March Haul

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By: Jaclyn Chua, OMS-II

This is not so much an article as much as it is a compilation. Similar to the “hauls” that many “Youtubers” post, this is a list of my favorite inspirational and motivational things from the year thus far. Medical school is simple, but it sure isn’t easy. It is my hope that the things on this list bring a smile to your face as they did to mine.

1. Story time was always the best part of pre-school. For those out there who have never had the chance to read or listen to “Oh, the Places You’ll Go” by Dr. Seuss, now is your time!
I know. The nostalgia was almost unbearable.

2. Pep Talks are simply crucial so here is a Soulpancake video that I would like to share if you were buried under books or living under a rock during its viral spread.

3. According to Ben Carson, who is the Director of Pediatric Neurosurgery at Johns Hopkins Hospital, “If we recognize our talents and use them appropriately and choose a field that uses those talents, we will rise to the top of our field.” The following is the trailer to Gifted Hands: The Ben Carson Story starring Cuba Gooding Jr. which Netflix has incessantly tried to make me watch. I finally gave in, and I do not regret it. 

4. Caution: TED talks are highly addictive which you probably deduced after seeing there is not just one TED video in this section. Indeed, there are three, but they are in no particular order.  Therefore, I hope you pick and choose based off of the inspiration you are needing at this moment.

This first TED talk, given by Amy Cuddy, actually graced my Facebook news feed one day because it was shared by a fellow colleague. It is titled, “Your body language shapes who you are.”

In this second TED video, Kathryn Shulz presents “On Being Wrong.” After watching this talk, I found a quote by Joseph Chilton Pearce who was an author on child development. In saying, “To live a creative life, we must lose our fear of being wrong,” he perfectly re-emphasized the concept that from mistakes and failure come both opportunity and success.


Lastly, Sugata Mitra presented, “Build a School in the Cloud” as the winner of the 2013 TED prize. As an educational researcher, Mitra placed “hole in the wall” computers within remote villages with which children, who had never seen a computer before, could play. Although school seems to be the only thing I have ever known, the human mind and the ability to learn will always surprise me.

Thank you for letting me share these with you. I hope between the beginning of this article and its final sentence, a smile crept up on you.

So You Think You Can Diagnose

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By: Eric Steinberg, Alumnus

  1. A 34yo recently divorced female went on a dissociative fugue to Cancun, Mexico and came back to Long island 3 days later with bloody, foul-smelling, straight up nasty diarrhea. About 10 days later, while getting a pedicure, she noticed weakness in her toes. 2 days later, she couldn’t breathe. Whats the dx? What do we see on CSF analysis? How is it treated?campylobacter sig.png8e44c873-d3e2-4259-871d-57e029ae2b4eLarge
  2. 4-year-old Cambodian child presents to your office with a 6-day history of fever over 105, bilateral conjunctivitis, a diffuse maculopapular rash, and swelling of his hands and feet. On physical exam, you also note a swollen tonue with red spotting as well as anterior cervical lymphadenopathy. What is the diagnosis? Treatment? After treatment what needs to be done?230px-Kawasaki_symptoms_B

 

Answers:

  1. Classic Guillian- Barre Syndrome secondary to a Campylobacter jejuni infection. Campylobacter is the most common cause of infectious diarrhea in the world (along with Salmonella spp.) Look for bloody diarrhea and a travel history. This is also one of the known, rare (but common on COMLEX/ USLME) causes of Guillian Barre Syndrome. GBS is an acute inflammatory demyelinating polyneuropathy, an autoimmune disorder affecting the peripheral nervous system, usually triggered by an infectious process. GBS is rare, with an incidence of 1 or 2 people per 100,000. The typical CSF finding is ALBUMINO-CYTOLOGICAL DISSOCIATION. As opposed to infectious causes, this is an elevated protein level (100-1000 mg/dL), without an accompanying increased cell count (very high yield). It is frequently severe and usually exhibits as an ascending paralysis with weakness in the legs spreading to the upper limbs and face along with complete loss of deep tendon reflexes. With prompt treatment with plasmapheresis or intravenous immunoglobulins and supportive care (on boards choose respiratory support d/t the possibility of Phrenic Nerve paralysis), the majority of patients will regain full functional capacity. However, death may occur if severe pulmonary complications and autonomic nervous system problems are present. GBS is one of the leading causes of non-trauma-induced paralysis in the world.
  2. Kawasaki’s disease is another rare disease that is commonly tested on boards. This classic presentation is most easily remember by the mnemonic “CRASH and BURN.” C-conjunctivitis, R-rash, A-adenopathy, S-strawberry tongue/skin findings H-hand and feet swelling, BURN- fever for at least 5 consecutive days. The treatment is IVIg and high dose aspirin (one of the only times you give a kid aspirin.) After treatment, it is important to get serial echocardiograms (about 6 months) because these children are at risk for coronary artery aneurysms (very high yield).

