When your first year med school student needs practice...

[creekland]

Brand new experience for us.  

 

My first year med school lad is with us for the holidays and is getting experience doing some of the "basics" he's learned - essentially practicing.

 

'Tis always "fun" when he does one and says, "Well, that isn't supposed to happen!  Let me try it on dad.  Ok, let me try it again on you."  What's it mean?  "Overall I'm not really sure other than it means something's not right with your vascular system to this part of your body.  I've never actually seen a problem with it before on our practice patients."  (sigh)

 

Eh, I'm sure it's just stress, esp since I asked REAL doctors if what I have going on could be a vascular problem due to things I read on google.  "No, of course not.  You'd be fatigued if there were a vascular problem.  It's just stress.  Stay off google and reduce stress."  BP and pulse are just fine too, but not once have I thought cardiac - just vascular.  But what does google know anyway - or a first year med school student doing a basic test.

 

I need the lad to get more experience... shall have to hold out for him, though he's already getting contacts and offering suggestions of who to see.  I'd just have to figure out the 6 hours away from home (one way) bit.  Being actually believed, even with the "this can't happen" aspect would clear one huge hurdle.  The info he's already given me (about other things) has been in far more depth than I've gotten from the "real" versions too - but he gets to spend more than 20 minutes asking and explaining things, so he has an advantage there.

 

A suggestion to others... aim a really competent, driven student toward med school.  ;)  You just might need them later on in life!  (We didn't aim ours - he pulled us along.  That way will hopefully still work in our favor too.)

[klmama]

Congratulations on raising a great son and a future great doctor!  I'm excited for you!  You may get those answers you need yet!

 

 

[Arcadia]

My medical school hostel mates came knocking on my university hostel room (single room) door when I sprained my ankle. It took me 3 weeks for my ankle to heal completely so they had a fun time examining. They were also my designated safe drivers for Friday night partying as they would be up late studying and don’t mind driving us back to hostel at 1am.

Once I went to a neighborhood dentist and met my hostelmate. He gave me a discount for crowning my two front teeth out of his own labour fees.

Out of 38 middle school classmates, almost half are doctors :lol:

 

ETA:

I fainted and had a bad fall in middle school, resulting in root canal treatment for my tooth. Luckily I didn’t fracture my arm in that fall.

Edited November 25, 2017 by Arcadia

[Pawz4me]

My aunt decided to go to college and become an RN when her kids were teenagers and old enough to stay home alone. She practiced her BP taking skills on them. Her son's was consistently higher than it should have been. Really high. She thought she must be doing something wrong, but she took him to the doctor to follow up on it. Turned out he was one of those statistical anomalies--a very thin, active, vegetarian teenager who had BP high enough to require medication. There's no telling how long he would've been walking around with dangerously high BP if she hadn't been studying to become a nurse. This was long enough ago that home BP monitors for dummies weren't yet available, and I suspect at yearly checkups it would have been brushed off as white coat syndrome.

[Carrie12345]

My daughters want to be EMTs and one is talking about being a paramedic. Right now, their main mentor happens to be a former navy corpsman.  I am constantly being told to drink water and change my socks.  :lol:

[Lanny]

He may be on to something and I suggest that you follow-up on this.  The hardest part of being an M.D. is to correctly diagnose the patients.  Many times I've read of people who've gone from doctor to doctor, trying to get a diagnosis.  

[Angie in VA]

I'm so glad you have him to help you!!!

 

My DO spends more than 20 minutes with each patient. I like hearing what he tells students who observe him (and me, w/ my permission of course, since they're observing him do OM on me). I love how bold I can be w/ those med students too, asking all kinds of questions like where they're from, how they got interested in medicine, will they specialize, etc.. My fave: "So, will you really do OM or will you just push Rx's?" 

 

I'm awful. I know. Especially since my DO wrote me a Rx that I (mostly) happily take!

Edited November 25, 2017 by Angie in VA

[creekland]

Congratulations on raising a great son and a future great doctor!  I'm excited for you!  You may get those answers you need yet!

