I've been taking a Foundations of Clinical Medicine class for the past few weeks, and to understand my story I should give some background info. Each week of FCM is like a mini rotation in preparation for the ones that I'll have this next year. So the first week was Ob/Gyn week, the second Psych week, last week was Peds week, and this week is Medicine week. During each section I've been assigned a different patient with a correlating disease for that field of medicine. I should note that these are standardized patients, a.k.a. actors who play up an illness. You gotta love those safety nets.
So this week I've been working with nine of my classmates on a case of a 54 y/o female with a history of significant alcohol use and Hepatitis B. Colby (one of my teammates) and I performed a complete history and physical on her, and of course her chief complaint was "I just don't feel right" x 1 month. nice. That's like going into the auto shop and saying "Um, there's something wrong with my car. not sure just what, but I can sense it. can you fix that? by tomorrow? grrreat." We got little from talking with her, aside from the fact that the day before she drank "half a fifth" and that multiple times a week she drinks before noon. In fact, when Colby asked if she drank to pass out, her exact words were "Yeah, on Fridays... and Wednesdays" and I chimed in "And Saturdays?" Yup. And Tuesdays, and Thursdays... She's a pro.
Her physical exam revealed acute liver failure. she's got severe jaundice, ascites, caput medusa due to portal hypertension. In other words, her liver has completely crapped out. If ever you are in a poker game where you find yourself betting organs, don't go for the liver. it's important.
Today she's now showing extensive signs of hepatic encephalopathy, which means that toxins are backing up in her blood and going to her brain since the liver can't process them properly. and she has an increasing fever which is difficult to treat since a LOT of drugs are metabolized in the liver. NOT GOOD. this is like One Foot In The Grave sort of news.
update: she's alive! our group rocked the house at treating her, and she pulled through. i knew there had to be a happy ending... after all, it's make believe.
3 comments:
I think that you should post more of your medical adventures *except of course for any HEPA violations...
I was throughly engrossed in what was going to happen to this patient/actor...
Way to go Team Jackie! One more actor goes on living! But seriously, very good job! I'm so proud.
Great job, Jackie!! I know this was an actor/patient, but things like this really happen in real life, too (and not good stuff, as well). It really is amazing what our body can do and how it can recover from near-death!! Keep up the great work! Just think - in on ly a couple of weeks you'll be telling us about real patients - and how you got to suture for the first time, etc, etc!! I can't wait to hear those adventures!
Post a Comment