Medical School People!

I've decided that I'm going to start a recurring topic on my blog about all of the people I've met in medical school. It will be called "Med School People," abbreviated to "MSP." In the past 20 months, I've met all sorts of characters. Some of them are amazing people to whom, in a few years, I would trust the life of a family member. Others are some of the craziest, most annoying, consistently underperforming people I've ever met in my life, to whom I would not entrust the life of my remote controlled race car. In each post, I'll introduce you to the type of person I'm talking about, point out a few of their distinctive qualities, and give you my opinions on where they'll end up in the future. Yes, these characters are all based on real people and real events, but I will not actually be giving up any identities or calling anyone in particular out. The first post is coming shortly...I hope you like them!

Up first: MSP #1: Mr. Einstein....WOW I'm smart!

Yes, I want one!

What is there to say, but Damn...that is one sexy piece of medical machinery! Currently, the LP12 is pretty much the standard or care in ambulances and emergency departments around the country. This bad boy is the brand new LP15! The looks has been somewhat updated, and it looks as though it now comes with a much nicer, multi-color screen. It also has the ability to do a pre-medication 12 lead, and then continually monitor the 12 lead in the background to check for ST segment changes...pretty cool stuff.

The new LP also has some hokey-sounding (to me) new prompts that give you the proper breath to compression ratio for CPR. I've never really understood the point of having an AED on these things though. AEDs are supposed to be simple to use. If you know what you're doing with the LP12, the AED is simple to use. But, if you're not entirely familiar with its operation, and most people aren't, you're going to be completely lost. It's my humble opinion that if you don't know how to manually defibrillate a patient, you have no business anywhere near one of these. Using an AED usually requires one or two buttons, but look at all the buttons on this thing! How in the world are you supposed to know which two to use, and not get lost in the sea of other flashy lights? Maybe people are just less easily distracted than me, but I don't think so.

Judging by the side of this particular one, it's completely tricked out with a bunch of ports that you wouldn't usually see outside of the hospital, such as invasive BP monitoring. But, they're all things I'd throw in there if I had the money and the need. I doubt the fire departments will be seeing this anytime soon, since the beasts can run over $20,000, but maybe I'll get lucky and get to play with one in a hospital.

Headed back to the island

Well, as of today, I've only got 15 days left on the island anyway, but I'm headed back to finish it off tomorrow. That will put me back in class on Thursday, in time to finish up ICM 6. I will barely have had any time to review for the comp (that's sort of hard to do while you're doped up on Morphine), but I've already passed it once, so not really a big deal. In the next 15 days, I have to finish ICM 6 (which from what I hear, is nothing to worry about), finish the couple days of ICM 5 that we still have left, take an ICM shelf exam, and finally, take the Kaplan comp. Also in there, I need to find as much time as possible to try and get through as much Kaplan as I can. I really do want to finish as much of Kaplan as I can before I head off to the Falcon program. And, between the crappy AUC 5th semester and being sick, I have not done nearly as much as I would have hoped by now. It seems that no matter how close we get to the end, AUC always comes up with some new silly hoop to jump through. But, they can only do it for another couple of days, so whatever! Next time i get on a plane out of St. Maarten will be the last time!

Success!! so far...

I just finished my Wendy's chicken sandwich, baked potato, and frostee....and they were delicious! They've had me on a strictly liquid diet, but I couldn't deal with the liquid hospital food anymore, so I had my mom sneak that stuff into me. Besides, if they are going to release me today, I wasn't going to be comfortable leaving before I knew I could eat real food! So I just ate the most I've eaten in days with only oral pain medicine, and my throat is feeling pretty good, all things considered. I just have to wait and see what the PA has to say once she comes back later this afternoon.

The only thing I have not been thrilled with while I've been here is the huge number of PAs I've seen and very few MDs! Most of them have done a good job consulting with physicians and relaying things back and forth (as they should). However, I had one particularly bad one on admission, who I think completely overstepped her role as a mid-level provider. On admission, she knew my ENT had written me a prescription for antibiotics and high dose steroids, in addition to pain meds and fluid. However, she decided that the steroids might be too much for my immune system and didn't know if I needed the antibiotics or not. Her two years of PA training were apparently equal, in her mind, to the 4 much more rigorous years of medical school, plus years of difficult residency that the MD went through, so she changed the orders. Fortunately, the doctor heard about that early in the morning and changed it back.

I really do like PAs, NPs, and nurses. I realize they play a valuable and important role in health care delivery. Some patients don't need to see a doctor for every little complaint, and doctor's couldn't do their job well if they didn't have some help. However, it's unfortunate when a few of them forget where their role ends and just how much more training the physicians really do have.

Discharge today?

I'm still admitted in the hospital, but it's looking like I'm going to be discharged finally today. Until last night, I've been hitting my magical morphine button almost every time it would let me, along with frequent Toradol, to keep the pain away. But, it looks like the steroids and antibiotics, along with time, are finally doing their job and things are starting to improve. My lymph nodes are still big, but no longer sticking out of the side of my neck. And, I'm about to try my first real meal, but I think the oral pain medicine might work. Time to eat a chicken sandwich and find out...here goes nothing!

Broadcasting from the Anne Arundel Medical center!

After the past two days of having to come to the ER for IV rehydration and pain medication, they finally decided to admit me to the hospital. When I got here today, it had been over three days since I've had a single bit of food or liquid by mouth. I know that mono doesn't usually sound like a terribly debilitating disease, but let me be the first to tell you....IT SUCKS, A LOT! Literally just swallowing is excruciating, and without medicine, even drinking water is not even a minor possibility. When I came in to the hospital, I wanted to die.

