Busy busy...

Wonder if I should start posting about MTG on another blog. Seems appropriate.

Had a few ideas about names.

Specifically, that names are inherently meaningless, but we accept them as being an identifier for someone or something, unconditionally.

And then when we meet someone with a similar/same name, we might look at them and think "...You don't look like a Samuel".

I guess it's more about stereotypes and how hard they are to change when you don't really question them now and again.

Anyway, between learning anatomy, getting enough sleep, work, maybe starting my assignment and other uni crap..

Hoping your uni breaks are excellent.

Once more into the breach, dear friend - Once more.

Came back to this because I figure I should do with leaving some kind of record around.

Though, I never re-read this either. And no-one particularly reads it.

Need to practice consulting and examining people D: Normal people, but still.

Hands and abdomens currently. Learning knee later.

Only been 3 people in my feed for blogger.com so it's nothing fancy.

Should sleep now.

Hoping I do look back on this later.

History

"A 22 year old male presented with a bulla under the left ear. He was given a prior diagnosis of an inflammed sebaceous gland and wondered if he should excise it himself. He had a preceding upper respiratory tract infection which started 2 to 3 months ago, but has since passed, along with associated symptoms. The bulla is roughly circular and is 4 cm in diameter. The surrounding lymph nodes were swollen. He was given cephalexin monohydrate and recently started taking twice the prescribed dose in an attempt to clear the infection faster."

....Not sure what else to put - this one was a weird one.

Coincidences actually exist. Believe in them.

I was always here.

Which is to say that I never left.

A lot has happened lately.

Braces getting fitted within 2 weeks. Teeth being removed to make my face look nicer, apparently. Apparently I have too many teeth. As do most of us.

Coincidence #1: Reading material on alternative health therapies in the hopes of being able to write an essay addressing the question of what to do if a patient with idiopathic symptoms insists on alternative med X,Y,Gamma + Desktop background disappeared somehow into black when it used to be that lovely picture Aereas drew of all of us.

So I wanted to write down a short draft of ideas (plot summary) here before trying to look for the  picture again.

Coincidence #2: Found myself in the office/pharmacy/clinic of a traditional chinese doctor.

NOTE: A day has since passed because I'm slightly lazy but no-one's going to miss it, hmm?

I used to not really care. I mean - I thought she was a conventional doctor (read: mainstream?) but the space was really small. I just figured she was a mainstream doc in a herbalist's shop. So I thought I might do something like that (6 years ago).

But therein lies the first problem. It's a small office...thing. That doubles as a shop. So there's no sense of confidentiality. Any problem you have - everyone can hear. Which I took the liberty of doing because I respect her as someone who has been practicing for at least a few decades.

 A case study I happened to be writing for practice:

"A 21 year old male presented with heightened irritability, nocturnal lows in libido

and general fatigue. He suspected low levels of circulating testosterone. The symptoms started two months ago, and have been constant. He did not notice any change in male pattern hair growth over the past two months. His fatigue is alleviated following intense physical exercise.There are no significant current medications or allergies. He lives with his boyfriend in an apartment in Homebush. His diet appears balanced. He has been smoking two cigarettes a day for the past two moths, and drinks heavily on occasion. He has used amyl nitrate and marijuana before."

A case study I managed to salvage from listening to a case yesterday:

"A middle aged male presented with flaking, inflamed skin lesions dispersed on the right side of his body. They varied in severity, size and shape but the most painful lesion was on his right index finger. The lesion was an elongated, oval shaped, purple-red plaque 3cm length by 2cm across. They were flaking, painful, and started last night (6th July). His blood pressure and pulse were taken. He has tried ______ (didn't catch the medication but I suspect it was an anti-histamine like Zyrtec or something similar. They don't put you on corticosteroids until it's the last resort. Steroids are baaaaaaaaad.) but they have been ineffective.

 He likes to eat lamb and other meat. He was advised to abstain from the consumption of all meat and fruit, [well, it was more like an order], and instead put on a diet of ginger rice. When concerned about a general sense of fatigue, he was advised that abstaining from meat and fruit, and consuming ginger would help. He was also given a lump of ginger to consume."

