Ugh...

The exam for 3.1 (Ortho) left me more dead than alive. I probably bombed that, and since the exam (which took place about 2wks ago) I haven't really done anything except for mourning the loss of my zero-retake streak.

Link

Surgeons are..

Seem familiar?
As far as I know, surgeons are a pretty odd bunch sometimes, but they're not necessarily mean.

...

Link

This is me, every time some blooming idiot thinks that people get the flu from the seasonal flu vaccine. 

The European/Dutch flu vaccines contain pieces of dead virus. 
Pieces of dead virus.
So no, it's not capable of giving you the real flu.
Yes, it is capable of making you feel a little under the weather for 1-2 days (that's because your immune system still responds to pieces of dead virus). But it's not a full-blown flu.

It's funny how the people with the most vague symptoms of thyroid disorders are often the ones to bitch the most about vaccinations and other stuff.
I sometimes wonder why the human race has not gone extinct yet.

:/

Well. I seriously considered going into A&E (or the Dutch equivalent of it, at least) for some time.

With my recent diagnosis of Graves' disease, and this vid showing the sheer amount of pressure and frustration that physicians have to deal with in emergency care, I'm starting to question my ambitions.

Stress means heart palpitations for me now that I have Graves' disease.

I don't like heart palpitations. 

And I don't know if my Graves' will relapse once I'm done with my pills.

I'm going to have to think about my decision to pursue a career in A&E or Trauma/Anesthesiology.

It's Pink! Again!

Every October, this blog turns pink.
Why? 'Cause Breast Cancer Awareness Month.

Don't like, don't visit.

Hate hate hate double hate

Wonderful movie, by the way.

I HATE MY THYROID!
I HATE THIS FUCKING DISEASE!
Why is it giving me hair loss and making me feel like I could go berserk in a split second?! I feel psychotic without the psychotic break!
Hell, call me shallow, but I absolutely do not like it when my hair is getting so thin that I might pass as an unhealthy hobo.

Stupid thyroid, stupid pills. Don't give me extremely unpleasant-and-ridiculous symptoms which aren't dangerous enough for me to stop.
Either don't give me those stupid symptoms and shut up, or give me some dangerous side-effect so that I can switch therapies. Or die.

Found on Wolfpackdopiiz' page

I WILL MURDER YOU!

Yes. Even medical students and doctors will sometimes reach that point where they're done with being nice and transition to wanting to kill someone. I reached that point the day before yesterday, and today, again.
It doesn't help that I'm having my period and am still slightly hyperthyroid.

Ortho e-learning 4

Onderste extremiteiten distaal
Het onderbeen wordt door een aantal bindweefselschotten in een viertal compartimenten verdeeld. U ziet hieronder een schematische weergave van een transversale doorsnede door het onderbeen met daarin de 4 compartimenten. Benoem de 4 compartimenten.
1. Compartimentum anterius
2. Compartimentum posterius, pars profunda
3. Compartimentum laterale
4. Compartimentum posterius, pars superficialis

Welke spieren bevinden zich in het compartiment dat met 1 is aangeduid in de onderstaande plaat?
- M. peroneus (fibularis) tertius
- M. tibialis anterior
- M. extensor digitorum longus
- M. extensor hallucis longus

Welke spieren bevinden zich in het compartiment dat met 3 is aangeduid in de onderstaande plaat?
- M. peroneus (fibularis) longus
- M. peroneus (fibularis) brevis

Welke spieren bevinden zich in het compartiment dat met 2 is aangeduid in de onderstaande plaat?
- M. flexor digitorum longus
- M. flexor hallucis longus
- M. tibialis posterior

Welke spieren bevinden zich in het compartiment dat met 4 is aangeduid in de onderstaande plaat?
- M. gastrocnemius
- M. soleus
- M. plantaris

De spieren in de comparimenten hebben hun eigen motorische innervatie. Welke innervatie hoort bij de 4 compartimenten?
1. N. peroneus profundus
2. N. tibialis
3. N. peroneus superficialis
4. N. tibialis

Geef de mediale zijde aan in deze onderstaande plaat door het rondje linksonder in beeld in de juiste helft van de plaat te plaatsen.
Kant van de pes anserinus (pees aan de knie die 3 spieren aan de tibia verbindt!). Of aan de kant waar de arterie zit.. Whatever floats your boat.

