Thursday, 24 February 2011

Twofer

Yesterday was something of twofer for me:

1) Onto the wards (briefly)! Practiced history taking with some lovely patients who were both engaging and actually knew the details of their medical history. It was great to sit and talk, smile and commiserate (not simultaneously, I hasten to add) and generally play Healthcare Professional. I even got to practice some skills (TPR, BP etc.) which was a nice opportunity to flex a little muscle memory and gave me chance to flick through the end of bed notes. It looks like St Clabert's uses very similar paperwork to the stuff I've used before, so that was comforting.

I've realised that I'm the kind of person that will use this blog to voice the times I'm really not in a great place, but I hope that I can use an equal portion of it to the times when things are going really well. I think it's just a facet of this year that due to its pre-clinical nature there will be more of the former than the latter ;)

2) I used to set-up Octreotide infusion for patients undergoing liver resections or Whipple's procedures and never really understood why. There was something called "carcinoid prophylaxis" that I was doing, but I never had the time to look into what it was and the relative importance of it. I knew that it could cause merry hell with their blood pressure and was potentially dangerous, but not the why behind it. That all changed when I talked with one of our lecturers who was a consultant endocrinologist. He was a really nice guy, who engaged with the class and spent a happy hour dropping knowledge bombs. It turns out that octreotide is a potent analogue of somatostatin and has a similar mode of action. We were using it pre-operatively to reduce the secretions of carcinoids - a bit like in this paper. This is the kind of knowledge I find really sticky. It interests me, has a clinical link and I can see this sitting in my brain for years to come.

2 comments:

  1. Dude if you wrote a post on octreotide and all those knowledge bombs and shit, I would totally geek out. That would be awesome.

    But I won't blame you if you don't. ;)

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  2. Sadly the knowledge bombs were mainly related to other hormones.

    I can construct something from his lecture, as I do need to revise it, but octreotide is only a small part of it :)

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