So we've all heard about the crocodile hunter's tragic death due to a freak sting ray attack, well there was a patient at our hospital last week who also got shot through the heart by a sting ray barb and survived (the story was on CNN!). He's had several surgeries, one of which Sears got to scrub in on, so we had our household brush with fame.
In other exciting patient news, DS was admitting our patients last night (while I enjoyed a fabulous day off) and admitted a woman who complained of not feeling well for about two years. Apparently, both she and her 13 year old son had started not feeling well about 2 years ago when she purchased a Nissan. In an effort to determine the cause of the illness, she went to an acupuncturist who looked for heavy metal toxicities and found that they both had some abnormalities. Upon interview, she revealed that she had "missiles" in her stool that we composed of multiple types of metals. She also reported that when she washes her hair, smoke comes off of her head and that her hair feels like "toasted bread and butter." Finally, she described her skin as "silvery" and reported that it clicks and pops. When the missile complaint was further questioned, she responded that they were "ya know, missiles" and made a hand gesture complete with a sound effect illustrating a shooting object. Yeah, we got a psych consult on that one...
My day off also provided some amusement. After work on Saturday, a bunch of us decided to play tourist and we took the water taxi around to various restaurants and bars. Drinking is allowed on the boat, so we brought our own and only got a few dirty looks when we broke out the beer at 2 in the afternoon. The looks got a little dirtier when we started discussing work and the people around us realized that we represent their future medical care! Oh well, even doctors need to have fun ;)
I've been putting this off since I was so sorely disappointed, but I'm sure that those of you who care know by now that Jeffrey won PR. I have no doubt that he cheated in some way, even if they had no proof. I can't believe he was even allow to show his line. Poor Michael didn't stand a chance, but Uli and Laura definitely made more wearable clothes and I would have been satisfied with a win for either of them. Grrr.
10.16.2006
Itchy penis
One of the joys of internal medicine is being able to address almost all of your patient's needs. Unfortunately, two of my recent patients have ended up needing attention to their more private parts. One, who came in for diabetic ketoacidosis (out of control diabetes), revealed during the physical in the ER an infection underneath the foreskin of his penis. Evaluation of such an infection involves making sure that the foreskin can be fully retracted and then put back into place. Naturally, I received some flack when reporting the findings of my genitourinary exam to the residents, but it was all in the name of our patient's health. The next day, however, I had to report that his infection had worsened and evolved to include swelling along with some discharge. On the same morning, one of my other patients developed a rash on his penis. So at morning report, I got to describe not one, but two male itchy parts!! The residents, of course, had a field day speculating about whether I was spreading some infection to my patients. All I want to do is catch babies, people. How come I have to deal with the itchy boy parts?? Ew.
Things aren't all fun and games in medicine though, we're working right now with a patient who came in with high blood pressure and had a stroke while he was in the hospital. It's really hard to think that he came in walking and talking and now, under our care, he has decompensated to the point that he can do neither. I am hoping that he will recover some function or that we can at least prevent him from deteriorating further. The worst part is that he is relatively young - in his 40's - so this turn of events seems especially tragic. Cases like his really emphasize the limitations of medicine even in our state of the art hospital.
On a personal note to h - I'm on call on Wednesday night, so I'm DVRing PR and will watch it on Thursday ;)
Things aren't all fun and games in medicine though, we're working right now with a patient who came in with high blood pressure and had a stroke while he was in the hospital. It's really hard to think that he came in walking and talking and now, under our care, he has decompensated to the point that he can do neither. I am hoping that he will recover some function or that we can at least prevent him from deteriorating further. The worst part is that he is relatively young - in his 40's - so this turn of events seems especially tragic. Cases like his really emphasize the limitations of medicine even in our state of the art hospital.
On a personal note to h - I'm on call on Wednesday night, so I'm DVRing PR and will watch it on Thursday ;)
10.12.2006
A fraction of my former self...
