The Friday Rewind 3/7

Time for the the Friday Rewind again! Here is the best and worst of what the week had to offer.

1. The Best of This Week

  • Earlier this week we had a hands-on lecture on how to perform the Musculosketal exam. I am not sure if it was the physician who taught the course or the fact we got to do it together as a big group–half of the med students were paired up in one room–but this was one of the most enjoyable classes I have taken in my first year. My medical institution is all about technology, which of course as a technology aficionado, I love. But it was very refreshing to hear a physician highlight the importance of the physical exam. No amount of technology can ever replace what we can learn through observation and our hands. I walked away feeling like my hands had new powers. I feel confident I can correctly identify any suspect sprained ankle or swollen knee–which I learned could just be bodacious fat pads, so it is good to know what you are looking for!
  • I had a 3 month follow-up with my cardiologist to discuss the new medication he put me on (pyridostigmine). I told him it helps with keeping my tachycardia at bay and limits my  palpitations  BUT it does nothing for the symptoms I really care about like chronic pain and fatigue. I was actually pretty surprised by his response. He said “great!” the medication is doing exactly what it is supposed to—we both knew it wouldn’t really help with the neurological symptoms but at least your heart is responding well. He said that this is probably as good as I am going to get and that in comparison to other POTS patients I am doing exceptionally well. Not having anything to compare to I didn’t realize I was actually a sterling example of the best case scenario for some people. This made me feel pretty good. All of my hard work in making sure I keep up with lifestyle changes has been paying off. He suggested my next step should be to try some eastern medicine things, which I am pretty curious about. I shall keep you updated with my foray into alternative medicine…
  • I am not exactly sure what this says about me, but I got a new vacuum this week and that made me really happy. We are about to start 2 weeks of intense examinations, we don’t even have any classes, just dedicated study time and exams– and nothing helps me prepare for exams better than a clean house. I spent the morning cleaning my entire home and now I feel ready to crush my histo and pathology exams on Monday. That is of course after I spend all weekend studying in my very clean home.

2. The Worst of This Week:

  • I had my anatomy dissection of the plantar foot this week. I love medicine but spending 3+ hours around cadavers is just not something I can get used to. I may still be jaded from my last exam but this is the class I have enjoyed the least in our training. Nothing will feel better than that Anatomy shelf on Friday, June 13th, which will mark not only the end of anatomy (forever!) but also the end of our first year of medical school!

3. Medical Breakthroughs of the Week: 

  • Researchers Report Treatment Clears HIV in Second Baby: Evidence is increasing that treating HIV-positive babies within a few hours of birth can dramatically restrict — and perhaps eliminate — infection.The baby, born at Long Beach’s Miller Children’s Hospital, was given triple drug HIV therapy starting within 4 hours of birth to a mother with untreated HIV.Tests at birth showed the presence of HIV DNA in the baby and testing 36 hours later — 32 hours after treatment was started — showed a plasma viral load of 217 copies per milliliter. A spinal tap when the child was 6 days old showed 32 copies of HIV RNA per milliliter of cerebrospinal fluid, Persaud reported. But within days, almost all signs of HIV had disappeared. The plasma viral load, for instance, was and has remained undetectable, defined as fewer than 20 copies per milliliter.

4. Just for Fun-The Friday Rewind Image Challenge 

What’s the diagnosis? (My medical school friends better get this histo themed challenge!)

Screen Shot 2014-03-07 at 3.43.46 PM

A) Adenocarcinoma

B) Candidiasis

C) Dieulafoy’s lesion

D) Schatzki ring

E) Systemic sclerosis

*Courtesy of the New England Journal of Medicine. Answer in the comments sections. 

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3 Comments

Filed under Friday Rewind

3 responses to “The Friday Rewind 3/7

  1. The answer to the image challenge is A. This nodular abnormality was found to be an early adenocarcinoma in a patient with Barrett’s esophagus.

  2. Hannah

    As someone who regularly experiences mild POTS symptoms and is about to start medical school, I was wondering if you could give any advice as to how you address your physical limitations with your professors/attendings? I know during rotations and shadowing we are required to do a lot of standing, which can sometimes trigger my symptoms. How have you dealt with this? Interesting to find someone else with a similar situation to mine!

    • Hannah,
      Thanks for your comment. I will try to address this in detail in a future post. Briefly, I would say the following:

      1. Know your body and your symptom triggers- then avoid them! For instance, whenever I am at the hospital I am constantly chugging gatorade or water to make sure I don’t get dehydrated. This helps with my pre-syncope symptoms and tachycardia.

      2. Be upfront about your limitations: If you feel you physically can’t do something–talk with your attending or program director and let them know. That being said, be selective. I don’t want to be treated any differently, so at this point, I still have not told many attendings about my condition. Mainly because I am fine without any special treatment, so it’s not necessary for me.

      3. Above all, take care of yourself. Get enough sleep, exercise, hydrate and take whatever medication regiment is working for you. I never allow POTS to be an excuse for me not to do something. So far it has not stopped me.

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