WILTIMS #343-344: Coffea arabica 12oz PO QAM prn fatigue

Pain indeed

The past couple days were a roller coaster of emotions and activity. Yesterday everything I touched seemed to go wrong - sometimes by my own hand and sometimes by the cruel hand of fate. Today, all is well.

Amidst the series of disasters yesterday, there was a pretty interesting lecture on radiologic findings in pediatrics. The dark room very nearly put me asleep, but the topic was interesting enough to keep me semi-conscious. An hour and one game of "find the fecalith" later, we stumbled out of the conference room. Then a surprisingly big moment occurred: I went and got coffee with my classmates.

I have never been a coffee drinker, and by that I don't mean that I like tea more than coffee but rather that, excluding one cup accidentally served to me with dessert at a family dinner, I have never had a cup of coffee. My joke has always been that I'm saving it for med school; I guess the time has come. I was exhausted, it was morning, soda/tea just wouldn't cut it: I needed some coffee.

And then, of course, I immediately did two things: I burned my tongue and I spilled on my patient list.

WednesdayIL: A normally inflated lung goes down to the 9th or 10th rib... unless the patient has abdominal distension. Then it becomes a physics problem. If the abdomen is pushing up against the diaphragm just as hard as the overinflated lung is pushing from above, then the lungs will appear to be normally inflated, even though they are at a much higher than normal pressure.

Cardiomyopathy (heart muscle disease) in patients using TPN (total parenteral (injectable) nutrition) is likely caused by a deficiency in the element selenium.

Look carefully at an x-ray of a swallowed "coin" in a child. A dime is fine to go through the digestive tract; a watch battery is not.

TIL: Scoliosis causes respiratory difficulties not because the bend of the spine constricts the lungs, but because the curve offsets the left and right sides of the chest, restricting the normal "bucket-handle" motion of expansion of the chest cavity.

Normal bucket-handle expansion