So I should blog every once in a blue moon eh?

Soooo its been a while yeahhhhh...

Indeed it has. Stuff tends to happen over time. In terms of this blog however, its quite the opposite. Since I haven't written anything original over the past half year or so (?) I'm gonna get down and dirty. And regurgitate everything that's happened in the life of this little MedKid since my last post.

Get ready. Get steady. Go!

Second year vs. first year - I may or may not have said this before (I ceebs rereading my posts right now), but 2nd year is a piece of noobcake with pwnage-icing topped with a slice of pro-ness compared to first year. Study is seriously chill. Reasons; 1) the workload is lighter - naive little MedKids go into first year thinking they know everything there is to learn. Unbeknowst to them, BAM! Cecil (refer here) ninja's in from nowhere and smacks them in the face, causing frontal bone fracture with concomitant coup and contre-coup contusion, leading to cerebral oedema, mass effect, central herniation and ultimately, the end point of all the best mechanisms, death. Whiiippeee! That was first year. In second year, you actually know stuff. You no longer quake in your boots when you see the words "clotting factor" or "parasympathetic stimulation". "Cytokines!" isn't your catch phrase anymore for any immune system related question. And now, you can actually read an ECG. (Hell yes baybee, hell yes.)

Word of caution: ECG machines mad baaaad alarm clocks.

And now, because you know your foundations, other stuff is a whole lot easier to learn. Also, the admin like pounding in the basics, so you oft get the opportunity to redo first year material to make sure it sticks in your head, which, for those that havn't forgotten everything, makes for easy studying.

Reasono numero two-o) you sort of know how to study medicine. The coursework is less, but the material is still just as difficult, if not more so (*shudder* brain anatomy */shudder*). Even so, you're so used to rote learning lists of random names (such as the muscles of the limbs) that beating out the obscurest names of the obscurest structures in the depths of the brain that no one really ever talks about is no big deal. (Example, the crus of the Fornix and the Habenular nuclei and whatever. I don't care anymore, I did my exams.) But anywho, as I was saying.. uhmmm yeah. By second year, you will have honed down your studying skills to a scapels edge allowing you to cut through swathes of boring junk without a single bead of sweat. That's the theory anyway. In practice, it certainly does help to have good study habits, but mine are nowhere near perfect aka I cannot blow up a mans head with my mind just yet...

3) Our mid-year medical exams were formative - meaning they didn't count. Need I say more?

4) Less contact hours. Instead of the deadly jungle that was my first year timetable, this years timetable is relatively desolate. Most days (Mon, Weds, Fri) I have afternoon CBL (refer here this time) meaning that I can sleep in until about 10 o'clock. On top of that, I've just been a naughty boy and have been skipping some of the more useless lectures. So instead of my almost impeccable attendance record last year, this years attendance record is only slightly more than a stained square of 2-ply toilet paper. Sigh. The reason for this ceebsness? Most of it stems from the fact that I know I don't need to work as hard as first year. I sort of regret putting in the amount of effort that I did. And now I have a feeling I'm going to regret not working hard enough this year. But that shall be reflected in the exam grades. In terms of clinical skills and CBL assessments however, I've been doing pretty good so perhaps that's what's been causing my false sense of security. Gah, we shall see...

And now for some random gratuitious picture! The caption: "Hugs keep us alive"

If only this were a T-shirt design... guess what, it is!

All this means MORE TIME TO CHILL AND STUFF. Chilling how I hear you ask? Read the next instalment of the Chronicles of a MedKid and you will find out!

Ugh

"If it were a two or above I wouldn't be able to answer because it would mean a pause in the screaming."

Ahh, xkcd. 

I'm such a faggot.

Medical charts

The following are actual, unedited, notes written by doctors on
patients’ medical charts:

1. Patient has chest pain if she lies on her left side for over a
year.

2. On the second day the knee was better,
and on the third day it disappeared completely.

3. She has had no rigors or shaking chills, but her husband states
she was very hot in bed last night.

4. The patient has been depressed ever since she began seeing me in
1993.

5. The patient is tearful and crying constantly. She also appears to
be depressed.

6. Discharge status: Alive but without permission.

7. Healthy appearing, decrepit 69 year-old male, mentally alert but
forgetful.

8. The patient refused an autopsy.

9. The patient has no past history of suicides.

10. Patient has left his white blood cells at another hospital.

11. Patient’s past medical history has been remarkably insignificant
with only a forty pound weight gain in the past three days.

