Thursday, February 22, 2007

I can't stand tests

The thing about test week is that I stop shopping, doing laundry, and cooking. I run out of vegetables, milk, and cereal. Even though I don't actually have food, I have this tendency to clean or reorganize my house/apartment. It doesn't mean my house is any neater or cleaner though, it's just different.

I also am seized (and I mean real seizure, not pseudo) to do random things. For example, I built legos today for a little bit. I don't know why, but the mood came over me. I also went hunting for my digital camera, which is now MIA for like month 6. Since this is my second . . . or third digital camera, I must not be using them very much.

Spring break starts tomorrow. I have no idea what I'm really going to do with my free time beyond sleep. I haven't decided when I'm leaving Columbus or coming back. I've been planning to fight in the Arnold Expo. Hopefully there will be other ladies to fight - or at least make cry.

On the other hand, I start my surgery rotation in about a week. It might be a good idea to spend some time with my significant other since he's about to find out how hard it is to be with one of the interns on Grey's Anatomy. (That show has a poor track record of outside the hospital relationships surviving - Izzy's hockey player boyfriend from season 1 and Meredith's McVet aka Chris O'donnell)

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Friday, February 16, 2007

Somebody save me!!!

Thank you, Five for Fighting for writing that song worthy ofSmallville. It also is due to the random topic of good deeds and saving others. I mean, I'm a med student, so I'm sort of required daily to do work that helps other people. However, recently, I have noticed a random number of good deeds.

1.Push random person's car out of the snow - I was walking home from the hospital and saw these two people who had no idea how to get their car out of the parking lot. (obviously not snow-belters) I set down all my stuff and helped trample down snow and push them out.

2.Lunch time blood donation - I was on my way to clinic and the red cross was having an emergency blood drive, also due to the snow problems. They sped me through, with some nice people letting me go ahead of them so I could get to clinic. I finished donating my pint in 6 minutes, got taped up, and headed to clinic - which ended up being canceled after all.

3.McDreamy rescues Meredith - I had nothing to do with that but I just watched Grey's Anatomy. And it was so heroic when he comes out of the water with her. And also I attended a pretty good talk on hypothermia during my emergency medicine rotation. Body temp 80 degrees F? No problem!

Okay, and I'm done for now.

Tuesday, February 13, 2007

neuro is psych w/IVs

I thought when I got out of psych I would go back to seeing patients with so-called 'real' illnesses. The history and physical would be important again, not just the patients perceptions of what was going on. I would be doing physical exams again, carrying my stethoscope and the all important reflex hammer.

On the contrary, here on inpatient psych . . . er neuro, I deal with everyone's favorite patients - the pseudoseizure patient. These patients are having non-epileptic psychogenic seizures. In other words, mental illness is causing them to have these spells. It's not a medical illness per se, it's a conversion disorder, and most of my day is spent weeding out the fake neuro from the real. I've seen a few strokes and LOTS of pseudo seizures.

How do I know that it is a pseudo seizure? Well, for example, if it lasts over 5 minutes (or 3 hours as one patient told me) and the patient did not have brain damage afterward, that would be a pseudo seizure. If there is head shaking, similar to saying 'no,' it's a pseudo seizure. If the patient checks out for a little bit and becomes unresponsive while over the age of 18, it's a pseudoseizure. If the patient has 4 different types of spells, also a pseudoseizure.

And all of that is just from description of the events themselves, let alone before I get the person's family and social history to know all the other psych and emotional problems the patient has. I had one borderline pseudoseizure patient try to manipulate me so blatantly that I had to write it up as an addendum for additional documentation purposes.

Don't call me heartless or angry. I'm just telling it like it is. I'm learning to be a doctor, and as much as patients don't want to hear it sometimes the answer is 'there is nothing we can do for you here because your problem is caused by stress.' I'm sorry if you don't agree, but there is no reason to waste more time and money on a problem that needs to be dealt with outside of my inpatient neurology unit.

For the record, two weeks and two days into my rotation, I have yet to see a real seizure.

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Friday, February 09, 2007

I am not a nice person

I guess I should amend that. I am not a nice person at judo. How mean I am varies from day to day, but on a competition day, I'm a killer. My first match lasted all of 10 seconds, which my team missed seeing, it was that fast. My second match was a little longer, maybe 20 seconds. I didn't get to fight the black belt I did last year because she gained 20 lbs and I lost 5 which put us two weight classes apart.

My third match was against this younger girl who gave me this sob story about being inexperienced and scared. I thought to myself, "let's go easy on her; I'll use this match to work on my extra throws." Jorn, my sandan, warned me to do otherwise, but I was pretty confident. So we went out there and I held back to see what she was going to put out there, trying my other techniques. She got a penalty for stalling and did a really crappy throw. I dodged the throw and went to choke her. She started to cry, and I didn't have the choke as well as I should have so the ref stood us up to continue the match.

So I backed off a bit and then she tried to go after me. Like seriously go after me. She wasn't being smart, she wasn't using good technique; she was just trying to take me down. My brain said the equivalent of 'are you f*cking kidding me?' Kid gloves off, I saw her go in for a throw, saw that it wasn't going to be a full point, and went down with it. I spun around her and cranked out my most merciless choke.

And she cried more. Too bad.

Lesson learned. Never ever lower your guard for anyone at a competition. Be fierce, be mean, be focused. Take names and crush them. It doesn't hurt to have a powerful okuri eri jime (sliding collar choke) to enforce your will. As I said, I am not a nice person, and I am willing to take you down directly.

(Of course, I was also at this website for people who are less direct.)