On a guess, it's eczema and/or dermatitis, but it hasn't been ongoing (I think). If the medication is an antihistamine, then I would definitely say it's an allergic reaction to something.

I'm not sure why you would need to check BP and pulse every time. It just... doesn't make sense.

It is painful to note that there is a acupuncture and Chinese herbal medicine fellowship and that their certificate of membership is almost identical to one of the ones you get for a bachelor of dental science. Mostly because it states something about high levels of clinical practice.

....

Disregarding the issue of confidentiality...

Performing tests without consent (BP and pulse), without even performing them properly (she wrapped the cuff around a jacket around his arm) can't be right.

Palpation without informed and verbal consent. (It was implicit, I suppose.)

Not undergoing a full or even focused history, and then prescribing medicine.

If I did all those things, I'd probably be deregistered :l

At the very least sued.

And then there's the issue of the ginger. I'll skip the next case summary but basically, a male presents with occasional bouts of vertigo which so far has been idiopathic. His blood pressure and pulse are taken, and then he as advised to precisely the same diet as the man before (with the skin lesions) with minor tweaks being the addition of tofu, and more ginger raw instead of ginger rice.

“All things are poisons, for there is nothing without poisonous qualities. It is only the dose which makes a thing poison.” - Paracelus

It's kinda odd to think that a substance that is perfectly safe has any use at all.

For example - paracetamol (ie; panadol) can cause severe liver damage if taken in extreme quantities (ie; more than recommended daily/time dosage). Even antibiotics which naturally have an affinity for disrupting bacterial RNA can bind and disrupt human RNA if the dosage is high enough.

But ginger? Nah, it's fine - it's totally safe and appears to be:

1) Anti-inflammatory

2) Boosts the immune system

3) Good for counter-acting vertigo

4) Plus much much more.

No side effects.

Lastly, of major concern is the advice to stop eating meat and fruit when presenting with general fatigue. Meat is one of the few easy sources of Vit B12, cobalamin, a deficiency in which will result in megablastic anaemia. (Basically less red blood cells, but they're bigger to try and compensate). Obviously, this is going to lead to even more fatigue. I have a friend who currently has to undergo a course of B12 injections simply because he's a vegetarian. 

(Maybe he'll be less lazy now. Lol.)

Did you guys know Jim Carrey is anti-vaccination? I didn't know until yesterday. It was pretty astounding, and shocking.

Conversation with a friend I sometimes slightly resent because I'm not really in-step with their attitude most of the time:

Me: Hey, did you guys know that Jim Carrey is anti-vaccination

Him: What, really? Wtf. So vaccination causes autism and all that?

Me: Yeah. Well, yes, that Carrey's anti-vaccination, but not that vaccines actually cause autism.

Him: ... You must be really dumb to believe that kind of stuff.

That's where I have to draw a line between what I would call "willfully ignorant" and simply "uneducated". I don't think anyone is "dumb", it's just a matter of what they know, how they know it, and why they think it's true. In this case, I suppose my friend is referring to those willfully ignorant, but it seems to me that he might as well be talking about both, and it's an unfair generalization.  

After looking in "The Complete Guide to Homeopathy" by Doctor Andrew Locke and Doctor Nicola Geddes (both actual MDs and not PhDs, mind you), I was pretty astounded by the lack of references and appendices to the book. Sure, it's targeted at the general public, but so is "Deadly Choices: How the Anti-Vaccine Movement Threatens Us All" by Paul A. Offit, M.D., and his book at least has some referencing, even if it is threadbare.

Anyway, that's enough for now, probably.

Yes, I'm dead, hi nice to see you for so long. 

 

Intriguing to read everything again.

Sorry I haven't been around.

Exam :l

Uncertainty

You know, people assume doctors know what they're doing.

I think it's mostly that doctors don't show that they don't know.

There's even a word for a disease with no known cause:

Idiopathic.

Weird word.

If you don't show your lack of confidence, no-one ever knows.

