Author Topic: Blowing Some Steam (Read 48744 times)

Lorenzo · « **Reply #440 on:** December 25, 2010, 07:57:51 AM »

I learned something interesting. The possibility of double majoring. Double-boarding, specifically.
It is possible to specialize in Psychiatry & Internal Medicine, one would merely have to take 2 boards: the Internal Medicine Boards and Psychiatry Boards. An additional 2 years of residency.

I am interested in this. Considering how both fields coalesce.

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Lorenzo · « **Reply #441 on:** December 26, 2010, 12:56:01 AM »

Just came back from Christmas Morning Mass!

Merry Christmas Everyone! God Bless Us All!

With Love Enduring,
Lorenz

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Lorenzo · « **Reply #442 on:** December 30, 2010, 09:37:30 AM »

On Call Lamentations
Dec. 29, 2010

A night ago during our on-call shifts, i was touched by the situation involving a Mr. N.J and a Mrs. T.W.
Despite the serious and non-expressive demeanor in my patient history taking, and presentation to the attending, I was really touched by the patients' situations. It is something that I must allow myself to become unphased by. Its always a bit hard to do so at first, I admit.

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Lorenzo · « **Reply #443 on:** January 06, 2011, 08:29:56 AM »

hello blog,

i want to buy a maxwell mini-booklet that i can put in my white coat. i also need to buy a new writing pad. taking all these patient histories and writing soap notes requires a firmer writing board.

i must say that doing my clinical rotations here in chicago is going great. there is always something new to see. and each new patient is as interesting as the last. the clinical years are enjoyable and its interesting--quite so! to see how all the theory and text-book material being applied in the actual hospital setting.

This week i performed my first stool sampling. i guess this is a necessary baptismal of fire (so to say) for all medical interns. lol. ive become quite good at it and has really shown to me the importance of a complete physical on patients. fine tuning my skills, as what the residents here say, is necessary for all medics.

so far, not so bad. i can't wait to start my surgical rotations. the head of surgery is a Filipino Surgeon.

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Lorenzo · « **Reply #444 on:** January 06, 2011, 08:40:54 AM »

Nurses and my experience(s) thus far.

Last week, i was on call with 4 other medics, with us were 2 resident physicians. so basically, we (the medic interns) were slaves for the night. then again i can't blame the residents for being annoyed and irritable. i would be too if i were on-call for 72 hours straight.

that night, i was able to meet 3 filipino male nurses and 2 other filipina nurses. 1 of them was from bicol, the others were from iloilo, mindanao and luzon.

there is something about filipinos that strike me. it is our ability to know when another filipino is in the room. our ability to identify each other is quite amazing. apparently i was able to identify filipino med-techs and nurses that my fellow medical interns (the indian ones) were amazed at it. lol.

that night, as i walked the halls of 2EAST, and taking patient histories, i was cornered by 2 filipinas. both of them much older, probably in their early 50s or late 40s.

They asked me, 'excuse me, Medical Student Lucino, where are you from?'
i, not expecting to be asked that question (since i was on my way to check the vitals for a dialysis patient that night), started a conversation with them. after revealing my 'new jerseyan roots' i also shared my being 'Bolanon'.

"Oh you are from Bohol??" said one.
i responded, "yes, originally, yes."

"Oh im from Iloilo!" said one
"And im from Manila" said the other.

They became my new 'titas' that night. the illonga would be the one referring to me as 'toto' that night. lol
so i developed an alliance with the filipino nursing staff. and most of all, their knowledge in the floor.

i guess it gives filipina nurses much pride to see a filipino medical student in the floor. much of all, it gives this medical student a great honor to be friends and working with such knowledgeable RNs!.

