synesthesia
June 25th, 2009
Crack.Attack.
June 9th, 2009
Had an interesting case at work yesterday - 49 year old guy was found passed out at 5am on his porch after mixing crack with xanax ( i guess people use the Xanax to curve the high) so he was shipped to our hospital for treatment for possible heart attack (the cocaine makes your coronary arteries spasm and gives lots of young people surprises- did you know cocaine is the most used drug in America??).
Turns out his arteries were fine - his problem was a massive blood clot in his lung arteries that was cutting off circulation to his lung- another risk of cocaine usage.. needless to say the guy is very sick, and for a while his head looked like a grape. I think he’ll pull through though.
Mi.Corazon.
May 7th, 2009
Heart transplants are tricky buisness, because in order to have good outcomes, the patient needs to not be too sick (poor organ perfusion over time will be problematic for organ rejection) - but sick enough to be elibible for a heart transplant. It’s not easy to decide and that is where the United Network for Organ Sharing (UNOS) is involved.
An interesting excerpt from their website:
Social criteria such as celebrity status, wealth, or prison status, are excluded from medical criteria and therefore are not permitted in consideration of organ allocation. Federal law permits use of medical criteria, not social criteria in organ allocation policies.
(source)
Under the UNOS policy 3.7.3(d) (yes, i looked it up under policies) part of the criteria for being at the top of the list for receiving a heart is being on a continuous infusion of a medicine that will be benificial in heart failiure for example Milrinone.
My patient today is on Milrinone, but he is not on a high enough dose to be counted on the 1a list, so we are giving him another medication to make his numbers look worse so that he will require more Milrinone, and be bumped on the list.
Shady buisness? Absolutely.
I just got done talking to our transplant coordinator and asked “is this cheating ?” Well no! Since of course, it’s in our patients favor. But where the ethical dilemma is, is what bumping someone UP on the list does to the person who WAS on the top of the list.. she didn’t have as much to say about that.
Chillax.
May 6th, 2009
My patient is in the MRI machine, which means I get to sit back and relax for the next 1.5 hours.. nice. It’s pretty chaotic today, and I can’t believe it’s almost 5pm! Sweet, almost done.
7 weeks to go before we do some switching up.
Today is nurses day so don’t forget to tell a nurse they need to shape up.
i got a free shirt, bagels and ice cream today. Pretty nice.
tweet.
May 4th, 2009
This weekend has been quite a whirlwind! Hanging out in Indiana, heading south today to wrap things up..
I’m trying out twitter and so should you.
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