Two people, a tutor and a student, talking about post-colonialism in a library while the world around them darkens, fades and starts to drench.

Somehow, they start talking about soy milk. That leads to a question on lactose intolerance.

The student insists that while they are no doctor, they are sure that in small amounts, you can build a tolerance to lactose.

I wonder if a HIV/AIDS patient can regain their immune system in the same way.

"Obviously if it's fatal, then it's not going to work."

I wonder how far tolerance goes in nature.

In neurotransmitters, we don't want tolerance for the most part. Same with hormones. Type II diabetes can result in insulin tolerance.

Alcohol tolerance is a "good" thing, but only by society's standards. To the body, it's a toxin one and the same.

Worse if you choose an alcohol that isn't ethanol.

Is the difference that I don't know for sure?

I'm too lazy to check it up.

Benign Paroxysmal Positional Vertigo.

Interesting that you can fix it with a few head movements.

The human body is fragile.

I wonder if I'm destined to be a mechanic, or a tinker, or...

But then, people are still people.

Either way, I was going to butt in and mention that the student's hypothesis is grounded in a false belief that tolerance is extremely common.

It is, but only to such an extent.

You can become tolerant to cigarette smoke, to an extent.

The cells lining your trachea transform from those with cilia to like those on your skin.

It doesn't mean that the smoke affects you less - rather, it affects you more.

Though, I'm not sure exactly when I'm allowed to cut in and mention to strangers that their view of a medical issue is probably wrong.

But I'm not sure. At all. Ha.

Felt like I needed to share something awesome.

THEY ARE SO COOL, RIGHT?! :D

Quite chuffed.

Played two games of magic today.

Lost both games.

0-2 Record with Eyes.

I'll fix it up. Need to get more sleeves :(

But that's ok. I'm travelling light tomorrow.

I'm not gonna Friday Night Magic. Haha.

Assignments to do. Better do them.

Quite pleased to find out that all my "old" cards, can still be played no problem in a new format called Modern. Hehe.

It was pretty easy to meet people and get to know them. Quite fun.

Thanks Kwanza for accompanying me.

Also got 2 copies of a card free from my opponent. Thomas is his name.

He's quite chill.

I like him.

Quick update

Fan service in Doctor Who? Oh my... Neil Gaiman!

But I think the Cyber-Doctor was pretty dramatic and likable, if sinister.

Imagine the Cyber-Planner as a companion. Unfeasible but still..

Didn't like the ending or the other plot.

Main plot was Cyber-Doctor, and that was done well. Everything else seemed to have just revolved around it.

Going to make a deck I don't need to update very much (read: budget) and fun, and casual. Cbf spending so much money to play modern/standard/whatever. I'll probably make it, then after uni, pop in for a random game with someone random in the card game shop then head home.

Key card for anyone interested:

It's a pretty junky rare. No-one plays with it. But it's fun.

It cost me $8 to get a set of four. :'C

Apparently it's so much cheaper in America. But healthcare SUCKS there. So... I don't know! T.T

Might be cheaper in London? I hope so.

My nephew X-times-removed and his parents are there. They've got a pretty good job there, but my parents think that he's (the husband) desperate for money.

Anyway, that's my little jaunt.

Tomorrow's 8-3, with a 2 hour break from 11 to 1. Maybe I'll meet someone. Who knows.

Hoping you guys are faring well.

Gotta start my assignments, damnit. Contraceptives and writing a play...

Lots of things I haven't gotten around to.

If anything, I should start my individual assignments.

But I don't feel like it. I dunno why.

It's stupid.

Tomorrow's going to be more about skin and pregnancy and stuff. I wonder when I'll be in a hospital.

Carrying a steth is kinda hard. And you can't just wear one in public right? :L

I should take a photo of the mounds of books in my room. And the state of my desk.

It's horrible.

I need to talk to someone who can motivate me to work.

Generally, that's anyone, but...yea.

I'll try to do it soon. Like, tomorrow I suppose.

Getting slowly into the swing of things. I suppose everyone else hasn't done much either. Oh well.

Maybe I don't feel so good.

I'll figure it out.

Hoping I do.