I had the school's first needle-stick incident while assisting the doctor remove a bump in a patient's mouth. The patient said he has Hepatitis C but does not have HIV, but in any case I still needed to get blood drawn to get a baseline reading for my virus levels. Since I didn't have hep C, my levels were 0, but they need that baseline so they can compare the virus levels at 6 weeks and 6 months out, just to make sure the virus didn't take hold. The annoying thing is that, being at a new school, plus using a clinical rotation system in which all the students are spread out at different clinical sites instead of at one hospital, no one quite knew how to handle the incident. I called our clinical coordinator, who said to go to the ER of the principal hospital we work with in the area. Since this was not the principal site for all our students, and since I was coming in from another clinical location, I was treated like any other ER patient and wasn't brought back to a treatment room until at least an hour later. In the next several hours, I had blood drawn and waited, talked to nurses and doctors sporadically and waited, got some juice, and waited. Along the way, I was told that the prophylactic treatment for hep C hasn't proven to be very useful, so I wasn't started on that, and since there was a low chance that I was exposed to HIV, I wasn't started on the treatment for that, either. So, I spent 7 hours just to get some blood drawn, and was released at half-past midnight. Subsequently, we have brought the patient back in to have his blood tested, and his active hep C viral load was undetectable, so my 1.8% chance of contracting the disease drops even lower, and he is indeed HIV-free, so that's a relief. I've been reassured that the school is working on making sure this prolonged response doesn't happen again, but the bulk of the response is dependent on the specific site's established protocols and smaller, private practice clinics don't necessarily deal with this type of thing very often. Anyway, like I mentioned above, I'll have blood drawn in a few weeks, then again in several months, and I'm not expecting any hepatitis to show up.
This month of primary care has further confirmed that my skills and interests lie in more acute care than in long-term health management and disease prevention, but it has also further demonstrated how important the primary care is. I still want to be a trauma surgeon, and this rotation has been good at showing me what sort of long-term health issues people deal with. Things like diabetes, hyperlipidemia, depression, hypertension, etc. don't just go away when someone has a traumatic incident, so it's good to have a feel for how their medical care is going to have to continue alongside their surgical care.
To finish off the month, some friends and I hiked up Pikes Peak last Saturday (pics below). We planned on hiking up and riding the Cog Railway down, but we ended up going at a slightly slower pace than I expected, missed the train, and had to have a friend drive up and get us. We lucked out that we had cell service to call our friend near the top of the mountain, because in my experience it's rather patchy up there. A couple of us had dinner with the knight-in-shining-armor friend and her mom on Sunday, then went to Seven Falls, a local attraction. I'm not sure if I had some lingering electrolyte imbalance from Saturday or got food poisoning Sunday night, but yesterday, on the second-to-last day of my rotation, I woke up with some mild stomach distress and diarrhea, which progressed by late morning to nausea to the point that I almost had to run out on a patient lest I throw up in front of her. The doctor said I could go home, and I had to bum a ride from an MA because my car was in the shop (racking up an $87 bill to tell me I simply needed a new gas cap). Anyway, I spent the afternoon emptying the entirety of my digestive tract out both ends, but by the end of the day I was able to sip some Gatorade and water, then even have some noodles for dinner. Today, I decided to take it easy, so I've been doing some simple things around the house, getting ready for my next rotation in Cardiology, and making sure I'm ok to go back to my Family Medicine rotation for the last half day.
I've had plenty of fun patient interactions, but I feel this is long enough already, so hopefully next month I can focus more on the patient side of things.
Scott
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| Fun on boulders. |
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| 7 miles in and still pretty happy. |
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| 11 miles in; only 2 to go! |
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| We made it! |
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| Poof we were at the top. |
