Shot through the heart and you're to blame...

So we've all heard about the crocodile hunter's tragic death due to a freak sting ray attack, well there was a patient at our hospital last week who also got shot through the heart by a sting ray barb and survived (the story was on CNN!). He's had several surgeries, one of which Sears got to scrub in on, so we had our household brush with fame.

In other exciting patient news, DS was admitting our patients last night (while I enjoyed a fabulous day off) and admitted a woman who complained of not feeling well for about two years. Apparently, both she and her 13 year old son had started not feeling well about 2 years ago when she purchased a Nissan. In an effort to determine the cause of the illness, she went to an acupuncturist who looked for heavy metal toxicities and found that they both had some abnormalities. Upon interview, she revealed that she had "missiles" in her stool that we composed of multiple types of metals. She also reported that when she washes her hair, smoke comes off of her head and that her hair feels like "toasted bread and butter." Finally, she described her skin as "silvery" and reported that it clicks and pops. When the missile complaint was further questioned, she responded that they were "ya know, missiles" and made a hand gesture complete with a sound effect illustrating a shooting object. Yeah, we got a psych consult on that one...

My day off also provided some amusement. After work on Saturday, a bunch of us decided to play tourist and we took the water taxi around to various restaurants and bars. Drinking is allowed on the boat, so we brought our own and only got a few dirty looks when we broke out the beer at 2 in the afternoon. The looks got a little dirtier when we started discussing work and the people around us realized that we represent their future medical care! Oh well, even doctors need to have fun ;)

I've been putting this off since I was so sorely disappointed, but I'm sure that those of you who care know by now that Jeffrey won PR. I have no doubt that he cheated in some way, even if they had no proof. I can't believe he was even allow to show his line. Poor Michael didn't stand a chance, but Uli and Laura definitely made more wearable clothes and I would have been satisfied with a win for either of them. Grrr.

Itchy penis

One of the joys of internal medicine is being able to address almost all of your patient's needs. Unfortunately, two of my recent patients have ended up needing attention to their more private parts. One, who came in for diabetic ketoacidosis (out of control diabetes), revealed during the physical in the ER an infection underneath the foreskin of his penis. Evaluation of such an infection involves making sure that the foreskin can be fully retracted and then put back into place. Naturally, I received some flack when reporting the findings of my genitourinary exam to the residents, but it was all in the name of our patient's health. The next day, however, I had to report that his infection had worsened and evolved to include swelling along with some discharge. On the same morning, one of my other patients developed a rash on his penis. So at morning report, I got to describe not one, but two male itchy parts!! The residents, of course, had a field day speculating about whether I was spreading some infection to my patients. All I want to do is catch babies, people. How come I have to deal with the itchy boy parts?? Ew.

Things aren't all fun and games in medicine though, we're working right now with a patient who came in with high blood pressure and had a stroke while he was in the hospital. It's really hard to think that he came in walking and talking and now, under our care, he has decompensated to the point that he can do neither. I am hoping that he will recover some function or that we can at least prevent him from deteriorating further. The worst part is that he is relatively young - in his 40's - so this turn of events seems especially tragic. Cases like his really emphasize the limitations of medicine even in our state of the art hospital.

On a personal note to h - I'm on call on Wednesday night, so I'm DVRing PR and will watch it on Thursday ;)

A fraction of my former self...

Well, it's been two weeks since the surgery. It was tough for a while, but swallowing is much easier now. Sadly, ice cream made my throat hurt worse, so my dream of having an excuse to eat nothing but ice cream for a week was dashed. Vanilla bean frappuccinos went down okay, so I've had a lot of those lately. Conveniently I started my internal medicine rotation back a the hospital, which features a Starbucks in the lobby!

Internal medicine has proven to be both demanding and very interesting so far. I'm very glad to be back in the hospital and working with the same patients for their whole stay in the hospital. On the first day that we were on call, I admitted a patient who complained of constipation for the last two weeks. Upon further questioning, I ascertained that this constipation was secondary to his consumption of four bags of microwave popcorn in one sitting. He had been seen in our ER a few days previously with the same complaint for which he received a colonoscopy. The colonoscopy showed a "popcorn bezoar" in his colon. A bezoar is a collection of foreign material in the GI system that is not digestable, often it is composed of hair or fiber. Apparently, popcorn was evident in this man's colon and was plugging him up. After several days in the hospital and gallons of Go Lightly later, my popcorn bezoar patient was sent home.

The next call day we, my colleague DS and I, admitted a middle-aged woman for chest pain. In the course of our very thorough history-taking, it came up that, although she is married, she is not sexually active. She told us that she was not very happy with this turn of events. She then added that she does enjoy watching "sex movies," but she isn't able to "enjoy herself" until she goes to sleep and dreams about them. So she feels like she's missing out. I have never worked so hard not to laugh in the middle of a conversation with a patient before. I hope now that her chest pain is better, her other problems can resolve as well.

I'm going to enjoy McDreamy and Fin on Grey's now! Oh, and McSteamy!