Wednesday, 13 February 2013

Taking the steps

We had a practical lab today, and we learnt how to take blood pressure in a number of ways, both manually and with machines of various size and ability. It sounds mundane, and plenty of people in all walks of life can do it, but it sure was exciting for me at least to get out my stethoscope and use it on someone else for the first time! It was fairly hard to find the brachial pulse on most people, but I'm sure that with practice that'll become second nature. As part of the lab we are able to take part in a research project organised by the medicine faculty, investigating blood pressure. It's the largest study of it's kind in the world, so it's no small thing. Part of it is to do with changes in how long it takes for our heart to readjust itself after we go from laying down to standing. My blood pressure went below 25mmHg when I stood up...that's really not good. Then I took an anti angina drug and repeated the experiment, and the blood pressure stayed lower for longer, which was what we expected. It gave me a thumping good headache too, because it worked by vasodilation.

On another note, the pharmacology lecturer made us watch this video,'s the scary summarises most of the drugs we're going to have to be very familiar with by the end of the year. Fantastic.


Tuesday, 12 February 2013

Microsoft OneNote

So, I figure it's a good time for an update! Lots has been going on and it's all very exciting.

Yesterday was my first day of actual proper medicine, as in learning things. It was an extremely full on day as well, starting at 9am and ending at 6pm. That was an ordeal, but thankfully we had an hour break in the middle of it all. So during the day we had 5 lectures and 1 case supported learning (CSL) tutorial. The lectures were pretty interesting, but were mostly introductory in nature. For example, we had general introductions to pathology, physiology and histology. It was a great chance for me to trial a new note taking system -- using Microsoft OneNote.

To put it briefly, it promises to change everything. No more do I look at a densely packed lecture screen and despair, because now I can just bang out everything on the keyboard. You can either organise all your subjects with separate notebooks, or, as I do, have a single notebook for the course and have tabs for each subject. Each tab in each notebook can then have pages...and its on each page that I write the lecture content. I don't use any of the fancy templates to structure a page -- they have too much frill for me. I even organised a few sub-pages in one of my pages -- blood, bone and cartilage are sub-pages to the page 'connective tissue'.

So already there is a vast amount of granular organisation available, but it gets better with a couple of tricks. Firstly, it has an almost instantaneous search function, so if I want to find out where I have previously been taught about something I can just quickly type the string into the search and have listed the page it's in, and when you then press enter on one it takes you straight to the instance it's mentioned. Secondly, having found an interconnection between two separate can then actually produce a link that will take you straight there to be placed in your other, current, note. So in the example I've just searched for something and it's come up in this other page before, clicking on that result takes me straight to where I've mentioned it, and right clicking on that mention and pressing 'copy link to paragraph' will give me a text link to place in my current page that will take me straight to the previous mention of the thing. It boggles my mind, and is probably going to be the biggest thing that keeps me now doing electronic notes. Thirdly though, I keep a wonderful little program open called 'snipping tool'. If you're unfamiliar with it, get familiar with it quick -- it basically lets you copy exactly what you want from the screen to your clipboard to be pasted anywhere. So for example, I'll have my lecture notes open as a PDF while I'm at the lecture, and if the lecturer has used a particularly good picture or table to illustrate an example then I can quickly pop into the snipping tool, crop around the picture or table, and paste it straight into my notes. WOW.

Aside from lectures -- which are a breeze now with my new system -- we've had a few tutorials as well. The CSL this week is about a patient with headache, photophobia, general malaise (what a favourite term), lethargy, cerebral disturbance and a bad temperature. It only took him 3 hours to get much worse, so his friends took him to hospital. We decided it was probably an infection, and more specifically probably a meningitis. We discussed things like what sort of history we would take, what tests we would order, etc. For the record, we'd start him on prophylactic antibiotics (types that cross the blood brain barrier, too) order a lumbar puncture and test the CSF for a number of things -- protein and glucose levels (will rise and fall respectively in the case of bacterial meningitis), cell count (PMN's will be high in bacterial infection, whereas lymphocytes will be high in viral infection), and you can do tests to detect bacteria in the CSF as well. It was a much better CSL session than last week's ones, because we'd all prepared a bit for this topic so we all had something to contribute.

We also learnt a bit about how to show patients that we're listening to them in our principles of clinical practice (PCP) tutorial. Things like when to use open questions, when to use closed questions, non-verbal techniques to use, etc. It was fun! This morning I had a lab where we tested the patient's CSF for the presence of bacteria, except the test was inconclusive...which sounds lame but it's still a result, and could point to the bacteria being Neisseria group B because apparently they don't get picked up by the test we did very often.

It seriously feels like a whole week has gone by already. This year is going to be crazy...crazy, but fantastic.


Sunday, 3 February 2013

The Beginning

Everything starts tomorrow. I haven't done any pre-reading. I'm feeling pretty unprepared, academically and psychologically. Ah well; into the deep-end we dive with naught but our wits.