 

The lad is already focused on the puzzle and wishing I could be there with his group when they work on puzzles (which are previous real incidents they discuss and learn from).  I wish it were that simple.  I have lung testing coming up next week.  I thought that would be a separate issue entirely, but maybe not.  He tells me lungs, cardio, and vascular are all pretty related.  He's chomping at the bit to get those results.

 

If this testing doesn't help someone local solve it, he will be able to sooner or later.  He won't give up and we know/trust each other, so that believable aspect is there - even if it all seems to be so odd.  Odd doesn't mean "not happening."  It just means there's a more difficult and unusual puzzle. He just needs to learn enough info.

 

My medical school hostel mates came knocking on my university hostel room (single room) door when I sprained my ankle. It took me 3 weeks for my ankle to heal completely so they had a fun time examining. They were also my designated safe drivers for Friday night partying as they would be up late studying and don’t mind driving us back to hostel at 1am.

Once I went to a neighborhood dentist and met my hostelmate. He gave me a discount for crowning my two front teeth out of his own labour fees.

Out of 38 middle school classmates, almost half are doctors :lol:

 

ETA:

I fainted and had a bad fall in middle school, resulting in root canal treatment for my tooth. Luckily I didn’t fracture my arm in that fall.

 

I've come into contact with a few residents and med school students with my own medical issues.  So far, I love them.  They haven't been jaded yet and are so used to explaining everything well (probably for tests or similar) that it seems to be second nature for them to answer all of my questions in the depth I want rather than just a couple line summary.  They have an eagerness one doesn't always find with regular doctors.  I suspect that holds true for pretty much all who are new to their job - any job - vs those who have been doing it day in and day out for years so it becomes autopilot.  (And there are exceptions.  One of my favorite doctors was in his 70s or 80s and still working part time because he loved his job - very experienced, very friendly, super accurate.  Experience definitely can bring a lot to the table.)

[creekland]

I'm so glad you have him to help you!!!

 

My DO spends more than 20 minutes with each patient. I like hearing what he tells students who observe him (and me, w/ my permission of course, since they're observing him do OM on me). I love how bold I can be w/ those med students too, asking all kinds of questions like where they're from, how they got interested in medicine, will they specialize, etc.. My fave: "So, will you really do OM or will you just push Rx's?" 

 

I'm awful. I know. Especially since my DO wrote me a Rx that I (mostly) happily take!

 

I ask a LOT of questions too, both about their background and about what they are saying.  They don't seem to mind at all.

 

I've shared a lot of my experiences with middle son, the good, not-so-good, and bad (the bad usually comes from my mom's experiences - her regular dr is  :cursing: ).  He's still super eager to learn.

 

Now he shares many of his experiences with us (not violating anything HIPPA, just nameless experiences of all sorts from their puzzles to real life situations with doctors, med students, and patients).  I will say a bit of it has been eye opening.

[Guest]

Creekland, you crack me up! And honestly, you have the best attitude of anyone I know.

 

Amongst my nieces and neohews, we have an accountant and a lawyer and we always joke that, “one of these kids needs to become a doctor, then we’ll have our bases covered!†Alas, I do not think it will be any of my three.

[Ottakee]

I love your attitude. Glad you have him to help make connections.

 

For years my girls main diagnosis was "hmmmm, that is interesting"......which isn't overly helpful.

[Lanny]

@Creekland  Years ago, when we had good medical coverage (a PPO) my main doctor was the Head of Cardiology in an excellent hospital.   I remember that when I was on my back on the examining table, when he was going to do a quick resting EKG, he would check on both sides of my body. For example, upper arms and ankles.  I remember asking him once, if there's a big difference is that really bad? He replied yes.  Both sides of the body should be approximately the same when they check.  If not, they need to find what is causing that.

[creekland]

Creekland, you crack me up! And honestly, you have the best attitude of anyone I know.

 

Amongst my nieces and neohews, we have an accountant and a lawyer and we always joke that, “one of these kids needs to become a doctor, then we’ll have our bases covered!†Alas, I do not think it will be any of my three.