Well, it's been two weeks since the surgery. It was tough for a while, but swallowing is much easier now. Sadly, ice cream made my throat hurt worse, so my dream of having an excuse to eat nothing but ice cream for a week was dashed. Vanilla bean frappuccinos went down okay, so I've had a lot of those lately. Conveniently I started my internal medicine rotation back a the hospital, which features a Starbucks in the lobby!
Internal medicine has proven to be both demanding and very interesting so far. I'm very glad to be back in the hospital and working with the same patients for their whole stay in the hospital. On the first day that we were on call, I admitted a patient who complained of constipation for the last two weeks. Upon further questioning, I ascertained that this constipation was secondary to his consumption of four bags of microwave popcorn in one sitting. He had been seen in our ER a few days previously with the same complaint for which he received a colonoscopy. The colonoscopy showed a "popcorn bezoar" in his colon. A bezoar is a collection of foreign material in the GI system that is not digestable, often it is composed of hair or fiber. Apparently, popcorn was evident in this man's colon and was plugging him up. After several days in the hospital and gallons of Go Lightly later, my popcorn bezoar patient was sent home.
The next call day we, my colleague DS and I, admitted a middle-aged woman for chest pain. In the course of our very thorough history-taking, it came up that, although she is married, she is not sexually active. She told us that she was not very happy with this turn of events. She then added that she does enjoy watching "sex movies," but she isn't able to "enjoy herself" until she goes to sleep and dreams about them. So she feels like she's missing out. I have never worked so hard not to laugh in the middle of a conversation with a patient before. I hope now that her chest pain is better, her other problems can resolve as well.
I'm going to enjoy McDreamy and Fin on Grey's now! Oh, and McSteamy!
Internal medicine has proven to be both demanding and very interesting so far. I'm very glad to be back in the hospital and working with the same patients for their whole stay in the hospital. On the first day that we were on call, I admitted a patient who complained of constipation for the last two weeks. Upon further questioning, I ascertained that this constipation was secondary to his consumption of four bags of microwave popcorn in one sitting. He had been seen in our ER a few days previously with the same complaint for which he received a colonoscopy. The colonoscopy showed a "popcorn bezoar" in his colon. A bezoar is a collection of foreign material in the GI system that is not digestable, often it is composed of hair or fiber. Apparently, popcorn was evident in this man's colon and was plugging him up. After several days in the hospital and gallons of Go Lightly later, my popcorn bezoar patient was sent home.
The next call day we, my colleague DS and I, admitted a middle-aged woman for chest pain. In the course of our very thorough history-taking, it came up that, although she is married, she is not sexually active. She told us that she was not very happy with this turn of events. She then added that she does enjoy watching "sex movies," but she isn't able to "enjoy herself" until she goes to sleep and dreams about them. So she feels like she's missing out. I have never worked so hard not to laugh in the middle of a conversation with a patient before. I hope now that her chest pain is better, her other problems can resolve as well.
I'm going to enjoy McDreamy and Fin on Grey's now! Oh, and McSteamy!
9.26.2006
T-day!
If all goes as planned (and there is part of me that really hopes it won't), today will be my last day as a tonsil-carrying individual. They're scheduled to depart my throat tomorrow morning at 7:30. Mom is on her way to aid me in my convalescence which will hopefully involve lots of popsicles and cheesy movies - Stick It, the gymnastics movie, is on the top of that list. I'll let you know how things go as soon as I get my voice back ;)
In other news, today was my last day with the geri's. I'll miss some of them, but I'm pretty excited to get back into the hospital for internal medicine. When I told one of the patients that today was my last day, she looked at me sadly and said that she would miss me because I was her favorite nurse. I thanked her nicely, but I must say I am perplexed at several parts of that statement. First of all, we rotate nursing homes on a daily basis, so she's only ever seen me maybe three times. Secondly, why are all female health care professionals assumed to be nurses by so many patients? I suppose this is a question I will be dealing with for years to come.
