Friday, 18 May 2012

Oncology Week, back in London + ICA cram

This week was basically a whirlwind tour of Oncology, ending with a visit to the local hospice.

I'm not too sure how or where oncology really fits into the 3rd year curriculum, and the oncology FY1 thought it may have been better placed in 5th year "when you've seen a bit more of everything". I think i have to agree with him here. A lot of the patients were quite ill, with multiple problems over multiple systems, which i had very little knowledge of, that and i don't think i was quite prepared for the palliative care side of things.

I found it quite difficult to understand why certain drugs were stopped, or why certain consultants believed a certain way of dying for the patient would have been a "better death". I know there must be a reason behind it, but i wish i had some insight into it too, i guess these things come with experience.

Oncology week aside, i'm finally back in London for a 2nd week of CCS (clinical and communication skills), and i've heard some pretty good things for this week, including putting NG tubes into each other.

Only 10 days left till my last ICA of the year, time to start the cram!
... well.. actually.. thinking about it....there's only 44 days until the end of year FINALS!


Friday, 4 May 2012

Patient: "A Normal Poo"

I have to admit, i use to find talking to patients about their bowel movements quite difficult, as i guess, i was embarrassed, or i felt it was slightly too personal and worried the patients would feel uncomfortable to discuss it  with me (I have yet to overcome this difficulty when asking patients about sex). However, it turns out, that i didn't really have to worry at all.

All the patients i've clerked so far, have been more than happy to tell me all about their bowel movements, from colour, smell and consistency, to if there are bits in it. Though, one memorable moment, is from a very fit elderly lady, who upon us entering her side room on an early ward round, jumped out of her bed, held my FY1 by her shoulders, and exclaimed that this morning she did a "NORMAL poo". She was so excited and happy, it actually made me smile and be really happy for her.

I didn't quite know what was going on, but i knew after the ward round i had to go back and clerk her. She seemed so happy, i guess i just wanted to find out what had happened to her before.

She very kindly let me interview and examine her, and i found out that she unfortunately has been having constant diarrhoea for 6 months now, sometimes going to the bathroom up to 16 times a day, and have awoken many times in the morning in soiled sheets. I can only imagine how difficult this must be. However, since admission she has had a colonoscopy with a biopsy taken and steroids started, and after a week of starting her on steroids she passed what she described as her first NORMAL solid movement in months.

Her joy was infectious.

Gastroenterology Firm

So i got things a little mixed up.

It turns out i wasn't going to start Met3a with colorectal and vascular surgery, but instead i was going to experience 4 weeks of Gastroenterology, 1 Week of Oncology and finally 4 Weeks of Surgery (just before the end of year exams) to finish the year.

Having been on an out-firm before, this wasn't too bad, i SERIOUSLY over-packed the first time i had to move out (who seriously thinks they need to bring 3 extra loo rolls for the first week ¬.¬ ... it was me). I settled in pretty quickly, and before i knew it, i sat through the introduction talks, met my FY1, was on daily ward rounds, went to clinics, watched endoscopy and colonoscopy on Wednesdays, and ERCP on Fridays.

All in all, Gastro. has been quite an action packed firm, and it's already been 3 weeks of it! Not quite sure where the time has all gone!