Tuesday, August 01, 2006

First day at VA

Today was my first day at the VA—it went very well. Everyone on my team (an attending, a senior resident, two interns, a fourth year student, and another third year student) is very nice and I think it will be a fun rotation. I have two patients whom I will follow til they are discharged. One is a man with endocarditis (bacteria growing on one of his heart valves). Once the infection has cleared, he will have to be given IV antibiotics for more than a month. The problem is that he is a drug abuser, and therefore cannot be released to his home if he has a direct route into his bloodstream. He will have to go to a transitional home until the line can be taken out.

The other patient was admitted this afternoon, and I will have to present him to the attending tomorrow. He has a history of heart failure which started worsening two days ago when he stopped taking his diuretic. His legs were huge, and had severe pitting edema (when I pushed my finger on his leg and then removed my finger it left a dent in his leg). Treatment will consist of restarting him on the diuretic, hopefully he can go home in another day or so.

I forgot to mention yesterday my best case of the day: earwax removal. The doctor had to irrigate the man’s ear until nasty chunks of wax started coming out. Then, he accidentally splashed himself, so he had me finish the irrigation while he cleaned himself up.


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