Tuesday, May 29, 2007

I’m not really sure if anyone will be reading my blog anymore because I haven’t been very good at writing in it lately. Things are starting to get very busy because we have our exams coming up in less than a month… and there is A LOT to learn. The exams don’t really count for much, but we are going to have to learn the stuff eventually so most people are taking the whole thing pretty seriously.

Last weekend was a fun weekend for me, but kind of unproductive school-wise! I spent most of my Saturday trying to find a refill printer cartridge for my laser printer… only to find out that there were no stores around who had any left- and ALSO that buying a new cartridge (if they even did have one) would be the same price as buying a brand new printer. So I’m not really sure what to do about all that!?!?! I’m hoping I’ll be able to find a cartridge on Ebay or something. Any suggestions?

My friend, Milad (from East York Swim Club- about 12 years ago), also came to visit on Saturday! He is going to Teacher’s College in Wollongong for the year, so decided to make the trip up to Sydney to say hi. (Wollongong is about 1.5 hours south of Sydney.) He came to meet Brooke, Janice and me in our PBL study rooms on Saturday afternoon and was a good patient for us to practice taking blood pressures on. In the evening, we went out to dinner (with about 12 of the Canadian med students) for Japanese food. It was really yummy and I even liked the RAW beef that someone let me try! After dinner we went to the Marly Bar (the place around the corner from my apartment) and then headed down to Circular Quay, the Opera House and the Rocks for some late-night pancakes.

We figured that Milad had to see the Opera House at night and get some pancakes from the 24-hour restaurant, “Pancakes on the Rocks” while he was here. We had to wait over 20 minutes to get a table even though it was past 2 am!!
This past Monday at the hospital was one of my favourite days so far! We got to spend the whole morning learning how to cast and splint. The casting was really fun and I took lots of pictures. Some of the people in my group kept their casts on all day so they could go home and scare their boyfriends and roommates! He he he.

My first cast... DONE! I even got to use the saw to cut it off! Harry with 2 casts on... 2 Casts at once! In the afternoon we went through some more musculoskeletal exams and then had a lecture on radiology. Reading x-rays is really quite hard (and pretty boring). I don’t think I’m going to be a radiologist. (Sorry Brent- I know you had your heart set on that one ;) he he he).

I’ve also finally got into a swimming routine again- which is really nice. I couldn’t get anyone to swim with me regularly here, so I’ve just been going alone. I guess it is better than not going at all… but I was really expecting Australia to be full of swimmers!

Our case of the week is pretty interesting- Osteoarthritis of the knee AND squamous cell carcinoma. Skin cancer in Australia is VERY common, so I think we are going to have a lot of cases involving it! (Oh and since summer is coming around at home, you should all make sure to get yourselves some BROAD SPECTRUM sunscreen... esp. Jules, George and Brent since you are going to be at the beach so much!)

I don’t have much else exciting to tell you other than I am coming home in 25 days!!! It looks like my few weeks home are going to be VERY busy… but I’m just SO excited anyway! Ps. Do you know what they call drunk driving here?? They call it “drink driving”!! How weird is that???! They are so strange sometimes.

Sunday, May 20, 2007

Our clinical session last Monday was mostly review and our tutorial session was focusing on the lower back and knee examination. Nick and I went to the hospital early so we could drop by the Drug and Alcohol Center and talk to some patients. We ended up talking to a man who was an alcoholic. He was pretty rough around the edges, but he was interesting to talk to and liked to tell us stories. I think if we were actually working (and had other patients waiting) we would have had to cut him off. He’d been in and out of jail several times and the last time was for ‘assault causing bodily harm’. I’ll have to tell you the story another time…

In between our clinical sessions, a few of us decided to go to the neonatal and postnatal wards. A really nice resident took us around with her and we got to see lots of little babies! We even got to help her do a blue book baby check on a little boy who was only 22 hours old. The mom had been in labour for almost 2 days before they decided to do a c-section- so needless to say, she wasn’t in the best of moods. Poor lady. We also talked to one patient who was 36 weeks pregnant with twins. Her tummy was massively huge.

The rest of my week was pretty uneventful. We had our first real cadaver lab and got to look at some shoulder and hip joints and some limbs. I can’t believe how heavy a human leg is!!! I did a cadaver lab at McGill, but we never did any limb anatomy, so it is kind of interesting to do it now.

I also went swimming on Tuesday and Thursday afternoons this week. On Tuesday I went with Bryan and Thursday I went by myself (which was actually really nice). I had my own lane in a 50m outdoor pool… the sun was shining and it was warm outside! That just wouldn’t happen at home.

