the rolling donut

contains a source of phenylalanine

Monday, November 17, 2003
 
right, so here i am, end of night 3, had a bit of action...

new arrival from the cardiothoracic ward around 0330. an elderly gentleman with bowel cancer, removed earlier this year, discovered to have a new lung primary on bowel followup (poor guy!), underwent right upper lobectomy earlier in the day. currently suffering total collapse of the remainder of his lung on the operated side. going off rapidly.

feel quite pissed off actually. after a good intubation, took several attempts to site a neck central line. ended up sticking in a femoral instead. =|

balloon pump lady is still with us, holding quite strong. she may well see herself through yet. *pleased*

lucky i had a whole load of shredded chicken fried noodles quite early tonight. wouldnt have had the opportunity once our new patient had arrived.

Sunday, November 16, 2003
 
ok, so almost coming to the end of night 2 on the unit...

one less patient tonight. autoimmune pneumonitis lady suffered another episode of massive haemoptysis during the day before i came on. when you bleed into your lungs like this, there is just no way of oxygenating the body. basically, you drown in your own blood. there really is not much one can do when that happens. she died. rip.

had to reintubate another lady, getting better at rsi* by the day. having been potentially ready to be stepped down to the cardiothoracic surgery ward earlier in the day, our boss made a good call to delay stepdown until her respiratory status was more stable. she has copd* on top of having just come out of a double bypass. very good call. shortly after i came on tonight, i put in a chest tube to relieve her right pleural effusion, hoping that would help her oxygenate better... got 200ml out... but still low po2... i think shell do ok.

the lady next to her is not doing so good. emergency salvage redo of a lima* anastomosis to her lad*, maxed out on full inotropic support, iabp* at full inflation going at 1:1, lvef* at around 20%... doesnt look like shes going to be around when i return tomorrow night i fear.

managed to eat during this shift, pretty good going. =)

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* rsi = rapid sequence induction, copd = chronic obstructive pulmonary disease, lima = left internal mammary artery, lad = left anterior descending artery, iabp = intraaortic balloon pump, lvef = left ventricle ejection fraction

Saturday, November 15, 2003
 
ok, so here i am, first night shift on the unit. scary...

so far, things have been ok. one death, expected. a triple a from daytime, full inotropic support postoperatively, went into arf* and ards*, then blew a pupil in the evening. rip. another gentleman not peeing after a complicated mi*. why is he still with us? should be on ccu*! ive just kept his urine output at around 20 all night with small boluses... ok, so his kidneys arent being perfused... thats cuz his lv* is totally knackered. yet surprisingly, he still manages to sit up and talk coherently, despite a systolic bp hovering around 80. well, at least hes still perfusing up top. very good.

have just come out of a sideroom after being called to attend to our autoimmune pneumonitis lady. 400ml of frank haemoptysis coming up her et* tube. very not good. =(

just a few more hours to go...

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* arf = acute renal failure, ards = adult respiratory distress syndrome, mi = myocardial infarction, ccu = coronary care unit, lv = left ventricle, et = endotracheal

Tuesday, November 04, 2003
 
finally caught up with rish and her bro mark tonight, visiting from melbourne, final stop of their european tour. didnt get the chance to get them the promised special promotion toffee crisp mcflurry. never mind. next time perhaps. =(

man, you guys should have planned for longer in london! 2.5 days is just not enough!

food of the day:

chiquito restaurant & bar, leicester sq, a reasonable texmex joint, spawned a chain around the country.

Sunday, November 02, 2003
 
right, back home from brum for the second weekend running. thats my quota of visits for the next four years used up. thank god wont have to go there again for a long time...

had dinner with helen, made me miss train back to london. meant i couldnt hook up with rish tonight. ill call rish in the morning. =(

food of the day:

two medium the edge pizzas from pizza hut (without green pepper, dont ask!) instead of one large, cuz they had run out of large bases. vfm or what! =)

 
so the report from my 10 year med school class reunion at the de vere belfry, wishaw,
north warwickshire (home of the ryder cup for those that didnt know!), 1 november 2003...

interesting points:

1. everyone was still the same! noone had changed! well, with a few exceptions. every guy had a belly. same face, extra belly. hmm... not very good. and noone recognised cliona. looking svelte. very good. there is this theory some (ie helen) say that the class babes and cheerleader types always return to reunions with loads of kids and looking fat and disillusioned... didnt see any of this going on last night with our lot. also pretty good. =)

2. everyone behaved just like they all used to. uncanny. the same people talked to the same people, those that you didnt know well you still didnt know well.

3. so even though it could feel somewhat disparate at times, everyone still seemed to enjoy the night with those that they wanted to enjoy it with.

altogether a unique experience. mostly bizarre, yet completely enjoyable. have some good pics too. there should be a site up soon with the official pics, url tba.

got a call from previna this morning. her husband was pissed off cuz there was no minibar in their overnight room at the belfry. so much for this world class resort hotel...

nobby said to me that hes already planning the next one, at 15 years, in case we all werent around anymore at 20 years... either that or ill still be around purely from the benefits of a triple cocktail of aspirin/yet another brand new statin/yet another new ace inhibitor*. =/

food of the day:

chicken. for such a classy place as the belfry, chicken. wtf?

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* angiotensinconverting enzyme inhibitors, the new aspirin. im with the school of thought that ace inhibitors will be the next universal godsend after aspirin. we shall see...

Saturday, November 01, 2003
 
fuck me sideways with a rolling donut! talk about spooky shit for halloween!

has been a long time coming, but have just seen "ringu" (hideo nakata dir, 1998) and "ringu 2" (hideo nakata dir, 1999) back to back...

if you havent seen these yet, do. then you too will understand why these japanese stories have become a global cult phenomenon. be prepared for genuine tingling in your spine and intense creepiness. however, i still feel that more shit was scared out of me in the chinese story "jian gui" (pang bros dirs, 2002), aka "the eye" (the international distribution title in english).

now to try to get some sleep before setting off for birmingham again for the second weekend in a row. going to my med schools 10 year reunion for the class of 93. looking forward to it. but also feel a little weird about it though. we shall see.

oh yeah, various things at the end...

IDEA
"the rolling donut" was inspired by jen jens "its a zoo out there".
she really needs to cut down on reality tv. is seriously hazardous to her health! =)

INTERESTING
others worth checking out: alas, these are all people that either have had the misfortune to have stumbled over the donut, or have mysteriously been stumbled upon by the donut. still...

UNDER CONSTRUCTION
dont panic!
other stuff should appear here soon too, when i have the time. links to all kindsa diff things. watch this space!
and yeah, i know this layout is lame. gimme time! css takes a while to sort out! =(

CONTACT
well, if anyone wants to get hold of me, umm... please dont. unless its funny (and i mean haha funny, not weird funny!), in which case go ahead.
ill be at the usual place i guess.
NOTICE TO SPAMMERS: SUCK MY GUTS

DISCLAIMER
if anything described is inaccurate/is inappropriate/pisses you off, let me know and ill rectify immediately.

© psychotic banana 2003-2006
ask before stealing any material off here.




man, ive gotta put this in, is one of my alltime favs... mr abc and friends. joe dean is a genius!
finally, if you wanna see some funny shit, click here. =)

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