Last Tuesday I had a really good day. Today was less so. As much of the miserableness involved people who control my grade and my little blog is technically a public forum, I will just leave it at that.
This week I started my two week stay in the hospital's geriatric clinic. Not my particular cup of tea, but it should be survivable for the short duration. I had an interesting experience today looking back through the chart of a very elderly patient. Currently about 85 years old with several serious health conditions, she needed of a good deal of assistance with her daily activities. As with any patient, I read-up on her recent admissions and notes from the doctors who had taken care of her. I learned a good deal about her medical history, but very little about her personal life - her story.
So then I dug into the social workers' notes. These provide great details about a person's living situation. I was surprised to find electronic records going back over ten years to when the patient was about 70 years old. And suddenly I realized that I had the documented history of one woman's journey into old age and frailty. each successive note showed how a heart condition or fall changed what she was able to do and how she was able to live.
I realize that the sorts of records have always existed in some form, but with the adoption of electronic medical records, it will become so much easier to essentially read the (very dryly written) story of someone's life through their interactions with the medical field.
TIL: AICD stands for artificial internal cardioverter/defibrillator.
The Beers Criteria is a list of drugs that should be used cautiously in the geriatric population. When it was first created in 1991 by Dr. Beers, it was a very simple, one-page tool to help prevent needlessly dangerous prescriptions. The most recent version is a dozen pages of very specific guidelines. Not sure if that's really serving the same purpose anymore...
While researching the Beers criteria, I learned what a non-anti-infective medication is. I'll let you read that one more time: non-anti-infective medication. What? Despite how it might seem, the negatives do not cancel out, which would make these simply infective medications. Actually these are medications other than those used to kill or weaken infectious pathogens such a bacteria, viruses, fungi, and parasites.
Endoscopic ultrasound is a nice alternative to MRCP for imaging choledocolithiasis.
Whereas gallbladder pain radiates to the chest and shoulder, the common bile duct radiates to the flank and back.
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