My Friday was ridiculously long. I had class starting at 10am and didn’t get out until 7pm. We were supposed to have lectures all the way through, but I was sitting beside Sadiq in one of the lectures and we got really bored, so we decided to go to Royal Prince Alfred hospital (a nice and HUGE hospital beside campus) for their Grand Rounds. We got a nice lunch supplied by medical insurance companies and then went to the Rounds. (In case some of you don’t know what Grand Rounds are- A doctor at the hospital usually presents an unusual case or situation, a rare disease… etc. and a bunch of doctors (and students, I guess!) show up, listen and ask questions.) The first lecture was about a recent outbreak of an antibiotic resistant bacteria in the hospital. The next was about a 29 year-old male who got electrocuted and when he was brought in to emergency, the doctors ended up finding a bigger problem (an aortic coarctation) … it was very “House” like. Also, the whole thing was kind of neat because doctors’ pagers kept going off and they’d be running in and out of the room the whole time.

After class ended at 7pm, a big group of us went to a nice little Italian place (called Rosalina’a) for dinner. I had my favourite… gnocchi… and Sadiq brought wine for everyone. When dinner was done everyone split up and I ended up going to Len’s house with a bunch of the girls to play “cranium”- which I had never played before. (What a crazy Friday night, eh??) The game was kinda weird because it was the Australian version, and none of the North Americans knew any of the songs or people in the game. I felt pretty useless!

I’ve had a pretty dull weekend because most people have started to study A LOT. Our problem of the week is a broken neck of the femur (in an elderly woman) caused by osteoporosis. More limb anatomy …! You wouldn’t believe how much there is to learn.

It is also starting to get a bit cooler here now :(. I don’t leave my window open very much anymore and I actually sleep with blankets on at night. It’s been getting down to about 14 degrees Celsius at night, but still goes up to the mid-20’s during the day. The leaves have started to fall off the trees- which also feels pretty strange since it is still pretty warm out… but apparently winter is coming. He he he.

Anyway, if anyone is wondering, it’s only 34 days till I come home (not that I’m counting…)

Miss you! xoxo

Wednesday, May 9, 2007

I’ve had another pretty busy week! My weekend ended up being pretty full even though I didn’t have much planned. Friday was Stuey’s birthday, so a big group of us went to dinner at a Japanese restaurant right around the corner from me. Stuey had gone to the campus bar straight after class (for a few hours before dinner), so he showed up to the restaurant already drunk. After dinner we went to the Marly Bar (right around the corner from my apartment too), but only stayed there for about an hour because Stuey kept getting kicked out. Eventually his luck ran out and changing his clothes didn’t fool the bouncers anymore. :( We had just finished our week on Alcohol abuse, so Janice, Brooke and I found the whole thing pretty entertaining. He should have been our binge drinking case study! Slurred speech, motor ataxia, loss of inhibitory control, super talkative and emotionally labile…! On his walk home he apparently stepped on some glass that went right through the sole of his shoe and cut him really badly. Luckily, Len and Janice were with him (and noticed the blood before he got into bed), so they wrapped his foot up with a sock and some tape to stop the bleeding. We were all home before midnight! He he he.

On Saturday I went for a swim and then ran some errands with Sabiha. We decided to have some dinner in Glebe that evening at a cute little Italian restaurant. I had some really yummy prawn and avocado pasta!!

I stayed in Saturday night since Janice and I planned to get up early to go to Coogee beach on Sunday. Brent was working at the Marine Unit on Saturday and while I was talking to him, the Headguards all came into Bruce’s office for Headguard training! So- I got to talk to Bruce and Jessica and a few of the others! Unfortunately, I didn’t get off the phone till past 3am (my time), so it made getting up at 7am not so easy.

Coogee was great, though! It is a smaller beach than Bondi- and has a much steeper shoreline. There were no waves, which wasn’t very good for body surfing, but was really nice for swimming and a quiet morning at the beach. There were lots of surf lifesavers around- practicing on paddleboards, surf skis and swimming and running up and down the beach. I think it might have been a club practicing. We stayed at the beach till about 2pm and then headed back to the city on the bus.

Monday was my longest day at the hospital yet. I left my apartment at about 6:30am and got home at around 8:30pm. It was pitch black out when we left the hospital to come home.
In the morning we had a long session on Basic Life Support. It felt like 3 weeks of headguard training squished into about 3 hours. It was a really good review, though! We had manikins hooked up to machines which told us if we were compressing the patient properly (hard enough and fast enough) and if we were getting the right amount of air into the lungs. It’s amazing how much energy it takes to do the new CPR standards properly! No wonder you have to switch every two minutes now. We also learned a lot more about AEDs and about the pericardial thump (which can apparently work)!

