Week 34: Little Pinch

I rubbed my abdomen, just a few centimeters to the left of my belly button, with an alcohol swab provided by my professor. With the site now clean, I popped the cap off of a syringe (an empty one), also provided by my professor, and centered it’s needle over my sterile abdomen. A bit hesitant, but determined, I gradually applied pressure onto my abdomen with the tip of the needle, and, just like that, I had successfully injected myself…

This week in Pharmacology, we continued to focus on treatment of diabetes, specifically relating to the dosing/prescription of insulin. The administration of insulin is through the use of a syringe, which therefore requires patients to self-administer the medication via daily injections. Since we will ultimately be explaining to the patient how to administer the insulin and self-inject it, our professor saw it fitting to have us all experience what the injection truly feels like. Honestly, the injection didn’t hurt! The needle was very, very thin, so all I felt was a little pinch.

All of my other classes have been going well. This week in Surgery, we focused on surgical procedures/treatments used to cure a variety of gastrointestinal disorders, from tumor removals to correction of various forms of hernias. My midterm for this class is Wednesday (mainly the reason for this late post!), so I’ve been focusing on this material for the bulk of my weekend. In Clinical Skills we began to learn the techniques of a neurological physical exam. There are many different components to this physical, but a good portion of the exam is a review from last semester, which makes things a bit easier. We had eight hours of Hematology/Oncology this week alone, so we covered many new topics, from anemias to leukemias and lymphomas. In Obstetrics, we focused on techniques used to monitor a fetus in the first hours and days following his or her birth (no new birthing videos to talk about this week though!).

Luckily, I found a bit of time to relax tonight to write about my week. It’s so difficult to just make time for myself, but I’m trying my best. October is going to get a little more chaotic, but after these next four weeks, things should calm down…should.

Question of the week: Which form of dietary fat is healthier: unstaturated fat or saturated fat?

Last week’s answer: The approximate size of the male prostate is 2.5 centimeters (in length).

Week 33: Traversing A Different Canal

I put on a pair of gloves and stood in front of my patient (a fake, but anatomically correct model). With the patient turned onto his left side, I readied my finger for entrance into his anal canal. Yes, the model was forced to endure the often-dreaded rectal exam, and lucky for him, it was my first time performing this exam. Lucky for me, my first time was not on a real human being. It only took less than a minute to access the rectum of the patient, feel the contours of his prostate, and complete the digital rectal exam. Next time I perform this exam, it will likely be on a live patient…but that’s still eight months away.

This week was another hectic one (what else is new!). We doubled up on three courses, so that made my schedule a bit more chaotic. In this last week of Geriatrics, we focused on various conditions associated with aging, including incontinence, pressure ulcers (in bed rest patients), polypharmacy (the effects of prescribing too many drugs to a single patient), and dementia. Next Thursday is my Geriatrics final, and then we move on to our next specialty, Hematology/Oncology (the study of blood disorders and cancer). In Surgery we focused on the management of trauma patients, like those who present to the emergency department with gun or stab wounds to the chest and/or abdomen. We also learned how to identify and surgically repair various breast conditions, in addition to gastrointestinal abnormalities. In Obstetrics, we continued to focus on the events leading up to and during normal pregnancy. The videos of childbirth have been disturbingly graphic, but uplifting at the same time. I give much credit to anyone who has ever given birth to a child! In Clinical Skills, we continued use of the models to perform rectal/prostate exams, in addition to vaginal exams. The models are not very giving at certain times…the speculum I used to examine the cervix of my female model actually got stuck on its way out of the vagina…again, luckily these are just fake models. We also practiced the steps of delivering a baby with a different pregnancy model. I’m ready to progress to using each other as patients again next week. I think the models have had enough of me too!

This semester has been a bit different from the others with the added component of the thesis work that we’ve been doing. Now, instead of eating, sleeping, and studying, I have to consistently add research to the list of things to do. Now that my group is a few weeks into the research process, I can confirm that our topic entails the study of anterior cruciate ligament (ACL) injuries (this is one of the ligaments that support the knee joint), relating to their prevalence in college-level athletes. I’ll leave it at that for now, but once more details are solidified, I’ll give a bit more information.

Question of the week: The approximate size of the male prostate is _________ centimeters.

Last week’s answer: The most common cause of hearing loss in a patient over the age of 65 is cerumen (wax) impaction.

