First day of the holiday and I relished pulling on comfy jeans and a slouchy hoodie. What with work and the policy we told on our induction day at PMS "you will be doctors, you should act and dress like doctors", I haven't been able to be a properly comfy scruffy bean in ages. I am also enjoying the after effects of a student diet and finally being able to fit back into my skinny jeans. Although with the abundance of biscuits floating around our house, I doubt they'll be fitting for too long. The new computer is shiny bright. I went for an all in one, touch screen PC in the end with the hope it will be hard wearing enough to be used often but still be portable enough to move from student flat to home and around various placements and things the course will be throwing at me. Unfortunately, I appeared to take on the role of Bean: Destroyer of Electricals as a couple of days after getting the new computer my phone died. Ten days after the warranty expired. Not amused. I am currently in that awkward phase of owning a new shiny thing where you have to keep fiddling to get things how you like them. What's worse is that I can't remember how I got my phone to how I liked it before so that's causing some frustration. It's getting there, but it's not right yet. On a similar times-they-are-a-changing note, anyone got any suggestions for a suitable replacement for Spotify once they change to only allow 10 hours a month and 5 plays of each song? First Pandora, now Spotify.... Huff.
Another perk to being at home that I had sorely missed was being able to sit on a sofa. It's not something you think about really until it's not there anymore, but I've so enjoyed being able to curl up on the sofa of an evening, be sat on by the cat (once she got over her grumps at me for abandoning her for months) and settle down to some knitting in front of the telly. My cousin is expecting twins soon so there's much knitting to be done.
I've only been off a week, but because the last three weeks of term were odd because of placement SSU it seems like ages since I've been stuck into studies proper. I'm torn. I want to be back studying because I love learning new things. However, I know I'm a little behind with lectures and I'd like to do some revision for the End of Year and the last AMK. I'm also quite enjoying the time off not being quite as busy as I normally am, although I'm still trying to fit in GP work and Census work. Reading all the posts about the 5th studying for finals is making me feel very guilty for not working harder at medical stuff and also pretty happy that I don't have to do exams like that. Best of luck to you all.
Saturday, 23 April 2011
Thursday, 14 April 2011
RIP Laptop
I'm not sure what I do to laptops. This is my second in 7 years, and this one only lasted 3. I love them, I treat them well, I don't spill stuff on them. I do use them all the time.... maybe that's it. I was kind of hoping that because everything was backed up I'd banked some karma, you know? I was prepared for it so obviously it wouldn't happen? Apparently karma doesn't work like that :( So I'm switching from a laptop to a desktop and hoping that will be a little more hard-wearing. As such this is my final post on my beloved laptop. I have two essays to write but can't because Word won't work in safe mode and I can't back up my work in safe mode either. I should be packing to go home tomorrow and I should be cooking tea after a long day of comparing laptops and desktops and 6 hours of censusing. What I actually want to do is go to the Slackers Club free film showing tonight. It's not a film I desperately want to see, but it's free and it has an actress I like.
Haven't done a lot of medical stuff since I last post. Nothing interesting anyway. I sat in a nurse's paeds eczema clinic and listened to teenagers explaining they hadn't followed the treatment regime they were given and look their eczema isn't any better. What a surprise. We were told to come back to see a Phototherapy clinic but when we got there no patients were due to arrive. We got shown around instead, which was fairly interesting but there isn't really much to see. It's a bit like a walk in tanning booth. I was half contemplating telling my facilitator that my colleague hadn't been ill for a week, he'd been watching the cricket. He wasn't able to answer the questions he was asked in the tutorial, and waiting and watching while he stalled and ummed and ahh'd was painful at times. Especially since the answer he was looking for was the same as the one he'd given not 15 minutes ago. However, knobbling other students isn't really me, and certainly not the type of person I want to be. I joked at the beginning of the year I'd only have to knobble 7 students in order to pass the year since the bottom 5% have to fail.
I went to quite an interesting lecture about how Exeter is the leading centre for blood saving. No blood is crossmatched from the blood bank for any elective surgeries. Instead, the blood the patient loses is collected, centrifuged to remove the plasma, diluted with saline and given back to them. Apparently blood treated in this way recruits pro-inflammatory factors and capillaries which helps the healing and antibacterial process. 1 unit of blood costs £150, which I did not realise. Clever stuff. It was a filler lecture because Professor Ellis was too sick to lecture. He'll be coming back to lecture at Plymouth and we'll be linking in telematically, but he can't sign my Lecture Notes on General Surgery from Plymouth.....