Benoem de met nummers aangegeven structuren in de onderstaande plaat.
1. N. tibialis
3. V. poplitea
4. A. poplitea

Welke vena mondt uit op de plaats aangegeven met de lijn in onderstaande plaat?
V. saphena parva

Wat is in de onderstaande plaat de origio van de m. tibialis anterior?
Rechter plaatje, rode vlek midden van tibia.

Wat is in de onderstaande plaat de insertie van de m. tibialis anterior?
Linker plaatje, blauwe vlek aan de proximaal-mediale kant van de metatarsus.

Wat is in de onderstaande plaat de origo van de m. tibialis posterior?
Linker plaatje, rode vlek bovenop het membraan wat tibia en fibula met elkaar verbindt.

Wat is in de onderstaande plaat de insertie van de m. tibialis posterior?
Linker plaatje, blauwe vlekjes boven de metatarsals.

Van welk bot maakt het sustentaculum tali onderdeel uit?
Calcaneus

Sleep de nummers in de bijbehorende vakken
Met de klok mee, begin rechtsmidden: 4, 7, 2, 6, 3, 1, 5

Hier volgt een ezelsbruggetje voor de kruisbanden.
LAMP
De letters vertellen ons hoe het verloop is van de twee kruisbanden in de knie.
Voorste kruisband: van Lateraal naar Anterior

Achterste kruisband: van Mediaal naar Posterior
Welke kruisband test men bij een voorste schuiflade test van de knie?
Voorste kruisband

U ziet hieronder een plaat van de mediale zijde van de knie. Er is een cirkel geplaatst op de plek waar drie pezen aanhechten op de tibia. Deze drie pezen tezamen noemt men het pes anserinus (ganzenvoet).
Welke drie pezen van welke spieren vormen tezamen het pes anserinus?
- M. semitendinosus
- M. gracilis
- M. sartorius

Benoem de met nummers aangegeven structuren in de onderstaande plaat.
1. M. semitendinosus
2. M. gracilis
3. M. sartorius

Sleep de nummers in de bijbehorende vakken
Met de klok mee, begin rechtsboven: 3, 4, 5, 6, 7, 2, 1

Benoem de genummerde structuren
1. Lig. talofibulare posterius
2. Lig. calcaneofibulare
3. Lig. talofibulare anterius
4. Tendo calcaneus
5. Lig. tibiofibulare posterius
6. Lig. tibiofibulare anterius



Total score: 100%

Ortho e-learning 3

Bovenste extremiteiten distaal
Benoem de genummerde structuren:
1. Radius
2. Ulna
3. Tuberositas radii
4. Caput radii
5. Trochlea humeri
6. Epicondylus lateralis
7. Epicondylus medialis
8. Humerus
9. Fossa olecrani
10. Olecranon

Sleep de nummers in de bijbehorende vakken:
Met de klok mee (begin rechtsboven): 1, 9, 5, 8, 6, 11, 12, 3, 10, 7, 2, 4,

Benoem de genummerde structuren:
1. Articulatio radiocarpalis
2. Articulatio mediocarpalis
3. Articulationes carpometacarpales
4. Articulatio radio-ulnaris distalis

Benoem de genummerde structuren:
1. Os capitatum
2. Os trapezoideum
3. Os hamatum
4. Os trapezium
5. Os triquetrum
6. Os pisiforme
7. Os scaphoideum
8. Os lunatum
9. Tuberculum dorsale
10. Processus styloideus ulna

