Today was very emotionally heavy day.
I guess I thought about it, but it didn't really dawn on me until I started talking to my mum about the day.
just thinking about it still puts tears in my eyes.
*
Our first patients are people who generously donated their body for education purposes.
Deep inside the university in a newly renovated lab lies ~60 bodies.
Embalmed and ready to go.
Faces, hands and feet were covered because they are all very defining features of 'human'. It brings realism to them.
Before we went to the lab, the instructor said we would get hungry so eat a big meal before the lab and after. Actually smells of formaldehyde and fixing solutions are too strong so it turns off your appetite. You can literally taste the air, of its bitter taste and you know its toxic. Small droplets floating in air are probably fixing tiny portion of proteins in your body.
He was right, you become so hungry.
*
There's a special program where medical students can get a better perception of being a patient with chronic illness. And I will be participating in that program as well.
My partner and I were paired with an adorable sweet boy.
We are still trying to understand what happened to him.
It seemed to me, just a really bad combination of congenital as well as medical error resulted him being the way he is.
His prognosis is an open question.
While talking to the parents, I found out that my partner has MS (Multiple Sclerosis).
Whenever I hear about MS I think about myelin sheath because it is a demylienating condition leading to no sensation and paralysis.
The level of severity may differ but I always think about a woman in a wheel chair at SPU who shared her story with me at 7am in the morning at the University Hospital on a cold night.
*
So young.. my partner is 7 years younger than I am. younger than my little sister.
To know about the pending condition, and still pursuing this very consuming career. I could only show my admiration towards him. Adoration and admiration both.
I still feel like crying.
Monday 30 September 2013
September 28th Ob/Gyn Shadowing
Wow, so many visits to my small blog.
I was surprised by the number of visits and no comments. I guess my writing still does not elicit any response of readers.
But if you are regular, welcome and I hope my notes are helpful.
*
Some terminologies
hemotypsis: hemo- blood + ptysis - act of spitting
nulliparous: nullus -not any + para>20 wks births; no pregnancy
Gravidity: gravis - heavy; # of times a woman has been pregnant
Some concepts
Gravida (# of pregnancy including current one)/Para (>20 wk births including viable and stillbirths)/Abortus (miscarriage or abortion)
Fetal Non-Stress Test (NST)
- measures heart rate of fetus and its typically higher. Look for deceleration and acceleration. Deceleration means fetal head compression-- good indicator for whether c-section is required or not.
Why ASA and tylenol is ok for pregnant women but not advil? advil (Ibuprofen) has an effect on prostaglandin system. That is why it is not recommended - as with any anti-inflmmatory.
*
Some facts
you can get acute tubular necrosis from prolonged surgery via hypoperfusion due to vasodilating anesthetic
Prolonged nulliparity is a risk factor for breast cancer (think too much hormone!)
no anti-inflammatory/antibiotics for pregnant woman
I was surprised by the number of visits and no comments. I guess my writing still does not elicit any response of readers.
But if you are regular, welcome and I hope my notes are helpful.
*
Some terminologies
hemotypsis: hemo- blood + ptysis - act of spitting
nulliparous: nullus -not any + para>20 wks births; no pregnancy
Gravidity: gravis - heavy; # of times a woman has been pregnant
Some concepts
Gravida (# of pregnancy including current one)/Para (>20 wk births including viable and stillbirths)/Abortus (miscarriage or abortion)
- G5P1: pregnant 5X 1 birth
- G1P1: That of a woman who has had one pregnancy of twins with successful outcomes
Fetal Non-Stress Test (NST)
- measures heart rate of fetus and its typically higher. Look for deceleration and acceleration. Deceleration means fetal head compression-- good indicator for whether c-section is required or not.
Why ASA and tylenol is ok for pregnant women but not advil? advil (Ibuprofen) has an effect on prostaglandin system. That is why it is not recommended - as with any anti-inflmmatory.
*
Some facts
you can get acute tubular necrosis from prolonged surgery via hypoperfusion due to vasodilating anesthetic
Prolonged nulliparity is a risk factor for breast cancer (think too much hormone!)
no anti-inflammatory/antibiotics for pregnant woman
Thursday 26 September 2013
End of the intro-block is near update September 26th
Right now my room is a mess, so is my kitchen, my inbox, study notes, but most importantly my brain.
