A long break...
Taken a long break from blogging... have been busy with preparations for my Internal Medicine boards... 6 more days to go...
Transfusion Medicine has been a good rotation... lots of free time to study for boards...
Overall it has been a good month... certainly the exposure to how blood banking works has been educational to say the least. A field of medicine that I have had very little exposure to in medical school and residency.
Things I have learnt in Transfusion Medicine (TM):
1. The word 'Clinician' is often a bad word in TM. It is often amusing to hear what the TM folks say about us 'consumers' of their precious products. The term 'Clinician' is also often accompanied by a smirk, and rolling of the eyes.
2. Cross matching can sometimes be a long, complicated process when patients have all kinds of allo-antibodies. I will have to learn to be patient when ordering blood products the next time.
3. Platelet refractoriness, the methods to test for it (FLAP, Luminex), and the ways to get around the allo-immunization. Often an area of disagreement with the 'clinicians' as well.
To be continued...
Transfusion Medicine
1 month down, 35 more months of my fellowship to go...
This month I am doing transfusion medicine. Starting a few days late, as I had been covering the BMT service for a colleague who was ill. Looks like a easy month. Spent the 1st day learning how to do cross-matches and blood typing. Most of the month will be spent in lectures and the lab, and hopefully lots of free time to study for the Internal Medicine boards.
Sigh... another exam... like most of the normal, sane people out there, I hate exams... unfortunately, I think if not for exams I don't think I will study...
Anyways, going back to Transfusion Medicine (TM)... it is interesting to note that TM here in the US is often in the domain of pathology and laboratory medicine, rather than Hematology. Even Hematology here is really 'Clinical Hematology' as hemepath is also within the domain of pathology and laboratory medicine (as compared to the UK system). I don't think we do more than a few months is heme path, cytology etc.
Sometimes you get what you wished for...
and I thought today was the last day of my BMT month... sigh...
I had mentioned in my previous blog that I wished I had learnt a little more about Allogenic Transplants... guess what? Just found out that I have to go back to the Allogenic Service to cover for an colleague who is out sick... I guess sometimes you get what you wished for :)
My colleague who was suppose to start the Allo service tomorrow has been ill for the past few days. I offered to cover for him, and he initially declined. He just called to say that he will take me up on the offer... so... looks like I will have to wake up at 5.30 again tomorrow...
Actually, at least I know that my colleague is someone that won't take advantage of me... he is someone that would have come in if he felt he could make it... so... back to BMT... probably for a day or two... maybe I will get my wish fulfilled and learn something :p
The Allo patients are sick though... everything from horrible opportunistic infections, CMV reactivation, graft-versus-host, failure to engraft, serositis, to just being plain sick. I don't think I would want an allogenic transplant performed to me...
Anyways, got to go to sleep... long day ahead...
Last day of BMT!!
Phew... initially I thought the month would never end... but today is the last day of my BMT rotation... woohoo!!! At least I can sleep in tomorrow... can wake up at a decent time like 7 am...
Overall, it has been a good experience, though I kinda wished I learnt a little more about Allogenic transplants. I spent the month on the Autologous service, and although I had to cross-cover the Allo service at night, I did not have much to do with them.
One of my patients had asked me whether I found the month on BMT a useful learning experience.. I think that looking back now, the experience of seeing the patients at the different stages of their transplant was certainly educational... having the benefit of having patients ranging from pre-tranplant through to the immediate and latter phases of stem cell transplantation gave me a little insight into the often complicated process.
Certainly fell a lot more comfortable discussing stem cell transplantation with patients now...
Looking forward to call-free month of transfusion medicine... have to start studying for my internal medicine boards though...
