Pessaries and Circumcision

This week was a bit more dull than last - probably because I wasn't in the OR at all. I spent most of the week with family docs plus some time in the ER and with an internist at the hospital. My list for this week:

• performed a 6 month well baby check up with the cutest baby ever
• met a born again Christian/recovering alcoholic
• danced with a delirious geriatric patient to try to keep her in her room in the ED
• heard the distinctive tinkling of someone with a bowel obstruction
• met someone who had been hit by a train and survived
• learned what shifting dullness was and how to properly check for pitting edema
• saw a stress test in action
• heard COPD, emphysema and chronic bronchitis
• saw a woman with shifting pain that the doc didn't know what to do with - not sure why she wasn't referred to rheumatology, even though it wasn't in the joints, it may have been fibromyalgia
  
• speaking of rheumatology, why are none of these docs on top of management??? Tylenol for RA?? wtf?
• was lectured endlessly on the woes of the Canadian family doctor and how we'll never make any money
• saw a woman with scleroderma and pronounced sclerodactyly
• she was happy to let me feel her fingers and skin to get an idea of what to expect
• there are support groups for those with scleroderma
• I think the doc was dissapointed - I'm pretty sure he was hoping to stump me with that one ;)
• watched moles and skin tags be burned off
• closely followed with the first time I've almost fainted (no lunch + burning flesh = syncope)
• saw a circumcision - uck - how can you do that to your baby??
• met a man who takes 72 pain pills a day for his chronic pain
• my first question - do you still have room to eat food? Apparently his appetite is still strong
• heard a pan systolic murmur
• found a melanoma spot in an elderly woman's mouth
• wrote the admission notes for a patient who was unconscious - or at least attempted to, I wasn't that great at it - this is how we learn though
• saw a uterine prolapse and a pessary insertion
• examined a few pregnant bellies
• saw several cervixes (cervi?)
• met "that guy", the one who thinks that because he's on lipid lowering meds that he can eat whatever he wants and as a result his blood sample was 1/2 fat so the lab couldn't do cardiac enzymes - those guys actually exist!