Visceral Leishmaniasis (aka Kala-azar or black fever… both of which are much cooler names)
Bechet’s Disease (at least we think this guy had Bechet’s disease… really weird constellation of symptoms… rheumatologic diseases are weird)
XDR Tuberculosis (Scary scary scary)
Intestinal Histoplasmosis
Guillian Barre Syndrome (guy is totally fine one day, can’t breath or move the next. crazy to see it unfold)
Granulomatosis with Polyangiitis (originally known as Wegener’s Granulomatosis… this name is apparently not used anymore cause Dr. Wegener, the guy who originally described the disease, was a Nazi)
Silicone Injection Granulomas (apparently a lot of transgender people in this area inject silicone into their bodies cause it’s cheaper then getting it done by a professional. only problem with this is that it leads to granuloma formation, disfiguring skin nodules, and cancer)
Cerebral Palsy (first time seeing this so that was pretty cool)
Horseshoe Kidney (first time seeing this too. This guy was also the guy with visceral Leishmaniasis. unlucky guy.)
This is just a list of the things that I personally saw. Also, these are all cases that came in during the last 4 weeks. Elmhurst is full of some weird stuff. Seriously.
*I didn’t include any pictures of the diseases cause I’m pretty sure all my non-med student friends would hate me…
So I posted a while back about my fear of getting tuberculosis at my hospital because we have such a high rate of it here. Well, we currently have a patient on the floor who has XDR tuberculosis. Now before I get into that let’s learn a little bit, shall we?
Tuberculosis sucks. But hey, we have an immune system so it’s less likely we’ll get it and if we do we just need to take some anti-tuberculosis drugs and bam, we’re ok. You just can’t drink alcohol for the 6 months that you’re on these drugs. No biggie.
But wait, then there’s MDR Tuberculosis. Multi-drug resistant. Dang, that sounds horrible. It is. This stuff is resistant to isoniazid AND rifampicin, 2 of the best drugs for tuberculosis. First-line drugs are now a no go. Alright, well we can move onto our second line defense. These drugs cost more, have more side effects and you have to be on them for even longer than our awesome first line drugs. Duration of treatment starts going into the years and death rates remain high despite optimal treatment. That sucks but hey, at least getting better from this is still in the realm of possibility.
Now let’s bring it back to our patient. She’s got XDR tuberculosis. Extensively drug resistant. This stuff is resistant to first-line AND second-line drugs. THAT SUCKS. So basically having XDR tuberculosis sucks. Oh yea, this lady also has AIDS and is most likely never going to the get better. It’s a horrible story of unreliable medication use leading to horrifying strains of already scary bugs.
Now let me get to the scary part.
She has kids. These kids go into her room without masks on. And then these kids leave the room without masks on. This happens multiple times. WHAT THE HELL. How is this ok? I don’t understand. I DON’T UNDERSTAND. This is horrifying. These kids are probably getting XDR tuberculosis and spreading it to EVERYONE (I’m exaggerating… I think…).
I feel like I need to get weekly PPDs.
Been a while since I’ve done fancy food pictures. Cajun butter seasoned tilapia with lemon juice and cherry tomatoes. So flaky and delicious.
So I started my internal medicine rotation today. I came in expecting long hours, lots of scut work, and tiredness.
Instead I got an awesome resident, free lunch (I knew about this one but hey, still exciting), two coffee breaks totaling about an hour long (none of which I paid for), a walk outside around the local park (a really nice day out too), saw a couple of interesting cases (intestinal histoplasmosis? so weird. also saw cerebral palsy for the first time. crazy seeing it in real life), had a chat with a pretty funny attending (we talked about cars and how awesome beaches are), and left at 4:00pm.
My thoughts while leaving today?
(Me having a dance party in my brain)
I always feel so relaxed listening to this song.
So I recently fell head-over-feet in love with this outrageously delicious bacon cheeseburger at F. Ottomanelli Burger & Belgian Fries in Woodside, run by the famous butcher of the same name down the street. The single is $5.39 (with unlimited free toppings), but of course I went with the double for $1.30 extra. For one of the most affordable burgers in the area, it tasted like a million bucks. They even make patties with seasonings mixed in, like chipotle or roasted garlic. And the truffle parmesan aioli for the fries is outrageous. F. Ottomanelli Burger & Belgian Fries, 60-15 Woodside Ave, Woodside; (718) 651-5544
I don’t know how I haven’t known about this until now.
Been a while since I’ve had a fully stocked fridge. One can never have too much kimchi… also 보리차 is amazing. Freezer is not as full but hey, I got my staples of pork, beef, chicken, and fish. And melona is love. Man, food makes me happy.
So I’ve been rotating through the child psychiatry partial in-patient unit for a little over a week now. It’s a program for children that don’t require full on in-patient treatment but come in for the majority of the day (9am-3pm) for activities, schooling, group and one-on-one counseling. It’s an interesting program but one that has been sort of difficult to go through. Talking to these kids is sad. Extremely sad. The things they have been through and are currently are going through kills me inside.
12 year old kids talking about a lifetime of physical abuse and then talking about how he himself physically abuses his younger siblings because of his anger.
10 year old kids talking about being sexually abused and wondering what they did wrong.
A group of kids finding a chart depicting signs and symptoms of bipolar disorder and pointing out 6 or 7 things on the list that resembles them.
Broken families. Drug abuse. Skipping school. The list goes on and on.
A 13 year old girl today told me that she had tried to kill herself back in December because of how sad she was about how her father treated her. When her father had discovered her he apparently had said, “If you wanted to kill yourself, why didn’t you?” The girl didn’t show any emotion while talking to me and I felt crushed inside. When I asked her what her greatest wish would be, her answer was, “to be happy.”
More than anything it really just makes me thankful for everything I have and how important it is to have a positive environment when growing up. I’ve been blessed with amazing loving parents so I can’t even imagine the kind of things these kids have been through but watching them in the program and catching them smiling and laughing while playing games does bring me hope that one day they might be able to find this happiness that they so desperately seek.
“What do you think? If a man has a hundred sheep and one of them has gone astray, does he not leave the ninety-nine on the mountains and go in search of the one that went astray? And if he finds it, truly, I say to you, he rejoices over it more than over the ninety-nine that never went astray. So it is not the will of my Father who is in heaven that one of these little ones should perish.”
-Matthew 18:12-14
Top 5 regrets of dying from the blog of a palliative care worker here at
http://www.inspirationandchai.com/Regrets-of-the-Dying.html
1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.
It is very important to try and honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it.
2. I wish I didn’t work so hard.
This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.
By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.
3. I wish I’d had the courage to express my feelings.
Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.
We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.
4. I wish I had stayed in touch with my friends.
Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.
It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.
5. I wish that I had let myself be happier.
This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.
When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.
