Finished BLS and ACLS

Since I shall soon be starting rotations in hospitals, I had to go through BLS (Basic Life Support) and ACLS (Advanced Cardiac Life Support) training and certification. Didn't take too long, and BLS was a recertification so that was no challenge - ACLS was a lot of new material and new sequences of information, along with a refresher course on EKG reading so that was fun! I particularly liked the instructor, as he had 42 years of experience as a paramedic and emergency department (ED) technician so he had lots of case examples to share with us.

Some take-away points for normal people which I feel I should mention - as it may save you or a loved one one day:

3 main things to know for CPR

1. Are they breathing? Do they have a pulse? (if no...)

2. Have someone call 911 and tell them to try to find an AED (often in hospitals, schools, major office buildings, gymnasiums) - no use doing CPR if no one is coming to help.

3. Chest compressions - fast and hard - at a rate of at LEAST 100/minute, so we're talking about 2 compressions per second. When you do compressions, middle of the chest (approximately between where the nipples are), compress about 2 inches into the chest. On kids, 1/3 of the way. *FYI: If you are doing compressions properly, you may very well end up breaking their ribs - don't let that stop you - keeping heart circulation going is much more important than a broken rib or two*

If you are comfortable doing mouth-to-mouth on this person (child, husband, etc.) do only 2 breaths, head tilted back, covering nose, and then go straight back to compressions -compressions are WAY more important, so alternate 30 compressions then 2 breaths.

Another take-away note about Strokes...

If you or someone else starts having signs of a stroke (one sided muscle weakness, face drooping on one side, difficulty speaking) - CALL 911 - DO NOT DRIVE THE PERSON OR YOURSELF (unless you are less than a block from a hospital MAYBE). Reason? You may feel well enough to drive yourself, or you may think you can drive your family member, but if an ambulance picks them up, then not only will they get en-route care, the hospital they deliver the person to will be completely prepared, with the neurologist, cardiologists, etc. all notified and ready to take care of the patient. It can take 45 minutes of assessment and evaluation once you get to the hospital before they decide it's a stroke and can do any therapy - by then, it may be too late.

Why is this so important? Fibrinolytics - you basically have a 3 hour window where you can be given a medicine that will essentially dissolve the clot in your brain. I have known people who drove themselves while having a stroke, or who started having a stroke in the middle of a golf course and played through to the end before going to the hospital - if you want that shot at a Fibrinolytic, which will GREATLY INCREASE your chance of restoring brain circulation, get to the hospital ASAP.

Bottom line: If you have a loved one, pass on this information so they get the fastest possible care, or so they know what to do if this happens to you. Time makes a MAJOR difference when it comes to blood not getting to your brain.

Enough with the public service announcements though - time to get back to studying for board exams! Wooh! Diuretic medications.

Nose Deep in Clinically Oriented Anatomy

One of our largest, densest texts is Clinically Oriented Anatomy, which our anatomy professor, during his very informal first class, told us we didn't really need to read in much depth. I think that was very misleading (he just wants us to read the easier beginning anatomy text he wrote himself). Also, they put up a lecture powerpoint for the anatomy lab, and even have a section on the schedule which logically is the lecture for the lab, but apparently we are not being lectured on the anatomy lab lecture powerpoints, so we have to go over them in depth beforehand by ourselves if we want to know what's going on in lab. I also know I wasn't the only one - no one else in my group knew what to do either. I don't think they were very clear with us about that, so I feel a little betrayed, but what can I do.

...except go into insane overdrive. Now I'm taking it upon myself to learn all human anatomy without the aid of lectures. Since we're also starting embryology and histology next week, I feel a pressing need to memorize the anatomy stuff before we start those subjects. I wish I had taken physiology or embryology as an undergrad - it would have made things easier for me now, and probably next week. I also dropped my phone in the toilet recently, so I went to Verizon and got a new phone - a PDA since there are some medical apps which are apparently crucial during rotations 3rd year. I ended up getting the Blackberry Storm - 8gb, all touch. I can't stand those little roller balls on the traditional Blackberries. Anyway...back to COA.