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Lorenzo · « **Reply #445 on:** January 06, 2011, 08:49:39 AM »

what is the difference between a medical intern, a resident, and an attending physician?

some medical intern answered: "The coats! medical students have shorter white coats. residents have long white coats as with the attending physicians. but residents tend to have pockets filled to the brim with notes , case books, and look like they're sleep deprived and underpaid. attendings are what we want to be. satisfied. and well paid!"

lol

(this heard today. chicago time. jan 5, 2011)

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Lorenzo · « **Reply #446 on:** January 07, 2011, 08:58:53 AM »

The hierarchy within the hospital setting

Here in the hospital, it seems to me that the medical student seems to be always looking up to the attending physicians or the residents. I find myself always doing the orders of the resident doctors, and the attendings. The environment in the hospital has relegated us medical students as 'cannon fodder' so to say for the residents. lol.

One thing that i do find relieving is the presence of nurses here. The nursing staff, tho are ordered around by the doctors , and at times even glossed over by uppity-uppity medical interns, are actually filled with knowledge and clinical experience that can supplement one's growing knowledge.

Developing a friendly and mutual relationship with the nurses, resulted in them saving me multiple times during 'inquisition' moments. lol.
When a resident asked me about the past sugar history of a particular patient, the nurse in the floor saved me by whispering to me, "tell him that he has been ordered for glycosylated hemoglobin already...". There are a plethora of examples.

Nurses, medical techs, physician assistants, therapists etc are all essential in this allied health care sytem that i work in. Thank goodness for the many nurses out there who are so receptive to lending a helping hand to us medical students. And all we have to do, in order to access their wealth of information, is merely ask for it....

I will always maintain this cordial, friendly, respectful relationship with the nurses. It is given, as my parents are both nurses, my aunts are nurses, and i have uncles that are nurses as well.

I guess it is true...if one asks, one will be given...

"Ask and it will be given to you; seek and you will find; knock and the door will be opened to you."
--Matthew 7:7

Thanks be to God!

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Lorenzo · « **Reply #447 on:** January 10, 2011, 09:45:57 AM »

Today, I went out on a lunch date to a Filipino restaurant here in Chicago called "Fishpond". I am surprised at how a certain Filipina can be so in love with Crispy Pata. lol. I had Sinigang in a bowl, a personal favorite.

This is a new year and I am intent on starting it fresh. A serious smile

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Lorenzo · « **Reply #448 on:** January 15, 2011, 05:01:23 PM »

The Medical Team.

Yours truly posing with fellow iterns and our favorite General Surgeon, Dr. B.

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Lorenzo · « **Reply #449 on:** January 21, 2011, 09:01:43 AM »

On call tonight in the ICU. I'm one of 5 medical students.

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Lorenzo · « **Reply #450 on:** January 21, 2011, 09:02:53 AM »

Today was interesting. i performed a Pick Line.

12 Hours on call today. I can't wait to go home in an hour. Ka tugun na jud ko.

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Lorenzo · « **Reply #451 on:** January 22, 2011, 01:42:59 AM »

Last night, after almost 16 hours of on-call duty, was able to show new interns how to do a fully neuro exam. i like teaching. our patient, a 86 year old AAF (african american female) was all too happy to take part of the teaching part. a good patient.

na kuratan ko kai she said, "doc, you have such a handsome beard..." hehehe.

my interns giggled. tsk tsk tsk.

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Lorenzo · « **Reply #452 on:** January 22, 2011, 01:46:31 AM »

my shift, technically, ended at 8:00 pm last night. however, like any situation, new admissions come in. and when they do come in, its like flood waters of mount sinai, that pour and overfloweth. I was unable to get out of work till 9 pm last night. at least we were able to stabilize this 86 year old patient that came in due to 2 spinal fractures that led to sensory deficits at the level of the dermatomes between the wrist to the mid thigh. the profound neuro exam resulted in our referral to the attending neurologist that night. i do hope she is okay.

tomorrow, im on call again.

Praise be to God! Glory be to God, give me more strength, Lord....

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Lorenzo · « **Reply #453 on:** January 22, 2011, 07:32:26 AM »

Taken before leaving the hospital. Night shift. 16 hour on-call.

