Sutures and Snow

This was a good week. We started the Nephrology unit, and spent the majority of the week on that topic. We had lectures on chronic kidney disease, dialysis, transplants, kidney stones, acid/base/metabolites, and a whole host of other kidney topics. We had a few really good lecturers this unit. It is great to have lecturers who are passionate about what they do.

We had a few more lectures on behavioral medicine. One of them was on personality disorders. The lecturer spent most of the time showing us examples from movies. It was a nice break from the monotony of power point. We also had a small group exercise where we acted out how to deal with difficult patients. The three scenarios were a COPD patient that did not want to quit smoking, a flirty patient who asked the PA out for a drink, and a patient upset about having to wait so long and then have to see a PA instead of the doctor. It was a really good learning experience.

I saw another patient this week at the hospital to get a history. I really enjoy doing that. I love to meet new people and I like finding out about them. I think that will be one of my favorite things about being a PA.

Friday we learned some more sutures and got to practice them. We also practiced scrubbing in for surgery. I have no doubt that my hands were cleaner than they have ever been. I got some pictures of my sutures. Remember, we were practicing on pigs feet.

This one is a sub cutaneous suture that is below the skin. If you look closely you can see two black, squiggly lines.
These are the vertical and horizontal mattress sutures. The skin is supposed to be raised like that, although I'm sure mine are a little too raised.

We had a winter storm warning for Friday afternoon. All day Thursday and Friday the news was saying that we were going to get 5-10 inches of snow. That is a big deal here. I'm sure that not too many people really thought it would happen, due to the false alarm last time we had a warning. But, it happened. We got 6 inches in Durham. It started about 6:30 Friday night and went all night and into the morning on Saturday. Church was canceled today, because the roads were still covered. By this afternoon, the roads were starting to clear a bit and we were able to go for a drive and get some good pictures.

Lastly, if you have a minute go to http://pa.mc.duke.edu/ and click on the movie in the middle of the page. I have officially made my mark on the Duke PA program.

These are of the PA building and the Duke Chapel.

Pulmonology and sutures

This week we wrapped up the pulmonology unit. The exam on Friday covered asthma, COPD, ARDS, Interstitial Lung Disease, Cystic Fibrosis, Lung Cancer, Pneumonia, sputum cultures, Spirometry, and chest x-rays. All great stuff to know.

We had a few more lectures in Behavioral Medicine: Anxiety Disorders, Mood Disorders, Psychosis, and all of the Pharmacology that goes along with those.

We had some more lectures in Surgery. I'm not sure if they intended it to be this way, but there are a bunch of students that are terrified of surgery now. They basically emphasized how rigid the OR can be. There are plenty of ways to make someone mad or to mess up.

Friday we practiced our suturing on pig's feet. That was the highlight of the week. It was definitely fun and a great break from the usual 8-5 in the classroom. I meant to take some pictures of my not-so-pretty sutures, but I forgot. We should be doing some more this week, so I will be sure to get some pictures then.

I am really enjoying the program. We have a great faculty and they all seem to care about us and making sure we learn what we need to know. As we visit our patients in the hospital each week, we have two wonderful advisers who go out of their way to accommodate our schedules and hand pick good patients for us to see. I have heard from many students that they were told by faculty from other institutions that they should not consider Duke because they don't care about their students. Nothing could be further from the truth.

So far, this semester has been a little less time consuming. I have been able to spend much more time with my family, which has been a great blessing for me and for them. Hopefully it will stay this way.

Just another week

This week consisted mainly of pulmonology. A bunch of lectures on pneumonia, COPD, asthma, ARDS, ABG's, etc. I have to say that it wasn't my favorite topic.

We had a few more lectures in behavioral medicine on depression and office and crisis management.

I saw my second patient at the hospital, who had to leave right in the middle of my history to get some tests done. I had to gather the remainder of the history from his wife, who was very kind and willing to help.

Friday was the most exciting day of the week. We had a second lecture on knot tying for sutures. We practiced tying knots with actual silk, instead of big ropes. We also spent a few hours discussing bandaging techniques.

Saturday I went with another student to see a patient at a nursing home to obtain a history. After seeing this patient, I am glad that I don't smoke. It had taken a serious toll on our patients body.

That's all for this week. Pretty boring, I know. Maybe next week will be better. We have the day of tomorrow for Civil Rights Day. The rest of the week we will be doing more pulmonology, behavioral medicine, and surgery. We have a CPX (which means we see a patient actor and do a history and physical) one day this week. We end the week with the pulmonology exam on Friday morning, then head up to the lab to practice sutures (I think).

"The best day of PA school"

This week in school was pretty good. I wish that things at home would have been better and the week would have been great. All four of us have been sick this week and we haven't gotten much sleep.

The week was mostly full of ENT stuff. We learned all about the wonderful ailments that come this time of year. The timing was very appropriate, both for the time of year and because of the nasty bugs that we have at home. We have the common Rhinovirus, acute sinusitis, conjunctivitis, a little pharyngitis, and something else that caused some vomiting.

We also began our Behavioral Medicine unit with a very basic introductory lecture, and a lecture on office and crisis counseling. Those were alright, not the most interesting.

