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I’m waiting to be tested for COVID (minor URTI like symptoms after returning from Northern Italy). Rather than stick out the 14 days I requested a swab so I can get back to work in ED. So I should be swabbed today with results back tomorrow.

My rota coordinator called and lamented at the isolation advice, and was wondering aloud if we could expedite things so I can return to work.

Yup, next day results are still not quick enough 🤷‍♀️

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@wayfaringmd replied to your post “Today in clinic I saw 0 patients, did 3 prior authorizations, and…”

Also obesity covers some screening things - screening lipids and A1Cs usually. And @irazuexperiment I do my own PAs too (though my partners don’t). I don’t have as many as they do though because you learn what will get covered and what won’t and you learn what will get a PA approved. It’s a good exercise, though in practice it does take up valuable time I don’t really have.

Yep learned that (and used it today when ordering labs).

My big gripe was that I was doing prior auths and hunting down acceptable ICD-10 codes for other residents’ patients, because that’s how our program does it (and I had twice as many to do because the resident assigned to the task the day before just…didn’t do any of them), and it was very frustrating since all of these things could’ve been avoided in the first place.

But hey, I’m learning. And telling the interns what I’ve learned so they’ll stop creating this work for me to do haha.

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@irazuexperiment replied to your post “Today in clinic I saw 0 patients, did 3 prior authorizations, and…”

@doctorspork hey wait a min , docs do their own prior auths at your practice? Do you feel like that takes time away from other things?

Yes and yes. It’s a residency clinic - I don’t know if other residencies have someone else who does them (and if so, I’m very jealous), but we’ve got poor funding and poor staffing, so we do them, and they suck, and I generally spend 3x as long on the phone with someone with 0 medical training trying to explain why my patient needs this medication than I actually do with the patient.

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100 days of productivity: Day 1

24/02/20 // So it’s officially 100 days until my last exam of med school fingers crossed so I’m going to be doing the 100 days of productivity, although to stop myself getting burnout etc, I will be counting productive rest days as well because self-care is important 

Had an unexpected day at home thanks to the snow (it would have been helpful if our tutor had told us before I’d already driven 1.5 hours to the hospital and got stuck in a huge traffic jam) so I’ve spent it finishing my general surgery notes while wrapped in a blanket 

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Today I intubated someone using direct laryngoscopy with a BMI of 50 and essentially no neck. Important take away points:

1. Positioning is key. Creating a little ramp with blankets to line up the airway is a life saver. Grade 1 view was easy peasy.

2. Having your adjuncts within arms reach is a great way to alleviate anxiety.

3. When you tell your patient to take deep breaths, you should be doing the same.

4. Don’t forget your patient is going to desaturate faster because of the sheer amount of mass that presses against their lungs leading to decreased FRC.

5. Always tell your attending what you see or they will start getting irritated at you.

That is all.

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Snowing again, and Day 45 on skis. My legs have been torn to shreds by the powder, and today I woke up – and sustained – a headache from dehydration. Still, I wouldn’t trade this for the world. Exhaustion aside, it’s been an incredible few weeks. I fly back to reality – and a sub-internship in internal medicine – in 6 days. I don’t want to leave. 

I have been dealing with some weird GI issues, though, which have made it hard to sustain the level of physical activity I’ve demanded of my body. Earlier this winter I caught some gross vomiting bug, and ever since then I’ve dealt with bouts of nausea (and once, vomiting) that seem to be triggered by foods. What foods – who knows? Wine, definitely. Pepper, maybe. Others are a toss-up. 

I hate nausea. I hate vomiting. And now I’m at a place where I’m afraid to eat for fear that an afternoon or an evening could be spent sweating on the bathroom floor. I’m naturally thin, so dropping a few pounds matters on my frame. When I looked in the mirror this morning I noticed angles that hadn’t been there before. Part of it is that I’m fitter – hello, abs – but part of it is that I haven’t been able to give my body what it needs. 

I’m going to start probiotics and have been trying to stick to a bland diet in order to appease the gastrointestinal gods. I really hope this all calms down, because as bad as it is to feel this way on skis, it’ll be worse trying to cope with the grueling demands of inpatient medicine in a weakened state. Fingers crossed. 

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Bought a inexpensive first aid kit at the store today. The instructions in it are…. interesting

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I have many questions

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“issued a distress” sounds like internet speak and i love it

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thorn finger definitely best way to refer to a bee’s stinger

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OPEN THE VENTS! 
Also these CPR ratios are at least 15 years outdated

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