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Lorenzo · « **Reply #454 on:** January 22, 2011, 07:49:08 AM »

Yesterday, i had duty calls in ICU 2EAST and then after 8 hours there, was sent to the Family Medicine Clinic , which is connected to the hospital, to complete rounds there from 2pm till 5:30 pm. One thing i realized when I was doing rotation rounds in the FM Clinic is that how very relaxed the work setting is in there. Patient cc's range from RX refills, to lab tests, lab test result readings, referrals etc. Quite laid back. Boring.

As soon as duty was finished there, being rushed back to ICU 2EAST was refreshing. The rushing step-in admissions and step-down admissions, was just ecstatic for me. I love the action. Not only that but there are so many Filipino nurses in the ICU. haha. During the quiet hours (yes there are quiet hours in ICU, thank goodness) i was able to talk to them. Salamat kaayo naay daghang 'Titas' sa ICU. Mo share pood sila ilang kanonon namo.

Mo post kog pictures next time.

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Lorenzo · « **Reply #455 on:** January 27, 2011, 07:56:10 AM »

I just want to say that there are times that I don't express my love and affection to family and friends. I admit this. The reticent nature that is within my being makes sure of that, and it is something that I am trying to slowly change. I should be more forward in telling a person that I love them, especially family members.

So , for those whom I have not expressed love to in a while, know this:

That I do Love You.

Lorenzo

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Lorenzo · « **Reply #456 on:** January 27, 2011, 10:52:52 AM »

Just found out that my younger brother, Don Rico, went to a semi-formal dance. As always, very guapo. I'm liking the fact that he's following his kuya's curly hair look. haha. Seeing his pictures i was so sad because i was not there to see him get ready for his semi-formal. He is getting older and has become a man in my eyes. Don Rico is turning 18 this coming May.

spanish mestizo kaayo da!

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luckybelle · « **Reply #457 on:** January 27, 2011, 01:18:50 PM »

Just found out that my younger brother, Don Rico, went to a semi-formal dance. As always, very guapo.

spanish mestizo kaayo da!

I agree!

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Lorenzo · « **Reply #458 on:** January 27, 2011, 01:40:14 PM »

hehe, serioso pero guapo ni si Don Rico. chic magnet raba ni sija.

Valencianon jyud kai hilig ug guapa baji..

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luckybelle · « **Reply #459 on:** January 27, 2011, 01:43:50 PM »

hehe, serioso pero guapo ni si Don Rico. chic magnet raba ni sija.

Valencianon jyud kai hilig ug guapa baji..

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Lorenzo · « **Reply #460 on:** February 02, 2011, 01:28:43 AM »

I just recently found out that my nephew was born this month. Im so happy. Am an Uncle.

The little boy's name is Roy Ethan. May God Bless my little nephew always. My cousin's son.

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Lorenzo · « **Reply #461 on:** February 03, 2011, 01:38:33 AM »

The biggest winter blizzard has hit Chicago , the biggest in almost 20+ years. We have snow piled outside reaching almost 4 feet. It's still snowing outside. I hope everyone is okay and that the Ambulances are able to get through and drive through the roadways...

God bless all those who are stuck without gas, electricity. Christ have Mercy.

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Lorenzo · « **Reply #462 on:** February 03, 2011, 04:17:08 AM »

And the Blizzard Comes!

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Lorenzo · « **Reply #463 on:** February 03, 2011, 04:18:20 AM »

Quite reminiscent of the blizzard that hit Chicago back in the 1970's.

$:-\$

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Lorenzo · « **Reply #464 on:** February 12, 2011, 12:18:16 AM »

Today , today. Today is a stressful day here in the hospital. I'm currently taking some 'time off' as I sit down in the medical resident/ medical student office. It seems like free time is running scarce here in the hospital. Kalingaw man ta i-orderan da. Jati-a!

Unsa...well let me think. (so much happened yesterday and today)!

