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Saturday, March 11, 2006
Sick as a dog...
Actually that is not quite true. My dog is nice and healthy. but I am sick. Well, I wasn't for a long time, with the occasional cough/sniffle. Last night, after coming back from F1 teaching, I started feeling not too well. My body started aching, and I felt lethergic. Not good, especially when i was intending to go to the gym yesterday evening. And so, I just lounged around my comfy chair for an hour or so. Feeling even worse, I went to bed. When i woke an hour later, I was burning up (temp of 40.8), and having cold sweats, and a heavy head. Despite lots of water, paracetamol, felt very unwell, and so headed back to bed, where I tossed and turned for another hour plus before finally falling off to sleep. Woke up this morning at 6am to sputum production of blobs of blood mixed in with yellow muck, and dizziness and more water. Thinking that wasn't too good, I dutifully went back to bed. And woke at 10am, feeling slightly better. Still have a residual fever, a heavy and dizzy head (which seems as if there are metal balls in my head knocking itself together), a dripping nose of yellow much and no more blood at present, and myalgia. Having a bit of toast and coffee makes me feel a bit more human.
No way am I presenting myself to the hospital. Don't think it's serious enough to warrant that. Besides, i already work there. I don't intend to stay there. Unless I start having chest pain and haemoptysis, then maybe I'll reconsider. For now, it's just inertia and immobility in my comfy chair. =)
Span of 3 weekends
Let's see now... ever since the last entry... Started on my applications - first draft in Feb, and left it alone till last weekend. When reality hit that it was the last weekend before the deadline on Friday (10/3), I frantically rushed it, and thanks to CL, stayed up till 4am on Sat to finalise it to almost perfection. I owe him one. =)
In this last week, I spent most of the time, trying to sort out my choices (of a minimum of 40). Finally got it sorted a couple of hours before the deadline, and submitted my application. Now is just the waiting game.
Spent 2 out of the past 3 weekends in London. On one of them, I had to rush down after teaching to London on Friday night, to make it for the SMSL dinner on 24th Feb. Supposed to start at 7.30pm, but I came at 8pm. It was held at Sofra, in Covent Garden, and it actually was quite nice food, a bit cramped though. Overall, it was good to see some of the juniors again, and to see some of the UCL lot of WM, Gaja and Shyan! She was one of my dancers for HCN 2002, when I was organising it, and we haven't met up in ages! It was good to catch up a little then. =)
Spent the Sat of 25 feb in central. Met up with Les and his friends (they all flew down for revision courses for the final part of their specialist exams), and brought them around. Well, not really, but brought them to Belgos for lunch, where everyone was talking about working in Singapore vs UK etc (4 of his friends graduated from UK), and how life is like at home. Then we went medical book shopping. and then proper shopping! Before some of us headed to Russell Square to have proper authentic Italian food. Simply delicious! =)
Just thought I'd mention this as it made me quite happy, amongst all the stress of applications. I had sent my application to my ex-SHO (in surgery) to peruse and comment. The night before, I was on-call in MAU/A+E, and clerked in this old lady who had a 10-day history of breathlessness, not getting better with antibiotics. No previous past medical history of admissions or heart problems, etc. And that night was the first time she went to the hospital. On examination, there was decreased air entry in both lungs, and there was dull percussion note in both lungs up to mid lungs. CXR showed ?bilateral effusions ?pulmonary oedema. My impression then was of acute pulmonary oedema precipitated by a chest infection, and which has resulted in bilateral pleural effusions. However, there were funny fluffy shadows in the apical regions of both lungs. ?cancer, but she was a non-smoker (and her whole family doesn't smoke), never drank alcohol. But anyway, we diuresis-ed her. By that time, I went back home. The next morning, when I came in, I heard that she had an arrest at night, was resus-ed and rushed up to ITU, where she was doing very well, till they extubated her. Within seconds, she had a respiratory arrest and despite resus, she died.
But anyway, my ex-SHO (MC) had emailed me back about my application, but she added a bit about my clerking of this lady (she was on-call on ITU that night)... 'your history on Mrs X was yr2-3 SHO standard and your interpretation of investigations and management plan were better than many SHOs by far (she came to the unit last night and i thought i recognise that handwriting!!).'
Heee.... I was pleased by that, but not too happy that she had died. Thought I had missed something. PM of that lady showed 1a) right Pulmonary embolus, b) metastatic uterine cancer, 2) malignant bilateral pleural effusions. So yes, I had missed something on hindsight - didn't put her on prophylactic fragmin. Crap....
Then talking to MC the night before about what posts I should be applying for, etc. I brought up several posts and was wondering in which order should I be putting them, and so asked for her opinion, with what she has seen of me so far, how I worked, how I managed patients, etc. I value her opinion a lot because she has seen me at work, and outside as a person, and she is not afraid to say what she thinks. MC said that I am good enough to start an SHO rotation - history and examination and management of patients, and that I shouldn't be wasting my time on this F2 rotation trying out various specialities, and if I know what I want to do, I should just go for it. Somehow, in some part of me, I believe her and I know I'm good enough for that. And yet, some other part of me is holding back and saying to myself, I might not be that good after all, especially if I can still miss things. Haiz...