Oops!

So its been nearly two weeks since I last blogged... My bad.

But seriously, its my blog, meaning that in theory, I can blog whenever I damn well want to and should not have people bugging me about not blogging right?

Unfortunately not, it would seem.


Anyway.

So 2 weeks of paediatrics down, and I still love playing with children and distracting them and receiving that little look of gratefulness from the doctor. It almost makes me feel like there is a point to me sitting in the corner of a little clinic room, sneakily asking questions to the mother/father when the doctor needs to go out to find something or clumsily poking and prodding a small child when the doctor asks me to perform an examination or take blood pressures.

Children have such small arms, yet they manage to make so much noise with them. Curious isn"t it?

The past week has been a lot of fun, with another week in clinics.

I sat in on the Child Assessment Team ( or the CAT team if you wanted to make use of the silly way in which people like to make use of silly repetition in such acronymerised names, such as like in ATM machine or BAT team - Brain Attack Team for you people not in the business.) which seemed interesting. Interesting in that it seemed like the most expensive play session you could organise with your child without actually investing in diamonds or a circus. 6-8 specialists sitting in to watch a child play with toys and draw.

I also sat in on a less expensive version in which the child was assessed by the speech therapist, physiotherapist and occupational therapist.

I was lucky to sit in on a Renal clinic as well, which happens only once a month at FMC. The consultant was a hilarious man with a very relaxed attitude and amusing manner. His questions to me were straightforward and naturally difficult (especially to me, as I discovered that I had managed to forget just about everything about the kidneys...) but was quite willing to teach me when there was time.

The most exciting thing about the past week is that my daddy was here!
Lots of good home made food (which were I less lazy, I could also make, but the laziness usually pulls me to quicker, just as delicious meals...) as well as a restocking of my freezer. I should be set if the Australian Army decide to come over for dinner.

This weekend was quite a bit of fun as well as Friday afternoon started off with a feast put together by my dad, and continued with the celebration of the birthday of a Britannian/Prydein colleague in true boozer style starting at some bar and leading on to some indie bands, most notably Flat One which stars a current intern of Flinders. Very inspiring and really ruins my excuse of not having time to do anything...
This was very enjoyable but the late nights and moderate alcohol consumption made the next day quite troublesome. Pancakes (with bacon, caramelised bananas and real maple syrup) on Sunday was thoroughly enjoyable as I didn"t even need to go anywhere as another fellow colleague (this one from Canadia) brought everything over to my house to make!
Definitely fun as we poor sAdelaide residers were graced with the presence of a very much loved colleague who usually resides where the general human population is probably outmatched by the population of horses and livestock.

So yes, a thoroughly enjoyable weekend to top off a quite enjoyable week!

This week: Inpatients!
Ward rounds and history taking seems to be on the menu.

Which reminds me, what should I make for dinner?

Kids

I am thoroughly enjoying paediatrics so far (so far being Day 4 has been completed) and have decided that it is definitely in my shortlist of future specialities.
The last few days have been clinic after clinic, which has been good to see the range of paediatric disorders coming in.

Day 1: Introduction to paediatrics

Day 2: General paediatrics clinic
 - Hemangioma follow-up (infant)
 - Constipation follow-up + thalassaemia concerns (adolescent)
 - Pertussis (whooping cough) follow-up (infant)

Day 3: Neonatal clinic
 - 6 week (corrected) checkup (twins, one still in NICU, 10ish weeks premature)

Day 4: General paediatrics clinic
 - Developmental delay and unknown disorder with left sided abnormalities in the left ear, left eye, left kidney, left brachial artery (child)
 - Failure to thrive/coeliac follow-up (child)
 - Night terrors and language assessment (child)
 - ADHD medication reassessment (pre-adolescent)
 - Trisomy 21 follow-up (infant)
 - Sotos syndrome check-up (pre-adolescent)

Grand Round = Free food. It"s great!

Tomorrow will be an immunology clinic and then another general paediatric clinic with the Paediatric Super Consultant.

Its been a great few days, especially as I"ve been asked to do simple things like taking blood pressure and listen to breath sounds or heart sounds. They actually go quite well, it seems children seem to like me. I base it on my funny eyes.

Anyway, most of the time I"m just playing the part of a fly on the wall, but quite often I"ll have to step up to play the part of "clown" in order to distract the patient. It works surprisingly well. I may have missed my calling in life.