The Past and Future

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By: Priyal Patel, OMS-IV

To say that I am excited about what’s to come is an understatement. Change, adventure, commitment, freedom and yes, uncertainty and frustration are the things that are lingering in my near and post-medical school future. However, before I can craft my future, I can’t help but reflect upon all that I’ve seen, the people I’ve met, and the amazing lessons I’ve learned on this journey called “med-school life”. It all sounds cliché, but I’m a firm believer of the notion that the future is masterfully concocted by one’s past and present. Nothing happens without a purpose and no one enters another’s life without leaving some sort of impression, be it a negative or seemingly trivial impression. Thus, it only seems appropriate to talk about what I’ve seen as a student before I talk about my residency and career plans.

As a student, one of my most humble experiences occurred during my family medicine rotation in my third year of medical school. I met an astounding middle-aged woman who left her day job and took on the task of creating a local organization for homeless and low-income families. She assembled what she dubbed her “army of angels without wings” and took on the task of feeding the hungry, writing books for the young, helping the elderly, and giving back to the community that yearned for any help that it could get. She was an artist, educator, writer and most importantly, a fighter. Oh boy! She one heck of a fighter! Standing five feet and one inch tall, she was a formidable force with which to be reckoned. Her feisty nature made it easier for her to deal with the metastatic form of breast cancer, which was invading the nooks and crannies of her fragile body. Yes, this woman was a cancer victim, but this was the last trait with which she identified herself.  She was undergoing a strict regimen of chemotherapy and radiation; however, her cancer was spreading and her body was slowly giving up. Despite her own personal struggles, this patient never gave up her role in her non-profit organization. She continued to run errands for the elderly, collect food for soup kitchens, and write children’s books. In a selfish, egocentric society, it was refreshing to meet someone that literally gave up her tangible, monetary security for an immeasurable form of wealth. From this encounter with a unique breast cancer patient, I learned that endurance was essential and self-sacrifice was, to a certain extent, an obligation.

The most impressionable experiences of my medical school life occurred in the past few days. I had a cachectic, middle-aged woman on my medicine service with stage II small cell lung carcinoma and a severe COPD exacerbation. On the second day of her admission, her husband, unfortunately, had a serious ischemic stroke and was admitted to the ICU. My patient was getting impatient to meet her husband. So with the permission of my attending, I took her upstairs to the ICU the next day. On our way to the ICU, she told me why commitment was a crucial part of life. My patient and her husband were married for over 40 years and raised three boys. Their marriage was not perfect and they had their share of conflicts and personal issues. Despite the hurdles, they stuck together and made it work. When we finally reached the room, we were greeted by a very distant and confused man. He was in physical restraints and drifting in and out of sleep. He had no idea who his wife was and he was not entirely sure what was going on. My patient held the man’s hand and reached out of her wheelchair to whisper, “It’s ok. I will come every day to see you.”  At the end of the day, it was the commitment she shared with her husband and herself that got her through her own and her husband’s illness. As a result of my interaction with this patient, I realized the value of personal and familial commitment and innocence and simplicity.

Experiences such as the two aforementioned have significantly impacted my medical school education. In the future, I hope that my patients continue to influence the type of person I am and the doctor I want to become. I am excited about my pediatric residency and hope that it is full of new adventures and stories.

Good luck Class of 2013!

 

You have brains in your head

you have feet in your shoes

You can steer yourself anyway you choose

You’re on your own.

And you know what you know.

And YOU are the one who’ll decide where to go

                                                       -Dr. Seuss

Late Night Munchies…

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By: Lauren Iacono, OMS-II

Although sleep may seem like a luxury for medical students, it is actually essential for the learning, memory and application process which are crucial elements for a medical student while also making us less irritable and groggy throughout the day and can help us fight weight gain and sugar high cravings as well!

Now that I may have grabbed your attention, you may be one  like I  who will hit the pillow and yet lay there wide awake and frustrated knowing I have to be up in less than six hours for class, lab or rounds.

Well, did you know that “late night snack” could actually help you reach slumber land?

I, being the health foodie that I am and a suffering med school insomniac, decided to learn of some nutrients that can be put together for the best late night snacks that may help you feel more calm and relaxed decreasing that hyper-sympathetic stimulation  and allowing you to drift into your dreams.

Best combination – protein and complex carbs with some healthy fats that help slow digestion and keep your blood sugar level maintained throughout the night.  However, avoid heavy meals before bed time; they can actually keep you awake or may you feel worse the next day.

Some other helpful tips I have learned of things to avoid as they can worsen one’s sleep include triggers that may keep you feeling wide awake – caffeine (chocolate, coffee, caffeinated teas); sugary and processed treats; strenuous exercise within at least two hours of sleep; oh and I cant forget – that blaring light of your alarm clock, keeping the sound on LOUD on your phones and way too much computer time (iPad, Tablet… tech of choice)… before you hit the sheets!

Melatonin is a hormone naturally found in the body produced by the pineal gland and is produced based on the body’s natural clock; however, when your internal clock feels like it has been on overdrive, melatonin has been shown to help get it back on track… it is recommended to be taken 30 minutes before your intended sleep time

            Natural sources of Melatonin 

Cherries – no, not the kind you find in your cocktails…

Cherry tea (sleepy time brand is my favorite!)

