- Confirmed Ectopic Pregnancy
- Testicular & Ovarian Torsion
- Confirmed Tuberculosis (yes, this was a little scary)
- Large pneumothorax (and placement of a chest tube at bedside)
- COPD exacerbation (leading to intubation)
- Syncopal Bradycardia (this case was very confusing so this is the best way to explain it)
- Benign positional vertigo, with saddle paresthesia and large weight loss (never confirmed Dx)
This year I decided to work 7 days out of our winter break (last week of February). Two days into this decision I felt regret and wished that I took more time off for myself, however, by the end of this past week I was very grateful for all the things that I witnessed. To list just a few, this week I witnessed the presentation, diagnosis, treatment and complications of the following:
Something new our class is trying is a 12 hour ride on an ambulance to help ease us into rotations a bit better. Many of my classmates have worked in emergency medicine but many of them have not. This was a great idea for everyone because we could finally see the meds we are learning about being used in action. There were two stations for this ambulance service that we were stationed at. Typically, 2-3 students were at one location and 1 at another. I was located at the station in Mechanicville by myself with two paramedics. At first, I thought I would get maybe one or two calls at the most. It was a very slow morning, we were just sitting in the station for 5 hours before we received our first call. By the end of the day we surprisingly received 4 calls, only 3 of which that we actually arrived at. (One of the calls was cancelled on our drive over because someone had passed before we arrived.) One call was unique and we did not need to provide much assistance. Two of the calls were related to SOB. One had COPD and lower back pain and the other was more of an emergency with heart failure and possible STEMI. I got to use my ER tech skills and place all the patients on the heart monitor and EKG. I listened to their lungs and the last patient we had was very crackley bilaterally. When we got to the hospital to transfer him, they took an Xray and there were kerley B lines diffusely spread across his lungs. At this point, I realized that one year ago, I had no idea what any of these things were. I would never be listening to a patient and being able to make differential diagnoses in an emergent situation. It was a satisfying learning moment. What amazed me most was just watching the medics work. It was interesting to see how well the paramedics could do everything in a bumpy vehicle while putting IV's in, filling the nebulizer etc. At the end of the 12 hour shift we were frozen because the temperatures out today ranged from -5 to 10 degrees. Arriving back at the station the medics wrote up their reports of the cases from today and even let me have a copy of the EKG's once they removed patient identifiers. I would just like to thank the paramedics that worked with me. They were extremely friendly and helped me learned so much in just 4 calls. I think that this exercise was definitely worth it, I hope my classmates got as much out of this as I did.
Today we finally took our exam on all the cardio drugs. If any of you readers are familiar with this area of medicine, you will know that there are many... MANY cardio drugs out there. Because of this, it was the largest fear I had about my future. Why? Because if I want to specialize in cardiology, I should probably know and understand the cardio drugs... if not? Well, then I should reconsider my future plans.
Studying for the pharm exam, I noticed that I was understanding the material pretty well. The concepts came naturally to me and the only thing holding me back was memorizing unfamiliar drugs. From working in the pharmacy, ER and ICU, I was very familiar with beta blockers, Ca+ channel blockers, diuretics etc. From my undergraduate days, I remember parasympathetic and sympathetic responses like the back of my hand. Baroreceptors, reflex responses, epinephrine, norepinephrine, isoproterenol, etc, this is the stuff that I like, feel comfortable with, and enjoy learning. I wish all topics required this type of thinking, reasoning, and problem solving skills.... instead of straight memorization that is just simply exhausting.
The biggest struggle I came across as I was studying was memorizing the classes of drugs that I never thought about before, like mixed alpha agonists, pure alpha agonists etc. Luckily, all my studying paid off and I did pretty well on this pharm exam! Once I realized this, I could breathe... I still have hope in cardiology... I think I can do it... I have a reason to believe it now. Now, I just need to survive and stay awake the rest of this term! -lol (<-- haha see what I did there? Beta blockers are funny!)
