Well I got to see the garage door man again today. Awesome. The one thing I can say about this guy is that he always shows up 30 minutes earlier than he's scheduled, calls 15 minutes ahead of time to give you a warning, and doesn't leave until he gets the job done. He's not terribly expensive either. It's nice to find a non-scary non-price gouging service man. So if your garage door ever breaks, just let me know and I'll get you his number.
Still no luck on the Woodrow front. We're planning on maybe/probably getting a puppy/dog Friday when Kris gets back from his little trip. He's leaving town today to go see a UFC fight in Nashville with his bestie. I don't think he's that interested in the fight, but is interested in a fun trip. I can't blame him. He won't be back until Thursday. What will I do with 3 days in the house all to myself? Hopefully I'll get some work done!!!
I felt the major pangs of guilt for not studying every hour of every day yesterday when sitting behind one of my classmates. During the lecture she pulled out her First Aid (the STEP book) to take notes in it. Not only did it have nifty little tabs all up and down the sides but as she flipped through it I saw highlighting in several different colors and tons of her own notes in the margins - on nearly every page. That book is about 500-600 pages long. how many pages have I glanced at? Not sure, probably around 30. Yikes. There's now less than 60 days before the test. It's time to get on the ball. The only problem is we have another week and a half of class left and I really don't want to just completely bomb this last round of tests in order to study for STEP. Not to mention I can't really afford to bomb these tests. Whatever though. I guess I just need to get organized and I'm hoping to make some progress on that front over the next week. It's looking a little doubtful though since before midnight tomorrow night I must accomplish all of the following:
* finish 4 transcriptions
* attend the PIG roast (this is a charity event for Blair E. Batson at Old Venice :))
* play in a tennis match (and hopefully win)
Thursday night I also have a transcription due and another tennis match. Maybe it will rain and one of them will get moved/cancelled.
Oh yeah, I nearly forgot - either on Thursday or Friday I have to complete my first witnessed (by my preceptor) history and physical. It's a little nerve wracking since we've done lots of pieces of a physical exam but hardly a whole thing. I am really comfortable looking in ears now and can almost always find the ear drum - except when there's so much wax it just completely blocks everything. That happens about 1/2 the time. It's pretty gross.
Must get back to class now, but thought I'd rant for a second. I'm sorry my posts are always so sporadic, but for those who know me well you know that's just how my brain works. I don't know any other way!
Showing posts with label preceptor. Show all posts
Showing posts with label preceptor. Show all posts
Tuesday, March 31, 2009
Friday, March 20, 2009
Uber Productive Day
Thank goodness for Spring Break. I think we should get one at least once every month or two. So far today I have:
1. made a Wal-Mart trip
2. made a healthy lunch
3. planted new plants in front yard
4. weeded most of the front yard
5. mulched(pine strawed?) most of the front yard
6. dozed off in the recliner with Woodrow while watching Jon & Kate (bliss!)
7. cooked dinner - not so healthy: baked pork chops, homemade mac & cheese, green beans, & crescent rolls
8. hung a curtain rod in the living room
9. balanced our joint checking account
10. balance my checking account (I was 4 months behind on both)
11. put some boots I never wear on eBay
12. cleared out my inboxes
Amazing, huh? I even got all dressed up and went to the hospital this morning to meet with my preceptor but he didn't answer his phone. After 45 minutes of chit-chat with my partner we decided to head out.
I swear - if I wasn't studying or thinking about studying or procrastinating studying 99% of my whole life I could really get some things accomplished!
1. made a Wal-Mart trip
2. made a healthy lunch
3. planted new plants in front yard
4. weeded most of the front yard
5. mulched(pine strawed?) most of the front yard
6. dozed off in the recliner with Woodrow while watching Jon & Kate (bliss!)
7. cooked dinner - not so healthy: baked pork chops, homemade mac & cheese, green beans, & crescent rolls
8. hung a curtain rod in the living room
9. balanced our joint checking account
10. balance my checking account (I was 4 months behind on both)
11. put some boots I never wear on eBay
12. cleared out my inboxes
Amazing, huh? I even got all dressed up and went to the hospital this morning to meet with my preceptor but he didn't answer his phone. After 45 minutes of chit-chat with my partner we decided to head out.
I swear - if I wasn't studying or thinking about studying or procrastinating studying 99% of my whole life I could really get some things accomplished!
Tuesday, February 17, 2009
Hypotensive and Hypertensive?
So I was supposed to meet with my preceptor today to see patients, but he was in clinic for about 15 minutes so I went around with one of the residents. She's one of my favorites and has the best doctor-patient interaction skills I've ever seen.
In my 3.5 hours there we saw 6 patients. Two of them had the exact same name and were put in the exact same exam room, one right after the other. Weird. They couldn't have been more different though. One had never been on any medications and was 65. The other had more doctors, surgeries, and prescriptions than I could keep track of. She was nearly in shock when the doctor told her that a family medicine doctor could do more than just annual pelvic exams. "You mean, you can refill my prescriptions too?" Uh, yeah... Maybe not your morphine and hydrocodone, but we'll get to that later. I think when you're taking so many pain meds that you require daily phenergan or else you vomit all over the place it's time to reevaluate the situation. Whatever though. I don't know much. I'm just a student.
