Official MCW Class of 2009 Thread

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Agent Splat said:
except that his head is tall and long were mine is more rounded. and I have facial hair and often wear a baseball cap. and glasses. and I'm better looking. and i wouldn't eat my own twin's soul.
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Because hats and facial hair makes you not related? That explains my siblings for sure...
 
Xandie said:
Nope, I have five months before I hit the big 25. Woohoo!

I think I need some gray hairs... no one takes me seriously. Too cute, I've heard. 😛
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Oh man do I feel old now. That's the problem with medicine as a second career. On the other hand, at least I don't act old. The good thing (for me) is that I don't take you seriously either. Not until you get some grays, kiddo.😉

So here's my day today: Up at 4 am, pre-round at 5:30, attending rounds at 6:00, to the OR from 7:30am until 9pm. Just got home. This is a non-call day. Too bad I was having so much fun.:horns:
 
donnyfire said:
So here's my day today: Up at 4 am, pre-round at 5:30, attending rounds at 6:00, to the OR from 7:30am until 9pm. Just got home. Too bad I was having so much fun.:horns:
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i will gladly take a horrible grade on my surgery rotation if I can avoid that crap.
 
Don's old.... definetely older than Micah. (Don, did I ever tell you that story? It's a good one).

By the way, anyone want to write a discussion on non-ST segment elevation MIs for me? Due tomorrow morning... need a presentation on carbon monoxide poisoning also. Chop chop.
 
Xandie said:
Don's old.... definetely older than Micah. (Don, did I ever tell you that story? It's a good one).

By the way, anyone want to write a discussion on non-ST segment elevation MIs for me? Due tomorrow morning... need a presentation on carbon monoxide poisoning also. Chop chop.
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it's done. but i won't bring it to you until you wire 30 dollars into my account.
 
Just steal it next time you sneak into my apartment, you naughty minx.
 
donnyfire said:
So here's my day today: Up at 4 am, pre-round at 5:30, attending rounds at 6:00, to the OR from 7:30am until 9pm. Just got home. This is a non-call day. Too bad I was having so much fun.:horns:
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Don, was that all one single 13.5 hour surgery, or was it multiple operations split up over the day?

Man, the only way I'll be able to tolerate a day in the OR like that will be if my ass is planted firmly on the anesthesiologist's stool. (Above the "blood-brain barrier [sterile drapes] if you will...:meanie: )
 
Gimlet said:
Don, was that all one single 13.5 hour surgery, or was it multiple operations split up over the day?

Man, the only way I'll be able to tolerate a day in the OR like that will be if my ass is planted firmly on the anesthesiologist's stool. (Above the "blood-brain barrier [sterile drapes] if you will...:meanie: )
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i have a feeling i might have lots of "problems" tubing my patients and might just "need" you to come to the ER all the time.
 
You should all stay away from my patients... no tubes, please.

Except for Andy... feel free to bring a little epidural cath my way on a regular basis.
 
Okay, tonight's projects:

design sliding scale insulin for a patient who has no understanding of his disease, another H&P, including a discussion about how to handle difficult patients, and something else which I now can't remember... that's not a good sign.
 
Xandie said:
Okay, tonight's projects:

design sliding scale insulin for a patient who has no understanding of his disease, another H&P, including a discussion about how to handle difficult patients, and something else which I now can't remember... that's not a good sign.
Click to expand...

make Marc cookies.
 
Xandie said:
Don's old.... definetely older than Micah. (Don, did I ever tell you that story? It's a good one).

By the way, anyone want to write a discussion on non-ST segment elevation MIs for me? Due tomorrow morning... need a presentation on carbon monoxide poisoning also. Chop chop.
Click to expand...

Do tell, do tell..... Too bad I just read this, I think I did that for one of my H&P's (although Fletcher would've read it).

Gimlet said:
Don, was that all one single 13.5 hour surgery, or was it multiple operations split up over the day?

Man, the only way I'll be able to tolerate a day in the OR like that will be if my ass is planted firmly on the anesthesiologist's stool. (Above the "blood-brain barrier [sterile drapes] if you will...:meanie: )
Click to expand...

