Antithesis to myself.
I look at others in such way.
Expecting their hard-earned path,
only gained through months and years of suffering.
Then I see people who do it so effortlessly.
10 years, short or long.
It is what it is.
Difference in age then is,
mere 2 years.
In those 2 year differences, I see so many things built.
Another degree.
Marriage.
And on way to tenure ship.
Have you ever seen anything else so smooth?
Amazing, amazing I said,
couldn't be helped so amazed.
The odds, the chances, the probability! I wondered
Perhaps to thee, my exclamation might be bemused statement,
but I say to thee, I'm simply amazed.
The odds I ask,
The interviews I ask,
I want to ask more questions, but I don't want to be viewed impolite.
Although I might have made myself seem rude.
I wonder about path so smooth.
Something that are meant to be.
Perhaps they were meant to be.
Can I change my path?
Do I dare?
Tuesday 19 February 2013
Thursday 14 February 2013
Feb 14: Lessons with Dr.J ; April: asking questions
How do you react to patients with difficult prognosis?
Thyroid eye disease is a terrible thing.
So far I have learned that:
Hypothyroid : treats with either synthroid, dessicated thyroid, levothyroxine
Hyperthyroid: treats with tapazole or beta-blockers (especially those who are allergic to tapazole).
Never mind all that primary or secondary disorder because I don't remember.
I know that Hyperthyroid --> heat, eat more but wasted, sweaty and tired all the time --> thin
Hypothyroid --> usually overweight (doesn't eat much but easily gain weight)
Treated with either thyroidectomy or radioactive iodine, thyroid eye disease may develop in either.
To be specific, thyroid eye disease is different from the actual thyroid disorder (Grave's (hyper), or Hashimoto's, or hypo or hyper) as ALL can develop thyroid eye disease. Reasons as explained in another post: Here
A patient walks in with stylish sunglasses and begin to tell me about the episode she had last Saturday and that Dr. J already knew about this, as the resident made phone call to Dr.J at 7am in the morning on Sat.
She has never felt any intense pain in her eyes before.
She has used drugs that costs thousands and had injections twice.
Yet, when the problem should be stagnant, it keeps on developing and evolving into grimmer situation.
There's no answer.
She might tears.
What do I do? is what she asks
What should professionals do in this case?
I could feel tears coming up - putting myself into her shoes.
Having to live with that.
Doing everything and no real progress. Not even a stop to its development.
Radiation treatment 1/3 of what is used to treat cancer, he says. But later, he adds, after we try this.
Giving prescription to the lady, asking her to not to get into argument with her loved ones and sell or buy any big things like house, property or cars (side effect of prednisone)
We will get through this.
We need to stop that.
That's what he says.
We have to be the calm one, then I realized.
We have to be the professionals.
Update made in April 2013
Dexamethasone (swelling) vs. Prednisone (inflammation) in use for thyroid eye disease.
If dexamethasone is 6.6 times more potent than prednisone (when you calculate the dose required for every 10mg of dexamethasone, approx 66mg of prednisone is needed). I then wondered why use prednisone when you have rampant thyroid eye disease, wouldn't it be better to use low dose dexamethasone.
I asked Dr. J this one day and he was honest with me that he couldn't remember exactly but that dexamethasone is glucocorticoid and so is prednisone but mineralcorticoid action in prednisone is very minor. He also mentioned from the end of his memory that the efficacy, and potency differences as well.
I tried to find if there are any comprehensive guidelines that firmly says why prednisone might be better but I haven't found a good source yet.
Thyroid eye disease is a terrible thing.
So far I have learned that:
Hypothyroid : treats with either synthroid, dessicated thyroid, levothyroxine
Hyperthyroid: treats with tapazole or beta-blockers (especially those who are allergic to tapazole).
Never mind all that primary or secondary disorder because I don't remember.
I know that Hyperthyroid --> heat, eat more but wasted, sweaty and tired all the time --> thin
Hypothyroid --> usually overweight (doesn't eat much but easily gain weight)
Treated with either thyroidectomy or radioactive iodine, thyroid eye disease may develop in either.
To be specific, thyroid eye disease is different from the actual thyroid disorder (Grave's (hyper), or Hashimoto's, or hypo or hyper) as ALL can develop thyroid eye disease. Reasons as explained in another post: Here
A patient walks in with stylish sunglasses and begin to tell me about the episode she had last Saturday and that Dr. J already knew about this, as the resident made phone call to Dr.J at 7am in the morning on Sat.
She has never felt any intense pain in her eyes before.
She has used drugs that costs thousands and had injections twice.
Yet, when the problem should be stagnant, it keeps on developing and evolving into grimmer situation.
There's no answer.
She might tears.
What do I do? is what she asks
What should professionals do in this case?
I could feel tears coming up - putting myself into her shoes.
Having to live with that.
Doing everything and no real progress. Not even a stop to its development.
Radiation treatment 1/3 of what is used to treat cancer, he says. But later, he adds, after we try this.
Giving prescription to the lady, asking her to not to get into argument with her loved ones and sell or buy any big things like house, property or cars (side effect of prednisone)
We will get through this.
We need to stop that.
That's what he says.
We have to be the calm one, then I realized.
We have to be the professionals.
Update made in April 2013
Dexamethasone (swelling) vs. Prednisone (inflammation) in use for thyroid eye disease.
If dexamethasone is 6.6 times more potent than prednisone (when you calculate the dose required for every 10mg of dexamethasone, approx 66mg of prednisone is needed). I then wondered why use prednisone when you have rampant thyroid eye disease, wouldn't it be better to use low dose dexamethasone.
I asked Dr. J this one day and he was honest with me that he couldn't remember exactly but that dexamethasone is glucocorticoid and so is prednisone but mineralcorticoid action in prednisone is very minor. He also mentioned from the end of his memory that the efficacy, and potency differences as well.
I tried to find if there are any comprehensive guidelines that firmly says why prednisone might be better but I haven't found a good source yet.
Subscribe to:
Posts (Atom)