I have once told my parents that sometimes my room reflect how my brain is, but I'm not sure if having messiness around me, reflecting my inner state, is helping or not. probably not...ok I will clean.
Anyhow, leaving behind my failure... H** application, G********, C***,
I have received my white coat, soccer jersey and C** member number. Yay!
*
I think writing and organizing my thought helps me to set priorities.
*
One thing about history taking is that doctors need to remember that patients are human.
As well as hard science and medicine, shifting focus to the social and emotion of it would help reveal the diagnosis. At least to narrow down to which diagnosis from the differential.
What I meant to say is that social history is important
open-minded question is important
attention on flags!
*
History taking...it goes something like this.
-ID: Patient Id
-CC: current condition
-HPI: history of presenting illness
-Past medical/surgical history
-family history
-allergies
--Physical findings
However, asking if patient is a smoker or drinker is also important.
And social history such as their occupation and their relationship is also important. Recent travel history is important and then Paraphrasing!
For me, I switch into screener mode as soon as I have to show my history taking skills to someone else. I don't have any elaborate mechanism but I remember the sheet in the chart and use that as a schema.
One interesting thing learned: Common Depression Screening.
I have once told my parents that sometimes my room reflect how my brain is, but I'm not sure if having messiness around me, reflecting my inner state, is helping or not. probably not...ok I will clean.
Anyhow, leaving behind my failure... H** application, G********, C***,
I have received my white coat, soccer jersey and C** member number. Yay!
*
I think writing and organizing my thought helps me to set priorities.
*
One thing about history taking is that doctors need to remember that patients are human.
As well as hard science and medicine, shifting focus to the social and emotion of it would help reveal the diagnosis. At least to narrow down to which diagnosis from the differential.
What I meant to say is that social history is important
open-minded question is important
attention on flags!
*
History taking...it goes something like this.
-ID: Patient Id
-CC: current condition
-HPI: history of presenting illness
-Past medical/surgical history
-family history
-allergies
--Physical findings
However, asking if patient is a smoker or drinker is also important.
And social history such as their occupation and their relationship is also important. Recent travel history is important and then Paraphrasing!
For me, I switch into screener mode as soon as I have to show my history taking skills to someone else. I don't have any elaborate mechanism but I remember the sheet in the chart and use that as a schema.
One interesting thing learned: Common Depression Screening.
Other cool concepts
Cushing's triage
-Bradycardia
-low respiratory rate
-HTN
Thursday 19 September 2013
September 19th 2013 Report on previous 3 weeks
From September 3rd -19th: Intro block
Overwhelming was what I felt as I was introduced to the curriculum. Dr.T going through curriculum and talking about oh-so-many different items. I wasn't hyperventilating, but I felt like I had to.
[Hyperventilating --> means increased PO2 and decreased PCO2. If the blood pH is less than 7.4, metabolic acidosis but since the compensatory mechanism - may be combined with respiratory alkalosis (look at HCO3 level)]
*
So far we have met 2 patient cases. Trauma patient and cancer patient. who knew trauma patient (ie.// stabbing) could have their kidneys affected to the point where it would threaten the life.
*
2 guest speakers. Father of adult down syndrome and breast cancer previvor.
*
We are learning about differential diagnosis. Who knew dry cough could be caused by ACE inhibitor (HBP med) but also from GERD? Who knew DVT could be caused by oral contraceptives?
*
Still struggling with research and being a critical reader to find the best possible resources for patient care.
*
1 documentary: Escape fire
Overwhelming was what I felt as I was introduced to the curriculum. Dr.T going through curriculum and talking about oh-so-many different items. I wasn't hyperventilating, but I felt like I had to.
[Hyperventilating --> means increased PO2 and decreased PCO2. If the blood pH is less than 7.4, metabolic acidosis but since the compensatory mechanism - may be combined with respiratory alkalosis (look at HCO3 level)]
*
So far we have met 2 patient cases. Trauma patient and cancer patient. who knew trauma patient (ie.// stabbing) could have their kidneys affected to the point where it would threaten the life.
*
2 guest speakers. Father of adult down syndrome and breast cancer previvor.
*
We are learning about differential diagnosis. Who knew dry cough could be caused by ACE inhibitor (HBP med) but also from GERD? Who knew DVT could be caused by oral contraceptives?
*
Still struggling with research and being a critical reader to find the best possible resources for patient care.
*
1 documentary: Escape fire
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