Clinic, clinic and more clinic

Today was quite a busy day but I didn’t actually get to do that much. I was in ante-natal clinic this morning which was quite good – spoke to a few expectant mothers and saw lots of US scans. Also got to feel my first pregnant tummy, very exciting! Before this placement, my only understanding of obstetrics was the so called ‘maternataxis’ so commonly written about by the likes of Tom Reynolds. However, today I saw a lady who was completely the opposite to this, this lady had been having labour pains since the previous evening, brought herself into clinic, was examined and told she was 4/5cms dilated and was admitted to the labour ward – she even refused a porter to take her upstairs and insisted on walking!

This afternoon was spent in a gynaecology clinic which I did not really enjoy that much. Its not the most thrilling of clinics as its mainly all menorrhagia and associated symptoms. The most interesting part of this afternoon was after I took a history from one patient and the consultant ended up having to refer her to the rheumatology department as she didn’t really have any gynae problems, but did have something that needed investigating.

You know that feeling you get where you need to cough and you know its not just going to be one but you are going to have a full blown coughing fit? Now imagine having that feeling whilst being sat in a room with a patient, consultant and nurse whilst they are discussing some intimate medical problem. I tried, but I just couldn’t stiffle the coughing anymore – I had to leave and have my coughing fit. The nurses outside were very nice though and got me a glass of water and ensured I wasn’t dieing/choking, which was nice.

Tomorrow is a lazy day, I’m not in hospital so I’m going to have a lay in and then catch up on some book work before next week.

Stay safe.

SD

Breast Clinic

Breast clinic this afternoon was quite interesting, I saw lots of ladies getting good news that the lumps they had been worrying about were nothing more than excess growth of breast tissue, cysts or benign growths. The look of relief on their faces as they received this news was obvious, I can’t even begin to imagine what it must be like, most of these ladies had been referred from their GP so had been waiting at least 2 weeks for their clinic appointment. It must be hell knowing there might be something seriously wrong but being able to do absolutely nothing about it.

I can see why working in oncology must be a very rewarding career when things work out well, I just don’t know whether I would be able to face telling these young women that they had breast cancer. I know there are now lots of things that can be done and many different treatments avaliable but it is still a huge life changing diagnosis. That said, there aren’t many areas of medicine that are easy!

Tomorrow is ante-natal clinic in the morning and gynae outpatients in the afternoon, both with my consultant. So hopefully I should get quite a lot of teaching and practise at examining pregnant ladies tummies (and gynae things). Looking forward to it, clinics are a lot better than wandering around on a ward looking like a lost sheep!

SD

Babies!

Today was the first day of a new module block and I’m loving it already! I didn’t think obs and gynae would be that great but I think I was wrong.

I spent this morning in GUM (genito-urinary medicine) clinic and it was amazing, the staff were really friendly and I was adopted by one of the SHO’s. I observed him take two histories and do speculum exams/take samples on those patients and then it was my turn. The next patient was mine! I took a history, wrote it in the notes, explained what was going to happen next, and then I did the speculum exam and took the samples. All this and it was only my first morning! Then I took the histories for the rest of the patients in that mornings clinic.

Since I started clinical placements in June last year, this was the first time I’ve actually felt like a useful member of the team. For the rest of the time I’ve just felt like I’m getting in the way and not actually serving any useful purpose but this was different and I love it!

Met up with some other students in the canteen at lunch – discussed how our respective placements are going, no one seems to be having many problems, except one who’s consultant is on holiday. I haven’t met my consultant yet but that will happen tomorrow morning in theatre.

This afternoon was spent in the early pregnancy assessment unit (EPAU), watching lot of ultrasound scans, it was very interesting and I saw lots of little pictures of babies. So cute. The best part of the afternoon was when one lady came in with her 5 week old nephew and I got to look after him whilst she had her scan – he was so tiny and so cute!

Early start in the morning for theatre followed by breast clinic – should be interesting but I bet I’ll be exhausted by the end of the day!

SD

What have you done today to make you feel proud?

On Saturday I helped to save a life.

We were sat in the first aid room when the call came in, “male, cardiac arrest”. Hearing that was enough to make me forget the hangover that I was trying to hide from the boss. I rushed to the scene with a paramedic and technician hoping that the info we had got had been over cautious. It wasnt, just by taking one look at this gentleman I could tell that we had a full blown cardiac arrest on our hands.

We attached the defib pads, he was in VF. Shocked. Remarkably the paramedic found a pulse, the defib showed sinus tachycardia, he had a chance! We planned how we were going to get him out and down to the ambulance that was on the way, I moved the crowd out the way so we had a clear exit route, I also got some details of the patient from one of the crowd, name, address etc. As we prepared to move him someone yelled “the rhythm’s changed”, we all turned to the defib screen the paramedic shouts to me “whats the rhythm?”, “VF” I reply and we prepare to shock him again, again he reverts back to sinus – this guy’s not giving up easy.

We got him back to the first aid room and waited for the crew, by this point he was breathing for himself with a good output. Fantastic! The crew arrive to take him off to hospital, he’s got the best possible chance for an out of hospital cardiac arrest, he recieved defibrillation within one minute of collapsing. The crew came back to the event to see us after they delivered him to hospital – they brought with them good news – by the time they left the A&E department, our patient was sat up asking the nursing staff what the football score was!

This is the second cardiac arrest I’ve been to and the first time I’ve seen someone receive a shock from a defibrillator. It looks brutal, to be jumping up and down on someones chest only stopping to force air into their lungs and hundreds of joules of electricity through their body but it really did make a difference today, hopefully our patient will survive this event and go on to have many more happy years, more time with his family, more time to enjoy life – it makes me proud to think that I helped to save his life and that I’m going into a profession where I will make a difference for the rest of my career.

What have you done today to make you feel proud?

SD