We have crossed the half way line through our General medicine rotation and i am looking forward to seeing the home stretch! As amazing and exhilarating as it is, a slightly slower and less intense pace would be just fine with me atm. We interviewed and examined an awe-striking neurological man today who was really nice. It was such a complicated examination we were all left a little baffled by what was happening! The man had signs of horners syndorme on his face, his right arm had muscle wasting and he was very weak mostly distally, both arms were hyperreflexive excpet for his right triceps and he had decreased sensation around C7 and C8.
Down his trunk he had weak sensation below T5 on his left and his left leg had reduced sensation. His right leg was weak mostly distally again and he had right foot drop and a babinski sign but his left leg was OK. He also had hyperreflexia on both legs with no muslce wasting (his knee reflex was so big!!). So it was a mixture of LMN and UMN signs but we think he has a lesion around C7/C8 and another or multiple lesions between C7 and T5 causing the UMN signs in his lower body but they don't know the cause yet... sound confusing??
I put in my little diagrams of explanation :P
I spoke to a lovely girl today who i wanted to speak to for a while. You can tell she is so bright and smart and a lovely person when you enter her room, if anyone should not be in hospital it is a bright 18 year old. She has anorexia and it makes me break inside to see. Maybe it is because my best friend has suffered the same illness for years and it hurts to think what she is going through? But she reminds me a lot of my friend and also a lot about me. I went in to talk to her and she was a little reluctant and asked how long it would take expecting more interrogating medical questions, i just said a few minutes and thankfully she agreed. As students we always start off asking 'so what brought you into hospital?' but most of the time the patients look at us funnily because they know we already know. Still its how we start from the start to get their perspective and work on from there. I didn't want to ask interrogating medical questions, i just wanted to know a little about her and it was strange how much we had in common! She has done athletics for years and even came down to Bunbury for a competition when i was there too.
We chatted about running, sport and had some good chats about baking and cooking and she loves cooking shows too. There were some issues which came up which she didn't feel like talking about with me which i completely understand! But i would love to keep chatting to her but just as a friend, i hope she doesn't think it is strange. They say in medicine you need to keep a distance between getting too involved in your patients, but what if it is a moment of fate in your life where you meet someone who you are meant to, as though you have a gut feeling that you should do what you are doing whether it is regarded as 'appropriate' or not? I can't let an opportunity go where i could be there for someone and make a new friend, is there really a line in this case? It makes me think about my future though as a doctor, when i work in a rural area and possibly be a pediatrician i also want to run or be part of a youth mental health organisation.
I took myself to McGillivray oval on Monday to test out my running and fulfill my craving to sprint! Crossing that finish line after each run I knew I was a little sore from the gym the day before but my times were OK, not the best but possibly enough to at least compete in a 1500m event and not make a fool of myself. If i have time maybe i will go again this week and do a 1500m time trial... if i have time. But even after one track run with spikes my injury from last year played up in the arch of my foot so the next 2 days it was a little painful! We started netball again for social games on Tuesday nights which was fun! I love netball too, i love the speed and agility and the challenge of reading the play and it it is such a nice way to see friends you don't too often anymore.
I just wanted to put in a picture of my breakfast i love! Apricot and almond muesli with nuts and cranberries mixed in natural yoghurt, a little vanilla protein powder, a drizzle of honey and strawberries (or blueberries and banana!) perfect start to the morning, yum :)
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