After our usual lunch and lectures (grand rounds), we went down to plastics again to see some more suturing. The registrar/attending doctor there is really nice and he pretty much lets us do whatever we want! He told me to take out some stitches, but I didn’t think I was ready. I think I’m going to go back and do it next week though- cause it really doesn’t look very hard.In the afternoon we met our new tutor. His name is Dr. Sew Hoy and he is an orthopedic surgeon based in Manly. He was really organized- gave our group of 6 a personal power point presentation, handouts and then did an example hip examination on me for the group. After that we got into partners and did examinations on each other. He gave me all kinds of tests that I could do on Dad, but I don’t think I’ll be able to now that Dad’s surgery has been pushed up to June 7th!In the evening, we had another 2 hour lecture on ‘party drugs’ (mostly about GHB, ecstasy, and methamphetamines). It was really interesting, but didn’t finish till 6:30 pm!
Our case of the week is ‘Heroin addiction’, which we should be finished tomorrow. Next week is a motor vehicle accident, but we don’t know what happens yet!

I’m going to bed early tonight because I am going swimming at Coogee beach with my friend Martha at 6am tomorrow morning. I found out that she drives there every Tuesday and Thursday mornings to go swimming- so I’m going to try and tag along from now on.

Hope everyone is doing well at home. I miss you all so much!! xoxo

Wednesday, May 2, 2007

So we are now officially finished our first block of the program (which was apparently meant to get us thinking like doctors!). We finished our last case (on Tuberculosis) last week. It was a really involved case an we learned a lot, but the most interesting thing that we learned was that approximately 1/3 of the world’s population (as in over 2 billion people) are currently infected with tuberculosis. Isn’t that crazy?!?!? Luckily, as you probably know, it stays latent in most people for most of their lives. (Dad and Brent- I’ll send you the flow charts when I’m done them, but this one might take a while!)

Our case this week is about alcoholism and substance abuse. It is a pretty interesting case and we’ve already had a lot of interesting lectures on it. We also have a new tutor for our PBL sessions. She is not a doctor (she’s doing her PhD in pathology), and she has told us that she doesn’t really know much about what we are learning, but I think she will be good for us because it forces us to look things up in text books. Here’s a picture of my last PBL group. The guy in the red shirt was our tutor. Last Tuesday I went on a student- organized boat cruise in the harbour at night. It was really nice and Janice and I took lots of pictures. I strongly recommend doing this when you ALL come to visit me (soon)!
I had a good weekend- but it ended up being busier than I would have liked. I went to watch a Rugby Union game at the university on Saturday with Brooke and Janice. Brent’s friend, Alphabet, invited us to come since he was part of Manly’s first aid team. It was kind of neat to be there (for free too!), but despite having played a season in high school, I really had no clue what was going on. After the rugby game, we went to a housewarming party at Jacqui’s house. They had a really good barbeque and a massive gelato cake for Bryan’s birthday- it was probably my first real meal since Fiji! On Sunday I got up pretty early and went for breakfast with Janice and Brooke in a really nice suburb called Glebe. If Brent is here by next year I’d really like to live there! (Brooke lives there now and it totally reminds me of the beaches- but with no beach :(…) In the afternoon I went to St. Paul’s college to play croquet with Sadiq, Len and Jacqui. It was actually really fun and there were even organized wine breaks added in to the game.After croquet we had dinner at a Japanese restaurant on King St. right around the corner from my apartment. It was great!! And another real meal! :)

This past Monday was “Drug and Alcohol” day at the hospital. We had a couple presentations from ‘drug and alcohol’ doctors and nurses and then got to meet and talk to some patients (and hear their stories).

The first patient my group saw was a 20 year old girl who was almost 5 months pregnant. She had done almost every drug out there, but was mostly only using speed, cannabis and tobacco now that she was pregnant. She said she was planning to quit smoking cigarettes by 28 weeks, but that she didn’t think she’d be able to quit the other drugs. She had tried to commit suicide several times and had track marks all over her body. She’d inject any drug into almost any vein she could find (including the veins in her ankles- which is a really bad idea). She had started university when she was 17 and was planning to become a nurse, but dropped out after about 8 weeks. She also had a fiancé- but he left her after her substance abuse became such a problem.

The second patient we saw was a 62 year old woman. She had polio when she was very young and had been through over 50 operations trying to fix her legs. Eight years ago, she got a staph infection in one of her legs and had to have it removed (in a hurry). Her husband also died two months later of cancer. There were apparently a lot of nerve endings in the woman’s leg that were left somewhat exposed, so she has had severe chronic pain since then. The doctors at the hospital gave her morphine in increasing doses since her leg was removed- until she of course became dependent on it. She has been taking the maximum allowed dosage for the past 3 years. When she decided that she wanted to stop taking it, she went to see a doctor who told her to go home, drink a coffee, take a nap and stop taking morphine all together. Of course, within a few hours, she was in severe withdrawal and had to be airlifted to a major hospital to save her life.
She has not had any morphine since that last hospital visit. She says she felt cheated because she didn’t even know that she was being given morphine (at first), let alone that she could become so dependent on it. She refers to herself as a recovering morphine addict (even though it was medically induced). She’s trying to deal with the pain in other ways now and she says she’s very lucky to have a supportive family around her.

