pure med student joy.

This week i got to see and do a lot of stuff. Heres a breakdown:

we had a patient come in with an ankle injury. after hearing the story and seeing it, we decided to send him up for ankle x rays [its actually 3 views] to rule out a fracture. it was swollen but didnt look too bad so the doctor and i didnt think it would come back with anything remarkable. we sent him upstairs to get them and 40 minutes later he came back down with the x rays in hand. the doctor told me to look at them and tell her what i saw and sure enough,  i found a fracture...a couple fractures actually. i was pretty proud of myself. to be fair, my sister could probably have found the fracture also considering how large it was so im not sure this is the biggest accomplishment of my career [no offense anna].

saw a 75yo lady who refused any kind of screening exams because whatever happens to her is natural selection and if she is meant to die, she will die. then at the end of the visit she said she wanted one test and that was for alzheimer's because if she finds out she has that then “she has plans.” [in 1997 Oregon enacted the Death with Dignity Act which allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose.... im pretty sure this is what she meant]. to each their own, i guess. 

a pretty depressing patient i had was a 30yo woman who was thrown off her horse last year and is still dealing with the effects. she hit her head and wasnt wearing a helmet so ended up with major brain damage. she has had two surgeries and though she is still totally functioning, she just isnt all there and was diagnosed with major depressive disorder [though almost all the patients i see are so thats not to rare]. the scary part was seeing how much her life changed in one instance and though i will still keep riding, i will make sure to NEVER be without a helmet when doing so.

last patient of the week was a woman who had chronic bilateral shoulder bursitis [basically inflammation of the joint]. she was a fun patient and both the doctor and i joked around with her during the visit. we decided to do steroid injections into her shoulder joints to temporarily relieve her pain and the doctor asked her if she wanted to do one or both of her shoulders. the patient said both if thats ok and i jokingly interjected and said “only if you let me do one of them.” then very suprisingly she answered “yeah sure why not.” i looked over at dr x and she said “see one, do one, teach one. ill do one shoulder and then you can do the other.” 

pure med student joy.

 so we drew up 2 syringes for each shoulder, one of lidocaine and one of a liquid steroid. we used a 1.5in needle and entered the shoulder joint. it was tricky because after putting in the needle and injecting the lidocaine, i had to unscrew the syringe to inject the steroid using the same needle and then take it out again to use another cc of lidocaine. my hands were steady and neither the doctor nor the patient could see how scared i was! i was nervous but pretended not to be which makes all the difference. after, the patient said it didnt hurt [which i am sure was a lie because thats a big freaking needle.] she told me it didnt hurt anymore than when the doctor did it so apparently, i did a good job. i love procedures!

oh yeah, and i watched the doc do a prostate exam on a 70yo man. that was not fun.