Four radical retropubic prostatectomies (RRP), two percutaneous nephrostomy tube placements and your standard garden variety OR delays (slow anesthesia turn over time, maybe? 😉 ).
Don't worry, there was a break in there around 4 pm when I was able to eat lunch.
On CT surgery, I did have the pleasure to spend over 9 hours scrubbed in. Note how I've ruled out CT surgery.
Moral of the story (another little pearl): eat something every day before you go into the OR, and carry a little snack in your white coat. I usually have a granola bar or two. If you can find me when you're hungry, maybe I'll give you one. Just another little service I provide.
 
donnyfire said:
carry a little snack in your white coat. I usually have a granola bar or two. If you can find me when you're hungry, maybe I'll give you one. Just another little service I provide.
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what ELSE you carrying in that coat?
 
I carry fruit leather. It's the perfect white coat food... can get hot, cold, can't be squished, good sugars, etc.

Micah was trying to make a list of people in our class older than he. I think you two have the same birthday, and he figured you were older because he was born at 5pm or something. I told him he was stretching it.
 
Agent Splat said:
what ELSE you carrying in that coat?
Click to expand...

Maxwell's
Sanford Guide to Antimicrobial Therapy
PDA
Pocket book of whatever rotation I'm on
Note pad (I use this all the time)
Pens
alcohol wipes (for stethoscope)
stethoscope (I carry mine in my pocket 😛 )
EKG calipers (on medicine)
suture removal kit, 4x4's, tape, needle driver (surgery)
scissors (always)
Food
Money
A copy of "the list", which is a list of all of the patients on your service. On this, I usually write labs, vitals, and stuff "to do", like follow up on xray, or whatever. Another good way to do this is to use scut sheets from www.medfools.com, which help to keep track of lab trends, plans, and pertinent patient info (like drug allergies, PMH, etc.).

That's about it. Now I have an idea. If you guys would like, I'd be happy to sit down with you before July (maybe during your PFI course in June or over cold beverages, and obviously not before your boards), and go over some of this stuff. If that sounds good, let me know. Xandie, are you down?
 
donnyfire said:
Maxwell's
That's about it. Now I have an idea. If you guys would like, I'd be happy to sit down with you before July (maybe during your PFI course in June or over cold beverages, and obviously not before your boards), and go over some of this stuff. If that sounds good, let me know. Xandie, are you down?
Click to expand...

She'd better be. I'm in for sure!
 
donnyfire said:
Maxwell's
Sanford Guide to Antimicrobial Therapy
PDA
Pocket book of whatever rotation I'm on
Note pad (I use this all the time)
Pens
alcohol wipes (for stethoscope)
stethoscope (I carry mine in my pocket 😛 )
EKG calipers (on medicine)
suture removal kit, 4x4's, tape, needle driver (surgery)
scissors (always)
Food
Money
A copy of "the list", which is a list of all of the patients on your service. On this, I usually write labs, vitals, and stuff "to do", like follow up on xray, or whatever. Another good way to do this is to use scut sheets from www.medfools.com, which help to keep track of lab trends, plans, and pertinent patient info (like drug allergies, PMH, etc.).

That's about it. Now I have an idea. If you guys would like, I'd be happy to sit down with you before July (maybe during your PFI course in June or over cold beverages, and obviously not before your boards), and go over some of this stuff. If that sounds good, let me know. Xandie, are you down?
Click to expand...

you're my new hero. that would rock. thanks!
 
Damn straight... here's my list:

Pocket 1:
Maxwell's, two black pens, a red pen (for circling abnormal values), pen light, scissors, notecards for quick reference like phone numbers or anything specific to my current service, money, atm card

Pocket 2: Notebook, reflex hammer, the "list" (mine's from http://www.studentdoctor.net/freeforms/), chapstick, vitamins (on peds), food, pager

Pocket 3: Pocket book for whatever rotation I'm on, palm pilot, alcohol wipes, folded up papers with all sorts of other things on them

I try to be a little slimmer than Don... I've got enough issues under the coat in the general region of the pockets without adding more to it.