U ziet hieronder een schematische weergave van een transversale doorsnede door de onderarm. Welke spieren horen bij de groepen?
M. flexor pollicis longus: 1
M. extensor carpi ulnaris: 3
M. palmaris longus: 1
M. pronator quadratus: 3
M. brachioradialis: 2
M. extensor carpi radialis longus: 2
M. supinator: 3
M. pronator teres: 1
M. flexor digitorum profundus: 1
M. textensor pollicis brevis: 2
M. extensor pollicis longus: 3
M. flexor carpi radialis: 1
M. flexor digitorum superficialis: 1
M. abductor pollicis longus: 2
M. extensor indicis: 3
M. extensor digitorum: 3
M. extensor digiti minimi: 3
M. extensor carpi radialis brevis: 2

 De spieren in de compartimenten hebben hun eigen motorische innervatie. Welke innervatie hoort bij de 3 compartimenten (uitzondering: in compartiment 1 worden 2 spieren (gedeeltelijk) geinnerveerd door de n. ulnaris)?
1. N. medianus
2. N. radialis
3. N. radialis

De arterie aangegeven met nummer 1 in de bovenstaand plaat is de arteria ...
ulnaris

De arterie aangegeven met nummer 2 in de bovenstaande plaat is de arteria ...
radialis

Welke botten articuleert het os scaphoideum?
Os lunatum
Os trapezium
Os trapezoideum
Os capitatum

Geef in de onderstaande plaat aan waar de gemeenschappelijke origo van de extensoren van de pols zich bevinden?
Epicondylus lateralis humeri (beetje eronder)

Geef in de onderstaande plaat aan waar de gemeenschappelijke origo van de flexoren van de pols zich bevinden.
Epicondylus medialis humeri

Sleep het groene rondje linksonder in de onderstaande plaat naar het tuberculum van Lister (tuberculum dorsale radii)
Middelste plaatje distaal, die gekke richel middendistaal.

Sleep de marker linksonder in d eonderstaande plaat naar de processus styloideus van de radius.
Zie p. 427 (Netters, 5th edition)

Total score: Geen idee. 90+

Water.. Everywhere!

I arrived at school/uni today, only to see a bunch of ambulances with police escorts arrive at the teaching hospital. My first thought was: "Oh. Probably a really urgent one, maybe a child.."
I didn't think much of it, until my classmates started talking about "Hey, have you heard about the VUMC yet?"
And that was when I found out about this:

This.. happened in one of the teaching hospitals here in the Netherlands (VUMC/VU University of Amsterdam, to be precise).

A water main somewhere on the streets near the VUMC medical center/teaching hospital decided it'd be a good time to burst, and well. There was water everywhere; water on the streets, in the parking lots, water in the basement of the hospital, where, sadly, some very important infrastructure elements were being kept..
The result was that the power failed in the hospital, and they couldn't use their back-up generators either because those are being kept.. in the basement.

So yeah. Lots of ambulances all over Amsterdam today, since they had to move a lot of patients to another hospital (including the hospital where I'm studying to become a doc!)

Luckily, it happened before most (if not all?) of the surgeons started operating. Imagine the chaos that would've ensued if the power suddenly failed out during your operations. Yikes.

Last movie shows a specialized ambulance - meant for transporting (pediatric) intensive care patients, cardiac patients, etc - and its police escorts.
And yes, that is 'my' teaching hospital, also known as my 'second home' for the coming 4 years.

Lalala

Things to watch when you're tired of studying.

Ortho e-learning 2

Onderste extremiteiten proximaal
Label:
1. Lig. iliofemorale
2. Lig. ischiofemorale
3. Zona orbicularis
4. Trochanter major
5. Spina ischiadica
6. Tuber ischiadicum
7. Trochanter minor

Ortho e-learning Week 2

Bovenste Extremiteiten Proximaal - Wk 2
Welke van de volgende spieren hoort niet tot de "rotator cuff" van de schouder?
- M. Teres Major (zie p. 413, Netter's 5th edition)

33% MD

And classes starting tomorrow.

T_T

Hyperthyroidism Quote #1

Random person: 
"You're hyperthyroid? Oh, lucky you.. You're losing weight and looking skinny without even having to work for it.. I want to have hyperthyroidism too!"

Last Ebola patient released from the hospital in Sierra Leone!

<3

More here:
http://www.itv.com/news/2015-08-24/celebration-as-last-ebola-patient-released-from-hospital-in-sierra-leone/

Doctors are...