12. Patient had waffles for breakfast and anorexia for lunch.

13. Between you and me, we ought to be able to get this lady
pregnant.

14. Since she can’t get pregnant with her husband, I thought you
might like to work her up.

15. She is numb from her toes down.

16. While in the ER, she was examined, X-rated, and sent home.

17. The skin was moist and dry.

18. Occasional, constant, infrequent headaches.

19. Patient was alert and unresponsive.

20. Rectal exam revealed a normal size thyroid.

21. She stated that she had been constipated for most of her life
until she got a divorce.

22. I saw your patient today, who is still under our car for physical
therapy.

23. Both breasts are equal and reactive to light and accommodation.

24. Exam of genitalia reveals that he is circus sized.

25. The lab test indicated abnormal lover function.

26. The patient was to have a bowel resection. However, he took a
job as a stockbroker instead.

27. Skin: Somewhat pale but present.

28. The pelvic examination will be done later on the floor.

29. Patient was seen in consultation by Dr. Blank, who felt we should
sit on the abdomen, and I agree.

30. Large brown stool ambulating in the hall.

31. Patient has two teenage children, but no other abnormalities.

32.  By the time he was admitted, his rapid heart had stopped, and he was feeling better.

33.  Patient was released to outpatient department without dressing.

34. I have suggested that he loosen his pants before standing, and then, when he stands with the help of his wife, they should fall to the floor.

35.  The patient will need disposition, and therefore we will get Dr. Blank to dispose of him.

36.   The patient expired on the floor uneventfully.

37.  She slipped on the ice and apparently her legs went in separate directions in early December.

38.  The patient experienced sudden onset of severe shortness of breath with a picture of acute pulmonary edema at home while having sex which gradually deteriorated in the emergency room.

39.  The patient was in his usual state of good health until his airplane ran out of gas and crashed.

40.  Coming from Detroit, this man has no children.

Medical school, round 2

Uni has started and I am once again up to my pits in work. Seriously, there's literally no space to move. But even so, I went to medcamp last night. Good drunken times were had. 

Also, Med tends to suck inspiration, time, and life dry. Who would have thought things could get worse than first year. In light of this, I'm not even going to promise that I'll post again anytime soon. Way too far behind in everything, especially sleep. 

$50 to anyone who invents a consumable form of sleep. 

Interesting Medical Cases: Unusual Foreign Body In Boys Bladder

(From ISPUB) Click here for the full text.
Below is the unTL;DR, slightly less medical version.

So basically, a 14 year old boy complains of pain, difficulty in passing urine with dribbling and subsequent urinary retention that is 24 hours in duration. On further questioning he told the doctor that while he was cleaning the fish tank in his house, he was holding a fish in his hand when he went to the toilet. When passing urine, the fish slipped from his hand and entered his urethra and he developed the subsequent symptoms.

An X ray and abdominal ultrasound were done, with the ultrasound showing a 1.5cm echogenic object found inside his bladder. 

For management a cystourethroscopy was done (i.e. sticking a flexible scope up his penis). A 2cm long dead fish was found inside the bladder. The medical team tried to remove the fish with forceps but was unable to due to its slippery surface. Instead, a rigid ureteroscope with stone graspers was used to remove the fish whole. 

Afterwards, the child was asymptomatic and was sent for psychiatric counseling.

This story begs the question, what the fuck was the kid doing with a fish in his hand whilst in the toilet in the first place.

The article itself then goes on about the Candirú or Canero fish, found in the Amazon river. Below is the extract. 

"One of the strangest stories from the Amazon was a fish that was urinophilic and could swim up the urethra or into the vagina who urinated while bathing in the Amazon. It was said that this fish, known as candirú [in Brazil; as carnero. Once inside it would eat away the mucous membranes and tissues until hemorrhage would kill it or the host. It was also said that even if one caught the fish by the tail, once in the urethra it could not be pulled out because it would spread itself like an umbrella. in Spanish-speaking countries], was long, thin, and capable of forcing its way into the body's passageways following the trail of urine."

 

Charming.