Non-productive day

感覺每個週一的精神狀態都特別差。我懷疑與週末prolonged bedrest/ deconditioning 有關。

2016 年開始都沒怎麼做過運動,除了每逢週二會到附近工廠大廈去射箭。嗯,是Q 君的提議,反正剛好整個一月都不用call 週二。相當享受射箭的過程,那種異常集中的精神,踏上線上,提起弓,上箭,拉弓,瞄準,放箭。嗖的一聲,命中。但二月份如果報中班,就會撞call,嘗試過去諗去同其他人調,但唔成功,long call 實在太難去調。

整大半年的好似迷迷糊糊的,沒有多少深刻事情留在心裡。又也許只是這一刻的錯覺,今日真係好唔尋常地攰。

做左一份chee 寄出來hku 的一份research questionnaire,內容大概講關於想了解一下postgraduate在工作後的身心狀況。我大概好似中晒所有burnout 的 description,同埋depression 的description。但,咁又點。路一樣係要行,錢一樣係要搵,身邊人一樣係要照料,即使,你感到多少身心疲累也好。

其實工作環境算唔話得,比起所大院,我嘅工作量只係蚊同牛比。老人家多,會死嘅,你點救都救唔返,救到佢今次嘅,大槪過一兩個星期又會返黎。

side effect of caffeine? withdrawal/ overdose? i feel so confused.

any remarkable cases?
1) A non-smoker, ex-petrol station worker, presented with progressive worsening of SOB for 1.5 years, so severe SOB even at rest for the past few days before admission; scanty cough/ sputum/ chest pain; deny any constitutional symptoms/ haemoptysis; o/e: thin elderly man, no clubbing of fingers/ cervical LN, chest: diffuse inspiratory crackles ++; CXR bilateral apical hazziness, and LMZ hazziness +; put into isolation room in view of risk of TB; Worsening CXR with parapneumonic effusion + despite empirical augmentin + doxycycline. Later however AFB smear -ve, sputum c/st grows pseudomonas aerugionsa; Very strange case of ??? community-acquired Pseudomonas pneumonia; But clinically does respond to sulperazon. WCC and CRP not high.

2) Another fever with cough. CXR showed a new RLZ radio-opaque lesion. CXR report cannot differentiate it from a tumor/ simply consolidation; Anyway given augmentin and zithromax again. But developed rash after 2 doses of augmentin. o/e: not typical urticarial rash. Drug history reviewed: previous use of augmentin back in 8/2015 –> no reaction at all. Initially I tried to ignore the lesion and continued on the antibiotic, in view of no life-threatening features of allergy. But the rash progresses, 😦 Labelled as allergic to augmentin…

3) A decreased GC case, demented elderly man, presented with no verbal output. CTB showed a large cerebellar haematoma, involving the Lt cerebellar and the vermis. Poor premorbid. No family relatives. But he got a young friend – who is the granddaughter of a po-po friend. Feel very touching because the young friend is willing to take up the role to hear the progress of the patient, and even any deterioration/ mortality issue, despite the po-po had passed away last year.

4) Malignancy, hypercalcaemia, acute renal failure, dehydration, DIC; not the first case, but already quite a few in the past 2 months.

5) The acquired haemophilia popo has passed away in surgical unit. I knew she had retroperitoneal haematoma one day presented to them with RLQ pain, and later with haematuria etc etc;

6) CA stomach case, he went to QMH, not sure about the progress, but I hope he is doing well

7) An aortic dissection man, he survived after the surgery!!

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s