 

TBH, when I can't keep a proper attitude about "life," that will be a major aspect of "quality of life" for me.  In our family it's common to laugh about what one can't change because the alternative of getting stressed or bummed isn't very attractive.

 

I've also noted that if the lung issues can't be improved or fixed, as long as I live a couch potato life (like here at my mom's where I only got 700 steps in yesterday) I don't notice them at all!  So instead of just moving south to avoid the cold, I need south and couch potato.  That can be done if needed.   :lol:

 

Speaking of steps.  It's entirely obvious that my phone makes me work for mine.  Hubby and middle son are in the exact same situation.  We play the same games, eat the same meals, go the same places - all together.  The only difference is the bathroom and they don't get oodles more there!  Their phones gave them credit for around 1500 - 1800 steps, 2 to 3 times what mine did.   :glare:  Mine literally doesn't count all the small steps around a house (or classroom).  Go to the bathroom downstairs?  Doesn't count.  (It is nice enough to count going upstairs back to the bedroom!)  Walk around the kitchen fixing food - nope. 

 

Since we all challenge each other weekly to "most steps," that's a wee bit unfair.  But... they offered to try to fix mine - adjust settings or whatever, and I declined.  There's part of me that agrees with my phone that I should have to work for my steps, and I'm usually ahead of both in the weekly tallies. ;)

 

BTW, I reminded my guy (again) that I can have his schedule full for him from my own contacts (IRL and Boardies) once he's an official doctor, and you've already met him, so ought to be able to get some sort of bonus from that.  :D

[Another Lynn]

Creekland, sounds like you "need" a fitbit for Christmas!   :D

[Junie]

TBH, when I can't keep a proper attitude about "life," that will be a major aspect of "quality of life" for me.  In our family it's common to laugh about what one can't change because the alternative of getting stressed or bummed isn't very attractive.

 

I've also noted that if the lung issues can't be improved or fixed, as long as I live a couch potato life (like here at my mom's where I only got 700 steps in yesterday) I don't notice them at all!  So instead of just moving south to avoid the cold, I need south and couch potato.  That can be done if needed.   :lol:

 

Speaking of steps.  It's entirely obvious that my phone makes me work for mine.  Hubby and middle son are in the exact same situation.  We play the same games, eat the same meals, go the same places - all together.  The only difference is the bathroom and they don't get oodles more there!  Their phones gave them credit for around 1500 - 1800 steps, 2 to 3 times what mine did.   :glare:  Mine literally doesn't count all the small steps around a house (or classroom).  Go to the bathroom downstairs?  Doesn't count.  (It is nice enough to count going upstairs back to the bedroom!)  Walk around the kitchen fixing food - nope. 

 

Since we all challenge each other weekly to "most steps," that's a wee bit unfair.  But... they offered to try to fix mine - adjust settings or whatever, and I declined.  There's part of me that agrees with my phone that I should have to work for my steps, and I'm usually ahead of both in the weekly tallies. ;)

 

BTW, I reminded my guy (again) that I can have his schedule full for him from my own contacts (IRL and Boardies) once he's an official doctor, and you've already met him, so ought to be able to get some sort of bonus from that.  :D

 

I would like an appointment.  I am a medical anomaly.  

 

Does he have any interest in genetic birth defects, arthritis, food allergies, or migraines?

 

Creekland, I hope that he is able to figure out what's going on with you.

[creekland]

Creekland, sounds like you "need" a fitbit for Christmas!   :D

 

Perhaps, but in a way I like knowing my steps are "real" in a "decent health" sort of way.  We're getting a laugh out of comparing values this morning.  Everything I've done around the kitchen getting breakfast and moving, etc, doesn't count for my phone.  We're liking it to a drill sergeant. "Do you seriously think going to the bathroom or making food to eat should give you health credit?  I don't think so!  You need to MOVE!"  My guys do the same steps - or fewer - and get plenty of credit.