Haven't done a lot of medical stuff since I last post. Nothing interesting anyway. I sat in a nurse's paeds eczema clinic and listened to teenagers explaining they hadn't followed the treatment regime they were given and look their eczema isn't any better. What a surprise. We were told to come back to see a Phototherapy clinic but when we got there no patients were due to arrive. We got shown around instead, which was fairly interesting but there isn't really much to see. It's a bit like a walk in tanning booth. I was half contemplating telling my facilitator that my colleague hadn't been ill for a week, he'd been watching the cricket. He wasn't able to answer the questions he was asked in the tutorial, and waiting and watching while he stalled and ummed and ahh'd was painful at times. Especially since the answer he was looking for was the same as the one he'd given not 15 minutes ago. However, knobbling other students isn't really me, and certainly not the type of person I want to be. I joked at the beginning of the year I'd only have to knobble 7 students in order to pass the year since the bottom 5% have to fail.
I went to quite an interesting lecture about how Exeter is the leading centre for blood saving. No blood is crossmatched from the blood bank for any elective surgeries. Instead, the blood the patient loses is collected, centrifuged to remove the plasma, diluted with saline and given back to them. Apparently blood treated in this way recruits pro-inflammatory factors and capillaries which helps the healing and antibacterial process. 1 unit of blood costs £150, which I did not realise. Clever stuff. It was a filler lecture because Professor Ellis was too sick to lecture. He'll be coming back to lecture at Plymouth and we'll be linking in telematically, but he can't sign my Lecture Notes on General Surgery from Plymouth.....
Sunday, 10 April 2011
Vaseline
Firstly, hello to all the new followers. I don't think I've said that yet,which was rude of me. It means a lot that you like reading my waffle :) So I haven't been able to do any suturing yet but I was given a very important job to do in the last surgery morning I was in. You know on Grey's or Holby where the Surgeon yells "suction, I can't see!!" well that was my job last week. Except since I'm on Dermatology which is slightly less invasive it was more here is a tissue pad, dab the wound clean. But I still got to scrub in and be useful which was awesome. The first surgery of the day I saw was removal of a pigmented lesion (mole) query malignant melanoma (possibly cancerous, probably not, better to be safe). This operation was performed by a fifth year from start to finish with the Surgeon stood observing. What an amazing thing to aspire to! He made a really good job of it as well. I know it only seems like small fry, but I don't really have a lot to compare it to, so it seemed pretty awesome to me. The surgeon was really nice in explaining what he was doing and pointing things out. He asked a load of questions, some of which I could answer, some were for the fifth year, and some were for the fifth year but he couldn't answer them and I could :) There's a lot more surgery scheduled for next week so hopefully I'll get to see some more. There are fourth and fifth years on the ward as well so we're sort of competing with them to see things and they have priority.
As for the title of this post - I have seen Vaseline used in a variety of ways over the last week; it really is a wonder substance. The consultant tells the patients on isotretinoin (an acne treatment, it used to be called Roaccutane) to use Vaseline on their lips as one of the side effects of the treatment is very sore, cracked, dry lips. The surgeon was using Vaseline to cover incision wounds and fill in holes in nails where he'd removed them before dressing. This is apparently because the wounds heal better and faster in a moist environment. Finally I was at a rowing race yesterday and in order to transport a rowing eight on a trailer it was be split in half. We used Vaseline to waterproof the two halves of the eight before we put it back together. A little whimsical but I figured it deserved a mention since it seemed to crop up a few times too often in my life recently. Clever stuff apparently.
