Another Catch Up Post

Daylight savings time is giving me an extra hour in the day to get caught on the necessities. One being this blog.  

So, this happened! Dec. 13th is the end of the semester and the end of our didactic year! Woot Woot!

It also means that I have only a few days to get my thesis project wrapped up. The subject upon which I am researching is, non-invasive diagnostic tools for prostate cancer.  I originally proceeded with the inconsistent methods for screening prostate cancer, but I felt like the US Preventative Task Force and the Urology Association had already hounded it to bits, like beating a dead horse.    

In short, too many physicians are relying on the prostate biopsy (TRUS/biopsy), which is determined by PSA (prostate specific antigen).  Two controversial principles: 1) Only 30 - 40% of the biopsies show true positives and it leaves a man feeling worse than when they came in.  In fact, they get bloody urine (hematuria), bloody sperm (hemaspermia) and possible UTI or other bacterial infections. 2) PSA levels…Too many false positives.  So, who is to say biopsies should be based off them…Anyways, I'm looking into EndoMRI, MRI pelvis images and urinal biomarkers vs prostate biopsy. I have to present this to the class and turn in a paper on it the week after Thanksgiving. 

 Last semester, we went down to Charlottesville to perform a male genitourinary exam.  Well, this last month we went back to practice a female genitourinary exam. The only real awkward part was the fact that she was mid-stream menses…yep, oh and the hairy armpits and legs.

The local hospital provided a surgery day for us.  They taught us how to properly wash our hands/forearms for the 5 minute rule and then, how to properly wear sterile technique.  Not only that, but they showed us basics on stitching and use of laproscopic utensils. 

It was neat to see the other side of the operation room.  I have been in the OR a few hundred times, but I had never gotten dressed in the sterile 'blues' before. 

We have also started learning how to perform sutures.  Practicing with a rope, just like scouts. 

In two weeks, we will a class specific to suturing. I'm pretty excited about it. 

This last week, I went to the local free clinic for a great clinical experience. My patient came in for a follow up for recently prescribed hypertension medicine and a colonoscopy referral. As I was reading through his medical record, I found that he was diagnosed with narcolepsy 7 years ago. An extremely rare case. And, supposedly his vehicle was broken into and his Adderall was stolen…ya, right!  Anyways, this is a Schedule II drug.  In other words, this can be a major abusive substance. It is along the same line as Cocaine and Morphine. Anyways, the rule at the clinic is that only one prescription of such potentancy per 30 days. Though, I do feel rather proud having written him a prescription for such a dangerous drug.  

After doing a full cardiac exam, I then did a pulmonary exam and found that he had a right lower lobectomy. Also, we did an EKG.  He had a biphasic wave in lead II and a possible early Right Bundle Branch Block.  Otherwise, he had normal sinus rhythm. 

Last couple of items: The fall season here on the east coast: 

My beautiful girls! This is a place called, "At Home, On the Farm." We were able to pick our own pumpkins.  Granted, this was the first year I didn't carve one cuz I was extremely busy with school.

Fall Colors!!!