Speaking of women and the wonderful things they can do, today is Mountain Day at MHC. During undergrad, we had one day off every fall semester that was announced by the bells ringing at 7 am. We were supposed to spend the day enjoying the amazing New England fall or the nearby mall, whichever struck your fancy. Having done both during various Mountain Days (and Millennium Day our senior year), this day represents some of my favorite college memories. In honor of Mountain Day, the alumnae association recommends taking a walk and eating ice cream. I'm not so sure about the walk, but ice cream is definitely in my near future... Happy Mountain Day!
In other news, today was my last day with the geri's. I'll miss some of them, but I'm pretty excited to get back into the hospital for internal medicine. When I told one of the patients that today was my last day, she looked at me sadly and said that she would miss me because I was her favorite nurse. I thanked her nicely, but I must say I am perplexed at several parts of that statement. First of all, we rotate nursing homes on a daily basis, so she's only ever seen me maybe three times. Secondly, why are all female health care professionals assumed to be nurses by so many patients? I suppose this is a question I will be dealing with for years to come.
Speaking of women and the wonderful things they can do, today is Mountain Day at MHC. During undergrad, we had one day off every fall semester that was announced by the bells ringing at 7 am. We were supposed to spend the day enjoying the amazing New England fall or the nearby mall, whichever struck your fancy. Having done both during various Mountain Days (and Millennium Day our senior year), this day represents some of my favorite college memories. In honor of Mountain Day, the alumnae association recommends taking a walk and eating ice cream. I'm not so sure about the walk, but ice cream is definitely in my near future... Happy Mountain Day!
9.24.2006
Freaky Florida
So this weekend turned into a series of very strange sightings here in South Florida. MM and I spent some time people-watching at a bar on Friday night and then at the beach on Saturday afternoon. Both bars and beaches bring out the best in terms of people's attire and behavior, so it's never surprising to see the curious and questionable at either. But I witnessed several other truly odd scenes that caught me more off guard. First of all, while MM and I were on our way home from the beach, we saw a big, gold Caddy kind of car turning in front of us on some kind of hydraulics that allowed for it to turn left up on just the two passenger side tires. As the driver was alone in the car, MM speculated that he was putting on the show for our benefit.
Later on, MM and I went to dinner with her psycho-worker (he's also an intern in clinical psych) but hit a minor delay on the way out of our complex. There was a car blocking the narrow street between the buildings. We stopped and saw an older gentleman driving the car and a younger guy in the passenger seat. The younger guy got out of the car and ran into the open garage. It was then that we noticed that he was wearing nothing but boxers. Weird.
My second nearly-naked man sighting happened when I was leaving the gym today. The gym I go to is primarily patronized by gay men, which often makes for good eye-candy. Unfortunately, as I was walking out today, I found myself behind a 50+ year old man with pretty significant paunch wearing tennis shoes and a Speedo. My gym has no pool, no sauna, no steam room. In other words, there is no obvious reason for someone to sport a Speedo while there. Once again, weird.
Later on, MM and I went to dinner with her psycho-worker (he's also an intern in clinical psych) but hit a minor delay on the way out of our complex. There was a car blocking the narrow street between the buildings. We stopped and saw an older gentleman driving the car and a younger guy in the passenger seat. The younger guy got out of the car and ran into the open garage. It was then that we noticed that he was wearing nothing but boxers. Weird.
My second nearly-naked man sighting happened when I was leaving the gym today. The gym I go to is primarily patronized by gay men, which often makes for good eye-candy. Unfortunately, as I was walking out today, I found myself behind a 50+ year old man with pretty significant paunch wearing tennis shoes and a Speedo. My gym has no pool, no sauna, no steam room. In other words, there is no obvious reason for someone to sport a Speedo while there. Once again, weird.
9.20.2006
The day the lights went out in the home
When I think of places where having power is really important, I consider hospitals, nursing homes, and other places where power is required for people's breathing to continue to top the list. However, when we got to the nursing home today, the entire place was in the dark. No lights, no elevator, no air conditioning. Apparently Florida Power & Light needed to do some work in the area and felt that the middle of a 90 degree day was the perfect time. The geri's actually seemed to be tolerating it pretty well, but we couldn't see them all as they couldn't make up the stairs to the clinic. We had a hard time seeing the ones that did make it - I got to weigh them all by flashlight. Having an old, tottery person climb onto a scale in the dark is definitely some kind of falling hazard.
