Saturday, February 24, 2007

An Early Introduction to the GI Block

We're starting GI block on Monday as I said, but I started mine last night. I came home feeling kind of nauseated, so I was lying in bed reading. Unfortunately, the stomach pain kept getting worse until finally I started vomiting and having these horrible spasms in my abdomen. It felt like someone was tying my intestines into knots. I thought it was probably food poisoning because I made the unfortunate choice of eating the POD lunch yesterday. But the pain was so bad that I wound up going to the ER at CCF on the possibility that maybe it was appendicitis. My PA came with me, and a couple of the M3s who were on call came down and visited me in the ER. If any of you three are reading this, thanks again for hanging out with me in the ER last night. My PA in particular deserves extra kudos for getting out of bed in the middle of the night to come pick me up and take me to the ER, and then spending all night up with me before going to clinic this morning.

There are a couple of notable things that happened last night. One is that when the receptionist was signing me in, I had to stop to take a puking break midway through her questioning. I had a bucket with me though, so I was prepared. But she was really nice about it, as was the nurse. They both came across being very empathetic, offering me tissues, telling me to take my time, etc. The M3s did a good job with showing empathy too. But the resident who examined me has an awful bedside manner. He didn't make eye contact, didn't listen to my answers to his questions, and didn't use language that I'd be able to understand. Keep in mind that at this point, I am most of the way through my first year of med school. So I'm almost certainly far more educated about medicine than the vast majority of the patients he sees. But when he asked me if I had had any ill contacts, I had no idea what he was talking about. It turns out he was trying to ask if I'd been around anyone who was sick. I told him that of course I had--this whole hospital is full of them!

After he left, my PA commented to me about how the resident didn't make much eye contact or really listen to what I was telling him. I was actually more annoyed that the resident didn't laugh at a joke I had made. I told my PA that I always laugh at my patients' jokes, even if they aren't funny. People cope with illness in various ways, and humor is a pretty good way to go as far as coping mechanisms are concerned. Besides, MY jokes really ARE funny! But this experience does drive home why it's important for us to learn communications skills. This doctor was a textbook example of what not to do.

The other interesting thing was seeing all of the hospital protocols in action. I had a patient ID band on, and the staff are supposed to identify me by at least two methods (name, DOB, patient number), which they did. They are also supposed to ask me certain questions, which they did, and provide me with a copy of HIPAA laws, which they offered to do. But I told them not to bother since I've already read them several times for school. I feel like I could TEACH the HIPAA laws by now!

Fortunately, it looks like I just had a really bad case of food poisoning. My appendix is fine, and I didn't need emergency surgery. They did some blood tests on me, which basically came back normal except that I had a slightly elevated white blood cell count. My PA told me that this was nothing to worry about. The staff gave me a bag of saline solution by IV, and then some promethazine by IV as well. Promethazine (brand name = phenergan) is an anti-histamine along with being an anti-emetic (something that stops you from puking), so it totally knocked me out. I got discharged around 5 AM, and my PA drove me home. I slept for the rest of the morning.

So far today I feel mostly better, although my intestines are still having little twinges. I haven't been eating too much solid food yet. Unfortunately, I can't go to the gym today now. Plus, one of my classmates had her birthday earlier in the week, and a bunch of people went out to celebrate last night. I had planned to go. But when they called me to make plans, I was otherwise occupied and could not take the phone call, let alone hope to go out anywhere. I'm also concerned about how much that little IV drink of saline is going to wind up costing me. I have student insurance through Case, but it doesn't cover everything. So it looks like now I'll be getting a personal lesson in medical care financing along with my early intro to peristalsis. (Peristalsis is the contraction of the smooth muscles in your digestive tract. That's what you feel when your stomach is growling.) I am planning to find out about getting the fees waived due to my financial status and the fact that I'm a student. We'll see how things turn out.

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