Tuesday, May 05, 2009
NKTI
I was going to write about my first duty as an intern at NKTI last May 1, but I was just too lazy to do it. I can only summarize it in this sentence: "MY FEET ARE KILLING ME!" Sobrang gusto na talagang kumawala ng mga paa ko sa sapatos ko. Sa wards ako nun. 2 floors ba naman na may 4 na wings ang iniikot ko. Tapos pag may provi (initial reading para sa mga OM people) na order sa chart maglalakad pa ko sa X-ray na nasa ibang wing din. Super walkathon talaga. Anyway, I was the nephrology intern on duty at the ER last night. It was way way less toxic than our ER at OM. Yun nga lang wala kang maupuan. Makikipag-agawan ka sa mga bantay at nurses ng upuan. Sumakit din tuloy yung paa ko. Tapos lahat ng dumadating na pasyente, pang-nephro or IM lang talaga. Like duh, national kidney transplant institute nga e. Wala yung thrill na makikita mong pang-trauma or OB or pedia yung patient at magagalak ka kasi IM clerk ka. Walang ganun. Halos lahat sila dumadaan sa nephro. At ang trabaho? Parang clerk lang ulit. Magsaksak ng lahat ng tubong pwedeng isaksak sa pasyente, extraction, provi reading, history at p.e. Pero parang gusto ko pa rin gumalaw kasi at least nakakalimutan ko yung pangangalay ng mga binti ko. But somewhere along the course of that very toxic duty at nephro-ER (16 admissions; usually mga 8 lang daw admission ng nephro. san ka pa.), my fellow, Dr. Santos taught me how to do paracentesis. Now, this can be considered a clerk-level job at OM. Some of you may already boast to have done it already during your IM rotation. Somehow, I didn't have the chance to do it. Baka wala lang talagang tiwala ang mga residente ko sa 'kin kasi pseudo-clerk lang ako. Saka konti lang ang dumadating sa ER na for paracentesis at madalas napupunta sa intern. Kaya di mapantayan ang kaligayahan ko ng ibigay sa akin ang paracentesis. As if may choice sya e ako lang naman intern sa ER. Madali lang pala. Saksak lang ng saksak ng IV cathula gauge 18 sa abdomen, 3 fingerbreadths mula sa navel dapat, pero pwede rin naman sa most dependent area. Basta wala ka dapat ma-hit na buto or blood vessel. Hayun, tapos dapat ipapractice ang aseptic technique, hindi sterile-sterilan na parang sa OM. Tapos kabit mo na yung cathula sa macroset and let it drain by force of gravity. Ganun lang kadali yun. Na-realize ko nga na boring pagkatapos e. Walang challenge. Pero masaya pa rin ako kasi another tickmark na naman ang madadagdag sa short list of achievements ko.Thoracentesis naman sunod, tapos CTT, and finally IJ catheter insertion. Excited na ko.
Morbid Indulgencestarted this journey at5/05/2009
Thursday, April 02, 2009
Chief complaint: fever
I have a fever. I can't believe I have a fever. You know, after 4 years in medical school I
thought I was invincible, kinda like Neo who understands enough to know how to dodge
bullets.
Heck, I've always been disillusioned.
Anyway, I've been running differentials in my mind but I'm just not so confident about my
diagnosis, so if anyone can just help me here, read this history I have come up.
CC: undocumented fever
HPI:
3 days ptc -------> (+) undocumented fever, (+) joint and muscle pain, (+) abdominal pain,
vague, umbilical area, 3/10 in severity
(-) anorexia, (-) chills, (-) rash, (-) headache, (-) nasal congestion,
(-) cough, (-) dob, (-) chest pain
(-) change in bowel movement, (-) dysuria....
(-) everything else
Px took paracetamol 500 mg q4 which temporarily relieved symptoms.
PMHx:
>nothing pertinent here
PSHx:
>non-smoker
>occ. alcoholic beverage drinker (super occassional, and I also cheat. I pour the drink on
the grass/someone else's glass when no one is looking.)
