Friday, August 27, 2010

First Call ever ....

Acute Pain - one of intern anesthesia months.
It's been busy so far. Acute pain is mostly epidurals and regional blocks. What it means is that we put local anesthestics specifically near a certain nerve that would help with pain control during operation and post operation. It's absolutely crazy in some areas that we can block. Epidural is one that we know well about since most labor and delivery patients have them, natural or C-section. The regional blocks, some are normal and some are very new, but nonetheless incredible to watch/assist.

My first call ever. I've managed to not have any calls all through med school because the hospital I was at wanted all students to be there every weekday so we can't stay past midnight hence no calls. People are amazed at what I have gotten away with so far. It just makes it seem like I have had an atypical med student experience where I was not going crazy with stress and crazy hours during rotations.

The experience ... It was good actually. I only had to call my staff about 2 things. First was because the nurse mentioned something and I felt obligated to call and confirm even though I was pretty sure of my findings. Oh well, joy of being an intern where people just don't trust your judgement. The second call was actually legit where it was something that the staff is required to notified. Otherwise, my call started off with running between 2 PCAU, putting orders in, bolusing pts with pain meds, seeing new consults, and others. Then time was spent running between orthro floor and others. By the time I actually sat down trying to eat dinner it was 9PM. Then the pager decides to go off. I think I finally ate dinner around 10PM. I'm glad that we on call meal allowance so I can get AuBonPain. I normally don't get ABP cuz it's expensive but oh so good.

The pager finally quiet down a little before midnight and I had some time to finish off the new consults. The last consult was finished a little after 2AM and finally able to catch some zzz's. Woke up a bit before 6am for sign out and one 1st round block before taking off for post call day.

Not bad for 1st call ever. No disaster, got some sleep. Now hopefully, the rest of the month will go as well.

Saturday, August 21, 2010

Nephrology ...

2 weeks on transplant and 2 weeks of floor consults.

Transplant: Basically, my work is with acute renal injuries in any transplant patients, heart, lungs, kidney and any other organs that CCF have deemed transplantable. It was a 2 weeks since with my luck, now new kidney/pancreas transplants but the Monday after I left the service there were 3, of course. But I definitely get to see some crazy transplants done. Lungs were the scariest ones since most of the patients either don't leave the hospital or if they do leave, they'll end up coming back a couple months of later and not leave then. Kidney/pancreas transplant seem to have the most success. Liver patients are disasters to start with so they are disasters to end. Heart transplant still amazes me. Patient comes with nearly nonfunctioning heart or already on some sort of artificial heart pump and they leave here with a functioning heart. Amazing. Definitely my first time seeing some of these amazing procedures that I have only read about in the last couple of years. With these people, either they do really well or they crash hard. Of all the transplant I would not recommend lung transplant unless it's the absolutely the last resort.

Floor Consult: Pretty much anyone with kidney problems, either chronic or acute. Acute on chronic, new acute injury, dialysis. It's almost always the same. But I did get to meet some of the other medicine residents/interns and urology intern. It was fun 2 weeks with them since each of us know different things/ procedures.

Overall this rotation, I have definitely learn a bit about the kidney and what happens during surgery/low BP from other reasons and how to care for it. Immunosupressants really do a number on the body organs, brain, kidney, liver and any other organs that bugs would like to live on.

Sunday, August 15, 2010

CMDA Picnic

CMDA annual picnic. My first contact here in Ohio with Christian medical people. Again, it was mostly caucasians but it was encouraging to see that there are quite a few number of Christian physicians active with CMDA. There were a few medical students from Case and Lerner that are active with CMDA. There's a women medical society type meeting once a month. The one in Sept will be hard for me to make since I'm on a call schedule for APain, but will seen. I'll definitely try to make it to one to see what's like and meet others.

It was here that I realized I'm sorely missing my Chinese Christian connections. I hope I can get settle with this soon.

Sunday, August 01, 2010

Church

Looking for my new home church ... quite a task and challenge.

I've been in Cleveland now for about 5 weeks and explored a couple of the churches in eh area. I'm stilling looking for a place to call home. So far I've come to the conclusion that finding a church with a group of young working adults is quite the task since the ones I've been to either are family oriented or college oriented.

Cleveland Chinese Christian Church
It's very close to my apt. It takes me less than 15 mins to get. That's a definite pros so I can get there even when I'm tired. The church has several branches but the young adult English branch is the one I went. It's actually pretty small. Mostly college or grad students there and a few residents and new attendings there. The teaching is good and it's base on the scripture for topics. I've only heard the pastor once and the other times I wents, it was visiting pastors speaking. They are good but they are not as good as the one I went to in Jersey. I feel like they are just still trying to find their own niche for the English group whereas, the Chinese services are already very well established. I can see myself coming for the next 4 yrs but will it be good for me? That's the million dollar question.

Parkside Church
It's a big church. Probably on par with Grace Community Church with J. MacArthur. I wouldn't have minded joining that church, but it's a bit far. On good days, I don't mind driving the 30 - 40 mins there but when I'm tired or it's snowing, I'm not sure I can do the drive. Even though the drive is only 10mins longer than the one I make in Jersey and home. Otherwise, the teaching is very sound and I could definitely grow there. I only wish that it's not so far. Their small group fellowship is on Wed, wish it's on Fri so I could actually have the chance to make it there. Midweek is just a bit difficult. Oh well.

Riverview Church
I went to one other church and I had high hopes that it would be good since the pastor is from Masters Seminary. The pastor was great and the sermon was very similar to Grace Community Church style. The biggest thing I have against it is that the church is mostly caucasians with families. There are not many young adult for me to at least associate with. So sad.

I think I'm going to settle with the Chinese church. Even though it's smaller that I'm used to in NJ, I think there are great potential that I can work with. Can't wait to see what God brings.