 

This has also been a little bit sobering to them since they know I often lead in these contests among ourselves.  Even now, after being in this situation for 5 of the 7 days, I'm still about 3000 steps in front of hubby.  :coolgleamA:   He'll lead in another day, but I'll make up for it when we get back home and I'm doing chores and normal walks/activity.  I only get docked when housebound or in the classroom.  Mine won't add few steps - not even when we count them ourselves (16 from one end to another).

 

I am, of course, way, way behind my Jordan lad right now though.  I'm housebound and he went to Jerash yesterday (ruins of the Decapolis city - gorgeous to see and plenty of steps walking around it) + Ajlun (ruins of a Crusade era castle - not as many steps as Jerash, but far, far more than we get here - even if my phone were adding correctly).

 

We're all also usually behind my nephew's friend.  She works as a nurse assistant at an elder care home - often double shifts.  'Tis tough to beat her when she's on the job - not so tough when her days off are added in or if we're in places where we can get significant walking in vs just everyday life (goal of 6000-10000 steps).  

 

I would like an appointment.  I am a medical anomaly.  

 

Does he have any interest in genetic birth defects, arthritis, food allergies, or migraines?

 

So far he loves almost all of it (orthopedics being the exception I've heard about - he's likened that to being a carpenter, just working with bodies instead of wood).  What he loves is the challenge (coupled with helping people). 

 

He's been that way since youth.  If there's something he couldn't figure out in any class or situation, his mind didn't quit with it until he did.  He knows how to locate sources of knowledge to fill in what he doesn't know.  He's smart and he's able to look at things from oodles of different angles.  He was loved in his research lab and with research professors too.  Several tried to get him to go in that direction instead of medicine.  When he had to choose, medicine won.

 

Being first year, he has a bit more knowledge to learn first, but he's on his way. 

 

Being a mama and feeling proud, I'll also share that he's already solved some tricky problems that they were given - in one case - being the dissenter and getting dissed by his fellow group members in a Twelve Angry Men (the play/movie) sort of way.  I'm aware that it was a "first year" problem so probably not tricky for later years, but still... he's smart, he doesn't cave to peer pressure, and he will do well, I'm positive.

 

Besides, he is likely my only real possibility for getting this solved and keeping my sanity in the process, so I'm believing in him!

[MedicMom]

He’s at U of R, right?

The main hospital I transport patients to is now affiliated with them, so we transfer patients up there many times a week. I am consistently impressed with them. I managed to get my grandfather transferred up there and the resident team in the hospital managed to find the obscure medical condition that had been eluding other doctors forever.

 

He is at a good place, and it would likely be a good place for you, even with the drive.

[creekland]

He’s at U of R, right?

The main hospital I transport patients to is now affiliated with them, so we transfer patients up there many times a week. I am consistently impressed with them. I managed to get my grandfather transferred up there and the resident team in the hospital managed to find the obscure medical condition that had been eluding other doctors forever.

 

He is at a good place, and it would likely be a good place for you, even with the drive.

 

Yes, he's at UR's med school and loving it.  I don't have enough comparison data to know the rest, so I appreciate your vote of confidence TBH.

[kbutton]

Creekland, sounds like you "need" a fitbit for Christmas!   :D

 

Will a fitbit count all the "move across a ten foot room" steps? I cannot get anything I do in the house to register on my ipod.

 

Creekland, you know that when your son is official, we're all going to want him to set aside a month or so for a big WTM clinic, right? 

 

Medicine needs more people who like a puzzle. Lots more. The things left to be figured out are going to be puzzles, and unless the practitioner end gets more curious, there won't be people to implement the solution to the puzzle in a meaningful way or to convince other practitioners to adopt new protocols. It's about time medicine got more well-rounded and diverse in personalities. People who continue to be good at "regular old medicine" will still be needed and helpful (and I have a family member who is exceptional at this while also not shutting people down when he doesn't have an obvious answer), but to move forward, it's going to take some push and pull of informed viewpoints to accompany the research and new understanding that comes with it.

