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Thursday, July 03, 2008


I have finished 1 of 7 rotations (each is 6 weeks and I am currently on my 6 week break right now). I was downtown and out in Meridian at St. Luke's. It involved the most work I have ever done in my life. I read articles, wrote papers, wrote presentations, did research on questions the doctors would have throughout the day, and wrote up hideously long notes on patients (~20 pages). I don't think I've ever worked that hard on something for school before in my life. It was pretty intense. Not to say that it was pointless work though. I think most of it was relevant, just the quantity got a little overwhelming at times. I may have gotten off at noon, but then I had meetings with my preceptor and an evening of homework (until midnight usually). Crazy stuff. I'll be glad when these things are done and I'm getting paid to work instead of paying to slave away.

I have quite awhile before I am done, but at least it's less than a year away:

And Speaking of St. Lukes…

Katie and I were playing Frisbee golf at a local park when she froze and looked at me weird. Half of her face started drooping and she said it was numb, as well as one arm. She tried to say "Oh my God, I'm having a stroke!" but it came out kinda slurred. Her symptoms only lasted about 15 seconds and she recovered completely immediately afterwards.

I was somewhat scared because it did look like she had a stroke. So we ran to the truck and took off to St. Lukes. I am pretty sure that they charge you about $200 for just breathing the vanilla scented air in the emergency department. As soon as we walked in the door, BAM! $200.

Anyhow, they diagnosed her as having a miniature TIA (transient ischemic attack). So in essence, she had a mini mini stroke. And yes there are two minis there. A TIA is a mini stroke, so a mini TIA is a mini mini stroke. A CT scan didn't reveal any deficits, nor did the MRI show any lasting signs of damage. So that's good. But now she gets aspirin 81 mg po qday x indefinite (there's the pharmacy dork in me- that's a baby aspirin by mouth once daily for life).

Der Wienerschnitzel

Everyone here knows of the ill-fated attempt at puppy ownership with Sammy, the not-so-smart but fun-loving mutant Dachshund. Well, Katie's cousin's girlfriend's parents raise miniature Dachshunds. Hmmm…

There was a litter born on April 6th, 2008. Some of them were black with brown and the others were white, grey, and black (all spotted and weird looking). I picked out the biggest black and brown male because he had the biggest, fattest, and therefore cutest head.

5 and a half weeks later, Schnitzel got to come home with me. His name is Schnitzel in honor of Wienerschnitzel, the fast food chain.

He's become quite the character in the last 7 weeks. He's now 7.5 pounds and sleeps all the way through the night (thankfully, god the first week was atrocious). He rarely has any bodily functions inside except for the occasional Purina fart. Here's a sequence of photos from when I first got him to now:

And yes, I'll be keeping him away from chew bones as much as possible.

First Song Phenomenon

How many times has this happened to you? You buy a CD after hearing a good song on the radio or internet. You expect the rest of the CD to be like that one good song, but it's not. In fact, it's nothing like the song you heard on the radio. It doesn't even sound like the same band. And usually, the best song on the CD is the first track on it. Let me give you some examples of what I mean:

Gnarls Barkley: Crazy was an awesome song from the album St. Elsewhere, but the rest of the album sucked. There were no other songs like Crazy. It was just all synth-ed out shitty weirdness. Technical terminology there, mind you.
Revis: Caught in the Rain was the big single (and track #1) from this album a couple years back. The rest of Places For Breathing was atrocious. And since then, this band has dropped off the face of the Earth (thankfully).
Coldplay: Viva La Vida had high expectations from me since their albums had been getting progressively better, but I guess their awesomeness culminated in X & Y for me. There is one decent song (Violet Hill), but that's it.
Panic! At The Disco: Their first album was just a jolly rockin' good time. I figured their second album (Pretty. Odd.) would be more of the same, if not better. Nope. Nine in the Afternoon is a solid song, but the rest of the album just falls short for me. P!ATD is a punk band, but they seem to think they are more like the Beatles. *Sigh*

Chris Cornell: This is only his second release as a solo artist and he just should not be a solo artist. He needs to stick with Audioslave, Soundgarden, or Temple of the Dog. I realize those bands are gone with the wind, but he sucks by himself. There is one good song on the disc: You Know My Name. It was the theme of the newest Bond movie (Casino Royale).
Linkin Park: Both of their first two albums were amazing. I know they have a narrow genre, but they excel at it. Their newest album (Minutes to Midnight) is just a dreadful departure from that genre. They ventured into U2 territory and U2 just blows. Really. Bono can kiss my ass. Anyhow, What I've Done is the only worthwhile song on there.
Chevelle: They are kind of a weird band, but their releases have been pretty consistent thus far. This latest time (Vena Sera) around though, I think they missed a beat. Anti-saint, the opening track, is the best track on the disc. The rest of it is just torture.
Finger Eleven: All of their albums have been great (with the exception of the track One Thing on the self-titled release, god that song sucks). I don't know what the hell happened on Them vs. You vs. Me. Paralyzer is a fun song, but the rest of the CD is whiny and pointless.
So I guess I have made my point. It's been the year for disappointing albums. Keep up the shitty work, bands.

$50 Gas Card

A few weeks back, I went to Del Taco because I was too lazy and/or tired to make my own lunch. Turns out that it was a pretty good decision. Well, not good for my waistline or cholesterol or blood pressure or risk of type 2 diabetes or etc….. But it definitely was good for my wallet and not just because I got the Del Deal.