But now, I've got a morphine drip hooked up with a magical little button that delivers me more every 10 minutes, IV toradol, and a bunch of steroids. It's also pretty likely that I've got a bacterial infection on top of all of this, so I'll probably have some antibiotics in there soon too. I'm not sure how long I'll be here, but they say at least 24 hours. I'm just worried that as soon as the IV's come out, I'll be right back to no sleep again. I guess they'll just have to taper down the pain meds eventually and see what happens. A few minutes ago, for the first time in a while, I had a major milestone...I ate my first bit of jello!! When you feel this bad, I guess it's the little things. But, on the plus side, I do have a private room with a TV and free internet connection. Time to watch some Cops, while I wait for Heather to get back.

The Ritz of hospitals!

When I went to the St. Maarten ER to have my mono checked out, they gave me a bag of fluid, hardly payed me any attention, and sent me on my way.

This morning, I woke up completely unable to swallow without being in excruciating pain. I couldn't get any medicine down and I felt like even the smallest sip of water would cause me to aspirate. So, since I had again basically eaten or drank nothing of the past couple of days, I went to the hospital again. The experience this time was wholly different. I felt like I was in a 4 star hotel! First, the tech did a much better job with the IV, and actually used modern IV and blood draw equipment. Then, the doctor actually seemed to know exactly what he was doing. Instead of just giving me a bag of fluid, he gave me two bags of fluid, dexamethasone, toradol, and 4 mg of morphine! They also had pillows and blankets from a heater.

While I left the hospital in St. Maarten feeling largely the same as when i walked in, I left the Anne Arundel Medical center feeling about 100% better. My throat is still sore and my tonsils are still pretty enormous, but at least I can swallow again, and I'm pretty sure I'm about to get some sleep for the first time in a while. I was also given a prescription for Roxicet, which is basically liquid percocet. So, that's taking the edge off. It's amazing how much being in St. Maarten for a while can make you appreciate the little nice things in the US.

you win some, you lose some

Yes, I am missing out on the Kaplan Live Reviews, as someone pointed out on my facebook wall. I've heard they're great and I do with I had gotten to see them. However, even if I was on the island, i likely would not be able to sit through them right now. Also, I'm paying an awful lot of money to sit through 7 weeks of Falcon Live Review in a couple months! So, I think I'll be OK.

However, what I did get yesterday for my birthday, that i absolutely would not have gotten in St. Maarten, was delicious fresh sushi and miniature ice cream birthday cakes from Maggie Moos!!

Happy Birthday to me

Since I felt (and still feel) like absolute crap, and didn't want to risk being sick in St. Maarten without power or water, I decided to come home for the week and try and recover here. Unfortunately, the mono did not decide to be any nicer to me on my birthday, and my tonsils are so swollen that I can barely swallow water. Taking a shower also sucks just about all of my energy out of me. This virus really is just not very considerate of the day!

But, I went to my doctor's office today (my real doctor who actually talks to me and gives me appropriate answers) and I have decided that I am going to kill the virus, for inconveniencing me today. He prescribed me prednisone to reduce the size of my tonsils and golf-ball-sized lymph nodes, and valacyclovir to try and kill the virus. Valacyclovir is not actually used for EBV yet (the virus that causes mono), but there have been clinical trials with it that have been very promising. In fact, in one trial, the virus was eradicated in 1 week from nearly everyone that took the drug! So, I'm just going to hope that it works for me! For those of you out there who were probably already thinking it, NO, I do not have herpes!

Aside from that, Heather is bringing me home Sushi from Joss (imo, the best sushi restaurant in the world) and a coldstone cake. I likely won't be able to get much down, but the little I do eat will be delicious! Oh, and I stopped at the grocery store today to get my prescriptions filled, and I was amazed at just how beautiful meat is, after seeing less-than-fresh meat for 2 years in St. Maarten. I forgot how red it is when it's fresh. And, I nearly forgot how nice a supermarket can look when it's properly stocked, labeled, and taken care of! I can't wait for my first major grocery trip at home when I'm healthy again! Some people on the island like to talk about how great the food is in St. Maarten. Well, I can tell you for sure, they have just been away from the US for a little too long, because the food on the island can't hold a candle to anything here.

And, Mono it is!

After being sick for 2 weeks now, I finally got tired of not knowing what was actually wrong with me. So, this afternoon, I took myself to the St. Maarten ER and requested a CBC, blood chemistry, and a mono spot. The doctor thought that sounded reasonable and went ahead with it, along with giving me a liter of fluid to help with dehydration. Not surprisingly (as my lymph nodes feel like golf balls), my monocytes and CRP (a measure of infection) are both very high. And, the test confirmed that I do, indeed, have mono! So, after 2 weeks of feeling like crap, it looks like I've got another 2 or more ahead of me! Couldn't have really come at a less convenient time, with Wine and Cheese tomorrow night and Fifth Semester Party next Saturday, both of which I'll almost surely be sick for. I'm supposed to teach CPR tomorrow but seeing as I can barely get myself to reach to my nightstand for water, I don't think I'll be waking up at 6am to go do that. grrrrrr....this is definitely the sickest I've ever been, or at least the longest!

Interesting note though for all the Americans out there...St. Maarten's lab will not run your lab tests unless you pay them first! After my labs had been ordered by the doctor, the lab tech came back, gave me a bill, and asked for my credit card! She then ran my card, got a signature from me, and then said, "thanks, now I can run the blood." Good think I remembered my credit card tonight!