Paediatrics

Looks like I"m falling back into my poor blogging habits... Gotta get on top of that.

So I"ve just started paediatrics.
First day down and I"m quite liking the fact that paediatrics is so organised.
Surgery was a poorly organised and poorly maintained rotation in my opinion. Sure, the coordinator is very nice, but as stated by another surgeon "JW needs to learn to email and stop living in the 70s".
We"ve got plenty of teaching sessions in paediatrics and the first day was buffed with introduction to history taking and examination in the paediatric patient, as well as community health. Both lectures were quite interesting and very relevant.

Anyway, I should probably go get ready. I don"t want to be late on my second day!

Wait, its Sunday already?

So I"ve achieved two of my goals for this weekend reasonably well.
Shopping is done and my fridge is fully stocked up again for the coming week, though I was quite disappointed in the price of broccoli, it seemed to have doubled in price...
The sleep front has gone alright as well, not an overly large amount, but very restful, which is good.
The study side of things hasn"t gone so well. The weather has been dreadful which, though would normally help the study along (since there would be no point going out), has actually made things harder as it has been quite chilly and just overall poor conditions for study.

Maybe I"m just making excuses.

TGIF

I"m looking forward to the upcoming long weekend. I have many, many plans. One involves sleeping lots. Another involves grocery shopping. The final plan involves catching up on a ridiculous amount of study.

Oh yes, gotta love the little breaks we get.

A tasty day.

Today started as any other, with my rising before the sun. I was annoyed, but that was usual. I was actually annoyed slightly less today as I knew there would be a group meeting with FREE BREAKFAST!

I cheerfully arrived at ward rounds, right on time and eagerly awaiting breakfast. I knew we could fly through the 4 patients we had in a flash and move on. Unfortunately, we managed to acquire 4 more patients overnight. I really can"t complain as everyone else I know of seems to have 20+ patients on their wards. Oh well.
That"s when the Registrar started playing with my emotions. He told us there wasn"t a meeting today.
My fellow students and I cried. Or at least, we were greatly disappointed.
After dragging ourselves through ward rounds, taking our time, our resident super nurse told us that we should be getting to the meeting. My eyes lit up, there was indeed a meeting today! My Registrar was wrong!

30 minutes later, I was satisfied (though not as much as I could be, there were bacon and egg wraps last week!) with mini pancakes, muffins, strawberries and yogurt. It was time for theatre.

Laparoscopic bilateral inguinal hernia repair, laparoscopic umbilical [EDIT: or rather, para-umbilical] hernia repair, zzz...


I managed to eventually escape so I could waste my time travelling to Centrelink for an appointment just so I could tell them things I could have told them on the phone...

Blah.

Squash in the afternoon was fun, as was a little bit of gym work.

I had decided yesterday that for dinner tonight (and for lunch tomorrow and probably the next day...) I would make pasta. I had purchased pasta sauce (because I cheat like that) on special (2 jars for $3!) and some fettuccine on special (500g for $1!).

Recipe as follows:

Ingredients:
500g beef mince

500g jar of pasta sauce (any flavour)
3 tomatoes
2 carrots
2 onions
1 head of brocolli
4 little chillis
as many mushrooms as you can find in your fridge (in my case, 4)
salt
pepper
tomato sauce
bbq sauce
500g fettuccine

Directions:
1. Brown beef mince. During this time, dice tomatoes, carrots, onions, brocolli, chilli and mushrooms.
2. Add tomatoes, carrots, onions, brocolli, chilli and pasta sauce. You may need to transfer to a pot as I did.
3. Add 250mL of water (half fill the pasta sauce jar and shake) and the mushrooms. Allow to simmer.
4. Boil water, adding some salt. Add fettuccine.
5. Taste your pasta sauce, add salt and pepper to taste. At this stage, the sauce should taste good, but quite mild. I like my sauce with a bit of zing so I added some tomato sauce, bbq sauce and lots and lots of pepper.
6. Check your fettuccine, I like mine slightly more on the solid side, but cooked.
7. Drain your pasta and serve in a bowl with a generous serving of sauce, with grated cheese.

I omitted some details in my preparation such as dancing around my house meeting and ending up with a ridiculous amount of pasta and sauce. I think I have enough for the next 3 lunches.