By the time we got to the dementia unit, which is completely locked-down, it was about 85 degrees inside. Nursing homes already smell a little funky, adding heat to the mix does not help. We went to see one of our patients who took a spill last week resulting in a nice black eye that gives her a tough guy trapped in a little old lady's body look. She was in rare form today insisting that everyone there treats her "like a piece of wood." She also told me that it's really hard to escape from the nursing home and proceeded to wheel herself into another patient's room at top speed. Once the nurses retrieved her she started yelling at them and asking why she's being treated like a mental patient. Hmmm.... Simultaneously, another patient was being taken to lunch when she spotted a Magic Cup at the nurses station. A Magic Cup is a high calorie ice cream-like food designed to help patients meet their caloric needs. The patient bolted away from her aid to grab the Magic Cup, rip it open, and shove her face into it - no spoon, just mouth to cup. She sat down in a chair nearby and did not respond to any of us until the Magic Cup was completely empty, at which point she declared that she was ready for lunch! I think the heat makes people a little crazier!
My day continued to be a little strange when I went to the school clinic for my pre-op workup. The workup itself was fine, but afterwards I passed a woman in the hall who was sight-impaired and walking with a guide dog (a black lab - my fave!). She asked me if I knew where medical records was. I asked some people and helped her find the right place. We were waiting for a response from the record people when her dog jumped up on me like a puppy and licked my face. I love dogs, but I thought that guide dogs weren't supposed to be so playful. She explained to me that he is in training still. I said that I thought he was pretty well behaved for a puppy, but then she said that he's actually three years old. So, why does this woman have an untrained, adult guide dog? Is that really helpful to her? He's cute and all, but I'm pretty sure he won't be dialing 911 in the event of an emergency.
Since Project Runway was a rerun tonight (boo on Bravo), I spent some time with my other favorite supermodel - Tyra - on America's Next Top Model. So far I like AJ, Anchal, and Brooke. I really don't like Megg and I'm not a huge fan of the twins. What I think would be really ideal is if Tyra and Heidi reunited - like back in the Body by Victoria days - and did a ANTM meets Project Runway combo episode. The designers could make clothes for the models to wear - that would be awesome.
By the time we got to the dementia unit, which is completely locked-down, it was about 85 degrees inside. Nursing homes already smell a little funky, adding heat to the mix does not help. We went to see one of our patients who took a spill last week resulting in a nice black eye that gives her a tough guy trapped in a little old lady's body look. She was in rare form today insisting that everyone there treats her "like a piece of wood." She also told me that it's really hard to escape from the nursing home and proceeded to wheel herself into another patient's room at top speed. Once the nurses retrieved her she started yelling at them and asking why she's being treated like a mental patient. Hmmm.... Simultaneously, another patient was being taken to lunch when she spotted a Magic Cup at the nurses station. A Magic Cup is a high calorie ice cream-like food designed to help patients meet their caloric needs. The patient bolted away from her aid to grab the Magic Cup, rip it open, and shove her face into it - no spoon, just mouth to cup. She sat down in a chair nearby and did not respond to any of us until the Magic Cup was completely empty, at which point she declared that she was ready for lunch! I think the heat makes people a little crazier!
My day continued to be a little strange when I went to the school clinic for my pre-op workup. The workup itself was fine, but afterwards I passed a woman in the hall who was sight-impaired and walking with a guide dog (a black lab - my fave!). She asked me if I knew where medical records was. I asked some people and helped her find the right place. We were waiting for a response from the record people when her dog jumped up on me like a puppy and licked my face. I love dogs, but I thought that guide dogs weren't supposed to be so playful. She explained to me that he is in training still. I said that I thought he was pretty well behaved for a puppy, but then she said that he's actually three years old. So, why does this woman have an untrained, adult guide dog? Is that really helpful to her? He's cute and all, but I'm pretty sure he won't be dialing 911 in the event of an emergency.
