Thursday, June 03, 2004

oh and cause I know you were worried, my bruise doesn't hurt anymore.
~me~ at 7:52 PM

Hey guess what! I just heard and FELT and 5/6 systolic ejection murmur! It was so cool! I could actually feel the rumble! My classmate on call with me showed it to me on one of his patients. And then my patient coded. That was interesting to see as well. Then my attending and resident had to speak with the parents and I was there as well. It went as smoothly as these things can go I suppose. He's on a vent now and tomorrow we have to decide what can be done for this baby and his tumor regrowth (he's 6 months old). Now I'm home and was pleasantly surprised with gifts from kevin and jodi from their trip to japan. Looks like mochi but I have no idea what kind and how long to heat it up or if I heat it up. I guess I should have taken japanese in high school afterall...not like I'm using my french speaking skills...oh wait, I already lost those.
~me~ at 7:38 PM

Wednesday, June 02, 2004

I know you're concerned about my bruise so here's the update: it still hurts. And it hurts to extend my arm fully and relieved with flexion so I sit here with my arm flexed. Occasionally I forget that it hurts but then I reach out to take a sip of tea and am reminded again of the bruise. Oh and learning about bleeding problems and thinking back on my childhood, I wonder, do I have a mild variant of a vonWillebrand factor deficiency? Recurrent nosebleeds (technical term: epistaxis...don't know where that word came from) that seemed to take forever to stop are one clinical manifestation of the disease and I've had a few of those. Of course, when I want to get on with my day, any nosebleed seems to take forever to stop. But then again, I suppose my bruise would be bigger. And Amber says once you learn about a disease, you can't get it...of course, if I did have this, it would have been from birth and I think Amber's theory only holds for those disorders that you aren't born with. Well, back to the books. Ugh, I'm on call tomorrow. I hope I get to go home early again. I better pack a peanut butter sandwich just in case. I know, not the best dinner but if I end up coming home, then I don't feel bad wasting it (I buy the generic brand of peanut butter) and I can pack a nice turkey sandwich for lunch. OH no! I ran out of oranges! I guess it's back to carrots or fruit leather for my side dish.
~me~ at 9:13 PM

I got my blood drawn today for a TSH before my refills are written. I was impressed with the lab tech as it took less than 30 seconds for her to stick the needle in and get all the blood and slap a bandaid on. On the other hand, I think my pain threshold has dropped during this year. While I was watching her stick the needle in, as I always do, I realized right before she stuck it in that, "hey, that will probably hurt because of all those little pain nerve fibers that exist there." And yep, it kind of did hurt and the needle looked bigger too. And then as I was walking up to the peds floor to get back to work, I kept feeling pain and my arm was hurting more than I ever remember it hurting before. So I kept thinking, "geez, I'm such a wimp now!" Then I removed the bandaid after allowing enough time so blood wouldn't get on my coat and I saw the reason for my prolonged pain - a 1 inch long bruise. And it still hurts. Sure, you say, "well, stop touching it you fool!" But how am I supposed to know when it's not painful anymore if I don't touch it? Afterall, every morning on my sickle cell patients, they tell me where it hurts and I push on it and ask if it hurts when I touch it. I don't know why it's important that I do this because I know the answer before hand but I guess the idea is that they can go home if I can push really hard and not get much of a response (crying, wincing, yelling ouch, any of those will do). So shouldn't the same principle apply to me? Wait let me check it again, yep, still hurts.

On another note, before I was allowed to leave, I had to go down to radiology and check on the results of a chest xray. The patient is clinically much better, only 9 hours had elapsed since the previous normal study, and I knew it would be normal, the attending didn't think it was enough time for any process to appear since the exam was normal, and the resident didn't think it would be abnormal, and yet I was told to go down and then report back. Ugh. So I told her I would call her from there then go home and surprise surprise, it was normal. So annoying since this study wasn't necessary but the on call intern ordered it anyway and then we probably could have waited for the report tomorrow since there were no clinical signs of worsening and then the radiology folks take soooo long to dictate a normal study. I was tired, I wanted to go home.
~me~ at 5:34 PM

Monday, May 31, 2004

Today when I was bored out of my mind, I decided to see if I could access my own personal medical file in the hospital computer. In the past, I couldn't because I had never seen a surgeon (the only time I was at tulane for clinical stuff). So I was quite surprised that I could access my file while on pediatrics. Then I realized that I had seen a med-peds doctor in the clinic and since I was authorized to view the patients of all tulane pediatricians, I was able to see my stuff. Nothing interesting. Just a few radiology reports from when I hurt my hand and fingers playing football this year. Remember that post way back then? I was freaked out because previous fractures had never resulted in swelling and so I wanted to make sure I was okay even though deep down I knew I was fine. That's why I have insurance anyway. Then there were the pap smear results that were negative. My address is spelled incorrectly in the patient demographics section. A few clinic encounter notes including that very special day when I had gastritis that hurt like hell. He incorrectly said I vomited once...I vomited multiple times that day and he called my block party experience, "overdoing the celebration." Made me chuckle a little. And then I got to see my TSH results. Speaking of which, I need to get another level before I get a new Rx (no more refills left). All in all, quite a small boring file...which is a sign of my health I suppose. My paper file was fun to look through...like finding that EEG of an old man accidentally placed in my file which could have only happened at the internal medicine clinic since I don't think my gyno sees male patients...unless they are transvestites or cross dressers (the anatomically female type of course).
~me~ at 5:23 PM