Dear Thyroid,

Wtf?!

That moment when your doctor tells you your Free Thyroxine (FT4) used to be over 100 pmol/L*. The resident treating me couldn't tell me how much, actually. Probably because the lab techs ragequit after they reached a count of 100.

How am I still alive and sane?



* Normal ranges: Anywhere between 8 and 24 or so. 100 is ridiculous.

Self-doctoring..

.. can be useful!

But only if you know what you're doing! :P
I got my earlobes pierced (a second earring piercing in each hole) several months ago, and initially, they healed up quite nicely.

Only just a few weeks ago, I noticed that one of my earlobes had started to grow a small smooth bump. No lymph, no crusting, just a small bump about half a centimeter in diameter.
It wasn't warm or an inflamed red or something, and there was no blood or pus either, so I really doubted that it could've been an inflammation or infection (besides, it's kind of late for the pierces to suddenly get infected now).

So there was only one thing I could come up with: keloids, also known as hypertrophic, ugly-as-hell, overgrown scar tissue.
If you're a person with a splash of colour on your skin (read: African/Asian/Hispanic/Mediterranean), you're a bit more likely to form keloids compared to white people.
Since I'm Asian, I belong to this unlucky group as well.
I didn't like the thought of having a keloid grow on the back of my earlobe, so I had to find a way to get rid of it (preferably without having a doctor tell me to take out the earrings and to have surgery done on my earlobes).

Luckily for me, I managed to dig up some topical steroid cream, which may or may not have encouraged the bump to disappear.
It's becoming smaller again, so maybe topical steroid creams can help against keloid formation, or maybe it wasn't a keloid at all.

Either way, I'm happy about my bump starting to disappear again.


So yeah. Topical steroids may have worked for me, but please don't go and buy the stuff to get rid of your own keloids without discussing it with your doctor.
I'm not responsible for the shit that might happen when you try to pull the same stunt I did.

Post-class/internship/godknowswhat essays..

That moment when you're pretty much done with exams and lectures, and such and so classes want you to write an essay before the end of the academical year..

Class: LET ME LOVE YOU!

Me: LEAVE ME ALONE! *Runs*

That moment..

When you don't have to actively look for a job and sollicit for one,
but someone actually wants you to come work for them.
And it's actually an interesting job with decent pay too.

Fuck yeah.

PTSD: The Aftermath

Trigger warning.

Do not read if physical or verbal abuse upsets you.

Do not read if you don't like negative stories either.

Psych and PTSD..

Possible Trigger Warning.

Graves' Disease.. Part 5: Getting Back On Track

Hey guys!
It's been a while since I last posted something here, so I thought I'd pop in and show that I'm still alive..
My thyroid gland has calmed down a lot by now, and the sudden mood swings and murderous thoughts and moods are slowly dissipating by now. Which is great!

EXAM STRESS

Not.

Things Med Students Hate.. #2

Failing a test.

Graves' Disease.. Part 4: Am I ill, or not?

I'm taking meds to freeze my thyroid gland in it tracks, to make sure it doesn't produce anymore thyroid hormone, as well as meds to push my heart rate back down.
The problem is that my meds can wither away my white blood cells - leaving me with a lacking defense against bacteria and the likes.
Thats why my endo explicitly ordered me to go to my hospital to get my blood checked anytime I get a fever, sore throat or the likes.

Things Med Students Hate.. #1

Nitpicking professors.

Graves' Disease.. Part 3: DO IT! NO DON'T! I WANT IT NOW!

Im-pul-sive

(ɪmˈpʌlsɪv)

adj

1. characterized by actions based on sudden desires, whims, or inclinations rather than careful thought: an impulsive man.

- The Free Dictionary

Graves' Disease.. Part 2: Insanity

The funny thing about this situation is that I'm more likely to stand up for myself.
The less funny thing is that I'm more likely to use violence in doing so.

Graves' Disease.. Part 1

A few days ago, I posted about me diagnosing myself with hyperthyroidism, cause unknown as of then.
It was Graves' Disease, also called Graves-Basedow, because those two people described the disease a long time ago.