Of course, I"m not complaining. It"s good.

:S

Its been a long day. Failed a cannulation on a patient which was quite the contrast to yesterday...

Also, one of our patients passed away early this morning at 2:30pm due to complications of sepsis.
This is kind of the first time I"ve really experienced death in the hospital.
I"m not really sure how I"m supposed to feel, is that bad?

The Hat-trick

It was an awesome day today.
It was also a long day, but we"ll come to that later.
Let us, for now, begin our story from where most stories begin, at the beginning.

I woke up fresh (what does that even mean?) and well rested (vaguely) and kind of freezing. The single sheet I had failed to protect me from the sub-zero (or 14 degrees Celsius) temperatures and thus it was quite difficult finding motivation to leave the bed which was cold-but-not-as-cold-as-not-being-in-bed-with-a-sheet.

After taking a shower and inhaling some cereal (not at the same time), I eventually made it to the RGH (Repatriation General Hospital or "Repat" for short) for Ward Rounds.
 At some point, I remembered that I was following (or is it shadowing) an anaesthetist in attempt to observe the fabled "Pain Round", so I told my Intern (who's awesome) and left to find this anaesthetist. I found him, but he had other commitments so he handballed me to another anaesthetist, which was performing the anaesthesia of ECT (electroconvulsive therapy, an archaeic treatment) patients.

Now, it has occurred to me that almost every anaesthetist I have ever met seems to really enjoy teaching students, whether it be because it takes a certain type of person to be an anaesthetist, or perhaps because all they do all day is sit around watching vital monitors and injecting white stuff into people. Anyway, anaesthetists are good.
This particular anaesthetist told me to put in a cannula and to bag and mask the patients. Since it had been months since I had last put in a successful cannula, I was not confident enough to attempt the first one, but following that, managed three successful one-shot cannulations in a row. Oh, it did wonders for my confidence. The "Pain Round" that followed was less exciting, as there was just one single patient to assess.

Returning to the ward following the "Pain Round" (which was a quick trip because the patient was actually one of our own patients on the ward), I learnt that things had gotten a little more exciting, as a fellow student had managed to diagnose AF (atrial fibrillation) in that patient we had just assessed. I was suitably impressed as our team burst into action, taking blood, doing examinations, writing in case notes and discussing the weather.

Hours (or hour, singular) passed uneventfully (but if you must know, I had lunch) and I eventually wandered up to the patient I had decided to take a history and present to the Registrar the following day (tomorrow). A lovely 80 year old lady, she seemed to be the perfect history. A simple elective surgery following a colonoscopy, how bad could it be? Oh, it could be bad. It was bad. There was blood. In Admiral Ackbar"s famous words:

She was not only a malingerer, but also a meanderer (as in she waffled on). She had much to talk about, some of it actually relevant, most of it describing the unending, diffuse, vague pain she felt, as well as every symptom under the sun. I don"t believe I had a single negative to the questions I asked. I exaggerate, there was one or two.
She was also the first person to have hit upon a positive for the third question in the "SADA" series of questioning. She had 1/2 a biscuit in an attempt to relax, 15 years ago. I was amazed. I felt the same way when we eventually reached the medication questions.

All in all, she was an interesting lady who I found was quite the experience taking a history from. I gained a lot of experience on interrupting and asking other questions, while sometimes repeating the same question I had just asked to see if it actually prompted an actual answer...

The afternoon was quite good as well as I was able to sit in on my CoC (continuity of care, an assignment) patient's outpatient appointments. They involved a follow-up with the surgeon as well as a follow-up discussion regarding stoma care with the stomal nurse.

Upon returning home, I found I had two packages waiting for me, one being the free glasses I had managed to order (which works, but kind of make me a little nauseous) and the other being amazing cookies!

After a quick visit to the university to deliver some things, I went on a run with a friend. We managed 6 kilometres of dangerous, unstable terrain along with the usual mix of push-ups, chin-ups and abdominal-work-outer-things.

A dinner of curry and toast (don"t diss it until you"ve tried it), finished with a dessert of chocolate cake and ice cream. Marvellous.

All in all, a wonderful day.

In the words of my favourite author:

And so, the time has come to close this post. There will be other days and other stories, but this tale is finished.