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!