>denies illicit drug use
FHx:
(+) Hypertension - maternal
(+) TB - paternal
(+) DM - maternal
ROS:
(-) everything
PE: conscious, barely coherent, NICRD
BP - 110/70 HR - 84 RR - 19 T - wala akong thermometer, basta febrile
HEENT: AS, PPC, (-) NAD, (+) submandibular lymphadenopathy, (-) CLAD, (-) TPC
C/L: SCE, (-) retractions, clear breath sounds
Heart: AP. NRRR, (-) murmur
Abdomen: i skipped this part. basta soft.
Extremities: (-) cyanosis, (-) edema, FEP
A> Systemic viral infection
R/O Dengue fever
P> increase OFI
For CBC with PC, tourniquet test
Meds: paracetamol 500 mg q4
Complete bed rest with tv and bathroom privileges
Refer
The touniquet test turned out negative by the way. Man, did it hurt. I had to cut it down to just 3 minutes. I just cannot stand the pain. Forget cbc, I don't feel like being poked with a needle.
My mother, who did not have any medical training whatsoever but had tons of life experience to
boot, offerred another explanation.
"nagdadahilan ka lang para di mautusan."
what can I say, the woman's a genius. she knows me better than I know myself.
Morbid Indulgencestarted this journey at4/02/2009
Monday, March 23, 2009
CLERKSHIP IS OFFICIALLY OVER
My days as an intclerk is finally over.... now all i have to worry about is completing the signatures in my clearance form....gusto ko nga pala magpasalamat sa mga sumusunod:sa mga nurses na napaka-efficient.... sa mga residente na nanigaw at nagdemerit sa akin... sa mga pasyente na sinungitan ako... sa mga care-of na paimportante... sa mga pay patients na ultimo pagkamot ng ilong nila e iuutos pa sa akin...sa mga bantay na ayaw gumawa ng paraan para gumaling ang pasyente nila...sa x-ray at mga rad tech na laging maaasahan...sa coop canteen...sa mga groupmates na tinulugan ako sa duty...salamat. salamat ng marami. nawa'y di ko na kayo ma-encounter.GOOD BYE OM!!!! GOOD BYE FOREVER!!!!
Morbid Indulgencestarted this journey at3/23/2009
Wednesday, April 11, 2007
wala lang 'to
I never thought it possible that I would someday get tired of books, but that is exactly what I am experiencing right now. My thirst for reading has not by any means declined, but nowadays my reading is limited on newspapers. I hate bound materials.Medicine talaga o...
Morbid Indulgencestarted this journey at4/11/2007
Thursday, March 22, 2007
Back with a vengeance
finals finally over.i'm packing for our class outing today. to hell with my grades and that evil thesis deadline, i'm gonna have fun tonight.that's all you need to know right now.=)i miss you all, my dlsu friends....
Morbid Indulgencestarted this journey at3/22/2007
Sunday, January 21, 2007
TIA - This is After-shifting week
I begged my mother to take me to the movies before i plunged myself into the torment of the dreadfully long shifting week. I initially wanted to see Eragon, but SM MOA has this policy of permitting only one show per ticket - meaning we cannot go inside in the middle of the movie and wait and start the movie all over again. Wise move, but very irritating in the side of avid moviegoers.
So we watched Blood Diamond instead and I was engulfed in Leonardo di Caprio's ultimate manliness... oooohhhh.... those squinting eyes... that rugged attire... the stubbly face... he had come a long way from his nauseating matinee idol image in Titanic and Romeo and Juliet. I never thought he'd be masculine enough to be in my list then.
And yeah, the movie was excellent too, with or without Leonardo. I vow never to wear anything with diamonds in it.
After the shifting week, I finally had the chance to watch eragon --> major snorefest. hated it immensely.
Back in my undergrad years, I could watch a maximum of 5 movies per week. Now I'm limited to like, 1 per month. If only I had known med school would be like this....
Morbid Indulgencestarted this journey at1/21/2007
Sunday, December 31, 2006
Good riddance
2006 was definitely not my year... sure, we had our share of good times, still the bad outnumber the good..
i say this with a bitter taste in my mouth. what my friend said is true, an ending of anything, whether good or bad, is a sad thing. i've undergone countless changes this year. i know i will miss my old self, my old life.
well, we have to move on sometimes.
so.... good riddance 2006
Morbid Indulgencestarted this journey at12/31/2006
