sanguinemare

August 3, 2017

Ear irrigation and Dix-Hallpike Maneuver and Updates

Today was an interesting day!  Surprisingly mostly because of clinic rather than what’s been going on in the in-patient setting.   So much a bit of background – I’ve switched over to the VA for the month on a different team, and we go to clinic once a week as well to experience what things are like at the outpatient setting.  The first time last week was a little hectic – my preceptor had just come back from a week of vacation and had a lot of catching up to do, so it was a bit of a whirlwind.

Today at clinic though, I actually felt like I was able to participate in the healthcare a bit, which was nice – I am starting to realize I would like to be able to do procedures/work with my hands at least a little with the patients.  Currently in the in-patient setting, I feel like my role has mostly just been talking to people (either patients, other team members, or making phone calls) and looking things up on the internet, but it’s mostly theoretical/medical management, and not as much hands-on.  But today during a routine check-up at the clinic, I got to help out with an ear irrigation due to earwax plugging up of ears leading to decreased hearing (and the patient was actually more comfortable when I did it I think), which was something I’d always heard about but never saw in real life.  Basically, she added drops into one ear (5-10) to soften the wax, then plugged it up with cotton and turned the head over to repeat on the other side.  Then they prepared a spray bottle with lukewarm water, attaching a small, flexible tubing to the end, and then removed the cotton, put the tubing into the ear, and gently spray into the ear until the earwax/dissolved debris runs out (don’t forget to put towels below and use a container to catch the water!).  Also don’t spray too hard, or it’ll 1) be painful for the patient and 2) it’ll spray all over you when it comes back out!

I also finally got to see how to do the Dix-Hallpike maneuver in person!  The latter was pretty exciting to me (even though the move actually turned out to be quite simple) because I’d had a patient with unexplained vertigo last month at the hospital that I thought might have BPPV, but since I didn’t know how to do it and no one on my team had done it before either, I wasn’t sure if I should try it, especially since she was so dizzy at baseline.  But now I know!  Essentially the person sits on the bed, turns their torso to a 45 degree angle, and they are supported down to the bed straight down in that manner (without turning their torso back to a supine position), to see whether they get dizzy.  As an aside, I did end up trying the Epley maneuver on that previous patient to try to improve her symptoms, but it was hard to tell which side was worse for her, and I don’t think it did anything much but make her more dizzy… :\  The one thing that did seem to help though, was talking to her and listening to her – she’d had a lot of really sad things happen to her children/family over the last few months, including deaths, stroke, diagnoses of cancer etc, and so talking with her and praying with her on the last day of her stay I think did much better than anything else we’d done for her during her stay.  I’m grateful I had that opportunity.  May God watch over and comfort that family.

April 7, 2014

Life/MSTP journey update

Hellloooooo!  I am alive!

So sorry it’s been so long since I last posted… a lot has been going on this year, so it has been difficult to find time to actually sit down and write something cohesive/coherent.

Part of the reason it’s taken a while is because I started up a blog for our MSTP earlier this year, as an additional part of our Communications Committee (which previously only consisted of making a bi-annual newsletter).  As you can imagine, that took a decent amount of time getting off the ground and trying to find people to write for it, and/or writing for it myself, which made me less inclined to write here, due to brain fatigue and the desire not to duplicate posts.  I have recently passed on the responsibilities of the blog to another member of my team though, so I am finally able to take some time and come back here to post.  Yay!

So since I’m on the topic, I’ve done a decent amount as the head of the Communications Committee this year – put together 2 newsletters so far, which I decided to have come out in time for the first applicant interview day, and another one for 2nd look day which was early last month.  Our next one will come out in time for our summer retreat.  By the way, newsletters take a surprisingly long time to put together… or at least ours does, which may be more a reflection about how our “newsletter” is more like a “newspaper” in glossy pages and in color, at this point.  I’ve realized why it’s important to set a word limit now – trying to put together a newsletter when some stories run 3-4 pages and others run 3/4 of a page is rather difficult.  Plus, I had to completely revamp the newsletter the first go around, since my team was unanimous in saying the layout, design, fonts, and everything pretty much were pretty displeasing to the eye at the time.  So I took about 2 full weeks’ worth of time learning how to use InDesign (and really also how to use a Mac… ugh, I hate Macs).  There was a lot of time spent fighting both the machine and program… many many hours.  And a couple of my team also tried tackling one page for at least 5-8 hours each, and also barely got anywhere.  Frustration abounded, but we eventually got something decent-looking, I thought.   I thought it would go easier the next time, but this was where I ran into the page limit problem, and had layout issues, so it again took at least 15-20 hours to put together. *Sigh*.  Here’s to hoping the next one will go smoother.  I’m definitely thinking about stepping down from that next year, as I’ll presumably have more research going on than I did this year.

