Thursday, November 29, 2007

Clinical Medicine Module: Cardiology

So, today was the second clinical attachment for me, the Cardiology attachment (I got to pick this one, and since I quite like Cardiology/Cardiovascular system, I picked it). I was pleasantly surprised to find that it was in Kirckaldy instead of Dunfermline, as the latter is an extra 20 minutes out. On arrival we went up the Education Centre, and then were forwarded on to the Cardiac Care Unit. 6 of us went with each Consultant (and switched halfway through). It was in the same general format of the Surgery Rotation, except more about heart failure and acute MIs. It was pretty interesting, and since I've always tried to be on top of my game on cardiac issues (since we see so many flowing through the ER), I was pretty on my game. At one point (after I answered that the treatment for a axillary vein blood clot s/p pacemaker placement would be a LMWH e.g. enoxaparin), the Consultant joked about "when I could start". It kinda made me feel like all those [unpaid] hours at the hospital really paid off. Bit of a confidence booster, if you will. The first consultant mainly dealt with cardiac causes of dsypnea as well as heart failure. He then showed us echocardiograms from the patients we had seen - I had never actually been taught what to look for, but he did a very good job at giving us a brief intro.
The second consultant took us to see a patient who had had an acute MI, was stented (I believe), and due to a bradyarrhythmia had a temporary pacer placed. Then after a bit of ECG review, we were let go.

Overall, I enjoyed it a lot more than the Surgery one, maybe because I've always leant toward Cardiology as a possible career choice...who knows?

In other news (one of which is semi-related to today):
Over the past few days i've seemed to develop a URTI. Most probably viral, and I'm trying to get through it. Got myself some Halls cough drops and some dextromethorphan/pseudoephedrine cough syrup, and it seems to be working pretty well. Also, today I decided that since I always get so nauseous on the bus to our attachments, that I would try one of the hyoscine(/scopolamine) tablets that I have. Now, I've never needed to take this kind of thing before - usually I just deal with the nausea - but I figure hey, why not? The whole bus ride went fine - we got to the hospital, and I figured everything was gonna be good.
Then I stepped off the bus. Immediately I could tell something was wrong. I didn't seem to be able to walk straight, my eyes were...funny. They weren't blurred, everything was just so...different. Not really sure how to explain it (well actually I do, we'll get to that later). However, I continued on and we all headed to the Education centre, Cardio floor, etc. The whole first hour or so, not only was I coughing up a storm, but I was having trouble speaking (bit of dry mouth?) and just coordinating in general. Things got better, over time though. So, hyoscine is an anticholergic - loss of pupillary constriction due to imbalance between para&sympathetic systems lead to the weird vision (must've had huge pupils - letting in a lot of light). Dry mouth is an anticholinergic side effect as well. I was trying to remember the rhymes for anticholinergic overdose, but all that came to mind was "Mad as a Hatter", and I sure as hell wasn't seeing things or grasping in the air - so I figured I'd be ok. It slowly drifted away, but I still feel kinda funny...hopfully it'll wear off by tomorrow.

And, in OTHER other news, I got a 17 (on the 1-20 scale that our Uni uses) on my midsemester assessment! (that's the lowest mark of a 1st class). Seeing as how I've never been able to get higher than a 15, I was quite happy. Except I know it was only because I did well on 2 questions that most others were fairly unprepared for...just means I'll hope to keep it up in the end of semester exam!!

p.s. it still freaks me out every time my sitemeter shows someone from within the University viewing my