Work is work (usual). Pero its getting more intense everyday. I attended an ACLS (advanced cardiac life support) class yesterday with EKG competency followup. The attending physician/physician instructor is hardcore. She teaches well and really went over good EKGs.
I feel much more competent in reading and interpreting patient EKGs now, from basis of their rhythm, rate, axis, qrs, pr intervals, u or t wave inversions. To be honest, before the class, my understanding of EKG was subpar, as were most of us. Attending the class really opened my interest in cardiac interpretation. In mean, through the class we were able to read and interpret not only wheter a patient was right axis deviated, left axis deviated or extreme right axis deviated, interpreted whether if the patient had a history of left ventricular hypertrophy, right atrial atrophy, could see if this patient had a previous MI, to prognosis of a possible MI. Amazing. The professor was tough, disciplined, and really broke us in order to build us up again. I was appreciative.

Today, as we started work. We had a patient that coded. Luoy pood. Code Blue was initiated and we rushed down to see the intensive cardiac resuscitative measures. The patient had a pulmonary embolism. We could not bring him back. The very first time I saw a patient flat line. It was intense. Shocking. Luoy pood intawn. Yesterday i was talking to him. Karon, wala na.

The lesson i learn from this is twofold:

1. Life is fragile; you will never know when your time is up, even when everything seems alright,stable.
2. Cardiac and pulmonary check ups are necessary and should be done regularly. This patient did not take care of himself, medically and mentally.

As a medical student, i try my best to be the best. And with honest and true intent. Pero, as I am learning now, through the medical internship years, i realize that we cannot save everyone. That the Hand of God chooses to take those whom He calls. And when He calls us home, we deign to bow to His decree.

My thought for the day.
-Lorenzo

All Glory, Honor and Praise belongs to God In The Highest~.

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Lorenzo · « **Reply #465 on:** February 12, 2011, 12:22:37 AM »

As i write this, the speakers ushered, 'SECURE CODE BLUE'.

My break time is over. Back to work.

For those who read this, I do ask that you pray for me. Pray for me because the Medical Internship Years are truly the hardest years.

Thank You.

Always,
Lorenz

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hubag bohol · « **Reply #466 on:** February 12, 2011, 09:13:49 PM »

Pero, as I am learning now, through the medical internship years, i realize that we cannot save everyone. That the Hand of God chooses to take those whom He calls. And when He calls us home, we deign to bow to His decree.

Mao na ni ron. Kon and abogado mapildihan og kaso, ingnong bugo; kon ang doktor mamatyan og pasyente, ingnong pagbuot sa Ginoo.

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Lorenzo · « **Reply #467 on:** February 12, 2011, 11:49:57 PM »

Thank for reading my daily thoughts, Nong.

It is very hard to see a patient pass. This one particular patient was in the ICU for quite sometime, hanging on, but developed pulmonary embolism even despite intensive care by well trained nurses, respiratory therapists, doctors. Doctors are not God. We cannot save everyone, nor can we treat and cure every single ailment. All our measures and abilities is to try to prolong life/ delay death.

The Master of all Life is The Lord God. It is He who deigns when life will begin, and when it shall end.

Even a doctor/ medical intern bows before the Life-Giving and Life-Taking Power of God.

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Lorenzo · « **Reply #468 on:** February 13, 2011, 12:57:21 AM »

Today is the weekend.

My girlfriend and I are going to go take the day off. No hospital work or any medical-related stuff today. That's a Doctor's Order. lol.
Today we're going to go drive out of the city, some 40 miles north to look for leather briefcases and a leather shoulder bag for the both of us.
Something that is sturdy, classy, yet reticent at the same time. Then spend the rest of the day out and about.

I need this weekend to relax and just enjoy my youth.

I'm going to see if we can visit this one really nice wine bar up north by the Italian District of Chicago.

I am craving a nice glass of moscato.

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Lorenzo · « **Reply #469 on:** February 14, 2011, 11:46:37 AM »

This weekend has been splendid. 2 new leather bags , both of them monogrammed with our initials. Truly, my lady is classy and refined.
We had our good friend Albert come over for dinner last night. A guest in our humble abode.

I must say that the chicken pot pie that my darling cooked was amazing. I prepared adobo, while Albert brought some Pancit Sotanghon.