It's essentially an auto-immune disease where my body thinks something fishy is going on and decides to create antibodies to something. This 'something' isn't known yet, but the antibodies stimulate my thyroid gland so that it creates more thyroid hormone than is necessary.

When my endocrinologist called me, I already had an inkling as to why my thyroid was going into overdrive. Graves disease is the most common cause for hyperthyroidism, and since I couldn't be all too special, I had to have some common things as well, right?
We had discussed my chances of having Graves Disease during our first appointment and came to an agreement that it was.. well. Quite high. 

Med Student become Patient..

Ladies and gentlemen, meet Thyroid Gland.

Did I tell you guys how happy I get when I make the right diagnosis? I get very smug and I'll wear a smug smirk on my face for the rest of the day if I get one right.

Are you kidding me? Really?

Today.. I found out that two Muslim students sued a medical school (Erasmus Universitair Medisch Centrum, Rotterdam) over peer physical exam practise.
The complaint..
Muslim ladies are not supposed to bare their bodies to men who are not their husband.
So these ladies didn't want to let male medical students practice physical exams on them.
..
There are few things which can make me absolutely furious, but this is one of them.

English article here: link

2.3 - Onderste luchtwegen Anatomie

Antwoorden ingangstoets:

100% goed (4 maart '15)

Physiology..

Dat feeling..

Gas Exchange & Physics

I've been reading/summarizing Medical Physiology (Boron & Boulpaep), and I thought I understood the whole shebang with the physics on gas exchange etc.
My thoughts on the lectures on blood gas exchange: "BRING IT ON!"
The first hour or so was alright, I managed to understand it.

But the second hour..

Brain is overwhelmed.

2.3 - Pulmonary disorders and gas exchange

 

Next Block! Lung diseases and gas exchange!
Okay, those are cat lungs, or so I've been told, and they're definitely NOT supposed to completely collapse like that.. But dayum, those lungs are beautiful.

I spy I spy..

A horde of Y1s (first-year meds of a 6-year traject) bitching about learning physical exams in med school.
Yes, I'm not a Y1, but I planted a spy in Y1, who alerted me to the issue of ladies not wanting to be practiced on by male students during their Anatomy block.
Reasons for this are shyness around males, or religious beliefs.
Similarly, some male students do not want to practice on females because of the same reasons.

Seriously?

You're in fucking Medical School. You're one lucky bastard to get into medical school, now don't be a prude and don't ruin medical education with religious beliefs. Learning how to save lives includes physical exam, and hiring simulating patients for practicing physical exams on is ridiculously expensive. (that being said, if I got paid for getting practiced on, I would totally do it).

So suck up and deal with it.

YES! This!

Thank you, pediatrician who put this up, and thank you, Redditor who posted it!

This is a rant post, specifically aimed at anti-vaxxers. Do not read if you don't like pro-vaxxers, because I am one. If you keep reading this, you might get your feelings hurt (not like I'd particularly care about crushing your anti-vaxx ideas, but I like to pretend I'm nice)

<3

First Aid and over-the-counter meds at events..

Those of you who aren't aware of my activities outside of med school: I volunteer at the Red Cross as a first aid provider at events. (Events being small local pop concerts, fairs, sports games, national holidays etc)
People generally never ask me for a paracetamol (acetaminophen) tablet. If they do, the occurrence is only about once or twice for every 50 hrs of volunteer work.
To be clear, our Dutch Red Cross district doesn't hand out pills if we can help it. Our volunteers also aren't given medication to hand out to people.
But at my latest 5-hr shift, I've been asked for aspirins/paracetamol/ibuprofen over 6 times.
Some people were suffering from headaches, others were trying to get one for their friend with a headache. And another was trying to get aspirins for a 2 year old child.
.. Uh. How about.. No.

The 8th Wonder..

.. is me passing the Cardiology exam.

After 1 week of getting up early

Holidays are over..

AAAH!

On a good note, I'm starting with Immunology as an elective. So far, I still like it.

Happy New Year!

<3