The third patient was a 34 year old woman (who had a 6 month old baby with her) and who was a customer at the hospital’s methadone clinic. Methadone is a synthetic opioid that can be used as a substitute for heroin. (For people who are dependent on heroin, methadone maintenance can help to reduce the harms associated with injecting an expensive illicit drug of unknown strength and purity.) This woman had been taking methadone (at methadone clinics) for over 7 years, and before that was addicted to speed and heroin. She has had two methadone babies (who she claims are healthy). She recently separated from her husband because she realized that they had nothing in common except for their drug habits and they were constantly relapsing when they spent time together. She hid her addictions from her parents for almost 15 years.

The last patient we saw was a 36 year old man who was an alcoholic. He was well-spoken and looked unbelievably put-together and relatively healthy, except for some freshly sutured wounds on his face. He went to Sydney University for his undergrad and then to teacher’s college. During university he drank a couple times a week as well as some binge drinking on the weekends (which is not unusual for a university student). He became a history and science teacher and taught for 8 years before he lost his job. He also got married when he was 24, but his wife left him when his alcohol abuse became really bad. He had been through detox programs over 20 times, and had even stayed sober for over 2 years at one point- but he’s always relapsed. He says AA works for him, but only when he goes. On Sunday, he was looking into homeless shelters that he was planning to stay at when he got discharged from the hospital on Wednesday, but luckily his parents decided to let him come home for a few months to give him one last chance. He always had somewhere to go in the past, so this was the first time he was going to be homeless. It gave me a little bit of a different perspective on some homeless people after hearing his story. I really hope he is able to stay sober.

I’ve been trying to scare Jamie into drinking less (jokingly) by telling him that he is going to get man-boobs, become impotent and will have shrunken testicles- but it doesn’t seem to be working. He he he. (Those are real effects, though!) I’m going to list the long term effects of alcohol for all of you- since most of us drink at least a little- and it is really interesting to see what it can cause! Here they are: mouth, throat, esophagus and lip cancers, brain injury, loss of memory, confusion, hallucinations, high blood pressure, irregular pulse, enlarged heart, changes in red blood cells, muscle weakness, loss of muscle, flushing, sweating, bruising, inflamed stomach lining, stomach bleeding, stomach ulcers, greater chance of lung infections (including tuberculosis), severe swelling and pain of the liver, hepatitis, cirrhosis, liver cancer, inflamed pancreas causing pain, tingling and loss of sensation in hands and feet, impotence, shrinking of testicles, damaged/reduced sperm, damage to fetus if pregnant and lots more. In case you are wondering now- a recommended safe amount of alcohol intake would be 2 standard drinks per day for 5 days of the week (slightly less for women)…and you can’t save up all your drinks for the weekend!

In the afternoon, we learned some more about the different kinds of drugs. Heroin, Inhalants, Analgesics, GHB, Alcohol, Cocaine, Ecstacy (and other amphetamines), hallucinogens, cannabis… etc. We have to learn everything about all the drugs: street names (ex. GHB is sometimes called ‘Georgia Home Boy’), what it looks like, how it is made, how it is administered, what systems it affects, short and long term effects, what happens in an overdose, if there are any antidotes, tolerance and dependence issues, withdrawal symptoms, treatment options, mixing with other drugs, pregnancy and breastfeeding issues, and first aid.

Here are a few other funny street names that I definitely hadn’t heard before!
Heroin- “elephant”, “big harry”, “horse”, “homebake”
GHB- “grievous bodily harm”, “soap”, “Georgia Home Boy”

“Piss” is a common name for alcohol here- but I’m sure you’ve all heard that one before. This is a picture of one of my good Australian friends- Harry- possibly after having a little too much to drink... he he heAnyway, enough about the drugs. After the hospital on Monday, I got a ride to Ikea, which was great since I needed a few more things for my apartment. Tuesday I had a long day of classes and Wednesday I had no classes at all, so was able to catch up on cleaning and some studying. Only 52 days till I get to come home! I can’t wait!

Here are a few pictures of my ‘kitchen’ and my bathroom. One more quick thing from me! This is really random- but Dad is always telling me to floss my teeth and I’ve never been very good at keeping up with it on a daily basis-! BUT I’ve recently started flossing my teeth in the shower and I seem to be able to get it done every day that way! I don’t know why it seems like less of a chore this way- but it does! So if you’re not very good at your daily flossing, I highly recommend trying it! (I’m not sure what Tom would say about its affect on my ecological footprint and wasting water, but better oral health could equate to a lot of money, time, and resources being saved, so maybe it would equal out?!?!) he he he.

Miss you guys!