Special touch

There seems to be another recurring theme - my very first patient on a new service apparently regularly turns out to be case report-worthy.

Remember, the patient I saw on the very first morning I started in this hospital was the deaf-mute lady that ingested 50,000 units of vitamin D per day for an entire year and came in wildly hypercalcemic.

I also told you about the young guy yesterday that could easily bench press me. Turns out, heart failure apparently was the right service for this guy after all. (Actually, general cards, electrophysiology as well as we ourselves were all consulting on this same guy.) During rounds today (that thankfully ended with only two hours of overtime), we got a call from the general cards attending that had evaluated this guy's cardiac MRI, who was apparently very excited about it. So we went to his office and had a look. He demonstrated patchy hyperintense infiltrates in the myocardium very much consistent with sarcoidosis (or maybe some other form of myocarditis). We call-conferenced with the electrophysiology attending and my current attending on the heart failure service received kudos for actually having come up with sarcoidosis on the differential in this guy even before the MRI.

So we (fellow, resident and I) had our work cut out for ourselves .. look up sarcoidosis and its manifestation in the heart till tomorrow.

So that's what I'll get started on while still here in the hospital, since I'll need access to uptodate and medical journals.

But I'm hungry, tired (got only 5 hours last night) and my feet hurt up to the knees.

Surgery suddenly looks very attractive right now. My feet are going to hurt anyway and at least I won't have to think anymore.

Blog to you later.