charity case" (nowhere to go), another one was doing some sort of PT, and 2 were in the MICU in comas. one of the guys was so bad off when the resident went to test for a babinski (this is done by forceful scraping of the bottom of the foot...it's supposed to be painful), he was scraping skin off of the foot. he wasn't doing it on purpose...the patient's skin was just that thin. sad sad sad. the other guy in the coma was in the coma due to a medication given to him by his primary care doc. the dude just wanted to get his health in order, finally goes to see a doctor, gets a medication, and bam, he's in the MICU with a trach and in a coma with literally no hope of ever getting out. very scary and very sad. highlights the importance of the front line doctors needing to really know their stuff.

after seeing the patients dr R goes through the neuro exam with A and i. i never realized how hard you have to hit to get reflexes, but now i know because a real live neurologist tested mine. (fwiw, she graded my biceps reflex as a 1+, but my patellar reflex was 2+.) i also need to get myself a tuning fork. 128 Hz. this weekend i will be doing a lot of practicing.

this afternoon dr R showed us a "mystery patient" and wanted us to guess the diagnosis...parkinsons! we got it right. i got to feel firsthand what muscle rigidity is. unfortunately i couldn't really detect the cogwheel rigidity, but evidently it wasn't very prominent in this patient at that time.

i have this weekend off. i'll be doing tons of reading up on how to do good neuro exams, reviewing CT scans, and practicing using the ophthalmoscope. and doing yoga. and cooking!

Wednesday, June 10, 2009

acls

today was acls. it was long. i did chest compressions. i practiced my intubating with the mac and the miller. i participated in mega code simulations.

all in a day.

and we got done 45 minutes after we were supposed to. alas.

then H and i went and split a hamburger. deliciousness.

i believe i will be going to bed early tonight and practicing waking up early tomorrow morning. if i gotta be up and running by 7:00 am, might as well begin waking up earlier than 6:45. so tomorrow, i'm shooting for 6:00 (i have to be at acls part 2 by 8:00).

now i understand why the M3s always look so tired...

Tuesday, June 09, 2009

all orientated and then some...

i figure i'm sitting around till 6:00 so i can go gym, so why not blog?

yesterday's orientation was a full day of boring. alas. it made my butt hurt from sitting in that stupid chair for that long. the white coat ceremony was nice, but not necessarily needed...i didn't feel all "shiny and new" so to speak, but my name looks spiffy on my coat. (and i need to get a second one so i can put my middle initial in it and possibly get my sleeves hemmed.)

today was a big day of wtf is going on. i had medicine orientation this morning. then it was VA orientation. omg. sitting in a room just to learn how to use a computer. i'm sorry, but i know that a lot of people probably don't know how to use computers, but WE ARE ALL OF THE MODERN AGE. i could have done everything that we did in 2.5 hours on my own in less than 10 minutes.

furthermore, we hadn't heard anything from neurology yet. finally in the afternoon we meet up with neuro people, and I AM SO EXCITED ABOUT NEUROLOGY. they have changed up the course somewhat from last year, and the new course director is really fired up about everything. my group is kind of getting the shaft on the timing, since we won't really start neuro until friday and the block is only 2 weeks long! but it works out in the end...we get a few perks as being the first guinea pig group.

so tonight i will be studying for ACLS...i renewed my BLS skills today and the instructor said that i did an EXCELLENT JOB. that's right kids, EXCELLENT. that made me super happy. not that BLS is hard or anything, but still...that's POSITIVE REINFORCEMENT.

ok, so i'm off to gym and to grocery shop. chao.

Sunday, June 07, 2009

school starts tomorrow!

TOMORROW! OMG!

tomorrow is orientation. tuesday is medicine orientation and bls skills testing. wednesday and thursday are acls training...you know, the "you're pretty much dead but we're going to shock you and give you drugs and POOF you're alive again" stuff. friday is my first full day of NEURO. THE HORRORS.

my brief summer vacation has been fun. a part of me wishes it could be a hair longer, but only because i want to really clean up my place. i think i'm plenty relaxed. today's agenda will be folding and putting up clothes, shelving all of my M2 books, possible shoe shopping, gymming, and grocery shopping. OH, and online bls skills renewing.

fun times. and can i say again how terrified i am of neuro? eek!

Monday, June 01, 2009

summer break!

so in my week and some change summer break, i've already done one road trip with H. we did a lot of cool stuff, like visit friends, eat at fun places, tasted wines and beers and even had some of the "world's best ice cream" at a dairy farm. woo!

tomorrow i'll be going to the beach with some girlfriends of mine...it's going to be SO much fun! i just need to pack...and go to the library to get some books. ok, scratch that, i got plenty of books at my place that i've picked up and never read. so i'll just do that. and packing shouldn't be too hard, i'm already still packed from the last road trip. just got to replenish some clothes and find le ol' swimsuit.

today is H's birthday...i hope he likes the present i have for him! i think we're going to get sushi later...

also, i must add again that being a med student has its perks: free drugs. yippee!

my caffeine withdrawal symptoms seem to be getting better...i have to admit, the first few days of my cutting back sucked booty, but they aren't so bad now.

one whole week to worry about NOTHING school related. it really makes me happy. OH, and i got my PDA! i've spent all morning playing with it. tons o' fun, really.