I entered my receipt into a drawing for a $50 gas card from Shell. Thinking I had no chance of winning, I dropped my receipt into the big old bowl full of receipts (probably hundreds, maybe thousands) and put the thought of the gas card out of my mind.

A few days after that, I got a phone call from an unknown local number. I let it go to my voice message and it turned out that it was the manager of that Del Taco. I had won the $50 gas card! Whoo-hoo! I never win anything, so this was pretty exciting for me. About a week after that, I got the card in the mail. Too bad it only paid for one tank. Damn. But $50 is $50, no matter how much or how little gas it buys.

A Pet Peeve in the Pharmacy World

At Walgreens, just to cover my ass, I always ask every patient if they have questions on the prescription or if they want the pharmacist/me to go over the medication with them. The most common answer I get is "no thanks." I am totally cool with that one. I then just hit "2" on the register to denote the decline to counsel and we move on with the transaction. It's the patient's right to decline counseling and I usually don't have a problem with them refusing it. The answer that pisses me off is "I've had it before and I know what to do."

I don't know why that one angers me so much. I guess it's because it's like the patient is saying that they know everything about a medication simply because they've taken it before (like the knowledge of the drug is osmotically acquired by ingesting it). It also demeans my education and time spent in school by saying that the lay public knows everything they need to know about the drugs they take and pharmacists aren't necessary. It pisses me off that people completely disregard the helpful health care resource at their fingertips with such a flippant answer to my question.

Just because you've taken a drug for years doesn't mean you can't develop new side effects or the more appropriately named "adverse drug reactions." A patient fairly recently asked me about muscle pain. I went to the NSAID section of Walgreens with the intention of recommending ibuprofen or naproxen, but after a few more questions, I decided that wasn't such a hot idea. The patient stated that they were on simvastatin (generic Zocor) and recently had their dose doubled with the goal of lowering their LDL further. They also stated that they had started a new diet where grapefruit juice was a core part. They could not attribute the muscle pain to any physical activity either. Ummm…..perhaps at risk for rhabdomyolysis (in case you're wondering, that is a no bueno condition).
So I said they should go back to their primary care provider and let them know of the muscle pain before treating it symptomatically. I never found out about the results on that patient, but I have a pretty good hunch that they were experiencing a fairly rare adverse drug event associated with statin use. Now, this patient had been on the medication for years, but they developed a new symptom and were smart enough to ask about it. They could have died from rhabdomyolysis had they continued on the drug.

So I guess that confirms my point that patients don't know everything about a drug just because they've been on it. And thus confirms my suspicions that the average layperson is retarded.

I Wish The Human GI Tract Were More Efficient
I am an utter hedonist when it comes to food: I love eating. I eat when I am bored. I eat when I study. I eat when I watch movies, TV, and play video games. I eat when I'm hungry (duh). I even eat when I'm not hungry (just for taste). I try to cook something different once a week so that I have something different to eat. I love salty snacks and sweet snacks (salty more though). I love going to bed with a full or semi-full stomach (even though I know you're not supposed to). But there's one thing I hate about eating: gas and having to poop.

I wish we were more efficient at utilizing the food we eat so that pooping wasn't such a common occurrence. I wish we could break down fiber and turn it into something useful instead of flushing it. Instead of laying a deuce once a day or once every other day, maybe we could extend it out to once a month or something. I just hate sitting there on the throne, stinking the place up. And wiping is no picnic either. I just hate the whole scene. Nothing about taking the Cleveland Browns to the Superbowl is enjoyable except for the knowledge that it's the longest possible time until doing it again. I mean, I like living free and easy afterwards, but the experience immediately prior and during is near the top of the list of my most hated things.

Gas isn't any better than taking a duke either. Just because it's not solid doesn't exonerate it. It can still make you feel awful and stinks just as bad (if not worse). And it sneaks up on you at the most inappropriate moments. Always. You laugh and out pops a loud one. You sneeze and accidentally blow air and possibly some projectiles out both ends. You shift your ass during class or a meeting and a silent, but deadly wave sneaks up on the people around you. No one would be the wiser, except you refuse to meet their eye and you're bright red. Guilty as charged.

Shooter: 3.75 of 5 stars. This movie had big shoes to fill. The book was such a success in its own right that it would have been disappointing had the movie simply followed it to a "T." The movie broke away from the novel's plot here and there and definitely told a slightly different story.

Transformers: 3.75 of 5 stars. The movie had a ton of action involving robots and not that much acting from people. There were some comedic relief moments and those were entertaining. Michael Bay just needs to understand that action is not plot.
The Pursuit of Happyness: 4 of 5 stars. It was sort of slow in parts, but left you with a good feeling. And yes, "happiness" was spelled with a "y."

The Black Dahlia: 0 of 5 stars. This was one of the most disjointed movies I have ever seen. Yet it wasn't like Donnie Darko or Memento were disjointedness was the point of the movie. The acting was less than weak, I'm not sure if it was supposed to be funny or serious, and the plot was feeble at best. Just awful.

Boondock Saints: 4 of 5 stars. This is like a more modern Death Wish. It was intriguing and thought provoking to say the least. It makes it hard to draw the line between right and wrong. Willem Dafoe is a certifiable psycho in it as well.

The Departed: 3.5 of 5 stars. Jack Nicholson is pretty funny in this dark, twisted film about a crime sting complicated by betrayals and snitches. Leonardo DiCaprio doesn't die soon enough though and we're forced to put up with his lame ass for longer than necessary.

Hostel Part II: 3 of 5 stars. A fairly unique ending to the movie made it better than the original. Otherwise it's pretty much more of the same. Gore, painful scenes, and screaming galore.

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