I need a vacation...
Haven't blogged in a while... have been busy, as usual.Internal Medicine boards are over!!!! Wooohooo!!!! Now all I need to worry about is passing it.
Started on one of our hematology inpatient services. The service usually admits lymphoma, myeloma, CLL, amyloid patients. Running a 'huge' census of 28 right now. Thankfully we have 3 good internal medicine residents. The team is made up of 3 residents, 1 consultant and 1 hematology/oncology fellow.
Have been pulling 14-15 hour days for the past 2 weeks, often skipping meals. Thankfully, we have a policy that the consultant takes over the service pager for a 24 hour period every week to allow the fellows some rest... I need some sleep!!
Learning how toxic chemo can be, and how needy cancer patients are.
Just had a case of ifosphamide cerebritis/encephalopathy. A lady with relapsed lymphoma getting ICE (Ifos, Carboplatin, Etoposide). Right after finishing the Ifos infusion, she was confused, delirious and rapidly progressed into a comatose state. I started her on methylene blue infusions, gave her lots of IV fluids to try to flush the drug out and even gave her a dose of steroids (didn't know what else to do). She was comatose for 2 days before finally waking up. We thought we had lost her. