Pethidine Pleasure

Raising the IQ on both sides of the Tasman

2007-12-13T16:13:00.000+13:00

OK, let this blog slip once again! I'm so useless. SERIOUSLY!!

I'll use this post to announce what everyone probably knows already anyway, but if you didn't know, here it is! Next year, I'm moving to Melbourne to work for at least a year. Yep, I'm joining the brain drain across the Tasman - not that there's much of my brain to drain...

Lots of reasons for moving really - but surprisingly enough, pay is not one of them. I don't think my income will improve at all. Especially when accounting for costs of living when I already live at home in Auckland. Main reasons are for experience - I've managed to get an ICU run which I couldn't get here. Also for personal development - it's about time I left home!!

Not sure how long I'll go for. Perhaps just 12 months - perhaps forever - perhaps somewhere in between. Who knows...

With less that 4 weeks to go, my time left in Auckland is running out fast! I just have one more week at work, then it's Christmas, and then I'm off early in the new year! So much stuff to organise, I can hardly get my head around it! I'll post more about my efforts to move over - or lack thereof - in future posts!

Hospital slut

2007-10-12T12:38:00.001+13:00

I picked up a couple of evening shifts this week - the first long days I've done during the week this quarter! Going back to ortho was fun but dealing with adults again was hard! Handed over to me was awful stuff like blood transfusions... congestive heart failure.... liver failure... acute on chronic renal failure... I couldn't even remember how much lactulose to chart! Then I couldn't just figure out the dose of paracetamol by going 15mg/kg/dose... ARGH~ what's happened to my simple little kiddies with bronchiolitis!?!?!?

Then I came across a needle phobic adult. Unfortunately on the adult wards you can't get a play therapist to come in and blow bubbles while the parents and nurses pin the patient down while he/she scrams in fear. One thing was the same though - the nurse had covered her in emla cream!! Anyway, In my true do-as-little-as-possible-when-on-call style, I just sited the expired luer and said it could stay in for another 24 hours.

My daemon!!

2007-10-03T16:51:00.000+13:00

Apparently my daemon is called Antigone! Her form is taking shape!! I don't mind her being a cat but I don't know about the name...

Thanks for that...

2007-09-25T20:31:00.000+12:00

... Sophie and Jeff. We have 23g butterflies too but don't you find that when blood is at a premium, the blood stays in the tubing and can't get anything into the syringe? Anyways, I've subsequently found out that the broken needle method isn't actually allowed anymore...

Oh poo.... literally........

2007-09-24T21:02:00.000+12:00

OK, so much for this one post a day thing - looking back I actually failed on the first day, but that wasn't my fault! It was because I went onto nights and I couldn't tell what was today or tomorrow or just what the hell was going on anyway. Anyways, I was posting even worse rubbish than normal so probably better that I don't try to post daily... on the other hand nobody actually reads this trash so it doesn't really matter! Oh my giddy aunt what the hell am I doing??

Other important things have been happening in my life anyway. Firstly, I've had some insolent 5th yr medical students, who should be studying for their exams, play havoc with my street credit on Facebook. They cheat, they lie... then they stab you in the back!!! What's happening to the youth of today? The world is changing fast.

Secondly, I'm sure some kid on the ward gave me rotavirus. OMG 48 hrs of missery. D's & V's big time!! Started with V's, then soon the D's followed. Then came more D's, D's again and then V and then DDDDDDDDD............. well yeah, you get the picture. Friday was definitely what I'd call a Sad Face Day. Thankfully I managed to avoid the polystyrene cup with pink paedialyte and Mum using a 10mL syringe to rehydrate me. Or worse, the 120mg/kg/day of continuous NG paedialyte, which yes before any smart comments are made, would be more than 13mL per hour.

Anyway, I'm sure I know which kid gave me gastro. You know that feeling, even though you've seen millions of kids with the same condition, you're sure you know exactly which one gave you the bug... oh revenge will be sweet... if only he was old enough to use Facebook... his zombie would stand no chance... mwhahaha....

re: Your Brains

2007-09-16T23:40:00.001+12:00

I love this song! I'm constantly humming it to myself in the wards...

I have Lag - jetlag without the jet

2007-09-15T22:51:00.001+12:00

Urgh!! Pain... agony.... really struggling to adjust back to sleeping at night and staying awake during the day... I don't know if I'm coming or going... sleeping or getting up... whether I'm having breakfast, lunch or dinner... I hardly know what day of the week it is...

Reflection

2007-09-14T16:28:00.000+12:00

I hate the day after nights. It's all part of the process of resetting the body clock to a sensible pattern. I try to stay up as long as I can but after sitting down I just pass out. However while trying to stay awake, I reflect on the week that's just gone by. In my moment of thoughtfulness earlier, I was thinking about how I greeted many parents in ED - "Hi, I'm one of the doctors working the graveyard shift..." Now I realise that while many people refer to working night duty as doing the "graveyard shift", it's probably not a good way to refer to night duty when working in a hospital............ especially when a child has come in acutely short of breath...............

I don't quite get it...

2007-09-13T10:24:00.000+12:00

Had to take bloods from a 3 month old baby using a "broken off needle" today. Involved literally breaking off a 22g needle off its blue hub, inserting it into a vein and letting the blood drip into bottles. I don't get why it's necessary! Without the hub I find the needle quite hard to handle, then the drips falls immeditely and are hard to control coming out the end of the needle. Wouldn't it be easier to leave the hub there and then suck blood out of the hub using a drawing up needle? Just like you do when putting in an IV line and taking bloods from the line? Oh the things that come to mind when you've just finished your 6th night shift...

Intellectual conversation

2007-09-12T04:48:00.000+12:00

I was in a restaurant with Mum the other day. Just so happened a friend and her family were sitting right behind me. Anyway, this conversation took place as we were looking at the menu
Mum: What would you like to eat?
Me: Hmm... not sure, anything eh... (usual non committal response)
Mum: DO YOU HAVE A COLDSORE??? (looking at a minor spot of perioral skin irritation secondary to not wiping mouth properly from dinner previous night)
Me: No. (saying it quietly moving back to looking at menu)
Mum: Ok... ... ... ... ARE YOU SURE IT LOOKS LIKE A COLDSORE
Me: no it's not!!! (as in... shush do you want entire friend's family to hear along with half the restaurant)
Mum: Ok... ... ... ... shall we eat the same as last time?
Me: Yeah, that sounds great
Mum: YOU DON'T NORMALLY GET COLDSORES EH!!??!?!?
Me: Yeah I like the prawn wonton soup.......

Awesome stuff!

2007-09-10T21:38:00.000+12:00

During my random browsing on nights, I found the most awesome stuff ever!! EMST merchandise! How cool is that! I really like the bowtie and socks. Buy now! BUY NOW!!

4.46 am

2007-09-09T04:45:00.000+12:00

3 ward reviews, 2 URTIs discharged, 1 admission
Grapes, 2 mandarins, pretzels, grainwaves, fruit salad soft jellies, muffin, banana, mizone rapid
Missed the rugby. Too lazy to find a tv to watch tennis. Eyes too tired to read a book...
Really hitting the wall... 3 more hours to go...

More nights!

2007-09-07T21:35:00.000+12:00

Going into nights again! Only my second set ever, after losing my nights virginity with Tarik in Gen Surg. A bit nervous since it's paeds because I still don't know anything. I hardly know what a normal child looks like, let alone a sick one that's crapping out on me. Hey, even a crapping child might be totally normal if it doesn't have a nappy on!! Hope nothing major happens! Definitely hope that I'll have some quiet periods to watch tennis and rugby... and to eat! I get so hungry on nights!! It's like totally the best excuse to stuff yourself silly with junk food :P

Time to wake up this blog!

2007-09-06T20:44:00.000+12:00

Time to wake up this blog! After being stupidly busy with gen surg and no time to think about anything else, I'm now on paeds where I can actually think like a human being. Hence a last ditch effort to post again. My mission - to post something every day for the next month... see if I can manage it...

So what better way to start things up with a picture of Tom! This was taken just a couple of weeks ago when I went down to Christchurch. He's getting so big and heavy now! Still just as cute as ever!!! That's until you want him to do something... then it's all tears!!! Tom, time to stop watching tv now... WAAAAAA!!!!! Tom, don't touch that... WAAAAAAA!!!! Tom, time to change nappy now.... WAAAAAAAA!!!!!! Tom, time to stop eating magic mushroom now.... whoops er no big sis I uhh... didn't let Tom do that!!!

Anyways, he's getting to that stage where he's of course still terribly cute but also establishing a certain level of assertiveness! His strong will definitely made babysitting interesting when it came to nappy changes. Especially when my sister forgot to leave babywipes for me!! Babywipes for me to use on Tom that is....

Night duty

2007-07-07T17:34:00.000+12:00

Whoops once again I've let this blog slip again. So hard to post anything when I HAVE NO LIFE and there's nothing to talk about except whinging about work. Oh well, in the absence of anything else interesting happening, I will make this ANOTHER whinge about work post.

I've just completed my first ever night shift! Not as bad as I feared actually. It started off with a BANG... with a 888 call before I had even finished handover! The rest of the night was just doing minor jobs so I spent most of it in the staff centre watching tennis! Really sad to see Ana Ivanovic lose... really enjoy watching her play because well... she's uh.... good at tennis!! At about 4am I got super tired. Just couldn't keep my eyes open! Didn't get paged about anything important though, so managed to snooze for a bit. Then I sorta felt ok but kinda numb. Managed to get home, sleep for almost 8 hrs which is more than what I normally get! Now I'm here typing, about to have dinner, and then I go back for another round! YAY!

I don't know my patient!

2007-05-15T20:18:00.000+12:00

I only discovered one of my patients was on warfarin last night because I was the oncall house officer asked to chart warfarin for her! How embarassing...

Mother's Day

2007-05-12T22:58:00.000+12:00

I was reading the newspaper this morning. OK it wasn't morning anymore since I woke up after noon, but it was quite soon after I got out of bed so I'll call it morning. Anyway, I saw a Farmers ad for Mother's Day and it had all of the usual items... kitchen stuff... cosmetics blah blah... but then I noticed that they were also advertising for lingerie! Now is it just me, or would it be just slightly disturbing if you wanted to buy your mother lingerie for Mother's Day???

Graduation!

2007-05-12T22:26:00.000+12:00

I graduated on Monday. YAY! Just like qualifying ceremony, it was a little anticlimatic but still fun to have a day of celebration. Having finished 6 months ago and been working most of that time, it seems a bit strange to dig up the past and celebrate something that ended such a long time ago. Seems kind of silly to keep the tradition of having the ceremony in May - apparently they had to make it so late because in the old days they had to send the exam scripts back to England for marking and it would take that long for the results to come back. Since it's heading into winter, that's why they put the fur on the hoods to keep the graduates warm while they become comatose waiting in the town hall ceremony which is excessively long and boring and has stupid speeches.

Anyway I digress. The best part of the day is getting to stop the traffic on Queen Street with the procession. It's also fun to walk around and mess up the walking in rows of 4 thing while the marshalls are pulling their hair out trying to keep everything in order.

The ceremony itself is kinda boring for 99.999% of the time while you wait for you 10 seconds of glory walking on the stage to be capped. Then it's a brief moment of all out stress. Firstly you need to listen out for your name and hope that they pronounce it properly. Then you have to walk across the stage without tripping. Next you have to shake the hand of the Chancellor and kinda bow your head so he can cap you. At that moment you have to be careful not to bow too low or too far so that you give him a headbutt. Then you walk across the rest of the stage, spending a microsecond to look out for your family while still trying to walk in a straight line - but not too fast cos then you'll fall down the stairs. Then you see the stairs and walk down while trying to not trip over your stupid gown. Back to your seat and it's all over. Only about another hundred people to do the same thing before the end of the ceremony.

So that's it! Finished with uni forever! Finally!! Unless I decide to torture myself by returning for a law degree or something stupid like that.... if I do please shoot me.

Whinge

2007-04-28T20:53:00.000+12:00

I've noticed that all I ever do is whinge. I complain about everything. Everything is stupid, unnecessary, hopeless, crazy, bonkers... that's all I do! I complain about stupid pagers. I complain about difficult bloods to take. I complain about traffic, weather, food, cricket, discharge summaries, lack of sleep, tennis... everything!!! Even right now! I'm complaining about how much I complain! I really feel sorry for everyone who has to listen to me whinge. Thank you for putting up with me.

I survived...

2007-04-21T23:14:00.000+12:00

... an entire week without a registrar! For some reason, the RMO support unit decided to give my registrar leave without having any cover! Most of the week was okay - the only really nasty day was Tuseday which was out post acute day. We had 12 new patients including two who needed lumbar punctures and another patient who crashed badly. The rest of the time, the fear was mostly psychological and my consultant was really nice and easy to contact if I had any problems.

Sometimes I really wonder about how the hospital actually manages to function. I had a patient who neede an urgent test - the patinet was sitting in the room waiting for the test; the techs who do the test were sitting in their work area doing nothing. I went to see what was going on and the only thing holding up was that the orderly was too busy to bring the patient over! In the end I took the patient over myself... it was the only way to get the stupid test done! SO STUPID!

In other things happening in the world... is it just me or is that TVOne ad really annoying? The one where they play the song Light Surrounding You and they have tons of people shining torchlights into the sky. For a country which claims to be really green and environmentally friendly, it really does promote energy wasting behaviours. Not only are they using precious and expensive hydro generated power, but they're also creating a huge waste of batteries which are difficult to dispose of and result in huge amounts of toxic waste. All of this occurring soon after Sydney went to the effort of turning OFF all of its lights to raise awareness of the need to use less energy. What's worse - I used to like that song but now it rings in my head all day...

In happier news, congratulations Mi² on getting your learners!!! After all these years you finally got it!!!!!! Now you can finally start using those L plates!!!!!!!!!!!!!!

Inhumane

2007-04-10T21:54:00.000+12:00

Medicine has really changed me. Today I was walking along the street and a guy from Amnesty International stopped me. He said, "Do you believe in basic human rights?". Without thinking I simply replied, "No, I don't." End of conversation. He didn't bother me anymore.

You've no veins

2007-03-24T21:24:00.000+12:00

You limped into the ward round
Like you were waking from gen surg nights
Ptosis strategically dipped your eyelid down
Your shirt stained with cinamon scone
You had Tramal on your drug chart
As you watched yourself convulse
And all the girls dreamed that you're in a coma
You're in a coma, and

You've no veins, you probably were an IV drug user
You've no veins (you've no veins!), I'll bet you were an IV drug user
Weren't you? weren't you???

You had me several years ago
When I was still in fourth year
Well, you said that I made such a pretty doc
And that you would never leave
But you self discharged against advice
And some advice came from me
I had some dreams they were phlebs who took blood tests
Phlebs who took blood tests, and

You've no veins, you probably were an IV drug user
You've no veins (you've no veins!), I'll bet you were an IV drug user
Weren't you? weren't you??? Weren't you? weren't you???

I had some dreams they were phlebs who took blood tests
Phlebs who took blood tests, and

You've no veins, you probably were an IV drug user
You've no veins (you've no veins!), I'll bet you were an IV drug user
Weren't you? weren't you???

Well, I hear you went up to the CCU
And your heart naturally failed
Then you threw your ST segments up
To see the triple 8 team of the day
Well, you're where you should be all the time
And when you're not, you're with
Some psychiatry team or the life of an intern
Life of a intern, and

You've no veins, you probably were an IV drug user
You've no veins (you've no veins!), I'll bet you were an IV drug user
Weren't you? weren't you??? Weren't you? Weren't you now???

You've no veins, you probably were an IV drug user
You've no veins, you probably were an IV drug user ...

Working life

2007-03-04T19:30:00.000+13:00

Gosh I've let the postings slip again. Partly because I had a really bad flu last week but also because I don't really have anything to post. "Why's that?" you may ask. Well the answer to that is quite simple - I HAVE NO LIFE. Work has consumed every part of me to the point where I have absolutely no time for anything else. If I'm not at work, I'm at home just trying to recover so that I can survive the next day at work. Don't get me wrong - I think I am actually enjoying the job, especially now that I've changed to general medicine. However I really wish that I didn't find it so stressful.

If only I had a bigger brain capacity. There's so many things going on with these patients, it takes me ages just to get my head around what's actually happening. If I've managed to do that, then I have to do something about it! Quite often I don't and it's only the registrar or consultant who notice - and then I feel really stupid for not having done what I should have done.

Even when I try my hardest, I still forget to do things. I even had to phone the hospital from home over the weekend because I forgot to leave a message for the weekend house officer. Every day, more and more, there's information to process. It just won't end!!!

Then I come home and try to relax, but I can't because my head is still spinning from the day's chaos. All of the stupid stuff I did during the day whizzes around my mind. I want to destress by playing tennis or the piano but I'm too tired to move. Now I really value the weekends - especially this one which is between two 12 day stretches in a row.

Like I said before - I do enjoy the job... I just wish it wasn't so stressful. I hope it improves soon, because I'll surely burn out if it stays like this forever...

Let's play!!

2007-01-31T20:22:00.000+13:00

Just spent 10 days in ChCh playing with my nephew! It was so much fun! He just turned 1 yr old. The last time I saw him was when he was 3 days old so he's changed heaps since then! Isn't he cute!?!? Well dressed too if I may say so!!! I bought him that shirt from Baby Gap in Toronto! We spent lots of time playing! Games included stacking cups, playing with clothes pegs and practising walking! While I was there, he learnt to stand up on his own. He could walk really far if he held onto something or someone, but didn't quite manage to walk independently of aids while I was there. As you can see, we had lots of fun!
He had a great sense of humour, but as you can see, I had to work quite hard to keep him entertained.

Things that he found funny at the start of the holiday soon got boring for him. I had to keep thinking of new things to keep him entertained. Sometimes I think he thought I was quite crazy.
Of course he's also very talented. He's playing the piano like a real pro!
I'll have to start the tennis lessons next time. Gotta get the walking thing sorted first. It was so hard to leave! It broke my heart having to say goodbye!! I still have the baby songs stuck in my head. I hum them to myself while walking around the wards. Clap clap clap your hands.... clap your hands together...

There's always a first time...

2007-01-15T20:31:00.000+13:00

Thursday fracture clinic was the first time I saw my own patients as a doctor in clinic and then have to dictate letters on them instead of writing notes. FREAKY!!!! It's such an unpleasant experience having to speak coherently into a computer.... and then hear your own terrible voice being played back! I sounded like a drug addict talking stupidly slowly with this monotonous voice that would put an insomniac to a deep sleep. Then I think about the team secretary having to listen to me blabbering like a fool because I obviously have no idea what I'm talking about. Then there's also the parts where I'm talking and then suddenly forget what I'm trying to say... *stunned silence*... then I get annoyed with myself and blurt out "OH SHIT! oops sorry far out geeez... good grief!!!!" Fortunately there's also a way of going back and deleting some of the mistakes...

---

On Saturday I picked up a short notice locum for ortho ward calls. During the day I noticed not may of the bloods had been done! At 6pm I discovered that all of the morning blood forms were still not collected by the phlebotomist! When the nurses called to find out what had happened, it turned out that the phlebotomist in the morning had gone directly to the nurses station to look for the forms, despite the fact that they have always been kept in the doctor's area, found no forms and simply walked off the ward! How stupid is that?? Wouldn't you think that it's just a little bit odd that nobody on the entire ward needed blood tests?????

Anyway, despite the blunder, the phlebotomy service refused to do the bloods because it was afternoon and they're not supposed to do morning bloods. I can understand this rule because it discourages doctors from just adding tests willy nilly during the morning. However I felt they should do them as this was an exceptional circumstance because I hadn't added any bloods and it simply was the bloods that their service failed to do properly in the morning!!!

Later on I saw a phlebotomist on the ward and asked him if he would do the bloods. I had even selected the ones which really needed doing and it was only 3-4 people anyway. Our conversation went something like this...

Me: *explain the situation from the morning*... so can you do them for me please?

Phelb: No I'm too busy

Me: Well I've been busy doing the bloods all day which your service were supposed to do this morning!!!!

Phelb: Sorry I'm too busy

Me: Busy doing what?

Phelb: Busy doing IV lines... and bloods...

Me: So are you able to do these bloods please?

Phelb: No, I'm too busy. I'm only supposed to do afternoon bloods and not morning bloods

Me: OK! So I don't have any morning bloods that need doing now, but I have some afternoon bloods which need doing!

Phelb: No you cant' do that!!!!

Then we both sulk and pout and go our separate ways. Then I had to do my own phlebotomy round. It was SO stupid because I was already flat out reviewing patients and having to take bloods from PICC lines... which is equally stupid even though it is my job.

It turns out that the phlebotomists aren't able to take bloods from PICC lines because they aren't certified to do so and it's not safe. Somehow it's so much safer for a doctor fresh out of med school who has never touched a PICC line before to search the hospital intranet and Google to find a PICC protocol, read up on it and take the bloods without supervision on a weekend with only skeleton staff in the hospital. WOW doesn't that make you feel safe in hospital!? At least I didn't need to use wikipedia...

---

On another note, I saw a patient on Saturday who was unwell in the afternoon. I didn't do much for her because I decided to just follow the advice from the medical team and keep an eye on things. Later on in the evening she wasn't getting any better. I couldn't figure out what exactly was going on but her vital signs were just starting to go off a little and I felt that the current management plan wasn't working and we were losing this battle. Then I called the med reg and gave a very clumsy explanation of the situation because I was tired from the long day and also confused about why she seemed so sick. I then went home because it was way past the end of my shift.

This morning I found that she had died. What a yucky feeling. Suddenly I thought... what did I do wrong? Did I miss something? Should I have called for help earlier?? What happened!?!? Is my indemnity insurance up to date!?!?! So many thoughts spin in your head in a microsecond. In reality you can't save everbody and sometimes these things happen in hospitals. I realise that. However you also feel really helpless and wish you could do more. One of the other house officers said I'd get used to it after a while. I probably will but right now it doesn't stop me from thinking that it could have been something I did, or didn't do, that caused a death. What a yucky feeling.

Special announcement

2007-01-07T22:10:00.000+13:00

I have set my MSN to save my conversation histories and to archive everytime I get to a 2MB block. Not that I read them, but I am sure it will come in handy when I become a famous Hollywood superstar, fall to shame in a sensational sex scandle involving Jessica Alba, and need to sell something to earn extra cash.

Yesterday marked a special occasion because my 10th archive of conversations with JW was saved. Yes ladies and gentlemen, that means that I have 20MB of MSN conversations saved with this special individual. 20MB of utterly useless blabber. When it gets to 1 gig, I will get a life. Promise.

Happy new year!

2007-01-07T12:44:00.000+13:00

This post is a few days late, but happy new year everyone! My gosh what an awesome year 2006 was! TI year was so relaxed and fun. I was able to actually enjoy doing hospital stuff which meant I could really learn stuff relevant to the real world! Not just crap stupid information for exam purposes. Then there was the 6 week attachment in Tauranga which was also cool, not because it was O&G, but it was just nice to hang out in a different town and get to know people you wouldn't otherwise get to know!

Of course, I couldn't recap on 2006 without mentioning my elective! Oh I still really miss Toronto!! It seems like a dream now, travelling around Canada on my own. It was such an amazing experience and unfortunately one which can never be replicated.

Next, was the very unexpected visit to ACH as an inpatient! Never in my wildest dreams did I imagine getting appendicitis! I had an acute abdomen!!

The final adventure of 2006 was starting work. I can't really sum it up briefly in a dignified manner, so let me say this: "Oh my freakin crazy giddy aunt this is totally nuts!!!!!!!!"

2007 looks to be a challenging year, with most of it probably being occupied with continuing to getting used to working life. Hopefully I'll manage to get myself organised so that there's time for other adventures too!

I hope 2007 is full of happiness and good luck for you all!

My life in othorpaedics

2006-12-23T23:42:00.000+13:00

Stress. Tired. Pain. That's all I feel right now;
12 days in a row. Over 120 hours in hospital;
Two long days of admitting over last weekend;
3 days off over the last 30 days;
No, I'm not picking up extra locum work;
Witnessed seizure in ED. Why did you give her tramadol???
Booking a patient for theatre by faxing the form from home because I forgot to do it the day before;
Blood forms. Referral forms. Consent forms. Drug charts. MMSE. Fluid reviews. I need some more stickies;
Who can find the drug chart? Afebrile, obs stable. NBM. Plan-continue. Sorry you're too swollen;
IV luers. Blood cultures. FBC ESR CRP U+E LFT. Drug level. INR APTT. Group + hold;
Consultant ward rounds. Where the hell has my team gone!?!? My offsider has gone for a nap;
Pager. Offsider's pager. On-call pager. Cell phone. Ward phone. Yes, you can get hold of me;
Grilling by consultant at handover. MDM. Home alone or private hospital or rest home resident;
ADLS, home help, walking frame, walking stick, hoist transfers only. PT OT SW please;
Urine, sputum, pus and blood. Generally mucky discharge;
PR, enemas, diarrhoea, malaena. That all smells like poo;
Patient confused. I'm confused!!! What is the day today?
Screaming kids, screaming adults, screaming nurses;
Why does that 7yr old weigh more than me???
Pharmacy, if I can't chart maxalon, what do I do instead?
Cinnamon scone, sushi bar, cold roast beef salad, fish and chips. All of it tastes like $#!^;
I need some coffee stat;
X-rays, CT scans, Ultrasound, MRI. I beg for one of these;
Hopefully my patient won't get stuck in the machine;
BMC for MUA, ORIF, DHS, THJR, TKJR, I&D, POP. K-wires, tension wires, plate and screw. Hemiarthroplasty. Who needs follow-up???
Scrubbed in theatre, stuck in clinic. Driving inbetween. I can't be in two places at once;
Where has my swipe card gone?
Yes, I know I'm useless. I apologise in advance;
Is the bone broke or not. That's all I care!

Change of career

2006-12-18T22:26:00.000+13:00

OK, so like I'm ready to retire. So my big plan is to stop working in a hospital and find another job. Currently I'm quite keen on the idea of licorice sushi! I'll develop the concept and then sell it on Dragons' Den. I think it's quite an original idea because people love sushi and people love licorice but has anyone had both at the same time? NO! I bet they haven't! I'tll be so easy to make because it's already long and skinny so it'll be easy to cut into pieces!! But shhhhhh..... don't tell anyone about my fantastic idea!

Sunday morning

2006-12-03T11:28:00.000+13:00

First day off since I started work. OMG it feels so good not having to rush around. I can feel the pain diffusing slowly out of my body. I can hardly move...

Posted at 7.04am

2006-12-02T07:02:00.000+13:00

Woke up at 6am for Saturday morning ward round at 7.30am. Grabbed a shower, shoved down some breakfast and just about to leave. Then my reg sends me a txt to meet at 8.30am.................... need I say anything more?

OH MY GIDDY AUNT

2006-11-30T20:08:00.000+13:00

Far out. How can words possibly describe the first few days as a House Officer. The whole experience is so freakishly overwhelming. Honestly, I was so scared on my first day. Everything I did made me shake - especially if nobody was checking what I was doing. The first time I charted a drug, and it was only maxalon, made me shake like crazy!

I'm just so scared of making a serious mistake. It's a horrible feeling because you want to know everything about a patient before you do something for them, but if you sit down and think about every single minor point, each job would take hours and you'll never get home! However if you do things too quickly, you get burned. For example I charted maxalon in an elderly patient and the next day a bright yellow sticker was left waiting for me by pharmacy saying that I shouldn't chart it due to extrapyramidal side effects! I also got burned badly by an AT&R reg for a crappy referral. She wrote with big font and asterixes telling me to rewrite the referral with clearer information... I was definitely feeling small after that...

One of the weirdest things has been getting used to having a pager! Sometimes it goes off and I hear it but don't respond to it! It just doesn't click in my brain that I have a pager, it's going off, and it's my job to respond to it! Several times it's been going on and on and on and it's only when somebody near me says, "is that your pager??" that I actually realise what's happening! I guess it's all those years of just ignoring pager sounds as a student.

Ward calls on Monday night was the most freaky thing. My very first call was for a painful red eye. On my way, I was trying to remember all I could about ophthalmology. Painful red eye... infection... glaucoma... exploding eyeball... when I got there, the eye was not painful or red. After asking a few questions, I soon found out that the problem was that he couldn't move his arms and just needed his eyes wiped! So I got a tissue and wiped his eyes for him. YAY! First ward call problem solved!

The rest of the night wasn't too traumatic. Mostly charting fluids and pain relief. Although there wasn't all that much to do, I managed to spend most of it running around like a bunny. In fact, the whole week so far has pretty much been like that. Not many jobs but I fill the day walking between wards, doing jobs in an illogical order, taking ages to figure out simple problems and generally flapping around. Like this morning it took me until 11.30 before I actually achieved something. It would be really interesting to track my movements around the hospital. It would look something like a bowl of instant noodles.

Actually I've been relatively lucky that the work load hasn't been too large. I've also had heaps of help from the other house officer on the team, the house officer buddies around the hospital and all of the other more senior doctors. I know things will get worse, but at least I've had a relatively gentle introduction compared with what I know it could have been. I'm just waiting for the $*** to hit the fan... lots has been coming my way, but none has hit the fan yet. It's just a matter of time... I just know it...

Fear Factor

2006-11-24T20:14:00.000+13:00

Just finished 3 days of orientation and I'm exhausted!! Partly because of the early starts and non stop talks all day, but also because for once I've actually tried to pay attention!!! For uni lectures I just drift in and out of reality as I please, but I thought I should try to remember what I'm being told!

I sorta regret listening now. The more they told me, the more terrified I got about starting work! Oh my giddy aunt!! It's going to be horrible!! I'm so terrified!!! I have no idea what I'm doing!!!!!! I've done new scary stuff before, such as trying to go 1 week without internet, but this is totally different because if I stuff up, it has very real and serious consequences! This ain't fun and games anymore!

It's the attention to detail which really gets me. As a student I could just pick and choose the fun bits to keep me entertained and when it got hard I could just give up and wait for someone else to pick up the pieces. I can't do that anymore!!! The fun bits, the crap bits, the medium bits, I have to do them all!

This is what my programme looks like:

Monday: Ward calls (15 hr day)
Tuesday: Acutes day

Wednesday: Post-acutes day
Thursday: All day clinic
Friday: Mental health day

Mental health day is when I cry by the sushi fridge in the caf. Anyone else who wants to join me is free to do so. BYO kleenex please!

The end of an error

2006-11-20T00:52:00.000+13:00

Sorry, I've gotten a bit behind in my blogging. There's been so much happening in the last week, it's unbelievable! The main problem is that while I've been recovering physically from my appendicitis, I've also had to get through the qualifying ceremony and ball!

The qualifying ceremony was a nice little occasion. A good chance for us to pat each other on the back and reflect on the last 6 years of life. It was a really strange feeling for me. It seemed like everyone else around me was much more excited than I was. I also had to self medicate with paracetamol+ibuprofen+omeprazole to get myself through the evening and get up on the stage with something that resembled a normal looking gait.

After the ceremony everyone came out saying to each other, "Hello Doctor (place surname here)!" and then giggling like crazy. I don't get it. Seriously. Perhaps I am just grumpy and cyinical but it just seems like a really cheesy thing to do. Afterall we're supposed to be mature adults and the best we can do is get a cheap thrill out of calling each other Doctor? Did we all really go through medical school just so that other people can rub our egos by addressing us with a this title that is suppoed to give us status and authority in our society? I certainly didn't and in fact the title doesn't sit comfortably with me at all. To me the title implies expertise in our chosen field, and I am by no means an expert in medicine. The real doctors are those who have gained their college fellowship, or in the world of academia those who have completed a PhD. That's what being a doctor is really about.

The strangest feeling was losing a sense of identity. For the last 6 years I have called myself a medical student and suddenly the safety of this disguise was being taken away from me! It means I'll soon be exposed to the real world of the work place, beeping pagers, responsibility, signing my name next to my work, and all that crud that only seemed theoretical a few days earlier.

The ball was also a nice fun event and it was really nice to catch up with classmates for one last time before we split into different directions. Again I felt really flat physically which kinda stopped me from being as sociable as I would have liked. I tried really hard but I just couldn't lift myself.

In a way, I feel kinda cheated. After all that hard work I finally had a chance to celebrate and I couldn't because of my stupid appendix! On the other hand, I guess I could look in the brighter side - at least I made it rather than being stuck on the surgical ward. It would have been even worse if I was sick while away on my elective. I was still surrounded with great friends even though I probably wasn't the best of company to be around.

Now that I've had a couple of days to let the dust settle and rest up properly I can look back now, and despite my whinging in this post, I feel that it was a really nice way to finish a major chapter in my life. Farewell student life! I've loved every moment of it, but now it's time to move on and face the real world. A new chapter in my life begins next week. Stay tuned folks!

Ward 78

2006-11-14T22:20:00.000+13:00

Far out! It was my appendix that caused me the problems in Melbourne! I started having similar symptoms but not nearly as bad on Tuesday night, but I also had this twinge on my right side. I thought I had giardia or something.

I just cruised along still going to radiology teaching on Weds and Thurs and then it got really freaky! I saw my GP at around 3pm and even then she wasn't convinced it was appendicitis so she gave me a letter to go into hospital if it got worse. Even on the drive home, I was starting to feel pain in the car everytime I went over a bump and I got the feeling something sinister was going on.... by 7pm I was chucking up all over again and I suspected my appendix was past its due by date. I then initiated ondansetron seeking behaviours and got Mum to take me to Auckland Hospital.

Good grief the agony. The nausea and vomiting made me want to roll around, but the pain was forcing me to lie still. No escape from the torture!! Then it was time for another 20g IV cannula! More stinging and this time they took bloods so it kept stinging as they sucked the blood out of my antecubital fossa!

I said that maxalon has been useless in the past and asked for my beloved ondanstron, but I only got cyclizine! NO GOOD! After a few more minutes of agony, I begged for my ondansetron and finally got it, but to my surprise it didn't help at all!!!! Oh no!! I'm in this stupid vomiting state for ever! The nurse then got some maxalon and surprisingly enough it actually worked!! OMG the drug that's supposed to be useless actually worked! Oh well, at least I got my taxes back in anti-emetics.

After being sufficiently poked and prodded by a House Officer and Registrar the diagnosis of appendicitis was confirmed. Apart from behaving from an excellent patient giving a good history, other evidence included spiking temps, WCC 15 and ESR 8. Also had K+ 2.9 due to the vomiting. I signed the consent for the execution of my appendix.

Due to an emergency case taking up most of the night, I wasn't operated on until first thing on Friday morning. My gosh it was a weird experience. Just a week earlier I was in Melbourne seeing other patients given the talk about the risk of post-op nausea/vomiting/confusion, heart attacks, strokes, death... or even worse... the dreadded chipped front teeth!!! Suddenly I found I was in Auckland operating theatre admissions bay receiving exactly the same talk from an SHO. There was even a 4th yr medical student to complete the picture!

I get wheeled into theatre, slide myself on to the table and in the process of being connected up to the montoring. Then I'm told that my parents are coming in! W T F!?!?!??! Somehow someone decided it would be cool for them to get changed into the hat and shoes and gown and come in to see me before the operation!!! Of all the time I've spent in theatre, that has to be the weirdest thing ever!!!! Like in paeds, I can understand that parents go in and stuff, but this was just absolutely bonkers!!! I'm just having my appendix out!!! It's not like I'm having a chunk of my brain removed!! (even tho some of you might think that's a good idea)

So anyway, with that ordeal over, it's time to get preoxygenated by the medical student. Then I had the fentanyl followed by the propofol went in which didn't sting at all! OMG that was such an awesome feeling those split seconds before my eyes closed. The experience was quite surreal. I felt so perfectly relaxed and happy. Wow....

My next memory is in recovery which is a shame because I wanted to know what it felt like having the tube pulled out just for the sake of curiosity. I had 16mg of morphine on board so I was pretty drowsy. I have vague memories of the PACU nurse handing back to my ward nurse but my next real memory is seeing my classmates visit me on the ward. Thanks for coming!! I really appreciate it! Sorry I wasn't very good for conversation!! Later that afternoon I also had a visit from mi² which was really nice although I still had a lot of morphine on board and probably looked absolutely terrible.

Part of the reason why I probably looked absolutely terrible was that I couldn't pee! OMG that was the weirdest experience. I was fairly sure that my bladder was full, especially because I hadn't been for almost 10 hrs and received tons of IV fluids, but it was quite hard to tell because of the pain. When I went to the loo, nothing happened! Absoultely nothing! It was quite bizzare! The intetion was there, but there wasn't any cooperation from down below. I even tried walking around... different positions.... ok, so you don't need to know all the details, but basically I just couldn't pee. Fortunately, the nurse threatened me with a catheter and after a couple of hours the water works kicked back into action again.... phew!!

The next couple of days were pretty dull. Every few hours the nurses would come and bug me for my "pain score", often waking me up in the process. This is supposed to be a number between 1 and 10 which represents a range from almost no pain to the worst pain imaginable. This "pain score" really started to irritate me! How on earth am I supposed to know what the worst pain imaginable!! This is the worst pain I've ever had, but I'm sure being in the middle of a nuclear explosion is much more painful! Even more stupidly, it seemed to be used to indicate what pain meds I was given, so I ended up trying to second guess what number I had to say in order to get the drugs I wanted. They also asked what my pain score was when I moved, but I often felt like saying, "I have no freakin idea but I was pain free while I was sleeping!!! Now give me morphine so I can go back to my blissful slumber!!!"

Over the weekend, I also had problems with nausea. Man that tramadol is really nasty stuff. I hated it!!! I'm sure the IV metronidazole didn't help either cos I always felt much worse after it had gone in. The other thing that didn't help was the food! YUCK stupid lite diet!!! Every time I lifted the lid off the plate, I had to suppress the gag reflex. What's with the melted vanilla ice cream! It tasted like chilled animal fat!! So disgusting!!! The beans were boiled to a mush and the bread had been stale for at least 2 days. Even the jelly tasted yuck!! Like how can you mess up jelly!!!

By Monday morning I was well and truly sick of being in hospital. I was still really really sore and quite nauseous but all I wanted to do was go home. I felt I could cope with regular panadol and I had stopped spiking temps for 24 hrs so I could take oral antibiotics. So even though I was still nauseous and not really eating properly, I felt there was nothing much more the hospital could do and I might as well be miserable at home than in the hospital.

Once I got home, I felt immediately better. It's funny how the hospital promotes sickness behaviours. Just being in a more normal environment made me feel more human. Having Mum's food also helped a lot.

So that's my hospital experience!! So many words I could use to describe it... unexpected... scary... interesting... educational... I wouldn't say it was fun, but since it had to happen, I'm glad to have experienced being a patient for once. I have a whole new respect for what patients have to go through. Even for a "simple" appendicitis I found it a pretty hair raising adventure. Imagine what it's like for patients with really serious conditions and have no idea what's going on!

One last comment before I finish this extremely long post - a huge thank you to all of the visitors and people who sent cards and txt messages. I really did appreciate it all even if I wasn't able to reply or say thank you properly!!!

It's all over

2006-11-09T13:42:00.000+13:00

Well, after 3 months on the road, I've finally returned home to Auckland. It's been such an amazing journey and I just can't believe it's all over. From those nervous first moments leaving Auckland airport, to the beaches of Honolulu, to finding my accommodation via the Toronto Subway, to Times Square in New York, to Niagara Falls, to the mountins at Whistler, to Federation Square in Melbourne, to arriving back in Auckland feeling like a totally different person... gosh what an amazing feeling!

The time away really was like a dream. In a way I wish it could last for ever, but probably part of what made the time special was that in the back of my mind, I knew it would only last for a finite time.

Unfortunately I've had to come back to reality rather quickly with a whole week of radiology teaching. It isn't quite as bad as I expected and I think the tutors know that we're all still in holiday mode so they don't drill us too hard. Honestly, I suck so badly at radiology! Everything looks the same to me. Blood, fat, fluid, bones... who cares!?!??! You don't have to worry about me overordering radiological tests because I will avoid looking at them at all costs!!! I think my psychic powers have more chance of reaching a diagnosis than my brain trying to interpret a T2 weighted MRI or whatever it's called...

I had my elective interview yesterday - the chance of the med school to make sure that I've actually come back. They asked me all sorts of questions, such as what my most memorable moment was... but I wasn't really sure what to say because I felt like talking about my encounters with celebrities, or travelling to New York, or the week I spent in Vancouver... but I couldn't think of anything medically related! Anyway, it's all in my elective report! Just read it and save me from having to think!!!!

Ode to ondansetron

2006-10-31T23:05:00.000+13:00

I developed severe abdo pain and nausea in theatre this morning. It just came out of the blue! I decided to just go home I wasn't able to do anything productive anyway. I was walking down the stairs and felt that I wouldn't even make the walk home without throwing up, so I went down to ED to try and find a place to sit lie down. They wouldn't let me lie down unless I actually checked in as a patient, so I sat around for a little bit but I was feeling super lousy.

I couldn't decide whether to see a doctor or not. On the one hand, I really wanted something to take away the nausea because I was feeling extremely ill. On the other, it seems stupid to get admitted to the emergency department for something like gastritis when symptoms had only been around for 3 hours and I was clearly not on death's door. That's what I really hate about being in med! It's impossible to objectively know if you should see a doctor or not!

In the end, I decided that I couldn't go anywhere fast, so I might as well get seen by a doctor. The moment I got into ED, I vomited a couple of times. The doc saw me quite quickly and prescribed IM maxalon which was extremely effective at giving me a sore bum. I was quickly shipped to short stay where I vomited another 5 or 6 times within an hour. The feeling was unbelieveable. I got no relief from the nausea after vomiting. There was no position I could get comfortable in.

An ED reg then charted IM ondansetron. It took ages to arrive because they only stock the IV version in short stay. Now I have bilateral sore bum! A few seconds after that, they decide that I'm vomiting too much to have oral fluids and I needed an IV! So all that sore bumness for nothing! I should have gone straight for the IV!! Anyway, I think a student nurse put in my IV and he did a good job - I would have killed him if he missed because my veins are like drain pipes! Anyway, I now have a new respect for 20g IVs. Even when he did it well, it still hurt!

Anyway, ondansetron is wonderful stuff. It really fixed the nausea. Honestly, I don't know why they make it so hard to get hold of in the community. They should add it to the tap water! Then nobody would ever have to suffer nausea again! It's not like maxalon is a super safe drug and it's even more useless than placebo.

Anyway, after a quick nap, I at least felt able to keep down some dry buiscuits. They gave me some meds to take home, which I didn't know would cost me $20 until after I recieved it. Oh well, at least the travel insurance will cover it. Soon afterwards, I made a quick getaway. Gosh I felt really silly, but then then I guess the ondansetron really helped me make a quick recovery and I couldn't have gotten it anywhere else.

Well, that's my breif encounter with the Australian public health system!

Back to school!

2006-10-27T00:36:00.000+13:00

Being an anaesthetics student is a lot like being a kid. The anaesthetist keeps telling you all of these scary things that could happen. Oo.... if you do that, the patient will have a stroke! If this happens, they'll have a massive heart attack!! Make one mistake and the patient will explode!!!

Of course, none of these things ever happen because you never dare to test them out due to fear of getting into trouble... "if you don't wash your ears, potatoes will grow out of them"... "if you don't ventilate the patient, the patient will DIE!!!!"

Blimmin ozzies!

2006-10-14T22:29:00.000+13:00

On Monday I tured up at the Anaesthetics department. I said, "Hi! I'm the elective student from NZ!" Effectively the response I got was, "What elective student from NZ!?!?!" Nobody was expecting me - nobody even knew I was coming! When the secretary made several phone calls, including a couple to my "supervisor", it was clear that they had no idea what to do with me. So I offered to go away for about 30 mins and come back. After that, nothing had happened so I was just showen quickly around the theatre area and thrown into an operating room. The rest of the week has been similarly chaotic. Every day I just turn up and find a theatre which doesn't have a local student in there already.

Although the lack of a proper schedule has been a bit frustrating, once I get into a theatre it's really good! Getting lots of practise with airway stuff like bag-masking and LMA insertion.... and even a couple of intubations! I've also been getting grilled on physiology stuff - like the 4 things that make the oxygen dissociation curve shift to the right...

Haven't done an awful lot of sightseeing in Melbourne yet. I think after 2 months of sightseeing in Canada, I'm kinda exhausted!! Went to the museum today though which is really awesome! Almost 3 hours in there and I didn't get through half of it! What made it even better is that it's free for students!! Perfect for my budget which kinda exploded in New York and Vancouver...

Aiya! I'm so hopeless...

2006-10-11T00:13:00.000+13:00

This blog posting thing really isn't going too well is it? I think I'll forget about catching up on the Hawaii and Canada bits for now - anyways, while most of it is interesting to me, reading about it will probably put you into a metabolic coma. I'll start posting about my activities in Melbourne and if I have time, I'll insert bits about my Canada trip when I have my episodes of longing to return to the mountains around Vancouver....

I haven't done all that much with respect to sightseeing in Melbourne yet. I've been here a week and I still feel like I'm getting over the jetlag. The 24hrs+ travel from Vancouver to here was quite exhausting. Perhaps I've just been running on adrenaline for the 2 months in Canada, and now that I'm back in semi-familiar territory, I've kinda relaxed a little. I have had the chance to catch up with some friends though which has been very nice. Although I enjoyed travelling on my own immensly, it's also very nice to have some company for a change.

Yesterday, I turned up for the first day of my elective at RMH. I turned up at the anaesthetics department, and nobody was expecting me. It seemed that nobody - not even my supervisor - knew that a student from NZ was coming at all! It took them some time to decide what to do with me. I even left for 30 minutes, came back and nothing had happened! Eventually they put me in a theatre where I stayed for the rest of the day. Today was fairly similar, where I just turned up in the morning and joined a theatre where no local students were already placed. I have been promised a schedule but nothing has appeared yet... while I don't mind sitting in on lists to get used to the environment here, it will be good to have a bit more structure to my attachment. Even if it's just knowing where to go each morning without having to bug the duty supervisor!!!

I'm still alive!

2006-08-25T06:35:00.000+12:00

Hi there! I've finally had a chance to post something! Internet access is somewhat difficult to get here, so all I've managed to do is check email from time to time. It's been an amazing 2.5 weeks so far. Hawaii was really nice, but way too touristy and the food wasn't all that fantastic. Toronto is a really awesome city - even though it has 4 million people, it's easy to get around and there are no traffic jams! The hospital is absolutely massive! The resources are also amazing - imagine getting a head CT and MRI all within an hour of onset of symptoms!!

That's all for now - I'll definitely try to write more soon. Sorry I can't use this computer for long. Oh yeah, and it's stone fruit season. The peaches taste really nice here!!

Anticipation!

2006-08-01T20:57:00.000+12:00

I'm flying off on my elective this weekend! It's so exciting - I'm absolutely bursting to take off! I've probably bored you to death before talking about it, but for those of you who don't know, my itinerary is as follows

4 days in Hawaii for holiday
6 weeks in Toronto for "work"
1 week in Vancouver for holiday
4 weeks in Melbourne for "work"

I've spent a lot of time thinking about what I want to do on my journey. Things I would love to happen but think is unlikely include

Bumping into Kristen Kreuk while walking around Vancouver
Having coffee with Charlize Theron after watching a movie at the Toronto Film Festival
Watching Andre Agassi's last Grand Slam match at the US Open
Sing Blame Canada in Canada and live to tell the tale
Travel north far enough to see the Northern Lights

Things that are more realistic include

Going to NY to watch some matches at the US Open
Seeing some celebrities at a red carpet event at the Toronto Film Festival
Going to Niagara Falls
Enjoying the fine food that's available in all of the cities I'm visiting
Visiting some of the other cities in Canada and USA that are near by

Of course, I'll try to avoid (touch wood)

Getting arrested for doing something stupid...
... and being put on the front page of the local newspaper for doing it
Bumping into Kristin and breaking her nose, or spilling coffee over Charlize
Singing Blame Canada in Canada and not living to tell the tale
Spending so much time in hospital that I don’t' get to do anything fun

Essentially, I've got no clue what I'm doing! While I've spent a lot of time thinking, my limited brain capacity means that in reality I still don't have any concrete plans yet! I'm really not quite sure what I will and won't be able to do. If you have any tips of must-see sights, I'd love to hear from you!!

While I'm away, I'll try to post regularly to let you know what's I've been up to. If I'm lucky, I might even be able to figure out how to post some pictures! This will be instead of sending out heaps of group emails, so please check back here a few times over the next 3 months!

OK! Time to go now. I better sort out my indemnity insurance...

See ya later!

I'm a country bumpkin

2006-07-20T18:22:00.000+12:00

Ok, so it's like this. I drive along Parnell Rd, slightly unsure of where this Working Style place is. I see these guys outside a small shop in flash black suits. They're standing behind a table with fancy snacks, wines and beers. I park the car and walk up to them, feeling slightly inferior in my Barker's jacket and shirt from Country Road. They offer me a drink, but being unable to make a choice from such a sophisticated selection, I choose the Kiri orange juice. Feeling terribly naughty carrying a glass of juice into a clothes store, I make my way in through the front entrance...

As I walk through the door, I wonder to my left and start looking at the clothes on the racks. It contained lots of nice shirts and most of them appeared to be various shades of pink. I started talking to myself, (internally only of course) "Hmm, that's interesting. It must be one of those modern shops like Marcs at 277..." Then I noticed that the shirts were all quite small and had an unusual cut. Very strange indeed! After a few moments of puzzlement, I looked up and saw the manikins modeling the clothes. Whoops!!!! I'm in the women's clothes section. Time to move on!

A group of guys are making their way upstairs, so I decide to follow them. Terrified that I'm going to spill my juice, I skull it down as quickly as possible. Then I proceed to look through another rack of shirts. This time, they're all very nice in various shades of whites, blues and browns. The cuts are more man like too. Next thing to check is the price tag. OUCH! Well clear of $200 each. Of course, these ones are not on sale.

There's a section where all of the items are clearly on sale. Now we're talking! Unfortunately, these items are still over $150 despite the massive savings. What sort of shop is this!?!? I look around at the other customers, and realise that they're all at least twice my age. Maybe I did receive that invitation by mistake. Speaking of the invitation, where is my free consultation!?!? By then I'd been in the shop for a good 10 minutes and nobody had approached to offer me any service. They must have seen my sorry state and probably triaged me - like when rescue crews prioritise people to rescue at the scene of a big disaster like a plane crash. I was probably Triage category 0 which means you're beyond help and not worthy of attention until the body bags arrive.

I was tempted to try on some stuff just to see what it's like to wear clothes that cost the same as a return flight to Melbourne, but I decided that there was no point even trying to pretend that I need, or can even afford, clothes like that. On my way down the stairs, I noticed that there were some men's clothes downstairs after all. It wasn't all women's clothing. Just to make sure, I asked an assistant, "Are there only guy's clothes upstairs?" I should have added, "Or are those men's clothes down there too?" however I didn't realise the ambiguity of my question until he replied, "We only have guy's clothes upstairs..." with a really suspicious tone as though I was actually looking for women's clothes. On that note, I decided that it was definitely time to leave, so I put my head down and made a quiet exit feeling rather simple and uneducated. Oh well, at least I managed to get a free glass of orange juice.

Mysterious mail

2006-07-18T19:20:00.000+12:00

The other day, I received a card in the post from this company called Working Style. I've never heard of them before, let alone shopped from them. I have no idea where they got my contact details from. Anyway, the card says:

Is your image in need of a little lift? Achieve the ultimate makeover this winter with cutting-edge prices available for all those who require "wardrobe surgery". Preferential customers are invited to join us for a free consultation with our experienced staff...

What does that mean?? What is this company?? It sounds like a fashion makeover thing. How did they get hold of me??? Do I dress so badly that someone has made an anonymous referral for me??? Have they got the wrong person? They spelt my name wrong but there's nobody in this building with the other name. Since it's free, I'm thinking of going along just to satisfy my curiosity. In the process, I might emerge with a completely newfound sense of fashion! A true metrosexual!!!

Vertical challenge

2006-07-03T19:38:00.000+12:00

Today I had to examine the retina of a 13 year old boy. He was standing in bare feet and when I walked up to him, I found that even when I was on my toes with shoes he was too tall for me. So I got him to sit on the bed, and I still had to get a foot stool to look into his eyes. Gutted.... absolutely gutted...

Messy desk, messy mind

2006-06-28T19:55:00.000+12:00

Back from sunny Tauranga! No more mountain climbing or trips to the beach for a while now... until my holiday in Hawaii - where I won't have to freeze my gluteus maximus off to enjoy great scenery! I really can't believe that my elective is so close. After 18 months of planning and about 200 emails, the only thing that stands between me and the airport is a 6 week paediatric attachment.

There are a few loose ends I have to tidy up before I leave, such as my absolute pigs sty of a bedroom! Oh! The tremendous amount of junk I've collected during med school. Yesterday, I cleaned out all of the journal articles I've collected over the years. By the time I finished cleaning out the filing cabinet, my room was even more messy than when I started! Then there's my wardrobe with old clothes in it which I haven't worn once since moving from Christchurch! I've really declared war on all of my rubbish, but I think it's going to turn nasty. The avalanche of useless waste is falling faster than I can run!

Junk is winning....

Junk is winning.....

JUNK IS WINNING~~~~~~~~

Life is beautiful

2006-06-11T18:39:00.000+12:00

I've just had the most awesome day. I went into the hospital in the morning, did a ward round and then saw a couple of procedures in theatre. Then I saw a baby being delivered down in delivery suite. I felt very priviliged to have been allowed to witness a very special and personal moment for the family.

After that, I went into town for a late lunch. While facing a very pleasant ocean view, I had a delicious Cajun chicken burger with fries and a nice hot coffee that wasn't too strong or too weak. After that, I felt very full and just sat in a bench and soaked up the view.

Then I drove to Mt. Manganui and climbed up to the top. I took a very steep route which got me to the top in less than 20 minutes, but I was also quite puffed due to my poor excercise tolerance! The hard work was rewared by a beautiful sunset view over Tauranga and the port. I managed to find a spot where I could see the endless ocean to my right, with boats coming slowly into the harbour. Slightly to my left, there was a small forrest of pine trees, which I'd love to say was wild and untouched by humans, but it was probably a tree plantation. Behind it, a warm and mellow golden sun was setting behind the hills in the distance. Further around still, I could see the port winding down for the evening and the lights of Tauranga starting to warm up. The best part of all was that there was no other human life near me at that part of the summit, and the only thing I could hear was the ocean gently brushing against the base of the mountain.

Unfortunately, because the sun was setting, I could only stay there for about 30 minutes before I had to make my way back down. I took an easier route but it also took longer. Almost 45 minutes. It was nearly dark by the time I got to the bottom, but it didn't really matter. A full moon now provided all the light I needed to make my way safely back to the car. I feel so relaxed now. I could easily stay here forever.

Shocking Situation

2006-06-06T10:06:00.000+12:00

Greetings from Tauranga! Gosh, it's been difficult to get internet access here!! There's only one computer that isn't restricted, and the connection is a painfully slow dial-up connection!!! I'm seriously getting withdrawal symptoms here. Shakes, tremor, poor concentration... What makes it even more painful is that there is nowhere to watch the French Open on TV!!!! There's so little to do, I'm actually going to bed early every night!!!!!

I really like Tauranga as a town. I haven't had time to look around that much, but what I've seen has been really nice. It's really easy to get around, plenty of shops to buy all the stuff you need, and the beach by Mt. Manganui is really awesome! I hope to get the chance to see more things later on this week, but it's really hard because I'm tied up with clinics and theatre most of the time. I also can't simply run away because I have so much time to make up for when I was sick!

I'm writing this entry because theatre has been delayed. It was super frosty here overnight and it has caused the humidity to drop. Apparently, this increases the static electricity and makes us more likely to explode if the diathermy machine is used! There are humidifiers going full blast, but they seem to be making not one iota of a difference. Absolutely bizzare. Never heard of this being a problem before!

OK, better see if theater has more mositure in the air. Maybe we should get some kettles and start steaming out the theatres. Sorry for the poor english in this post. Too lazy to proof read. Bye!!

Oil of Oily

2006-05-23T21:23:00.000+12:00

Sorry to have inflicted the story of my illness on you the last post. What can I say? I'm male - I become very pathetic when I'm sick.

There's just a small corollary to this illness. When I went to the GP, she said that she couldn't see my eardrums because they were so full of wax! How embarrassing! When I saw patients in GP land with this problem, I usually suggest either buying some waxsol or using some olive oil. Now, since I'm sick at home and not really keen to go out shopping, I thought I'd try the second option! And why not? You're supposed to practise what you preach right!?

Now, I spent the morning thinking long and hard about how I was going to do this. It's important to get these kind of procedures right! Preparation is the key. Firstly, I thought of the most direct route which was pouring the oil directly into my ears, but that obviously had the potential to go horribly wrong. The next idea involved searching the house for a little pipette. Unfortunately I wasn't sure if we had one. Finally, I decided to keep it simple and just use a small teaspoon.

Round 1. I put a couple of drops on the teaspoon and put it in my right ear. Ooooo! It feels funny when it runs into your ear canal. I sit down with my head tilted for a few minutes and then repeated on the other side. My ears were just a little bit oily but everything seemed fine. Too fine. Had I put in enough? Perhaps there's so much wax in there that it would just soak up the oil and turn into goo!?!? Maybe I should try putting some more in.

Round 2. This time, I put more oil onto the teaspoon. I started with the left ear this time. I relived the feeling of it running into my ear. Then with my head still tilted to the right, I move into the living room, lie on my side on the couch and watch TV for about 15 minutes. Surely it must have soaked in by now. Now it's the right ear's turn! Same drill. Tilt the head to the left, pour it in and back to the couch!

Then after a few minutes, I realise I have a problem - the oil in my left ear coming back out! Ooops! So I grab a tissue and try to soak it up. I can't hear a thing because the tissue is covering my left ear, and oil is completely blocking the right ear. By now, Dad's looking at me a little funny but he doesn't really say anything. A few minutes later, my left hand is soaked with oil, so I decide to sit upright again. Then the right ear starts leaking oil too! MY EARS ARE LEAKING OIL!!! Do you have any idea how strange the experience of your ears leaking oil can be?? Let me assure you right now that it's quite bizarre.

So there I am, sitting with oil coming out of my ears, I can't hear anything, and nothing appears to be helping in the wax department either! I even tipped my head to the side and tried tapping lightly to get some to move. No luck. :(

Oh well, I'm going to try and wash my ears now. They're quite oily now. I wonder what it looks like inside now.....

Dying Swan

2006-05-21T22:52:00.000+12:00

It all started harmlessly enough. Just felt a bit more tired than normal on a Sunday night. I woke up on Monday morning feeling a bit achy in the legs, but it's nothing a couple of panadol can't handle. Breakfast isn't as appetising as normal, but that happens sometimes. I proceed to attend the first day of the ACLS course. I'm really enjoying it, but as the morning progresses, something doesn't quite seem right. The panadol has worn off much faster than expected. The aches in my legs are starting to spread to the rest of my body. I'm tired as though it's 11pm already, but I check the clock and it's only 9am.

Lunch time can't come around fast enough. The aches are getting worse. It is a frosty day, but the quick trip across to the caf causes quite an unpleasant feeling. I'm positively shivering when I get there. I'm so cold that I buy a slightly unusual combination for lunch - hot pie and pumpkin soup. It certainly warmed the soul a little, but it didn't help the aching that had now well and truly set in. I tried to sit quietly for the remainder of my lunch break but GeekBoy next to me refuses to shut up. I started to get a headache too.

The remainder of the afternoon was an uphill battle. Every movement required so much effort. When we moved to a different room, the temperature would change too and I would start to shiver whether I was hot or cold. In fact, I couldn't tell if I was hot or cold at all. I don't know why I didn't just go home, rather than wait for the 5pm finish.

That night, the rot really set in. Fever, headache, and muscle aches from head to toe. I'm so tired. I can't move at all. The only way to avoid the pain is to sleep. I cannot take enough panadol to keep up with the symptoms without killing my liver at the same time. My hopes of completing the ACLS course, and the start of my O&G attachment have to be postponed.

By Tuesday night, the sore throat started. At first it was insignificant compared to the pains in the rest of my body. However by the next morning, I thought I had swallowed a cactus. Not any normal cactus, but one of those really nasty ones that Wile E. Cyote would use to try and catch his Road Runner. Swallowing became so painful that it was almost impossible. My appetite disappears. Along with the continuing fever, headache and myalgia.

By Thursday, I'm sick of it all. I make the decision to see a doctor. When I ring Pink Cottage, I find that they're all booked for the day and their next appointment is tomorrow. I might be dead by tomorrow!! So I decide to call Mum's GP and I find that because I'm not registered with them, it will cost me $57!!!! After coercion from Mum and V D, I still attend. The GP is very nice and tells me what I half expected to hear anyway. "It's probably just viral". She was good enough to take a throat swab anyway to make sure it wasn't strep throat.

That night, I slept for over 12 hours. On Friday morning, I wake up with no voice at all. It's totally disappeared. I also discover that I've developed a productive cough. My Mum, who has been fantastic by keeping me alive with regular hot drinks, gets me some neurofen and throat lozenges. They make a huge difference, and finally with the combination of neurofen and panadol the pain starts to feel more managable. Unfortunately, the neurofen is also not so kind on the stomach, particularly because I've had almost no food since Monday, I started to feel more nauseous.

It's the weekend again, and I'm still alive, but only just. Fever, headache, myalgia, sore throat, productive cough, with sore ribs and abdo muslces from coughing. When will this all end!?!? At least the Crusaders winning their semifinal provided a little relief from my grim outlook on the world.

Sunday morning again. Day 7 of my illness. To my surprise, I wake up feeling a little more human. It still hurts like crazy to cough, and I still can't talk, but at least I don't need panadol to survivie. The other pain symptoms and fever had settled. Perhaps there is a chance of recovery. Still unable to start O&G tomorrow though. I think I'll need another day at home at least.

Halfway House

2006-05-12T21:25:00.000+12:00

I know when I've enjoyed a rotation when I'm sad to leave. The last seven weeks has been so amazing. In 4th yr I hated general medicine, but this year I've learnt more that I could have possibly imagined. I had an awesome team with a House Officer who worked me like a slave, and a registrar who was a walking encyclopedia! I also had a great no-nonsense consultant who had this amazing ability to focus on the useful information and ignore all of the crap that just confuses matters. We also had fantastic patients with such a wide range of interesting problems! I couldn't have asked for more.

I'm not sad about having done my long case though. I sounded like a bumbling fool throughout the my presentation to the examiners. It got off to a bad start - I realised I had forgotten to ask the patient her age! Then I had forgotten to write down all of her medications! As I kept talking, I could see the examiners change from looking bored to confused to dismayed to irritated. With each morphological change in their facial expressions, I got more and more nervous which made things even worse. Finally I got to the end and had a chance to shut up.

Then it was question time! Of course, I handled these with true professionalism.

Them: "How is a bone scan done?"

My brain: "I fill out a yellow referral form and ask for a bone scan, and it just happens"

What I said: "I dunno"

Later on...

Them: "What dose of morphine would you give?"

My brain: "As per IV protocol"

What I said: "I dunno"

That's just a brief glimpse of my stupidity. Oh well, it's all over now and there's nothing I can do to change the crazy things I said.... or didn't say.

Anyway, there's more exciting things to think about! I'm now exactly half way through TI year! Half way towards becoming a House Officer. Hence, you can call me House while I earn the Officer part over the next 6 months! (OK, sad joke I know) All of the big rotations are over now. There's just O&G, paeds and my elective to go! Going to out of town for O&G is a bit of a nuisance, but I'll make the most of it and try to enjoy having a rotation outside of Auckland.

Of course, the most exciting thing coming up is my elective!! I've finally managed to get my plane tickets sorted. My hands were shaking with excitement this morning when I signed the forms at the travel agents! I'll talk more about this in another post!

Stupid

2006-05-07T22:46:00.000+12:00

Whoops! I've kinda slipped a bit with posting! Been super flatout the last couple of weeks. Mainly because I accidently found myself admitting patients over last weekend. Admitting in itself isn't too bad, but it means having to go into hospital for 12 consecutive days which is quite tiring!! I was extremely tired this week and I kept switching off. My consultant must have noticed because he suggested that the TI should do a brain biopsy on one of our patients. I actually heard the comment but it didn't even register to me that it was a slightly unusual suggestion!!!

The stress was exacerbated by the stupid case history that was due in on Friday!! The stupid word limit meant I ended up deleting more than I was writing! ARGH so stupid.

I've also had to practise presenting long cases which is quite a stress in itself. It's really hard to find appropriate patients. When you have one and see if you can talk to them, either they are eating, sleeping, having family visit, or simply don't want to do it.

Also, 45 minutes to talk to a patient and examine him/her is actually a very short length of time. You have to cut corners but then it puts you at risk of missing something really important!

Next, it's amazing how stupid you feel while presenting to a registrar or consultant. Even when you think you have all of your bases covered, someone can come along and rip you to shreads from a totally different angle which you never expected!!! It's kinda like having a komodo dragon bite into your spleen while a neurologist tests both plantar reflexs at the same time... or so I would imagine. Gosh, it's so depressing to think about how little I know. There's so much study ahead of me it's not even remotely funny.

Even more depressing - I have to wake up at 6.20am tomorrow... AGAIN!!

"You cannot be serious!"

2006-04-16T23:08:00.000+12:00

Today, I was a volunteer linesman for the men's finals of the club champs at the tennis club I play for. I've never done anything like that before and it certainly was an interesting experience! For three hours I sat in a plastic chair watching the baseline at one end of the court.

Being a linesman is a job filled with mixed emotions. On the one hand, you hope that the ball never lands near your line so that you don't have to make a difficult call. On the other, when you have nothing to do, it gets really boring and your concentration wanes. When you do let your guard down a little, that is when the ball does come near you line and suddenly you realise that you've missed where the ball landed and you have to guess whether it was in our out!!! OOOPS!!!

Fortunately, the guys in the final like to play really safe and seldom hit near the lines. I only had a couple of close calls to make and they didn't do a John McEnroe on me. I also wore my dark sunglasses which helped me avoid making eye contact with them after making a close call!

Something random - I was just watching Laurie Fisher, coach of the ACT Brumbies being interviewed on TV. Suddenly I thought, "Santa must have really bad rosacea." Hmm.... go figure...

NG tube anyone?

2006-04-11T19:49:00.000+12:00

I just spent the last two days doing the Surgical Skills course. The first day covered stuff I've managed to do a few times already, such as suturing and applying local anaesthetic, but it was good to learn how to do them more formally. The second day was really good and covered more tricky things like lumbar punctures and chest drains.

The only problem with the course were the two people who were running the course. They were really patronising and treated us like school children. One of them was particularly unhelpful and I got really cross when she was telling me I was tying a knot incorrectly without explaining why I was doing it wrong or how I should be doing it properly. I know I'm stupid but I don't appreciate being reminded of it. Anyway, once she went away and VS sitting opposite me showed me properly for 5 seconds, I had no problems tying the knot.

One of the tasks was learning how to insert a nasogastric tube. We had the chance to do it on each other and it has to be one of the most uncomfortable things I've ever had done to me. Firstly your nose become very irritated when the tube enters the nostril. Then your eyes water as it goes further in. It becomes painful as it passes over the nasal septum and bends down into the pharynx. Next, you feel it scratch the back of your throat as it touches your gag reflex and you start to want to vomit. Then it's shoved quickly all the way down the oesophagus which isn't painful in itself but the sliding against your throat makes you gag even more.

When it finally reaches your stomach the tube is still triggering the gag reflex while the person who is inserting the tube aspirates your gastric contents. The sight of instant noodles, chicken, berry smoothie and gastric acid mixed together reinforces your desire to vomit. Finally the torturer decides to pull the tube out, and you relive the experience of it being inserted again but in reverse. Phew!! The tube is out!! Your nose aches like you have sinusitis. Your throat is sore like when you have a cold. You can taste blood from the trauma. Eyes are still watering too. At least the desire to vomit has disappeared.

From one madhouse to another

2006-03-27T21:49:00.000+12:00

The last three weeks of rural GP has been great fun. There was no assessment apart from my consultant marks, so I could just turn up each day and enjoy the attachment without the stress of having to do annoying presentations or study for tests. It was close enough that I could drive out each day. Going against the traffic, it didn't take very long at all!

When I arrived, I was able to do all kinds of things. Seeing patients and sitting in on consultations took up about half of my time there. There was also a GP there who focussed on dermatology so I got to see lots of skin stuff. I found that really helpful since I find derm quite difficult.

There was a lot of down time, especially in the afternoons since patients preferred to come in the mornings. However that gave me the chance to gain other skills that I hadn't expected to learn. While I was there, the practice staff were doing a major spring clean. They had lots of documents that needed shredding. So whenever there was nothing to do, I sat at a desk, took staples out of the papers and fed them into the shredder. Unfortunately the shredder was unable to keep up with my efficiency and frequently overheated and went on strike. Then I would go back to a consultation room and browse the web.

In the last week, a handle broke off a drawer. I went over the road to the hardware store and bought some supaglue. Then I returned and supaglued the handle back on. That was so fun! You don't learn skills like that in hospitals!!

Alas, the fun can't last for ever and I'm now back in hospital for General Medicine. Today was my first day and having been away from hospitals for three months, it certainly was a rude shock to the system!

Firstly, I forgot to set my alarm and overslept - I have to wake up an hour earlier for this attachment. Then I had to put on a long sleeve shirt and tie! I could barely breathe. Then I got on the motorway, and as I was driving along, I was struggling to remember how to drive to the hospital. When I got to the offramp I normally take, I found that I had to take a detour because of roadworks! That made me really late so I parked my car and rushed in as quickly as possible.

When I got to the meeting place, I found that I was still 20 minutes early because I hadn't read the arrival instructions!! It never occured to me that our orientation book would tell me when to turn up. The orientation never happened because the orientation person was in Australia.

I proceeded to join my team and got plunged into a consultant ward round. Then I found myself writing in the notes of a patient when I had no clue what was going on. Then I began to write super duper brief notes in a surgical style. My house officer reminded me to pan things out a bit more appropriately for medicine.

After the round, it's time for ward jobs. I was asked to put a luer in a patient. Things were going smoothly - I managed to get all of the bits and pieces ready, lined up my target vein, donned my gloves and feeling all ready to go. Then I opened up the luer pack and held up the needle. Then I looked at the needle. After three months of not looking at a needle, these things look huge!! I stared hard at it and thought, "$#^! do I have to stick this in someone's arm??" I checked the pack to make sure I had the right one. I did. Then I started shaking - this was not a good look.

After a few seconds of internal screaming, I managed to pull myself together and got the luer in without spilling a drop of blood! Feeling rather proud of myself, I proceeded to secure the luer with one of those sticky thingies (whatever they're called). Then I totally stuffed it up and got the sticky stuck to itself. That's when you say to yourself, "L-O-S-E-R"

Well, that's day 1 completed! Six weeks, 4 days to go! Let the fun begin!!

SARS is more prevalent than you might think

2006-03-18T23:34:00.000+13:00

I was playing interclub today and one of the balls I was playing with rolled behind the neighbouring court. I waited patiently for the rally on that court to finish. The guy at my end hit the ball in the net and I went to pick up my ball. Then I heard him scream out in his native language (he was from Eastern Europe) and a split second later heard a massive WHACK as his racquet hit the fence and then deflected off and hit me on the leg! How spastic is that!?!? Thank goodness it didn't hit me before it hit the fence.

That guy had serious anger issues. In the first set he threw his racquet and cracked the frame. In the third set he cracked another frame and then proceeded to totally destroy his racquet on the ground. I heard from one of his team mates that he broke a racquet last week too! That leads me to several conclusions

His mummy didn't hug him when he was a child
He can afford to buy tennis racquets every week
If he runs out of racquets, don't lend him your one
He has a notifiable disease: SARS (Spastic Abuse of Racquet Syndrome)

I'm certainly glad I didn't have to play him. Instead, I had to play a 13 year old kid. He also had SARS but to a lesser extent. I drove him up the wall by playing soft lobby shots which got him really frustrated. This caused frequent exacerbations of his condition. Unfortunately he was able to control his symptoms in the community setting and he ended up beating me 7-5 6-2. I really feel old now!

I'm also annoyed now because this was going to be a non-med post, but somehow I've managed to spoil it with this stupid SARS thing. Oh well, better luck next time! Tata for now!

I just had to post this picture...

2006-03-08T22:32:00.000+13:00

No pain, no gain!

2006-03-06T22:53:00.000+13:00

Well my community psychiatry attachment is over. Once again I have mixed emotions. Happy because that's another attachment out of the way. It was also a little tricky feeling so lost most of the time just floating around trying to observe stuff where ever possible. I'm also sad because the staff were all really friendly and I did get to see a lot of interesting patients. The OSCE was a complete nightmare and I'm not even going to start talking about that!

Over the weekend, we had the introductory BBQ for YACMA. It went really well but the turnout wasn't quite as big as we had hoped. It's funny how things unfold differently each year. There must be some deep and meaningful psychological factors which influences whether people are motivated enough to turn up for events such as these. While our advertising campaigns does contribute, I have the feeling that there are other factors beyond our control.

The kebabs went down really well at the BBQ! I'd like to claim credit for making them, but WW donated the recipe, YH mixed the ingredients and I didn't really do anything particularly useful. However I would like to say how much pain and suffering I went through to make them possible. I had to chop two whole bulbs of garlic. Do you have any idea how much it hurts when garlic juice soaks into your fingers for 30 minutes!?!??!? I was in such agony while chopping and later that evening I had to soak my hand in a bowl of cold water! Three days on, and my fingers still stink of garlic. Also, my fingerpads are now numb where they were stinging on Friday night. The sacrifices I make for YACMA! Forget about claiming expenses! I'm going to claim physical disability!!!!!!!! Oh well, at least I am safe from vampires for the next few nights. Buffy can have a holiday from watching over me while I sleep.

Today marked the start of a new attachment - rural GP! As you can probably tell, it must be in a town not too far away from Auckland City if I'm still posting on my blog! In fact, it's hardly has a rural feel at all. There are at least 4 GPs working there, a physiotherapist, a pharmacy and a brand new x-ray machine! Basically I just had an orientation day so I didn't get to do much. However it should be a nice and enjoyable three weeks ahead!

Gosh this is a boring post. Sorry about that. I can't think of anything really interesting to say right now... Actually that's a lie. There's heaps I want to post but it's hard to talk about things that I see in clinic and not break patient confidentiality. I really have to figure out a way of telling stories without saying stuff that I really shouldn't.

Psych is cool

2006-02-25T23:50:00.000+13:00

I've found a problem with the way I've been posting on this blog. I wait until the end of the week but by that time I've forgotten all of the things I want to post. I might try posting short bits during the week rather than a big weekly post.

Psychiatry is starting to grow on me. At first I found listening to all of the difficult stories literally made me feel like a huge weight was pushing me into the ground. They're all so emotionally draining. However I'm starting to toughen up and starting to think that psychiatry is quite a nice specialty. It's really cool being able to help out patients in so many different ways. From medications to psychological interventions to family involvement, there's so many things that can be done - and when it works, it's so fantastic to see!

There are very few emergencies in the outpatient setting. If anything is urgent, the crisis team can sort it out. Appointments are for 30 or 60 mins. So, if your patients don't turn up, you could have a whole hour to kill. If two patients don't turn up, you might have half a day completely free!

Another advantage is that you can work part time. That means you can spend the rest of you time researching into more important things such as the next Final Fantasy release, places to see in Toronto or playing tennis or whatever else takes your fancy.

Of course, like every speicalty, there are disadvantages. For example, you might have a patient who thinks that you are the direct descendent of Satan and decide that you need to be introduced to his/her machete. But that's okay because you have spent your 2 days off each week perfecting techniques such as the Kamaehamaeha Wave or summoning your favourite aeon. I would favour Bahamut in a situation like that.

The other down side of psychiatry is the mountain of paperwork that needs to be sorted out for each patient. However once again there is an easy solution. You can ask your TI (Trainee Idiot) to write them up for you.

In summary, psychiatry is a very interesting specialty with potential for great job satisfaction and equally great lifestyle. There are a few disadvantages but there are ways of overcoming them. Defintely something to think about for the future!

Difficult to please...

2006-02-19T00:21:00.000+13:00

I spent first week of psychiatry sitting around doing nothing for half the day, sitting around trying desperately to stay awake. If I was lucky, I got to see a patient, but the consultant rooms were too warm and that made me even more sleepy. Painfully sleepy. My eyes would water, overloading my lacrimal ducts, causing my nose to run as well. I even resorted to reading a Cochrane review of olanzapine for schizophrenia to try and stay awake.

Then week two arrived. Before I knew it, I had sat in on three new patient consultations and had to write them all up in full psychiatric glory - 4th year case history style. Except in 4th year we had to write up two cases over six weeks. I had to write these new patients up ASAP! Oh, how I long for the days of surgery....

S-abdo pain

O-RLQ tenderness

A-appendicitis

P-NBM, BMC, OT

Psych could be the same really...

S-sees dead people

O-what dead people!?!?!?!? *play spooky music here*

A-MAD

P-clozipine stat.

Alas, psych is not like that. Painting the picture of a psychotic patient is very difficult indeed. Yes, I know being slightly psychotic myself, it should be easy for me however unless you've had exactly the same delusions as the person you're writing about, it's quite tricky to portray how the patient presents in a Word document.

Anyway, I digress. Fortunately, by Thurday morning I had managed to catch up on all of the paper work. Then I sat in on another new patient and had another case to write up! I spent all of Thurday afternoon working on that. Received feedback on Friday, and spent the rest of that morning making the necessary changes. I emailed it to my consultant before I left, but sent it to the wrong email address! So now he's probably thinks I'm a complete slacker and didn't get the work done before I ran away for the weekend.

In other news, I'm quite disgruntled with my tennis. In singles, I'm on a 4 match losing streak. I feel like it's becoming a habit and I don't know how to win anymore. Today was particularly frustrating because all of my shots were working - even my backhand which I've been dumping in the net - but I couldn't get a decent serve in! I even tried rolling my arm over just to get the ball in play but they kept on dumping into the net! A sure sign of a lack of practice. Unfortunately, that's just another of adverse effect of medicine. It insidiously draws you away from other things that you enjoy, until they become fun no more.

However I'm trying to not let medicine destroy the fun of tennis. I'll try to practise a little more this year and at least get back to a decent standard where I don't have to do scream in agony every time the ball dumps into the net.

OK, that's enough rambling for one night. It's getting late and my English is deteriorating fast. BYE!

A cool video!

2006-02-12T22:42:00.000+13:00

I've added a really cool link to a video. It's called Yellow Fever and was first shown to me by JW. Have a look and let me know what you think!

Warning - it's quite large, so beware dial-up users.

I survived GP

2006-02-06T13:04:00.000+13:00

Oh my giddy aunt. I knew Trust Health Care would be busy, but I never expected to have a near death experience. OK, perhaps I exaggerate a little, but the run was seriously busy. Especially the days TF was there. There were a couple of days where I didn't get home until 7pm. That's nuts for a GP attachment! Oh well, I can't really complain as I asked to go there, and I knew it would be hard work. It was worth it though since I learnt heaps and still had lots of fun despite the chaos.

Now to the world of psychiatry! First day today. I nearly died of boredom waiting to see a patient. I was allocated a small desk in the cubicle area and was waiting quietly for a consultant to see a patient. However I think I was probably too quiet and they kept forgetting to tell me when they were about to see someone. Finally at 3pm, after reading the 4th yr notes for the millionth time, I managed to see a couple of people but nothing particularly dramatic happened. After that, I was out the door faster than a speeding bullet!

On Saturday, I'm going to be a model patient for the surgical part 1 exams! I'm quite looking forward to that. It will be a good experience to see what it's like for the registrars without having to sit the exam myself. I hope they don't tell me to be a hernia patient. That would suck. *cough*cough*

The pleasures of life

2006-01-26T20:40:00.000+13:00

I'm sitting infront of my computer, trying to write another blog entry. I'm tired. It's been a long week. I want to write something but I can't quite figure out what it is.

Then I hear you calling me. No, it's impossible - it can't be - I must be imagining it. I focus on my writing. Minutes later you call again, this time more persistently. I try to block you out of my head but for some reason I cannot shake you from my mind. Resistence is futile.

So I follow your calling. I walk around the corner and see you sitting there waiting for me in an inviting pose. I try to play it cool - walking past and pretending that I don't care - ignoring your symmetricaly, perfectly shaped form. However your beauty is too much and I cannot bare to be separated from you any longer. Picking you up gently but firmly so not to hurt you, I carry you away.

I turn the tap and the refreshingly cool water runs over both of us. Oh, how nice that feels after a long day in the summer heat. Then slowly, carefully, tenderly, I slowly peel off your outer clothing. It is not an easy task as it hugs your body so tightly but soon enough your smooth bare pale flesh is exposed to me. My heart races with excitment and anticipation.

After drying you off with a towel, I lead you hastily to the couch. It would be nice to get comfortable but there's no time. I smell your wonderful scent and the desire to taste you is overpowering. Gently, my tongue touches your flesh. My mouth tingles with delight. Then I can resist no more! Suddenly, I sink deeply into you like nobody has done before! Your juices flow everywhere, and pure ecstacy flows through every vein in my body. In a mad rush of passion, I sense an overwhelming urge to taste every part of you. Your body is part of mine. My body is part of yours. Suddenly we are one and a state of absolute pleasure that I never thought possible is achieved.

Then as quickly as it began, it is all over. Alas, our short passionate affair ends. We must part ways as what we had is no more. Tomorrow is a new day and I will be with another. Life is both wonderful and crule that way.

Oh, how I love eating peaches.

Here's Tom!

2006-01-21T00:31:00.000+13:00

Introducing Tom

2006-01-20T22:06:00.000+13:00

I've been so flat out since creating this blog, that I've had no time to post!

I would like to introduce TH, my brand new nephew . He is the newest addition to the family, my sister's first child and my parents' first grandchild. He weighed a massive 4.44kg and will probably be bigger than me sometime next week. (OK, so I exaggerate a little, but he's a big kid!) He is only 9 days old but it sounds like he is definitely making his presence felt in the household! It seems like he may be naturally nocturnal - just like me! I will upload pictures of him as soon as I figure out how.

I've just had the first week of my urban GP attachment in a very busy practice in South Auckland. It has been a fantastic experience and the work is very challenging because many of the cases are very complex. Since almost all of my attachments have been in the controlled environment of a hospital, learning how to handle these complicated patients in the community setting is scary but also very satisfying. Also, the patients come from a really cool community. They're a great bunch of people to work with.

Despite all of the difficult cases, the most scary moment this week actually happend on Thursday morning at peer review group meeting. It all began late on Tuesday afternoon when my supervisor, TF, asked me to read up a little on the evidence for giving Vitamin D for the prevention of osteoperotic fractures. I thought she asked me this so I could follow the discussions at the meeting. I did a quick medline search, and found a nice little meta-analysis in JAMA. I just skimmed over the abstract, introduction and discussion quickly to get a very brief idea about the latest recommendations about Vit D.

On Thursday morning, I innocently turned up and waited for the meeting to begin. GPs from several practices were there. Then TF announces that I'm going to give a short presentation on Vitamin D. At that moment, I very nearly lost all sphincteric control. The overseas elective student laughed his head off when he saw the terror in my eyes. I suddenly felt very very small and hoped that the ground would just open up and swallow me. Unfortunately that didn't happen. I just managed to scramble together the salient points from the article and made it sound like I had read the whole thing, being careful not to mention things that would lead to more complicated questions. Luckily, I remembered the NNT, which one of the GPs is particularly obsessed with because he has a special interest in public health. That seemed to fend off any major attacks on my limited knowledge and withering self esteem.

This entry is much longer than I would have liked but there's just so much I want to put in! As time progresses, I'll figure out what's important to blog and what's not. I don't want this to become a long and boring blog that nobody wants to read. Any input from you is most appreciated. Please post a comment!

See ya later!!

Moving to blogger

2006-01-11T17:35:00.000+13:00

I've decided not to put my blog on MSN spaces because the design is too limiting. Hopefully blogger will be better.