25 December 2012

Long gap in my posting.

Just started my 7th rotation as a neurology intern. 'Family Medicine'.   What a joke. They have a pretty rough time with all the random ass shit they encounter, but this rotation is 'tarded. At least I get the holidays off, right?

My zeal for learning and dedication to doing neurology readings has all but halted. Lots of things going on in my life (new baby: Adalyn, New lifting crew, Family issues, etc.). And reading has just not been too high on my list of things to do.

Medicine:

I'm disenchanted with modern medicine for the most part. The litigious atmosphere is bullshit. I've noticed a lot of what my attendings do is based on 'not getting sued' rather than what is best for the patient.  "Oh, the patient has a headache? Better get a CT, CTA, MRI, and prep them for a 4 vessel angio... Normal neuro exam? Can't be too cautious, ya know." 

Example:  We come upon our HIV patient who has PCP (PJC?) pneumonia. He's completely encephalopathic, agitated and lashing out. My attending, being fearful of intubating this patient because of the overall risk of death of intubating a patient with PCP PNA, delayed intubation. What he failed to understand is the risk of death is in tubing a patient BECAUSE of PCP PNA, not because they are unable to adequately protect their airway. The patient had sats dipping into the 70's, not responding to any intervention they tried. This persisted far too long, until I got an Istat that showed PO2 in the low 50's and an O2 sat in the low 80's. At this point I had to take it upon myself to call anesthesia to get the patient tubed, and the critical care unit for a transfer.

It is unacceptable to have a situation deteriorate in this manner with someone who, fearful of the outcome of one intervention, withholds all interventions and puts the patient at an even more immediate, grave risk.

Sometimes a little knowledge is dangerous... especially when it paralyses you and interferes with your judgement.


Lifting:

Found a new couple of guys to lift with. One is on my level as far as strength goes, the other is a bit stronger than I am ( and 70lbs lighter.) 

We have been doing "The Cube Method" for the past couple months. LOTS of volume, (bench, squat, and deadlift sets in the 10-20 rep range.)   It's pretty intense, and I already have felt my strength get considerably increased.

Recently:
Did reverse band bench press with ~30-45lbs off at the chest, did 395, and had a bit more in my tank. 3 board presses with 275x11+ and other ridiculous exercises were done as well.

Squats have been lacking because of a nagging back injury. These guys do a lot of Safety squat/Yoke bar training with squats, which is a new experience. Sets of 10 with 225 is pretty rough, where sets of 365 for 10 were doable with a standard bar... I maxed at just under 500 a couple weeks ago, but once again, I think technique is the problem, not strength...  I keep collapsing forward... and I can only goodmorning so much weight...

Deadlifting has been pretty good.   Most notably getting a 505 conventional pull last week was pretty good for me... considering it was after some snatch grip deadlifts ( 3 sets of 15 at 315, and one set of 11 at 405)...   Speaking of Snatch grip DL's...  These light up the glutes like you would not believe.


--I look forward to making some gains with these new guys... as Long as my schedule will let me lift with em... Lucky bastards are able to work and lift at the same place, so their schedule doesn't always mesh with mine... Schade.


--Hope to update this a bit more often nowadays.

---Merry Christmas, all!

--Darktide