Caffeine and Touro

Well, I submitted my second deposit to Touro-CA for $1,000 today. I am really horrible with fax machines and phones - I don't know how to transfer calls for one, and I am so used to my cell phone I forgot that all other appliances require a "1" before an out of area phone number, so I wasted 5 pages thinking that the machine on the other end was busy (the option is busy/no response). I am getting more and more used to the idea of living at home again - I almost look forward to it. It'll be my last chance to really be a part of the family again, before I'm a truly independent adult and starting a family bud (only scientists can think of yeast while talking about starting their own family). Also, the prospect of saving an estimated 17k per year is very exciting - nearly 80k cut off my loans. The commute would be great also - 35 minutes each way, no traffic. Whether I stay at home more than a semester hinges on how well it works out for me, and for Kit (my boyfriend). Being long-distance and not having my own place will be difficult. We've worked out a contingency plan though, so we're prepared.

On an unrelated note, my cognitive science textbook has some very interesting tidbits thrown in, most recently on caffeine. It is a cool mechanism - as we are awake, adenosine accumulates in the brain and is thought to induce sleepiness. Caffeine acts as an adenosine antagonist, so it competes with adenosine for binding spots on adenosine receptors, but does not produce drowsiness when bound to the receptor. As more adenosine receptors are tied up with caffeine and not adenosine, the accumulated adenosine has a weaker effect. This explains why using caffeine too late has no effect, and why you "crash" after ingesting a lot of caffeine. First, if caffeine is administered after adenosine molecules have bound to a significant number of receptors, then you will be too sleepy for the caffeine to reduce the effect much. Second, if you have caffeine in the receptors, adenosine accumulates in the space near the receptors, so when the caffeine dissociates from the receptors you get a rush of adenosine binding and the subsequent drowsiness.

How I Got Here

If any other pre-medical students or passerby are curious as to what activities and qualifications got me to this point, that is the purpose of this post. With that in mind, here is my combination of activities, with minor activities left out:

• 4 years member of pre-med student org, 1 year social chair, 2 years president - involved coordinating CPR training, volunteering in Mexico, guest speakers, etc.
• 1 quarter and a half of research (Autism)
• Certified phlebotomist, worked at Kaiser for 3 years
• 7 months shadowing D.O. physician
• Double major, Biochemistry and History
• GPA: Overall 3.4, BCPM 3.1; MCAT: 32R
  

I only write this for the record, or so I can refer people here later. In the meantime, I am anxiously waiting to hear from TUCOM-CA, and the interview at WesternU is next week! I have a good feeling about this!

As an afterthought, I had the pleasure of attending my history of ancient Egypt class tonight. We covered the relevant topic of ancient Egyptian medicine. Several interesting tidbits came up. For one, Egyptian physicians were exalted, of course, and even more specialized than medicine today - each physician specialized in a particular ailment (head trauma, stomach pain, broken legs, swollen throat, malaria, tuberculosis). Imagine going to the hospital and seeing the "influenza doctor" for treatment, or the "lower back rash" specialist. At that time, it was probably feasible - as they could not easily differentiate intestinal blockage, swollen appendix, or extreme diverticulitis - it would all fall under the jurisdiction of the "lower stomach pain" specialist. Today, there would need to be at least a thousand physicians in a single hospital to match the number of known individual diseases, symptoms, and conditions. As for their treatments, they used pills, liquid drops, liquid, food, and combinations. Some common effective treatments were castor (oil, fruit, root), prunes, and coriander for digestive problems. Fitting that many of the earliest treatments involved herbs or foods which affected the digestive tract, such as anti-diarrheals, laxatives, diuretics, anti-diuretics, and gas/bloating relievers.