Bienvenidos!

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Beware: may contain jargon.

The web fairies have been appeased somehow. We still have internet even though it rained again today.

My patient went number two, so I didn't have to examine any bottoms. I'm sure that made the patient just as happy as it made me! I've never really been sure why senior docs are so keen on digital rectal exams (and that's digits as in fingers, unfortunately). There's only so much you can feel and whatever's up there is bound to come out at some point. Except tumours. I think DREs were invented just to spite the med students and the newly-qualified. Although, for examining prostates, they are quite good. I'll give them that.

Anyway. Today was a pretty good day actually. The ward round that I was supposed to lead got kind of taken over, I got med students to take bloods for me, and since I had wrapped up all my jobs by half three I got to leave at four! We did have a couple of patients go into AF though. Luckily the SHO and SpR from the other team were still there so they gave me a hand. I completely missed a T wave inversion on one ECG though. I was so worried about looking for ST segment changes that I missed the most obvious sign. (Ok, I know that got a bit technical. AF = atrial fibrillation, where the top chambers of the heart don't contract rhythmically, they just quiver, so the lower chambers have to set the heart rate. Has a risk of developing blood clots which fly off into the circulation. T wave inversion/ ST segment change on ECG usually means a heart attack or close to one.) After some oxygen and digoxin they were ok. One back to her usual vocal confused self ("I'm covered in bags, I'll be smothered, where did these all come from? The bus driver was supposed to take me to Maghull, I don't know why I ended up here, I've got a job, I need to be there on Thursday." She's 90-odd with only one tooth left in her head. Looks like a tusk.). The other one is the bendiest old lady I've ever seen. Every time I walk past the bay she's got her ankles by her ears.

Friday tomorrow. Hurrah.

8:16 p.m. - 2008-09-11

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