Saturday, June 12, 2004

I have a headache. I am sure it was caused by too much studying as I started getting one earlier today after studying at starbucks and now after studying for 3 hours and I had good lighting in both places. I'm kind of nauseated too. Bleh. And on top of all that, I have to go in tomorrow. I wonder how many patients we have now... I think I'll go in by 7 am and see how many notes I can write in 2 hours. God, I hope we don't round late so I can get home by noon or 1 pm.
~me~ at 9:34 PM

Today I made the mistake of going to the shopping mall to make my hair appointment (just getting a little trim) for after my exam on friday. Anyway, there were tons of people there! And they all move sooooo sloooooow! There was a health fair there and the booths ranged from alternative medicine to the usual BP and cholesterol screening booths. And the people were in incredibly long lines waiting to get these exams for free. Hmmmm....they bitch and moan about having to wait in waiting rooms for the exact same tests that occur in private rooms but they'll wait with no problem to have them done in public. I guess that free factor is a big one. So I made my appointment then got out of there fast. It was a good break after studying all morning at starbucks. Actually, there was some weird reunion going on there. I couldn't tell if it was planned or random chance because these people, as they arrived, appeared surprised that each other was there yet they spent quite a bit of time there and took all these pictures. At least they weren't too annoying.
~me~ at 7:52 PM

Friday, June 11, 2004

7 more days left of third year! And only 4 more days of note writing...for now at least. And tomorrow is my day off. I'm so happy right now. All my patients have been discharged today - I cured them all! Nah, they just finished their chemo and get to try to avoid horrible infections only to come back in a couple of weeks to do it all over again. Certainly glad all I have to do is take a little pill.
~me~ at 5:22 PM

Thursday, June 10, 2004

Ugh! I hate it when residents feel the need to teach...especially this far into the block when there's an exam in a week. We were pretty much done by 1:30 today and the intern tried to get permission to let us leave but instead they made us sit there until 4 pm to go over board questions for their level of knowledge. Yeah, I can use the time for more efficient studying. So there I had to sit while all this was going on, at first, I paid attention, but after 3 questions, I finished my H&P and ignored the whole thing going around me, then I did a little reading and occasionally would pay attention. I could have been home sooner and avoided the whole traffic mess! so annoying! I feel teaching is fine but it has so much more of an impact on me when it's done in context of a particular problem a patient has, not some random reading of board questions. And I need to read the explanation myself, read to me hour is so useless to my learning but that's the way I learn. I need to read it, then think about it and assimilate it. It also makes it hard when the people trying to teach have accents or use terms from their countries. It gives me a headache trying to learn that way.

~me~ at 4:46 PM

Tuesday, June 08, 2004

Okay, this is what is frustrating about the student clinic here...compared to UO's clinic at least and my experience growing up. Growing up, I hated knowing what my thyroid blood levels were because it really didn't matter what they were because Dr butthole (name changed to protect those involved...except mine) would scold me for something I did or didn't do anyway. In college, I was called almost immediately with the results and things progressed logically with that doctor so I got used to being told what my TSH and freeT4 was. Well, here, they take FOREVER to call results and I had to call today to get them and asked to be paged with the results when I had to leave a message. No page. Instead, they call home so I couldn't talk with the dr who orders my tests for me. Now, since I can access my record on the hospital computer, I know the results were back the day after I had the blood drawn - last week thursday. And today is tuesday. Granted, they are busy in that clinic but sheesh! I only have 2 more pills left! Anyway, the level was 4.3 and the highest limit of normal is 3.6 or 3.4 (can't remember right now). My last level was 2.3 in november when I was feeling much more tired than I am now (stupid surgery rotation). I currently take 100 mcg everyday and the next logical step from my standpoint would be to actually get a free T4 to make sure it's a true hypothyroid state since clinically, I'm fine. Sure, I'm tired, but so are the 153 other third year medical students. Or if it will be increased, to increase it to the 112 mcg pill but she wants to increase it to 125 mcg and then retest. I would personally prefer having to titrate up rather than titrate up then have to move back down. But this is only because I have been hyperthyroid due to too much medicine in the past when I had to be titrated down from 150 mcg to 100 mcg. And it took forever...okay, 6 months isn't forever but you get the idea. And I don't want to deal with insomnia again...especially since as a 4th year, it's my right to sleep in! I earned it damnit! But what I really want to avoid is the chest pain. You see, that's how I discovered my thyroid levels were a little too high. I was at the UCLA-Oregon basketball game and we were beating the crap out of the UCLA team and I had this substernal chest pain. And since I hadn't eaten recently, I knew it wasn't heartburn. But I had one of those moments where you go inside your head and all the sounds around you are faded and all you hear are your thoughts and so I remember thinking, ow, this hurts! And since I was taking my CPR course, I started doing to checklist of symptoms for a heart attack to convince myself that I wasn't going to die in the immediate future. I really don't want to experience that again. I do remember dr butthole saying that he liked to keep me at the higher end of normal the last time I saw him so if 125 puts me there, then fine but I just don't need an episode of thyrotoxicosis during interview season since that can cause psychosis...not helpful for getting that spot in a program I wish to enter. So tomorrow I will call and talk this over with my doctor here and express my concerns and plan I would like to do before making any changes. It's not that an increase of 25 is way out there but it seems odd that I would need to be increased to halfway near what I was on in college. I guess it's time for that fun game of trial and error. Le sigh. Dad, don't worry, I'll live. Even though this means that in 4-6 weeks I'll have to let them bruise me again.

and so concludes another episode of Cara: the physiologic freak of nature
~me~ at 6:47 PM