I have spent the morning lazing in bed, knitting and catching up on my TV programmes because last week was hectic. To be fair it was my fault it was hectic, I may have possibly taken on too much. Again. Bit of a mantra for me recently :-/ But it won't be for very long. SSU blocks are notoriously slack, so when I saw a job advertised for over Easter holiday and two weeks of SSU paying good money, really good money, I jumped at it. The selection process was long and fiddly. There were lots of emails saying you must do this 3 hours of online assessments in the next 48 hours, but at each stage I got through, and finally heard a month ago I got the job. After going through all that I wasn't going to say no, and besides, it's only four weeks. Then I found out my timetable for SSU and the 3 hours a week I was told it would be morphed into a good 4-5 hours everyday. I have to do token efforts at the GP surgery, but they don't mind if I'm in clinics and can't work. Job number 2 is mainly to be done outside of normal working hours 5-9 and weekends. I am a census collector. One of the smiley, friendly but menacing people who go door to door and remind/bully people into filling in their census forms. I'm a nice one, don't worry, I'm not mean at it. They get a half jokey "fill it in or you'll have to put up with me keep knocking on your door". I am pooped! I started Wednesday and did clinics or surgery 9-12, GP's 1-6 and census 6-8.30. I have 3 patches and have done a first pass on two of them. It's going well and it's lovely to have an excuse to be out in the sun but my did I need to spend some time doing nothing. Now I have some errands to run and to start the essays. Back to it!
As for the title of this post - I have seen Vaseline used in a variety of ways over the last week; it really is a wonder substance. The consultant tells the patients on isotretinoin (an acne treatment, it used to be called Roaccutane) to use Vaseline on their lips as one of the side effects of the treatment is very sore, cracked, dry lips. The surgeon was using Vaseline to cover incision wounds and fill in holes in nails where he'd removed them before dressing. This is apparently because the wounds heal better and faster in a moist environment. Finally I was at a rowing race yesterday and in order to transport a rowing eight on a trailer it was be split in half. We used Vaseline to waterproof the two halves of the eight before we put it back together. A little whimsical but I figured it deserved a mention since it seemed to crop up a few times too often in my life recently. Clever stuff apparently.
I have spent the morning lazing in bed, knitting and catching up on my TV programmes because last week was hectic. To be fair it was my fault it was hectic, I may have possibly taken on too much. Again. Bit of a mantra for me recently :-/ But it won't be for very long. SSU blocks are notoriously slack, so when I saw a job advertised for over Easter holiday and two weeks of SSU paying good money, really good money, I jumped at it. The selection process was long and fiddly. There were lots of emails saying you must do this 3 hours of online assessments in the next 48 hours, but at each stage I got through, and finally heard a month ago I got the job. After going through all that I wasn't going to say no, and besides, it's only four weeks. Then I found out my timetable for SSU and the 3 hours a week I was told it would be morphed into a good 4-5 hours everyday. I have to do token efforts at the GP surgery, but they don't mind if I'm in clinics and can't work. Job number 2 is mainly to be done outside of normal working hours 5-9 and weekends. I am a census collector. One of the smiley, friendly but menacing people who go door to door and remind/bully people into filling in their census forms. I'm a nice one, don't worry, I'm not mean at it. They get a half jokey "fill it in or you'll have to put up with me keep knocking on your door". I am pooped! I started Wednesday and did clinics or surgery 9-12, GP's 1-6 and census 6-8.30. I have 3 patches and have done a first pass on two of them. It's going well and it's lovely to have an excuse to be out in the sun but my did I need to spend some time doing nothing. Now I have some errands to run and to start the essays. Back to it!
Thursday, 7 April 2011
Quandary
Well, I passed the AMK. Still dead centre in the middle of the satisfactory band. I found whilst digging the other day that if I can pass everything with a satisfactory I should get a merit. All excellent I think is a distinction, but I'm happy with a merit. Not that I was planning on failing or borderlining anything that is. I also passed the last SSU and the professional judgement that went with it. This SSU is going well too. Well, no, the essay isn't going anywhere at all but the attachment is going fantastically. I'm seeing so many patients, getting the chance to see common and rare diseases, getting to examine, diagnose and offer a treatment plan. I get to chat to them and take detailed histories, and answer questions fired at me from the consultants.