Magnesium – Has been found to have a calming affect on the nervous system, and levels were reported low in those with sleep disturbances and anxiety!

            Some Sources include

            Almonds (healthy fat)

            Peanut Butter (healthy fat)

            Whole grains (complex carb and fiber!)

Tryptophan – An essential amino acid necessary to form serotonin and melatonin, both of which aids in the sleep and relation process.

            Some common foods include

            Oats

            Banana

            Milk and products

            Nut, rice and soy based milk alternatives

Some ideas to help get you started…

Sleepytime Sundae

Greek style or naturally sweetened low sugar yogurts (or dairy free yogurt such as almond or coconut).  Add some almonds and cherries and you have yourself a late night Sundae

Soothing Smoothie

Frozen cherries, frozen banana, lowfat dairy/ dairy alternatives and nut of choice (almond or peanuts)

Banana dream boats

Slice banana in half, add nut butter of choice (peanut or almond) and warm in microwave for 30 seconds (based on strength of micro)… enjoy with glass of milk and you will be sailing into dreamland with this one…

And some of my other favorites…

Whole grain cereal and almond milk, with a banana and/or almonds

Pistachios and dried cherries

Whole grain rice cakes and nut butter

There are also some other natural aids that may aid with sleep if you don’t find yourself hungry before bed; these include herbal teas such as Lemon balm, Chamomile, Cherry teas and Valerian; each of these may help with both anxiety and insomnia and does not leave you feeling groggy when you wake up the next day!

Ok, Ok… so you’ve had your snack, your tea and you avoided all those triggers and you still can’t seem to get your mind to quiet down.  Instead of shutting it, here are some techniques that help you refocus your thoughts and allow you to wind down and ease the mind so that the only thing left is the desire to dream.

Yoga – my favorite is Tara Stiles; she has a variety short yoga routines for sleep on YouTube that you can do right from your bed!

Meditation – This is great for focusing the mind on your breath, a mantra or something that makes you happy!

Relaxation techniques – such as belly breathing, a gratitude journal, focusing on your goals and the PRESENT moment, visualization of a beautiful scene – I tend to fall asleep to a beach sunset  – and so much more!

Believe in yourself and believe in your dreams. Focus on the present moment and yourself living presently. Stop and enjoy a moment. Get fresh air. Drink plenty of water. Remember to continue doing what you love. Get Sleep. And “Oh, the Places you will go!”

“Today is gone. Today was fun. Tomorrow is another one”. Dr. Seuss

 Sleep tight!

**Disclamier – this information is meant to inform and aid in sleep awareness. If you are having true concerns regarding your sleep please contact your physician.

 References

“Coping with Excessive Sleepiness: Natural Sleep Aids.” WebMD. http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/sleep-supplements-herbs

 “How Magnesium Helps you sleep.” Nutritional Magnesium Association. http://www.nutritionalmagnesium.org/articles/insomnia/309-how-magnesium-helps-you-sleep.html

 “Living With Insomnia: Get a goodnight’s Sleep.” WebMd. http://www.webmd.com/sleep-disorders/living-with-insomnia-11/natural-solutions?page=1

 Wong, Cathy. “Natural Sleep aids.” 2012. Alt. Medicine. http://altmedicine.about.com/cs/conditionsitoq/a/Insomnia_2.htm

Don’t know where I’m going but I know where I’ve been

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By: Ashley Fox, OMS-II

A 2nd year’s perspective:

For the next month my fellow second years and I are in a unique position where we literally don’t know where we’re going. We have the promise of the future without having to deal with the reality of it. We don’t yet know which hospitals we will be at for which rotations and when. We have all the excitement of getting to start our clinical education years still intact. The boards still loom ahead of us. We all have to get past that before we can reach the future I’m talking about, but we are almost at the midpoint of our time at NYIT-COM. We have survived.

For two years we’ve tackled the basics,  poured over books and lecture notes. We’ve made it through hours spent exploring open stomach cavities. We’ve lived through months where our most frequent perfume was eau-de-formaldehyde with more than a hint of decaying body. We’ve progressed from struggling to feeling transverse processes (in a manner that could only be described as reminiscent of a drunken man trying to cross an icy road) to feeling the subtle motions of the primary respiratory mechanism.  We have made it through doubled-up systems, seemingly impossible exams, name changes and hours spent taking medical histories from standardized patients. We’ve conquered long nights of studying spent holed away in silent studies and libraries while our friends out in the world were enjoying holidays, parties and nights out. We have even managed to save a “real” robotic patient in intense 30 minute scenarios designed to test our teamwork.

This has been our medical school life. This is where we’ve been. In two more years we will have been so many more places. Stop and take comfort for a moment in the fact that as poet Carl Sandberg said, “I don’t know where I’m going but I’m on my way.” We are, most definitely, on our way and where we’ve been will be what we take with us wherever we go.