The overwhelming majority of the patients I’ve encountered on the wards have diabetes mellitus (DM). While there are countless ways to manage DM as an outpatient (insulin injections, biguanides, sulfonylureas, etc.), sliding scale insulin (SSI) seems to be the most routinely used method of controlling blood glucose (BG) for hospital…
On more than one occasion, I’ve shared my desire to pursue microsurgery with some of the residents and attendings, and on more than one occasion, I’ve been told that I just don’t have that kind of personality. An upperclassmen said I’m “too happy-go-lucky” and not “stern enough” to fit in…
On the first day of orientation for internal medicine (IM), the faculty noted that they now have statistical evidence which supports the notion that students who start on IM tend to do better on all their subsequent rotations. Why? The reasons are up for debate, but halfway through the rotation,…
Six weeks of internal medicine done. Six weeks left. *Sighs* It seems that each step in my training to become a physician passes at a progressively faster rate. What’s worrisome is that the shelf exam is in six weeks, and I’m not even halfway through my main prep book. It’s…
After all the patients I’ve seen with ascites secondary to hepatic cirrhosis, I wondered why we tend to start them on 100 mg Aldactone (spironolactone) with a 40 mg Lasix (furosemide) adjuvant. What’s the rationale behind this ratio? What’s the added benefit of using two different kinds of diuretics to…
I’m on the gastroenterology consult service at St. Luke’s Episcopal Hospital (SLEH) for the second month of my internal medicine rotation. Last month, Ben Taub General Hospital (BTGH) provided me with the team-centered, primary caretaker view for the uninsured/homeless/EC population. Now I’m learning about the world of specialized consult services…
Yesterday marked the end of my first month of clinics – 21 amazing days of internal medicine at Ben Taub. In February, I’ll be at St. Luke’s working on a consult service to be determined Monday. We were allowed to “request” a service (general medicine, heme-onc, infectious disease, etc.) ahead…
Negative pressure wound therapy (NPWT) is a form of wound care which utilizes a vacuum to create a suction interface at the site of the injury. It’s being utilized in all sorts of scenarios ranging from pressure sores and post-op wounds to open abdominal wounds and injuries with bone exposure.
If there’s one thing I’ve learned on my internal medicine rotation, it’s that the differential for “abdominal pain” is about a mile long. It helps when the pain can be localized to one of the abdominal quadrants, but when it’s a diffuse, constant discomfort… yeah… lots of possibilities.
The meninges are layers of tissue which envelope the surface of the brain and spinal cord and carry a lot of the superficial vasculature which feeds the central nervous system. When these tissues become irritated or infected, the resulting inflammation is called meningitis. There are many infectious organisms associated with…