And yes, I'm all over that plan. Adjusting for the fact that I'm on surgery in May and June... find me on a good day and I'm up for some margaritas and dispensing of advise. Let the mayo fight begin.
 
Two posts while I was making that list... damn. I'm losing my edge.
 
donnyfire said:
That's about it. Now I have an idea. If you guys would like, I'd be happy to sit down with you before July (maybe during your PFI course in June or over cold beverages, and obviously not before your boards), and go over some of this stuff. If that sounds good, let me know. Xandie, are you down?
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Oh, oh, me too, me too!!!! 👍
 
Also... I thought you'd all enjoy this.

The reason for this admission is primarily social. As such, the main issue facing this patient is the difficulty the staff has had in communicating effectively with him, both in order to extract and disseminate information. Therefore, it is paramount that we, as health care providers, find ways to successfully exchange information with our patients. A large barrier to this is the physician's responses to the patient's behavior. Traditionally, physicians have been trained to repress their emotional responses to patients in order to maintain clinical objectivity. According to a study by Marshall, the natural responses that we have to our patients can facilitate the development of stronger physician-patient relationships. Additionally, according to Novack, it is not the existence of a physician's personal characteristics, past experiences, values, attitudes and biases that negatively affect the relationship, but it is when those aspects are subconscious. Awareness of these potential mitigating issues can enhance rather than hinder communication.
In addition to being aware of our own biases, it is also important to identify the features of the patient's personality that makes them "difficult". With each type of stereotypical "difficult" patient, we must find a balance between catering to those needs and maintaining an appropriate relationship. Patient-centered care, which includes being willing to apologize to the patient for any situation that rightfully upset the patient, even when it is required for the patient's care. For example, in this patient's previous admission, I tried to spend a significant amount of time with him, apologizing, whenever I had to perform an intervention to which he objected. In my experience, when trying to convince a patient to undergo an uncomfortable procedure, the physician frequently becomes uncomfortable herself and leaves the patient alone in order to relieve her discomfort, leaving the patient feeling abandoned and not cared for. By spending time with this patient after subjecting him to an unpleasant intervention or test, I was able to effectively calm him and try to diminish any ambient negative feelings between myself and the patient.
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I just noticed there's a line in the middle that doesn't make sense. I already printed it and I'm lazy though, so oh well. I doubt my attending will notice, to be honest.
 
Xandie said:
Also... I thought you'd all enjoy this.
Click to expand...

Whew. Is that part of an on-the-record H&P, or did you just have to write that up as a separate report? I'm scared of having to be able to do that next year...especially the part where you find literature to back up what you're saying. MIM didn't really do much for my horrible literature searching skills.
 
Gimlet said:
Whew. Is that part of an on-the-record H&P, or did you just have to write that up as a separate report? I'm scared of having to be able to do that next year...especially the part where you find literature to back up what you're saying. MIM didn't really do much for my horrible literature searching skills.
Click to expand...

That goes on the end of my H&P... normally you write them on something medical (this month I've done NSTEMI, OSA, and ileus). My attending specifically asked me to write something about dealing with the difficult patient because my patient is a little... difficult.

And the answer to all of your literature search problems? UpToDate and MD-consult. Don might have other ideas, but those two are KEY to me. UTD can be used on campus and in the hospitals, but you can get MD consult at home. Good times.
 
Xandie said:
That goes on the end of my H&P... normally you write them on something medical (this month I've done NSTEMI, OSA, and ileus). My attending specifically asked me to write something about dealing with the difficult patient because my patient is a little... difficult.

And the answer to all of your literature search problems? UpToDate and MD-consult. Don might have other ideas, but those two are KEY to me. UTD can be used on campus and in the hospitals, but you can get MD consult at home. Good times.
Click to expand...

I didn't even realize we have to do this kind of crap!
 
Only during OB, medicine and peds (Don can correct me if you need it for surgery). You do have a lot of busy work though... PBL during family, community health project during family, etc. All in all, it's still better than first and second year, I swear. 🙂
 
It's Taco Wednesday. Topic of discussion: Your ideal taco. Homemade only - no restaurant tacos.