The night was finished with a nice bottle of Moscato and Pinot Noir.

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Lorenzo · « **Reply #470 on:** February 14, 2011, 11:50:18 AM »

To my darling,

I adore you, respect you, and most incorruptible of all--I love you.
The support that we give one another--mental as well as physical support--has been a breath of fresh air.
Every day with you, I am growing ever so much attached and used to the idea of being with you for always.
I do love you. As i write this and read my notes, you are studying your notes in the desk.
My brown eyes caressing you with a gentle look.

For Always,
Love,
Lorenz

PS. Will you be my Valentine?

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Lorenzo · « **Reply #471 on:** February 14, 2011, 11:57:34 AM »

Blast from the Past

(December, 2009)

Take in the Caribbean.

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Lorenzo · « **Reply #472 on:** February 17, 2011, 03:23:37 AM »

Heart Murmur ACRONYMS:

MRS ASS

Mrs = mitral regurg systole
Ass = atrial stenosis systole

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Lorenzo · « **Reply #473 on:** February 17, 2011, 03:25:17 AM »

MSD ARD

msd= mitral stensosis diastole
ard = atrial regurg diastole

--

TSD PRD

tsd= tricuspid stenosis diastole
prd= pulmonic regurg diastole

--

TRS PSS

trs = tricuspid regurg systole
pss = pulmonic stenosis systole

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Lorenzo · « **Reply #474 on:** February 17, 2011, 03:35:50 AM »

On Professional Flirtation, Is It Wrong?

Today, i found myself looking for more white paper for the printer in the medical lab. Beyond my control, there have been a plenitude of inconsiderate students and doctors who use the printer paper without refilling it for others. So today there was a paper crisis. Yes. I know it sounds funny but there really was.

So i took the helm to try to solve this technical difficulty, so i ended up going to the nurse's desk to ask the RNs there if they could help me out. Paper-wise, that is. I talked to 2 older nurses who were at first telling me 'we can't just give you med students what you want all the time. you need to solve that yourself'.

i was dismayed. but , i used the power of the 'professional smile'. so i did what came natural. i smiled. at them both.

in the end, after the end of a conversational tirade, they did acquiesce to my simple request: they gave me a stack of white printer paper. 300 pages worth.

so, was it ethical that i used the professional smile to get what i want?

Lorenz.

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Lorenzo · « **Reply #475 on:** February 17, 2011, 12:39:24 PM »

On The Word of God

I tend to find myself reading passages from the bible and questioning the meanings, interpreting the meanings and then referring to catholic interpretation at the same time. No other book is as powerful and thought provoking, yet at the same time, so grace-filling and empowering as the Holy Bible.

During these times of trials and difficulties, we tend to put away reading the bible, the source of spirit, to focus on worldly pursuits.
i have allowed this to consume me this month. i need to go back to reading and searching scripture again.

to those who read this, open the bible, too. come, let us read from the WORD..

peace and blessings.

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Lorenzo · « **Reply #476 on:** February 19, 2011, 04:35:58 AM »

The status of our puzzle so far. Almost done.

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Lorenzo · « **Reply #477 on:** February 20, 2011, 12:54:40 AM »

A new charcoal sketch. A recent acquisition by Sam Karres.

Beautiful.

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Lorenzo · « **Reply #478 on:** March 05, 2011, 01:23:58 AM »

Porsche Panamera Turbo S

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Lorenzo · « **Reply #479 on:** March 09, 2011, 12:03:56 PM »

Today we had a code yellow. They declared a code as soon as i got into the hospital today. I drove 30 minutes to the hospital for nothing, why can't they (the adminisration) develop a better communication channel so that students can evade having to drive to a , "oh sorry, they have a code yellow, you can't go in today."

As I walked out of the hospital, I was met with 8 other medics who were told the same thing, "you guys can't go in."

Truly, we were vexed. Waking up at 6 AM and then being unable to go in to work. It's worse than performing a rectal exam.

Whatever.

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