Saturday, March 14, 2009

Being the Patient

So in the past month I have been sick with the stomach bug two different times. Both times I was vomiting and having diarrhea for like 4 days. It has caused me to miss clinical days - which is a big deal and has really messed me up. It put me in the bed for like four days. It got me behind on my homework and study schedule. And it caused me to have a sore rectum.

This last time was much worse than the first time. I lost a lot of fluids. It got to a point when I wondered if I even had anymore fluids in my body to lose. It was bad.

The problem though with having medical knowledge and being sick is that you know too much. Case in point. I had gone to bed this past Sunday evening around 9:30 with the hope of sleeping all night and feeling revived in the morning. Around 11:00 I woke up with horrible stomach pains and quickly found my way to the bathroom. I was in their for a while. I was sitting there and began thinking about my plight. My train of thought was as follows:

I've lost a lot of fluid the last few days. I know I'm dehydrated. I haven't eaten in like 3 days. Plus my electrolytes must be way out of whack. I know that I must be hyponatremic and hypokalemic. Those are cations. Losing cations leads to a state of metabolic acidosis. I bet I'm getting ready to start hyperventilating in order for my respiratory compensatory mechanisms to kick in. I wonder if my hemoglobin in low? If my hemoglobin is low and I start hyperventilating then I will become hypoxic. Hypoxemia could lead to confusion and coma. I wonder if I go back to sleep if I will just go into a coma. Plus my current state of hyponatremia can lead to confusion. That's not as bad as my state of hypokalemia. That can lead to muscle cramps and heart attacks. I bet I'm going to have a heart attack. This is how I'm going to die: sitting on the toilet in a dehydrated state. It would kind of be embarrassing if I died and my pants were pulled down. Oh well, I guess I'll get back in bed. It would be better to have a heart attack there anyway. I'll probably start having muscle cramps soon. That will be annoying and painful. Ideally I can go to sleep before the muscle cramps start, then I will go into the coma and have the heart attack. I am begining to become short of breath and I can't get comfortable. I know this is because I'm getting agitated due to hypoxemia (Actually it was because my sports bra got twisted when I got back in bed and I couldn't breath, I never sleep in a sports bra, but I was to sick to take it off when I went to bed earlier.). I'm so exhausted. I feel the coma coming on.

So I fell asleep. I woke up the next morning. I had no muscle cramps, no heart attack, and I don't believe I was in a coma. My stomach bug resolved within 36 hours. I never get sick. I don't like to get sick. But looking back, it sure was funny.


Today was day 1 of 2 of my FCCS course. FCCS stands for Fundamental Critical Care Support Course. It started at 7:30 this morning, so that meant that I needed to be up by 5:30 a.m. Whenever I have to get up early, I don't sleep well - I worry in my sleep. This has resulted in me waking up many times in the middle of the night, in the shower about to turn the water on to begin my day. Fortunately 75% of the time I wake up before I turn the water on. (I tend to go back to sleep better if I'm dry.) Last night I was having dreams about patients with subarachnoid hemorrhages and was up at 1:30 this morning trying to get ready for the day. I woke up thinking my alarm had gone off and then I turned it off. I realized it was the middle of the night reset my clock and went back to sleep. So I reset my clock, but I didn't turn the alarm on. So I needed to get up at 5:30 and leave my house no later than 6:40. I woke up at 6:49. I got to school at 7:25 - class started at 7:30. I was freaking out. If we were more than 10 minutes late to the class, then we got kicked out - so I barely made it. It took me a while to settle down.

So the FCCS course was fast and furious - what else is new?? From 7:30 until 1:00 we had 10 30 min lectures straight. We covered a lot of topics very quickly. The afternoon was comprised of 4 labs. The labs were a lot of fun. Two were simlabs with patient scenarios. So we had manequins and they both crashed and we had to save them and give them drugs and intubate them and everything. It was fun and they both lived and so it was good stuff. The other two labs focused on mechanical ventilation. We talked about vent settings and played with some of the ventillators. One of the two labs we had a pair of pig lungs in a jar hooked to a ventillator. We turned them up and down and watched the pig lungs inflate and deflate. It was really neat and I enjoyed it a lot. the instructor for the lab station was an Indian doctor from the SICU and he was hillarious. We had a really good time with that.

Tomorrow, on day 2, I have to take a test at the end of the day. I have to pass with a certain percentage in order to become FCCS certified. I really hope that I do well, but the pre-test I had to turn in by 7:30 on day 1 was very hard. It was 15 multiple choice questions and took me about 2 hours to answer. Tomorrow I have an hour for 60 questions. I'm hoping to be faster and do well. If I don't get certified though, then it'll be okay.

So overall I really learned a lot today and had a really good time. I look forward to tomorrow and really hope that I don't turn my alarm off in the morning.