Here's mine:
Soft shell tortilla - Fajita sized (8")
Ground beef w/ Lawry's taco seasoning
Kraft 4-cheese Mexican blend
Lettuce
Tomatoes
Black olives
Ortega Mild taco sauce
Sour cream

Sometimes I toss a little refried beans in there, too, but only if I'm feeling extra saucy.
 
Xandie said:
Only during OB, medicine and peds (Don can correct me if you need it for surgery). You do have a lot of busy work though... PBL during family, community health project during family, etc. All in all, it's still better than first and second year, I swear. 🙂
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🙁 I hate write-ups and stuff.
 
Xandie: currently being featured at the south computer lab.
 
Me = cuter. That is all.
 
Xandie said:
Me = cuter. That is all.
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True, but Prowler certainly tries to be disturbingly cute for a male.

Moral of the story: men should never be cute.
 
Gimlet said:
It's Taco Wednesday. Topic of discussion: Your ideal taco. Homemade only - no restaurant tacos.

Here's mine:
Soft shell tortilla - Fajita sized (8")
Ground beef w/ Lawry's taco seasoning
Kraft 4-cheese Mexican blend
Lettuce
Tomatoes
Black olives
Ortega Mild taco sauce
Sour cream

Sometimes I toss a little refried beans in there, too, but only if I'm feeling extra saucy.
Click to expand...

prefer soft shell 8" or 10"
CHICKEN with lawry's seasoning (take THAT, Gimlet!)
Pretty much any cheese is good, chedderish stuff is great
Lettuce
Tomatoes
Onion
Sometimes olives...in taco dip i LOVE green olives.
salsa or taco sauce
lots of sour cream

I knew I shoulda gone to Qdoba today. dang.
 
Mmmmm.... tacos.

Ok, so for meat taco:
ground beef, lawry's seasoning, hard shell tortilla
tomatoes, cheddar cheese, and salsa from this one restaurant in Phoenix called Jordan's (best salsa ever it's all smooth, no tomatoes, just peppers, but mild -- I would put it on all of my mexican food if I had access to it. My family's been going to that restaurant since it opened in 1946).

Fish taco:
deep fried mahi mahi
same salsa, soft corn tortilla, cheddar cheese, maybe a tiny bit of sour cream

I want Mexican food now, but tonight my parents are making corned beef and cabbage to celebrate St. Patty's day early.:luck:
 
donnyfire said:
That's about it. Now I have an idea. If you guys would like, I'd be happy to sit down with you before July (maybe during your PFI course in June or over cold beverages, and obviously not before your boards), and go over some of this stuff. If that sounds good, let me know. Xandie, are you down?
Click to expand...

Now I found the part of the thread you guys were talking about. I think I got lost in all the birthday/age stuff earlier along with propoxyphene (not bold -- don't worry).

I'm so down! Unless it's when my parents want me to go somewhere since I'm now taking the boards earlier than most of you guys, since Splat changed from D-day.
 
Ashers said:
Now I found the part of the thread you guys were talking about. I think I got lost in all the birthday/age stuff earlier along with propoxyphene (not bold -- don't worry).

I'm so down! Unless it's when my parents want me to go somewhere since I'm now taking the boards earlier than most of you guys, since Splat changed from D-day.
Click to expand...

were you on the same day as I originally was?
 
DoctorFunk said:
True, but Prowler certainly tries to be disturbingly cute for a male.

Moral of the story: men should never be cute.
Click to expand...
hold on, I have some pics of me with a widdle puppy coming up.


NOT. Btw, you were looking cute earlier this week, so I wouldn't talk. Er, wait, take that back.
 
You people are all disturbing... but very fun.

And it's fine with Don/Xandie. 🙂 (basically I feel that I can speak for both of us, right? Because that seems reasonable).
 
Xandie said:
You people are all disturbing... but very fun.

And it's fine with Don/Xandie. 🙂 (basically I feel that I can speak for both of us, right? Because that seems reasonable).
Click to expand...

you already do speak enough for 2 people anyways 😀
 
Marc. Don't be jealous that you can't keep up.
 
You mean the breast fondling?
 
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