Tuesday, January 31, 2006


I've blogged about medical lyrics in rap before... it's pretty interesting actually how medical words are thrown around.

Heard on the radio yesterday:
Jamie Foxx featuring Ludacris -- Unpredictable (luda's verse)
I'll be your Tylenol just take me till you doze off

So Tylenol is acetaminophen whis is a mild analgesic(pain reliever) and an anti-pyretic (fever reducer). So while not actually a sedative... it can relieve your pain enough so you can sleep, or reduce your fever, so you're more comfortable and thus can sleep. I guess Luda's right still.

Monday, January 30, 2006

heart trouble follow up

negative heart cath.

This means the stents he got last year are still open. Doesn't really explain his minor chest pains. And we learned that I inherit my stubbornness from my dad

Tuesday, January 24, 2006

Heart Trouble part Deux

So about a year ago when I started this blog, my father had just had a cath and seven stents... Tonight my mom called me and apparently a routine followup stress test was positive again. He's going in on Friday for another heart cath. Likely a restenosis of a stent from what my dad says. So I'm talking to him about he feels... and being the retired physician he is he notes that he only got a little chest pain when he exercised but was otherwise okay. I could have killed him. That's denial for you.

Anyway. Last year I was all about lifestyle change... exercise, diet modification, etc. Well i'm not exercising, though I do have an exercise machine, my diet is pretty much the same (off and on) we'll see what friday has to show.

Sunday, January 22, 2006


Lately I've gotten some questions from readers and I thought I'd take the chance to answer some of them. I've been rather delinquent.

Some questions from some one beginning premed studies...

1)Any opinions regarding DO vs MD training particularly as it applies to anesthesiology?

Hmmm... interesting question. I think both avenues are good approaches to medicine, and they don't differ as much as you would thing, allopathic and osteopathic classes are almost the same with a few exceptions. I think in general MD programs give you more choices when you are choosing a what type speciality you want to practice in. I've trained with DOs and done a fellowship with a DO and find so generalities applicable. I will say in particular reference to anethesiology is that it seems to be becoming more competitive as a residency. Thus we are seeing less DO physicians meet the rigorous requirements for interview selection in my facility, but those we do see are amazing candidates. So I would have to say that doing well in school and getting high board scores are the most important requirements.

2) What is your experience with physicians who were non-traditional students (i.e. older -- I am already 30), again with particular reference to anesthesiology?

First of all, I do suggest to all my friends who are considering medicine as a career to reconsider it. It is a tough road with long hours of work and study. It is physically as well as mentally taxing. There are better ways to earn money, influence, and/or respect. Saying all that, if you are one that really wants to be a medical professional, who am I to stop you? I do love my job, but the road to where I am now has been a rough one. I would however do it again.

Next, I don't think being a non-traditional/older student necessarily puts you ate any sort of disadvantage in being selected for a residency program. I think it provides an interesting perspective in the field of medicine. Being older, I think the physical demands of medical training may be more difficult. Also there is more likely to be a family involved. And that has needs of its own. All that is fine though, many people train in the medical field with large families. It just requires more juggling.

Just think though if you're considering anesthesiology at age 30 and start medical school in the next few years you may be 40 or older before even starting to have the opportunity to practice on your own. That time is valuable and it is quite a commitment. In reference to anesthesiology, there are plenty of older residents, some have completed all or a significant portion of another medical residency (anesthesia is a field that is highly switched into), some have just gotten a late start as you have. Also anesthesia is demanding, but may require less time commitment in residency some places, then say other residencies such as surgery (although there are wide spread work hour limitations)

Another question from an electrical engineer.
3) How accurate are the new monitors that are supposed to indicate depth of anesthesia in a patient?

That also is an interesting question. The device you're most likely referring to is the Bis monitor. It's gotten quite a lot of press lately. It's basically a transcutaneous monitor that picks up electric activity from the brain (EEG), performs a complicated "black box" calculation and spits out a number ranging from 100 (awake) to 0(No electrical activity). We do not use this device at our institution. There are several problems that I see. First of all there are plenty of other ways to measure consciousness clinically. The device and disposables are not inexpensive. Also what bothers me the most is that the calculations that are performed by the devices are a proprietary formula, and we are not privy to those aspects. I'm not sure how accurate thes e devices are, but regardless I'm not sure they're necessary. (just one man's opinion)

Picture taken without permission from Aspect Medical Systems, Inc. website

If I missed your question, let me know I'm trying to keep up.

Monday, January 16, 2006

IV starts

Bit of a strange couple of days for IV starts for me.

Two nights ago one of my roomies went on a bit of bender and thus couldn't keep any food or water down yesterday. I started an IV on her at home, instead of her going to the ER and waiting for hours and having the same thing done, except with a large bill.

Today near the end of the day one of my residents requested I put an IV in her because she wasn't feeling well and had some sort of flu bug... I was going to put in for her to go home early, but she was relieved by a late resident anyway. What a trooper.

Anyway, wonders that a couple liters of fluid will do to help with how you're feeling.

Tuesday, January 10, 2006

More anniversary stats from the last year

Shortest time between posts: 3 minutes
Longest time between posts: 17 days

Sunday, January 08, 2006


Three days ago this blog turned one year old... It's been a slow year and a fast year at the same time.

I've finished a cardiothoracic anesthesiology fellowship. Started a full time job as a cardiothoracic anesthesiologist. Bought a house.

On the other hand... I am working today on a sunday, doing a semi-emergent (as in booked two days ago) coronary bypass. (well supervising a resident anyway). This after doing a Heartmate II and a heart transplant on Friday, two chest closures yesterday (see friday's cases). At least I have tomorrow off.

Some stats:
365 days.
72 posts.
Avg. 1 post every 5.07 days.
5006 vistors by counter since March 7, 2005 (when I started counting) some of those are me however.

I hope for many more years.

Wednesday, January 04, 2006

cargo pants

heh. Wore cargo pants to clinic... realized no one can stop me.

Tuesday, January 03, 2006

Readily available

I'm trying to be a good anesthesia attending today... but failing. I flew back late last night from being out of town for the New Year. The anticipated late arrival after the weather delay and the walk through baggage and the shuttle bus to the parking lot and the drive home became the ridiculously late arrival. Got settled at home and slept for only an hour before coming in to work. Good thing I slept on the plane. I am working with 2 senior residents today. Both very good. Both rooms I'm supervising have long cases, so not much to do after getting started. Instead of teaching I've been hanging out in my office. Being "readily available" for crises from my chair.