[Halftime Hope]

Yup, I'm going to take a number and get in line for him, too.  :001_cool:  I need to get him to look at The Hubs and engage his problem-solving skills....just to keep him practiced in treating guys, ya know!  :w00t:

[MedicMom]

Yes, he's at UR's med school and loving it. I don't have enough comparison data to know the rest, so I appreciate your vote of confidence TBH.

I have had patients who had been to John Hopkins and Cleveland Clinic and it was the doctors at U of R that figured them out. I have hope it will be a good connection for you! Plus, you could hang out with me while in the area. ;)

[creekland]

I have had patients who had been to John Hopkins and Cleveland Clinic and it was the doctors at U of R that figured them out. I have hope it will be a good connection for you! Plus, you could hang out with me while in the area. ;)

 

Nice perk!

 

Also nice to hear you compare with JH because they are one of the entities that told me not to worry about vascular.  No tests with it.  Just don't worry.

 

Middle son has reached the puzzled stage with my stuff (and his limited knowledge).  I told him not to worry.  If it were that easy to figure out, I suspect normal docs would have already done so.  Almost everything tests just fine including most blood numbers.  BP is low (but normal).  Resting pulse is low.  Cranial nerves test ok with basic tests.  All literally seems fine, so I fully understand why the doctors reached their conclusion (aside from stopping without that final check).

 

And yet, there are issues - hearing pulse (and the last few days, the actual heartbeat while lying down on my left side - really haven't figured out where that one is coming from!), ear pain, face numbness issues (what I feel vs what can be felt - no problem with the latter), common chest pains, left side underarm painful lumps, common neck pain, but no movement issues, and if connected, significant breathing issues as soon as I add the least bit of normal (for me) exertion, and that's getting worse more quickly than before.

 

I doubt it's connected, but I still never get hungry either.  That, at least, is one nice benefit aside from reducing my metabolism making it super easy to gain weight eating normal amounts, esp when I lose the normal exercise levels like when housebound.

 

I'll see what happens.  He'll keep things in mind and see what he learns along the way.  There was one other test he did that he said wasn't normal - he'd never encountered it before, and hubby is "normal" with the same test.  It could be his inexperience.  It could be something that comes out with the lung tests.  Time will tell.

[MedicMom]

Pulsatile tinnitus can actually be somewhat serious. Have they done an ultrasound of your carotid arteries and checked for blockages or narrowing? Looked for leaky cardiac valves?

 

I had a patient once who had a leaky cardiac valve and her ONLY symptoms were Pulsatile tinnitus and increased shortness of breath on exertion. I actually completely agree with you that it sounds vascular/cardiac.

[Ottakee]

Pulsatile tinnitus can actually be somewhat serious. Have they done an ultrasound of your carotid arteries and checked for blockages or narrowing? Looked for leaky cardiac valves?

 

I had a patient once who had a leaky cardiac valve and her ONLY symptoms were Pulsatile tinnitus and increased shortness of breath on exertion. I actually completely agree with you that it sounds vascular/cardiac.

MedicMom.....glad you mentioned these 2 things.  They were my first 2 thoughts but my medical degree is just a lay degree from caring for special needs kids and lots of health issues with inlaws.....as well as my own interest in medicine and picking my friend's brain (hospitalist who also did 20 years in family practice).  Glad someone with more knowledge piped up.

[creekland]

Pulsatile tinnitus can actually be somewhat serious. Have they done an ultrasound of your carotid arteries and checked for blockages or narrowing? Looked for leaky cardiac valves?

 

I had a patient once who had a leaky cardiac valve and her ONLY symptoms were Pulsatile tinnitus and increased shortness of breath on exertion. I actually completely agree with you that it sounds vascular/cardiac.

 

No.  They have done no tests on it whatsoever beyond checking for more tumors or cysts in my head (and that turned out fine).  Ok, they had two ENTs look for ear damage too.  Nothing.