I know that I have posted before about our suturing clinic that was directed by our PA program faculty. But, recently, we received an email about a suturing clinic that was open primarily for medical students, but also anyone who needed extra practice suturing. Luckily, many spots were open for us to fill in and surprisingly, we made up the overwhelming majority of the event.
Since we have experienced practicing sutures before, were jumped into practice pretty easily. What I enjoyed most from this was the different styles of suturing that they taught us! We learned some basics in PA school like a running stitch, vertical and horizontal mattress, but this clinic taught us how to throw an interlocking continuous suture (first picture below) and a baseball suture. Surprisingly, I found the interlocking continuous stitch to be very easy compared to the others (and it gave me some confidence with suturing that I did not have leaving the session we previously had). We also were able to practice subcuticular running sutures, with absorb-able material, which are primarily used for cosmetic purposes for better healing of scars. (see second picture below). Finally, we practiced hand-tying knots. Typically, this should have been the first station, but I did this last. At first, I found this very confusing, there are particular ways to tie these knots to make them strong and fast. We were given thick string to practice and make sure that we are creating the correct knots (third picture below). Fortunately, after practicing a bit, I was able to get the hang of it! I even brought a piece of string home to practice tying on a coffee mug =p
Here it is again! WEAR RED DAY! Below is our class of 2017 and the new class showing support for the AHA! This week our classmates have been fundraising for the American Heart Association by purchasing wrist bands and lapel pins. Last year we raised a good amount of money, but this year the 42 of us raised OVER $120! Great job guys! Thank you for helping raise money to tackle the NUMBER 1 KILLER OF WOMEN... which by the way... is 80%+ PREVENTABLE! With fundraisers like this, we can educate more Americans about the dangers of Heart Disease, inform them about what they can do to prevent it and even find better ways to treat it.
The photo below is one of my favorites (even though it is from 2 years ago the statistics still hold TRUE!), it brings up the cold-hard-truth about heart disease. This is what more Americans need to know.
Please contact me if you have any questions about the AHA and what fundraising can do for all of us!
Last year a group of students from our PA class attended the med school formal not knowing what to expect. In all honesty, I thought that this formal was the most fun social event held by AMC since I started PA school. Since we had so much fun last year more people from our class attended the event this year! I would say that between the three classes of PA students (Classes of 2016, 2017 and 2018) we had about 4 or 5 tables of 10 people each! As always, it was a beautiful venue with amazing food and a fun photobooth! It is still hard to believe that we attended this same event one year ago!
Part of our Counseling and Preventative Medicine class requires us to complete a fun project: changing a "not-so-good" behavior for two weeks. The purpose of this project is to experience making a change. Often, providers tell their patients to "lose weight" or "stop smoking" but may not really understand what it is like to make a behavior change like that. Each of us selected a topic that we not only believed we could change in two weeks but also would better ourselves by changing it. For example, many students chose to exercise more and create a routine to follow. Some chose to change their dietary habits by either drinking more water or, like me, changing actual foods they are eating.
When I first selected my topic for this project I thought that it would be easy, follow the diet plan and in two weeks it would be changed. I know changes are difficult, but in the past, I have been able to change many things about myself. For example, I trained for a half-marathon and ran nearly every weekday during class time. Or maybe, I purchased a new water-pik flosser and now floss every day! However, this behavior change is much more difficult. For some reason changing my dietary habits is not like anything else I have tried before. My goal for this change is to limit my carb intake and force myself to try other protein-rich foods. (I may be able to feed all the pasta and bread I want into my 22 year old body now, but in ten years my body will not respond the same way and I will have to find better and healthier foods to fill my diet.) Needless to say, my behavior change project is extremely difficult for me and I have only been doing it for one week! One week! I am barely halfway through the project and I am already struggling.
Take away points:
I may be struggling, but now I understand what it means to "feed a craving" even if thats not related to food. Sometimes I find myself giving into my wants and binging on all the foods I can't have! After that, its hard to get back on the wagon and keep the plan going strong. I am learned the difference between a slip and a relapse and what I can do to prevent both of those things from happening. All in all, I think this is a great project and I almost wish that it was continued for more than just two weeks!