7:00 am: conference in the morning. they had m&m which is the short form for morbidity and mortality. 8 complications with 6 deaths. one of the biggest discussions yesterday was on HIT. HIT stands for heparin-induced thrombocytopenia. what that basically means is the heparin, an anti-coagulant can actually go and reduce platelet count in the human body leading to complications. so the question arose should we test for HIT in a patient pre-operative procedure or what should be the best way to administer this. i don't exactly remember where the debate ended up, but in short it was undecided.
after that, Dr R. showed me around Shapiro. it's a really nice building. very glassy and flashy. had gone to the ICU for a catch-up round! met the fellows. pretty interesting stuff.
afternoon, basically had clinics with Dr B. most diagnoses involved mitral valve stenoses. so we had to weigh out, along with the patient's family, whether we wanted valve replacement or repair! need to choose between mechanical valve and pig/cow valve. some patients have really interesting social history. remember one lady, probably Portuguese, with large hazel eyes, reddish-brown hair, artificial curls, and heavy eye-make up. came with a complaint of severe shortness of breath. she admits to snorting cocaine everyday, marijuana 3 times a week and heavy smoking and daily consumption of alcohol. she smiles for twenty seconds and adds that she never forgets her calcium pills. paradox after paradox you encounter in this professions. no excuses, no judgments allowed! do your work and get outta here!
other than that, i read up on aortic dissection. cases tomorrow are mitral valve replacement and coronary artery bypass graft. so i'm reading up on them.
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