Weeks 43, 44, & 45: Three Down, One More To Go

Note: The “patients” I speak of are paid actors/actresses, hired to simulate real patient encounters for us students.

Three Fridays ago, at 4:00 pm, I stood outside exam room number 7 and waited for the cue to knock on the door, enter the room, and meet my first patient of the afternoon. When that time came, I introduced myself to the patient, a middle-aged female. Upon eliciting her chief complaint, she reported that she had been experiencing bouts of pain directly below for her right elbow, which occasionally radiated down the side of her forearm. For this encounter especially, it was most important to inquire about her occupational history, which included working as a landscaper at a local botanical gardens, in addition to coaching tennis on the side. It was nearly clear after eliciting this history, that this patient had a case of “tennis elbow,” which is irritation of some of the tendons surrounding the elbow joint, following repetitive bending motions at the wrist (as with tennis). The physical exam was fairly simple and only required a few tests to help rule out other potential diagnoses and to help support what I suspected the issue to be. After recommending an elbow brace and a higher dose of ibuprofen (for her pain), I exited the exam room and completed my first patient encounter of the day.

On this same Friday, at 4:30 pm, I introduced myself to my second patient, another middle-aged female. While decorating for Christmas over Thanksgiving weekend, she lost her footing while placing outdoor lights on her bushes, and twisted her ankle in the process. I asked her to remove her socks so I could examine the region, and her left ankle was noticeably bruised (the lab actually placed fake bruises on the patient, so there was something identifiable). Once again, it only took a few tests to help support my suspicion of a lateral ankle sprain. The patient was concerned that she had fractured one of her ankle bones, but she was able to walk with little to no support, so this decreased the likelihood of a fracture. After recommending that she continue to apply RICE (rest, ice, compression, and elevation) to the ankle for symptomatic relief, I exited the exam room and completed my last patient encounter of the semester.

In the final weeks of the semester, we completed our Neurology specialty focusing on movement disorders (Parkinson’s disease for example) and peripheral nerve disorders (Lou Gehrig’s disease, Guillain-Barre syndrome, myasthenia gravis…etc.), and our Rheumatology specialty focusing on systemic joint disorders (lupus, psoriatic arthritis…etc.). Pharmacology focused on prescription writing, specifically how to fill out a sheet of prescription paper (eventually most scripts will be in an electronic form though). Surgery focused on subtopics including ophthalmic (eye) surgery and cardiac surgery (techniques used to perform bypass surgery, heart valve replacements, and correction of heart defects of infants present at birth, such as tetralogy of Fallot). The last couple of weeks of Gynecology focused on gynecologic malignancies (breast, ovarian, uterine, vaginal, and vulvar cancers). So, unsurprisingly, the last couple of weeks of classes were no less jam-packed than any of the others.

And so, eleven classes later, I have at last completed my third semester of PA school, and boy did it live up to its reputation as being the most stressful and busy of the semesters thus far. Luckily, all of my finals went well, and the time I put into each class paid off once again. I don’t know how I made it through 15 weeks like this, retaining my sanity along the way (kind of), but all that matters is that it’s over and I’m now officially 50% done with PA school! Next semester, I’ll be taking three fewer credits and I will supposedly have Fridays off, which would make time constraints a bit less daunting. Semester four, the last semester of classes, is basically a massive review of all topics that we have covered over the past three semesters, which will be much needed because I’ll be meeting my first real patients on rotations in a mere 162 days. I’ll give more details about semester four next month. For now, it’s break time!

Last week’s answer: False. Alcohol is a depressant.