Week 32: The Models

It’s amazing how quickly time seems to go by when balancing the load of eight classes on your shoulders. I’m two weeks into the semester and already losing track of time, but luckily managing to keep up with the material as best as possible. Ideally, I would be able to dedicate two hours of study time to each class over my weekends. Unfortunately, a sixteen-hour study day does not seem feasible to me…at least at the moment!

My last new course, Pharmacology, began this week. The biggest difference in Pharmacology this semester will be the need to learn dosing regimens for all of the drugs that we cover, so I expect that my math skills, which I really haven’t used since undergrad, will be very often used moving forward. This week in Pharmacology we focused on drugs prescribed for diabetic patients, specifically those with type II diabetes (the category of diabetes associated with weight gain). It’s not so much only the drugs that matter in the treatment of this condition, but what’s even more important is the promotion of diet and exercise to supplement the drug therapy used. In Surgery, we focused on post-operative treatment of patients, like how to determine the amount of fluids and nutrients patients should be given intravenously (IV) based on their overall weight and hydration status (even more math!). This week in Geriatrics, we had several different lecturers visit our class to speak about their specialties in reference to the treatment of elderly patients. One lecturer was an audiologist (hearing specialist) and the other was a physical therapist, both integral players in the care of such patients. In Clinical Skills, we learned how to perform a gynecologic exam as well as a physical exam of a male’s genitalia, including assessment of hernias. I know what you’re thinking…no, we did not use real human patients OR each other to practice these exams! We used plastic/rubber models to practice the techniques required of these physicals. The first time I perform these techniques on real patients will be during my rotations this summer. Next week we learn how to perform rectal and prostate exams…luckily, using the models as our patients once again.

Speaking about time flying by, the first big deadline for my research class is right around the corner. This is the one and a half year-long class, in which time we (in groups of four) complete our thesis project, required to graduate from the program with a Master’s degree. The first deadline is our concept project in which we present the concept of our research study in the form of a written paper and an oral presentation. I’ll say more about the concept of my group’s topic as the research progresses this month. Right now, I think we have an interesting topic that will keep us busy over the next year!

Question of the week: What is the most common cause of hearing loss in a patient over the age of 65?

Last week’s answer: Late in pregnancy, a female’s cervix may dilate as much as 10 centimeters leading up to delivery.

Week 31: Home Sweet Home

          Well, classes have officially begun, and I surprisingly feel like I never left school back in May. Did I really have an entire summer off? Merely a three-day school week, and those three months have already become a blur. Three days of classes, yet my weekend already warrants a twelve-hour study schedule…something I guess I’ll have to get used to early on in the semester! But, I’m actually happy to be back, and ready to take on these new courses.

          In the three days of classes I had this week, six new courses began including Surgery, Clinical Skills, Geriatrics, Health Promotion/Disease Prevention (HPDP), Obstetrics/Gynecology (OB/GYN), and Research. In Surgery, we began by focusing on the history of surgery from ancient times to present day, in addition to complications that may ensue in the first week after operating on a patient. The first half of the semester will focus on general surgery, and then we will cover specific surgical specialties including orthopedic surgery, ophthalmic (eye) surgery, and cardiothoracic (heart and lungs) surgery. I’m super excited to learn about all of these surgical techniques! In Clinical Skills (the physical exam course), we learned how to physically examine a pregnant patient, from determining the extent of cervical dilation prior to the patient’s giving birth, to detecting the heart rate and position of the developing fetus using abdominal ultrasound. In Geriatrics, we focused on the aging process and changes that occur in the structure and functioning of various body systems as one ages, in addition to the nutritional advice that we should offer such patients. For our OB/GYN course, we spend seven weeks of the semester learning about each component (obstetrics and gynecology) of the specialty. This week we began the obstetrics (pregnancy) component, where we focused on the events of conception, how to measure the size of the mother’s pelvis to ensure ease of delivery, and various recommendations for medical screening tests in women (Pap smear, mammography, bone density…etc). So, this first week of PA school was unusually jam-packed, but semester three is definitely notable for it’s speed and LARGE quantity of content.   

          Luckily, this week went well and didn’t come as much of a shock as the first week of my first semester came one year ago. In fact, if I had a first week like this last year, I probably would have lost my mind! It’s amazing how much of a difference one year makes. My goal is to keep up the blog posts on a weekly basis, but as is already apparent, I may be posting on a different day each week, whenever I need a good break from the books. Already one week down…just fourteen more to go…

Question of the week: Late in pregnancy, a female’s cervix may dilate as much as ____ centimeters leading up to delivery.

Pre-semester quiz answers: True; Eardrum; Blue; Inflammatory bowel disease; False