I had one event that put me in a bit of a professional quandary however, and I'm still not sure if I should say something, or if it's too late now. My partner and I were sat taking a history from a patient on immunomodulators for his eczema. He was pointing to and describing a crampy pain running in a thin band inside his right iliac fossa region which is just above your hip (Imagine your abdomen divided into a 3x3 grid with the top being a line across the the bottom of your ribs and the bottom being a line across your hips. Right iliac fossa is lower right hand corner). I had the patient's notes on my lap, where the consultant had requested an ultrasound scan of the right hypochondrium which is just below your rib cage and contains the liver and pancreas (right upper corner). The consultant was worried about pancreatitis and so was running a blood test for amylase and ordering the ultrasound. The only problem is that the pancreas is not where the patient was describing the pain, and it wan't the right sort of pain. It's true pancreatitis pain radiates, but to the back, not down. My partner flicked through his note book which just happened to have the last LSRC notes in it with the abdominal checkerboard drawn out which confirmed we were right. The consultant had muddled his basic anatomy. I should imagine he'd seen the area, incorrectly remembered it as being the right hypochondrium and recalled pain in this area could be pancreatitis. Neither of us could summon the courage or work out the tactful way for two first year medical students kindly being allowed to interview his patient that he was wrong. What would you do? Whilst walking back to halls we placated ourselves with the hope the patient would say something when the jelly for the ultrasound was being put in the wrong place. Since his creatinine kinase was up we wondered if he was experiencing death of one the transverse abdominal muscle bands (creatinine kinase goes up after a myocardial infarction as it is released by the dying muscle cells), but that really was us pushing our limited knowledge.
At my GP job I was marvelling at some old patient letters I was summarising. When he was a young boy in the 1940's he'd contracted TB. Upon discharge from hospital the Dr had written him up for extra milk, the way we would do now for any other drug. It was fascinating. I was also amazed at how long it took him to get over TB. Knowing nothing about the disease in detail at all, he spent a year in hospital and was followed up every year for six years after that with the recommendation for extra milk and no PE. Apart from trying to decipher the handwriting I love going through old notes.
Continuing the wistful happy vibe, if you like Mr Scruff, or are curious, I have The Voodoo Trombone Quartet on repeat on Spotify at the moment. Hope you're enjoying the sunshine.
I had one event that put me in a bit of a professional quandary however, and I'm still not sure if I should say something, or if it's too late now. My partner and I were sat taking a history from a patient on immunomodulators for his eczema. He was pointing to and describing a crampy pain running in a thin band inside his right iliac fossa region which is just above your hip (Imagine your abdomen divided into a 3x3 grid with the top being a line across the the bottom of your ribs and the bottom being a line across your hips. Right iliac fossa is lower right hand corner). I had the patient's notes on my lap, where the consultant had requested an ultrasound scan of the right hypochondrium which is just below your rib cage and contains the liver and pancreas (right upper corner). The consultant was worried about pancreatitis and so was running a blood test for amylase and ordering the ultrasound. The only problem is that the pancreas is not where the patient was describing the pain, and it wan't the right sort of pain. It's true pancreatitis pain radiates, but to the back, not down. My partner flicked through his note book which just happened to have the last LSRC notes in it with the abdominal checkerboard drawn out which confirmed we were right. The consultant had muddled his basic anatomy. I should imagine he'd seen the area, incorrectly remembered it as being the right hypochondrium and recalled pain in this area could be pancreatitis. Neither of us could summon the courage or work out the tactful way for two first year medical students kindly being allowed to interview his patient that he was wrong. What would you do? Whilst walking back to halls we placated ourselves with the hope the patient would say something when the jelly for the ultrasound was being put in the wrong place. Since his creatinine kinase was up we wondered if he was experiencing death of one the transverse abdominal muscle bands (creatinine kinase goes up after a myocardial infarction as it is released by the dying muscle cells), but that really was us pushing our limited knowledge.
At my GP job I was marvelling at some old patient letters I was summarising. When he was a young boy in the 1940's he'd contracted TB. Upon discharge from hospital the Dr had written him up for extra milk, the way we would do now for any other drug. It was fascinating. I was also amazed at how long it took him to get over TB. Knowing nothing about the disease in detail at all, he spent a year in hospital and was followed up every year for six years after that with the recommendation for extra milk and no PE. Apart from trying to decipher the handwriting I love going through old notes.
Continuing the wistful happy vibe, if you like Mr Scruff, or are curious, I have The Voodoo Trombone Quartet on repeat on Spotify at the moment. Hope you're enjoying the sunshine.
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