Since Project Runway was a rerun tonight (boo on Bravo), I spent some time with my other favorite supermodel - Tyra - on America's Next Top Model. So far I like AJ, Anchal, and Brooke. I really don't like Megg and I'm not a huge fan of the twins. What I think would be really ideal is if Tyra and Heidi reunited - like back in the Body by Victoria days - and did a ANTM meets Project Runway combo episode. The designers could make clothes for the models to wear - that would be awesome.
9.19.2006
Hello Newman
I took a quick jaunt up the east coast to sunny New England this weekend to visit some friends and family. Much like the last time I flew into the Hartford, CT airport, my flight was delayed over two hours due to lightning on the runway. I suppose one can't really argue with a lightning delay, but it's really annoying to have the start of what is already a too-short weekend postponed when it isn't even raining outside. Anyway, the weekend officially began at 7 am on Saturday when Baby BT arose to greet the day. We had lots of fall fun in the Pioneer Valley including a trip to Atkins for cider, a Tailgate picnic at MHC, and ice cream from Friendly's. I guess we really just ate our way through the day...
Baby BT is exceptionally adorable and very articulate (surprise, surprise!). One of his favorite expressions is "Hello Newman," which he says with perfect Seinfeld intonation. He's also very tough - we took a walk through a little zoo and he started running down a hill ahead of us. It all seemed to happen in slow motion... his upper body pitched forward and his little feet slid out from under him and his whole body went up in the air balanced on the side of his head in a Matrix-esque, time-standing-still maneuver. Fortunately, he got up, looked around for a minute, decided that he was okay, and kept going.
On Sunday morning I made my way down a maze of "scenic routes" with really low speed limits into Connecticut to visit my great grandmother. These days I've been spending lots of time with old people - people in their 80's and 90's - none of whom are as old as my great grandmother. She will be turning 105 years old next month. 105! And she's completely with it still, she knows who I am and that I'm in medical school and when I'm going to be graduating. It's pretty amazing, really. I just wish I could spend more time with her.
The geri's are doing fairly well. We lost a patient over the weekend. We had seen her on Friday and she had some abdominal pain, but she seemed okay. She passed away in her sleep that night. I suppose this kind of thing happens frequently when working with the elderly and I'm very glad for her that she wasn't suffering, but I was alarmed by how quickly she went from being alive and seemingly healthy to not being alive anymore. I guess you just never know what's going to happen, huh?
Baby BT is exceptionally adorable and very articulate (surprise, surprise!). One of his favorite expressions is "Hello Newman," which he says with perfect Seinfeld intonation. He's also very tough - we took a walk through a little zoo and he started running down a hill ahead of us. It all seemed to happen in slow motion... his upper body pitched forward and his little feet slid out from under him and his whole body went up in the air balanced on the side of his head in a Matrix-esque, time-standing-still maneuver. Fortunately, he got up, looked around for a minute, decided that he was okay, and kept going.
On Sunday morning I made my way down a maze of "scenic routes" with really low speed limits into Connecticut to visit my great grandmother. These days I've been spending lots of time with old people - people in their 80's and 90's - none of whom are as old as my great grandmother. She will be turning 105 years old next month. 105! And she's completely with it still, she knows who I am and that I'm in medical school and when I'm going to be graduating. It's pretty amazing, really. I just wish I could spend more time with her.
The geri's are doing fairly well. We lost a patient over the weekend. We had seen her on Friday and she had some abdominal pain, but she seemed okay. She passed away in her sleep that night. I suppose this kind of thing happens frequently when working with the elderly and I'm very glad for her that she wasn't suffering, but I was alarmed by how quickly she went from being alive and seemingly healthy to not being alive anymore. I guess you just never know what's going to happen, huh?
Subscribe to:
Posts (Atom)