fourhumours

A&D Time

2009-01-04T23:24:00.001-05:00

Here we go again...

2008-11-15T16:32:00.002-05:00

I am trying this on my SP today at 3

2008-10-17T14:20:00.001-04:00

What's better than being a fighter pilot?

2008-10-08T22:58:00.001-04:00

Boston

2008-10-05T22:53:00.002-04:00

Boston was awesome :D I don't have a lot of awesome stories to tell as it was pretty low-key, but it was exactly what I needed. Sadly, I'm home now and already back at studying. Tomorrow I'll be memorizing the brachial plexus, and finding said structure(s) on my cadaver. Something tells me it will be a long day.

Joe Biden = Teh Winner

2008-10-02T22:35:00.002-04:00

'Nuff said. Someone should teach Palin how to answer a question.

Books?

2008-10-02T20:01:00.001-04:00

Just thought I'd state that Rohen's is my new favorite book. Who'd have thought I'd actually LIKE a textbook??

P=CMB

2008-10-01T21:48:00.002-04:00

Check off another course.

Now onto HSF, complete with dissection, histo lab, etc. So far, its way fun. They went on and on about emotional responses and difficulties people might have working on cadavers... but I guess I'm just a cold hearted bastard or something. I'm incredibly grateful to the donor, and absolutely fascinated by everything I've been doing... but I have not been struck by any sorrows or extreme nerves of any sort. Mostly, I'm just eager to find everything, and learn as much as I can... and so far it has been incredibly fun! I've been spending several extra hours a day in the lab working on cleaning structures and identifying new things. This extra time is definitely the best opportunity to learn as Ellen from the anatomy staff is usually there, but this time without 50 other students asking questions. It provides a chance to work at my own pace and learn a great deal more than would be necessary normally. Most kids can recite the table on what each muscle is, where it is, what innervates it... but I've really enjoyed learning some clinical tidbits afterwards about different things we've been covering.

Will it help on a test? Probably not. Is it really fun to learn? Absolutely! That said, I need to get back to studying those tables to make sure I know them as well as my peers.

CMB = Done

2008-09-26T15:07:00.000-04:00

Sweetness. Exam went ok I think, so hopefully I'm in the clear. Now on to HSF.

Mmmmmmm bacon.

2008-09-25T16:41:00.002-04:00

2 more days...

2008-09-25T12:48:00.009-04:00

Exams are killing me. Why did I think this would be fun?! I mean, I find the medically pertinent material fascinating, but I can't wait to move on to HSF. Careful what I wish for, right? But I think anatomy lab and such will be inifinitely more interesting than memorizing cellular signalling pathways.

On the plus side, someone complemented me by saying he always pictures my medical work as being about like this:

And... a few other things of genius I would like to add:

And finally, in light of our upcoming exam:

And a sample of my awesome note taking!

Updates and more updates

2008-09-15T21:35:00.002-04:00

It has been some time since I updated this blog. I figured I'd at least give an excuse, which comes in the form of "Blogger was blocked in China while I was living in Beijing". That said, I have now returned to the US and am now attending medical school. The lowly MA becomes the.... even more lowly Med Student. But at least I have being an intern to look forward to.... wait a minute! Can I just retire now?

As such, (no longer being an MA), the direction of this blog is going to change, and will more likely be covering such banal trivalties as how much I hate a lecture method practiced by teacher X, or how I can't believe intern Y managed to pass the MLE's. One can hope I might find some more interesting things to post, but time will be the judge of that.

ED Stories, vol. 3

2008-01-17T22:24:00.000-05:00

Last week I picked up a rather interesting phone call. Pt described himself as a male in his late 20's who was curious if we could treat him. What did he need to be seen for? After a little rhetoric with him saying "a problem", he finally conceded that he had taken several viagra tabs from his father, and used them all at once to impress his girlfriend. We sent him to the ER. God only knows how that gets treated....

What man has seen the viagra and cialis commericals and not been TERRIFIED by that brief little fine print/afterthought they mention in the side effects? "Seek immediate medical attention if you experience an erection lasting for 4 hours or more." When I hear something like that... lets just say I would do everything in my power to avoid such a situation. Overdosing on an ED medication is probably NOT the best way to avoid the side effects.

Bzzzzzz!

2007-12-07T22:06:00.000-05:00

Not a long detailed post here today, but I saw something remarkable. A 32ish y/o male, working on a flooring project, sawed the back of his index finger from the base of the nail up to the knuckle by the hand essentially splitting it in two. Despite this, there was no major vascular damage, and all tendons were intact. 17 sutures later, and he was on his way home. This was the largest number of sutures the medical director had put into a patients finger before without having to repair tendons or arteries. And of course, like all good laceration patients, he came in about 10 minutes before we would normally close the clinic.