So now research/grad school.  Both have been rather trying, in different ways.  Hm. Looking through my blog, it looks like I started an update draft back in October (10/8/13 says the date on WordPress) before my last post on conferences but didn’t end up getting time to write anything.  So!  To recap the whole school year then – last semester was ridiculous, school-wise.  Due to obligations in both my PhD program and the MSTP, I ended up with 16 units (normal load is 9-10 units), so it was effectively almost a double load, and unsurprisingly, not a lot of research got done that semester, though I did do enough to write an abstract over winter break for the American Diabetes Association (ADA), which got accepted as a “guided audio tour” poster (which I gather is better than a poster, but less than an oral presentation).  Whoo.  Also, I am going to insert what I wrote back in October here – since I wrote it at some point, might as well not let that go to waste right?

I finally picked a lab!!!  

This is probably the biggest hurdle that I had to get over this summer, and a pretty decent source of chronic, underlying stress because picking a lab is one of the bigger decisions I think we as MSTP’s have to make (prior to residency decisions), since that’s where we’re basically going to be living for the next 4 years or so.  Given that I had chosen a field that is not normally part of the MSTP-affiliated PhD programs here, and rather late at that, I had not had any rotations with professors in the program yet, so had to cram 2 6-week rotations in this summer.   One was a pathology lab, and my project focused on inflammatory markers and monocyte rolling, while the 2nd was an obesity/diabetes lab where I worked on glucose transport in cells.   In total, over the last 3 summers starting the summer before med school, I had rotated in 4 labs: a LC-MS lab that was more chemistry-based, a stem cell lab, and these last two.  Ultimately, I decided to make this last lab rotation my thesis lab for a few reasons: the funding is relatively stable (or so I think/hope), the projects were decently interesting, the PI knows a lot and is willing to introduce me to a lot of people involved in the field (actually I was lucky enough that all 4 PI’s seemed like they would be great mentors), and there is potential to do translational research – that is, some bench-work, but also some clinical work.  The last reason was probably one of the more important deciding factors for me, and it seemed like that was something the PI really wanted to push for in my training with him.”

Well, looks like I was rather excited at the beginning of the school year in relation to lab, which subsequently has waned some due to the complications listed above and below.  This semester, I had somewhat of a lighter load, but still above the normal (13 units), which has been fine for the most part… although I recently had a review paper that I literally spent the entire spring break working on, as well as pulling my first all-nighter ever for school, working straight from 9am the previous morning until 5pm on the due date… which eventually came out with a poor grade last week, and I now have to re-write it.  That was quite a bit of a disappointment, as I’ve never spent so much time on something for school before.  Plus, due to some miscommunication, the professor who graded it (who happens also to be the director of the program) now probably thinks I’m one of the worst students ever… blah.  I really hope that doesn’t prejudice them against MSTP’s because I am not reflective of the typical MSTP, and also I think there was just bad miscommunication. :\  Research was also basically stalled for 3 months, due to my mentor not being that available and thus me not being able to do much since no one else in the lab is doing anything related to my project.  At least now I have a direction and can actually start gathering data again this month, whoo hoo!

Anyway, with all that going on, as well as helping out with being an SP (standardized patient) and various other things, I think I may have over-stressed myself because I have been having strange joint pains for the last 3 weeks or so, and a couple days ago, after being outside for a few hours, I noticed I had redness on my face and in patches around my legs.  Given the distribution of the rash, the arthralgias (joint pains), photo-sensitivity, and various other problems I’ve had in the past, I’m fairly certain I have either exacerbated or just triggered a systemic autoimmune disease, which is rather unfortunate.  (I’m sure if you look up those symptoms, you’ll be able to figure out what it is).  So that has been something that’s been weighing on my mind a bit the last couple of days.  I am hopeful this won’t impact me too much, but I think it’s also a sign that I need to stop piling up so much on my plate and to start taking better care of my health.  I just sent an e-mail last night to the people in charge of SP’s to let them know I might need to quit, especially if I can’t become a trainer anytime soon (which is the whole reason I became one in the first place, since it was a prerequisite to the position).  I may slowly need to start phasing other things out of my life as well.

In other news, I have also become much more involved in the church that  I decided to officially join/become a member of here.  I see that in October I was probably going to write a decent amount about it because I started out with “This is generally not something I would normally share on here, but I feel it has been such a significant part of my life in the past couple of months especially that I felt I should”… and it ends there.  Not going to go into too much detail right now as this is already getting long, but becoming involved in the church (which I’d been attending fairly regularly for a year prior) this summer and subsequently has played a huge role in helping me get over a depressive spell over the summer due to a bad break-up situation, as well as helping me feel a lot more grounded here.  I feel like I actually have community and friends now.  Not to mention being able to play violin on worship team has been a HUGE blessing… I knew I missed it, but did not quite realize how much until I was able to play again.  It helps center me a lot, and is good for stress relief sometimes, or just as an expression of joy.

Along that route, I have also started teaching violin this semester – one student has now been with me for 2 months and has made pretty good progress (to even my surprise haha, since it’s my first time teaching violin really).  I may also be getting a second student soon, which I am pretty excited about.

Ok! I think that about sums up things going on in my life right now.  I had a bunch of links I was going to put at the end here, but as this is so long, I think I’m going to save it for the next post.  Stay tuned!

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