We began our Patient Assessment course this week. We get to see patients at the hospital once a week to practice our history and physical skills. I saw my first patient and got a brief history as though I were admitting him to the hospital (in reality he had been admitted a few days prior). After our histories were taken we met in a small group and presented a written and oral history. This was the first time that I wore my white coat to the hospital. I must admit I felt very out of place. I didn't want anyone to mistake me for someone that may be able to help them with anything medically related. I sort of felt like an impostor.

Friday morning we had a lecture on Pulmonolgy. Pat, the program director, told us that we all looked depressed and said that we should be excited because "today is going to be the best day of PA school" because we were beginning the practical part of our Surgery unit.

We had an introductory lecture on the operating room. I am sure that most of the class is scared to death to scrub in now. I know it made me a little nervous. Friday we practiced putting on casts and tying knots for sutures. We put on a short arm cast and a short leg walking cast. I guess that is what Pat was talking about. It was a lot of fun and a nice break from everything else we had going on. Here are some pictures from casting.

This is me applying my first cast.

This is the finished product.

Finals week

This is the first of two new posts.

Finals week was crazy. We had four tests and one final project. Each day we had one test at 8:00 am and then were off to study for the next one.

We started out with our final Anatomy test. I studied all day on Saturday and woke up at 4:00 am on Monday to finish it off. The test went well.

Tuesday was our Musculoskeletal exam. It was the easiest of the four, partly because I had a small background in Orthopedics already, and because it interests me the most. I started studying on Monday about 11:00 am and studied until 10:30. I woke up at 4:30 am to finish studying. That test went well also.

Wednesday was the Cardiology exam. I started studying at 10:30 am on Tuesday and studied until 2:00 pm when I read an email which informed me that I had been studying for the wrong exam. Thank goodness I read the email when I did. Of course I panicked and frantically started studying for the right test. I had been studying for the Oncology test that was on Thursday. I studied until 10:30 pm and woke up again at 4:00 am to finish. Needless to say the Cardiology exam did not go as well as I wanted it to. But, I passed.

Thursday's test was Oncology. Thanks to my mistake the day before, I didn't put as much time into studying for this one. I studied from 12:00 to 10:30, and woke up at 5:00 to finish. The test was a success.

Friday we just had our final Evidence Based Medicine project. It was very easy and we were finished at 9:30.

I was able to get a earlier flight to Utah, but it was canceled due to "Mechanical" reasons. My two year old and I spent about 7 hours in the airport on Friday and 2 hours on Saturday. But we finally made it to Utah to meet up with the rest of the family.

Pretty exciting week, huh?

Here we go again...

Christmas break is over, back to the grind. We had a great Christmas in Utah and enjoyed the time we had to spend with family. The two weeks went way too fast. That's right, we only had two weeks off for the break, while many other grad programs don't start up for another week. The second year PA students also get one more week off. The good thing about that is that we will get three weeks off next year.

I am very happy with the results of last semester. I know for sure, now, that I can do it. My grades were great and I had a lot of fun. School is so much better when you are studying stuff that interests you.

This next semester covers units in Pulmonology, EENT, Nephrology, Rheumatology, Endocrinology, Neurology, Gastroenterology, Dermatology, and Geriatrics. I believe we also have some surgery stuff included along the way. We also start seeing patients in the hospitals to do history and physicals.

I look forward to the upcoming semester and all the exciting information that will come with it. Not to mention that the sooner it is over, the sooner the clinical year will be here.

Now, I have received a special request from one of my "followers" to continue a special feature from my previous blog. The feature is called "This or That". It is pretty self explanatory, just vote for one of the two options.

This or That-

Would you rather freeze to death or burn to death?

Please leave a comment.

Thanksgiving break was great. It was way too short and by the time class started again, I had lost my motivation. It was hard to get back in the swing of things. This week went by way too fast. I'm really looking forward to Christmas break, but with all the tests we have coming up I feel like I need more time to study for them.

This week was full of lectures for Evidence Based Medicine and Oncology. We were told that one of the Oncology lecturers we had is one of the world experts in Radiation Oncology. He has developed new procedures for radiation treatment that should become the standard treatment. That is one of the really neat things about being at Duke. There are so many experts right here and they are willing to take time to lecture to us PA students.

We had our first CPX this week. The CPX is when we have a standardized patient (an actor) to do an evaluation and physical on. I was pretty nervous going into it, but I think I did a pretty good job. We had 15 minutes to get a history, do a focused physical exam and to discuss an assessment and plan. We were video recorded during the exam and were able to watch it afterward. We will have more of these spread throughout the rest of the year.

We did have one exam. It was the EKG exam. For some reason we were lead to believe that EKG's are so hard and that it is a really tough unit. To be honest, I didn't think it was that bad. I did well on the test.

So, next week we have another Evidence Based Medicine exam on Thursday and we have to present a research article on a specific topic. We will have a bunch more Oncology and some Cardiology lectures. The week after next is the last week before Christmas break. That week we have one test every morning and the rest of the day off to study for the next one. The exams are on Anatomy, Oncology, Musculoskeletal, and Cardiology. That Friday we have to present our final project for Evidence Based Medicine, which is an evaluation of several research articles.