ED Stories, vol. 2

2007-12-06T21:17:00.000-05:00

Today, waiting for a new chart, I overheard a gem from reception. A middle-aged man walked in, and when asked why he needed to be seen, he gave the following response.

"I need someone to screen me for ED."

I'm used to seeing patients at the office for treatment of ED... namely in the form of more Viagra. However, screening for ED? Technically I'm sure he was referring to the bloodwork panels to check thyroid levels, testosterone levels, blood chemistry, etc. But instantly I found myself envisioning the medical director showing him pornography. As my friend put it, a porn assay.

"And now? What do you think of this one? Any reaction? No? How about lesbian porn? Does that do it for you? STILL no? Well, then it's clear, you have ED. It's science."

It's Personal

2007-12-04T20:33:00.000-05:00

Enter a fourty five year old, slightly balding man. His chart reads... nothing. Why? Because he refuses to disclose what he thinks is wrong with him to any medical staff save the medical director of the clinic.

It's game time: Who can figure out what the problem is?

If you guesed "Erectile Dysfunction" you're a winner! ED can be replaced by any other problem a man can have down there. It seems some guys link the health of their penis to their viability as a human male.

Here, have a yogurt

2007-11-28T19:37:00.000-05:00

Perhaps not the quirkiest, or funniest piece, but today a man came in, and passed out in our waiting room. We rushed him back, rapidly got vitals, blood sugar levels, a history, etc. while trying to diagnose what was wrong with him. Ambulances and Firetrucks soon pulled up, but not before this jewel.

Me: Sir, when was the last time you ate?
Mr. Hungry: I haven't eaten since Saturday... [it's now Wednesday afternoon]
Me: Ok... and have you had anything to drink recently?
Mr. Hungry: Yes... I had 4 beers last night. And 3 beers the night before.

Case solved? Who knows, at that point he was whisked away. But not before we gave him a yogurt and a cup of water.

Lawnmower Boy

2007-11-27T19:20:00.000-05:00

LB is a 37 year old male, from Milton. (Author's Note: Milton should be a tip off that there is something seriously wrong with this man. Possibly involving his cousin-dad or his grandparents being the same people.) He presented with an acute laceration to his right index and middle fingers nearly severing them at the proximal interphalangeal (PIP). He had been mowing his lawn for the last time in the year and decided to clean his lawn mower with it running. He reached in, dug around a little, and then probably screamed like a little girl as the blades nearly severed his hand into 3 pieces.

One very common question to check up on with this kind of wound is how up to date their tetanus vaccination was, and that conversation went something like this:

Me: Ok LB, do you know when the last time you were vaccinated for tetanus was?
LB: Hmmm... I don't rightly know... Would they have done it when I did this 2 years ago?

At this point LB holds up his left hand, on which the 2nd and 3rd fingers have been removed at the PIP.

Me: Yes... yes they would have. Let me just check your hospital records on that...

Fast forward 5 minutes, and what does the HPI show? He had a lawn mower accident resulting in the loss of the two fingers on his left hand. Luckily for him, I believe the orthopedic surgeon was able to save these two fingers... for now. I hope nobody buys him a Cuisinart for Christmas. He just might think it's a hat.

The Man Who Wouldn't Go

2007-11-26T23:40:00.000-05:00

Entering the world of professional drug testing is a daunting undertaking. First, you must undertake obtaining a degree from a highly competitive, world renowned, 4 year institution. Then, you must learn how to pour pee into little cups without getting any on you. The latter step is all you really will ever need.

Within this high stakes world of professional piss collectors, we have some industry jargon that you should all be familiar with. If say a patient is unable to provide enough pee into said cup, it is demarcated as "QNS" for Quantity Not Sufficient. This is a frequent occurrence, resulting in a speedy dispatch to the waiting room, several glasses of water, some coffee, some more coffee, and soon a burning desire to piss in a cup. Rarely does one record two QNS's in a row.

Enter The Man Who Wouldn't Go. Paruresis. This interesting condition provides a bit of a conundrum to the drug testing world. If you must be observed giving a urine sample... and you have a severe psychological condition which prevents you from going in the real or imaginary presence of others... just what do you do? In TMWWG's case, drink more coffee. 2 hours, 4 cups of coffee, and 8 glasses of water later, along with a guttural moan that sounded like a gorilla orgasming, TMWWG managed the impossible; he peed in a cup. I made sure to write down the exact time and date and sign an affidavit saying I was there to witness it.