 

I fully expected they'd go with vascular next, but was told that couldn't be a problem because there aren't enough symptoms for it - chiefly fatigue, but also no leg swelling, high BP, etc.  There are other vascular issues going on - weird, unexplainable ones - and they have no interest in those.  "Definitely strange, but not connected and not an issue with life (agreed) so no problems there."

 

They tell me all of my issues are due to stress and being super sensitive from the brain tumor experience - or perhaps radiation issues/side effects even though the radiation doc says it's definitely not related (and out of his specialty, so he can't help me any further).  

 

I disagree - esp since I've given it time (years now) and things haven't even remotely gotten better.  They continue to progress (mostly slowly).

 

When I left their last recommendation was to try a third ENT.  WHY?  

 

(The radiation theory could be it I suppose, but I'd feel better with that assessment if they had checked out vascular first.)  

[MedicMom]

Can you ask him what test he did?

[creekland]

 Allens test is the main one - esp in my left arm.  We "played" with it a bit yesterday after totally "failing" it the night before.  It seems to be a signal of circulation.  It was totally off (white hand that didn't regain color) when I'd been a couch potato for so long (days now).  This totally matches my feeling much worse with my extremities without movement - the longer I go - the worse it is.  Yesterday morning it was slow, but color returned, so sleeping overnight didn't hurt and probably helped.  I did a little bit more activity yesterday - walking around - not sitting so much.  During the day and last night it seemed normal.

 

ETA:  This correlated with the strength in my ulnar artery.  He couldn't find it when things were off.  He found it just fine and it seemed normal when it wasn't.

 

In general, it is more of a reminder (to me) that I can't be inactive.  My body already tells me that anyway.

 

The other test he wasn't sure about dealt with listening to my lungs (so not vascular, but fluid - or something other than air - in the lowest sections).  He thinks he's wrong on that one after a bit more practice.  He thinks my lungs don't go down as far as he thought they did.  (No doctor has heard problems in my lungs, so that has colored his thinking, but probably in a positive way.  None have ever done the other test.)

 

I had him listen to my heart after a day (or half a day anyway) of my chest hurting.  It's in the aortic valve area if heart related (so he says), or around the third rib (in common language) otherwise, but he didn't hear anything off.  It could easily be due to something lung related - or who knows?  I live with it.  It's been around on and off for quite a while now and hasn't killed me yet.  The one thing that makes it worse is adding iron to my diet (esp in a pill).  Since I stopped that, it comes less often, so that's a plus.

 

The lad heads back to school today - in a couple of hours actually.  I'll get lung testing this week.  It'll be interesting to see what comes of it all.  While living as a couch potato helps the lung issue (aka, I don't notice it at all as there's no "stress" like hills, basements, or chores in the barn) it's not really an option for the rest of my life considering the other stuff gets worse.  There may be a happy medium with flat/level walking if needed though.

 

Also ETA:  The lad was just sent home with the assignment to practice doing some of these basic tests on willing participants to help get a feel for what was normal  and not with what they see and to start learning some tips on bedside manners, etc.  I can definitely see where that's worthy.  Few complaints with friends and family members too - compared to the general public who comes in with expectations anyway.   (I'm also not positive it was an assignment as much as just something he and some peers decided to assign themselves TBH.)  There is no diagnosing - just pure discussion among us in the same way we'd be discussing anything else we've shared from books to movies to life experiences. 

 

The only "surprises" from anyone were the results from those tests - and my BP being low (103/62) for what he's used to seeing on practice patients.  I told him that's because he's not really a doctor yet.  :lol:  That reading (and sometimes lower) is quite normal for me at home.  It raises up about 10 points for donating blood.  It can go high enough that I've had to combat the recommendation to take BP meds when in a real doctor's office.  There they often do my BP both first and last to affirm that it isn't a problem.

 

I was also able to show him a few "strange" things dealing with my body - known things - told to me by other doctors (the real variety).  I can make my right eardrum move (supposedly unusual enough that one of the ENTs hadn't seen it - a younger guy) and there's a nodule in my left nostril.  Neither are "do something" deals.  They're just part of what he might encounter in life.

 

 

Edited November 26, 2017 by creekland