I got to hear 2 heart murmurs, though I really don't think I would have caught them if I hadn't known they were there. They were both very faint. I got to see otitis externa for the first time - that's just an infection of the ear canal and not an inner ear infection. Basically the canal looks red and inflamed with some flaky debris.
Probably the best part was when during a yearly check-up type thing for a new female adolescent patient the mom busts in during the doctor's history and starts asking questions about some online drug prescription plan thing that sounded kind of shady. Then the little girl busts in and says "Mom, this is MY time." Priceless. It was so true.
We also had an older patient who was STILL bitter about a breast lump from 5 years ago that wasn't picked up by radiology. She tried to tell us that calcifications in the breast tissue were a sign of cancer because they signified change. Umm no. You don't tell patients with calcification (a very normal thing that can happen in older women) to go out and get a double mastectomy. Whatever though. It's just kind of funny when the patient tries to tell you how to do your job. I'm not bitter though.
Oh yeah, I almost forgot the whole reason for the title. We had one patient who was hypertensive and obese (no diabetes Laura. She wasn't the trifecta :)) She was on no meds for hypertension. She had never been on any meds and was otherwise healthy. So the resident was going to start her on a drug for hypertension. Then she tells us sort of on the way out the door that she FAINTED last week. The way she described it was typical vasovagal syncope (fainting due to hypOtension). She got up from a seated position, walked to the bathroom, and woke up on the floor. This happens when blood pools in your veins when sitting or lying. You require the muscles of your legs working to pump the blood back up to the heart (and brain). Then she also mentioned some tingling sensations in her face and a feeling of something stuck in her throat. Seriously? Needless to say the doc decided not to go with the meds just yet and to get a further workup of the patient - EKG. The problem? No insurance. A simple in-clinic EKG is about $800 when you're self-pay. Some places don't care and just do all the tests, no matter how expensive or necessary. UMC tries to work with you and figure out what tests can be delayed, which are most important and the cheapest meds that are the most effective.
Anyway, that was just a typical day at the clinic. I kind of love family medicine so far, but I'm not sure that I won't fall in love with something else next year. I'll keep y'all updated.
In my 3.5 hours there we saw 6 patients. Two of them had the exact same name and were put in the exact same exam room, one right after the other. Weird. They couldn't have been more different though. One had never been on any medications and was 65. The other had more doctors, surgeries, and prescriptions than I could keep track of. She was nearly in shock when the doctor told her that a family medicine doctor could do more than just annual pelvic exams. "You mean, you can refill my prescriptions too?" Uh, yeah... Maybe not your morphine and hydrocodone, but we'll get to that later. I think when you're taking so many pain meds that you require daily phenergan or else you vomit all over the place it's time to reevaluate the situation. Whatever though. I don't know much. I'm just a student.
I got to hear 2 heart murmurs, though I really don't think I would have caught them if I hadn't known they were there. They were both very faint. I got to see otitis externa for the first time - that's just an infection of the ear canal and not an inner ear infection. Basically the canal looks red and inflamed with some flaky debris.
Probably the best part was when during a yearly check-up type thing for a new female adolescent patient the mom busts in during the doctor's history and starts asking questions about some online drug prescription plan thing that sounded kind of shady. Then the little girl busts in and says "Mom, this is MY time." Priceless. It was so true.
We also had an older patient who was STILL bitter about a breast lump from 5 years ago that wasn't picked up by radiology. She tried to tell us that calcifications in the breast tissue were a sign of cancer because they signified change. Umm no. You don't tell patients with calcification (a very normal thing that can happen in older women) to go out and get a double mastectomy. Whatever though. It's just kind of funny when the patient tries to tell you how to do your job. I'm not bitter though.
Oh yeah, I almost forgot the whole reason for the title. We had one patient who was hypertensive and obese (no diabetes Laura. She wasn't the trifecta :)) She was on no meds for hypertension. She had never been on any meds and was otherwise healthy. So the resident was going to start her on a drug for hypertension. Then she tells us sort of on the way out the door that she FAINTED last week. The way she described it was typical vasovagal syncope (fainting due to hypOtension). She got up from a seated position, walked to the bathroom, and woke up on the floor. This happens when blood pools in your veins when sitting or lying. You require the muscles of your legs working to pump the blood back up to the heart (and brain). Then she also mentioned some tingling sensations in her face and a feeling of something stuck in her throat. Seriously? Needless to say the doc decided not to go with the meds just yet and to get a further workup of the patient - EKG. The problem? No insurance. A simple in-clinic EKG is about $800 when you're self-pay. Some places don't care and just do all the tests, no matter how expensive or necessary. UMC tries to work with you and figure out what tests can be delayed, which are most important and the cheapest meds that are the most effective.
Anyway, that was just a typical day at the clinic. I kind of love family medicine so far, but I'm not sure that I won't fall in love with something else next year. I'll keep y'all updated.
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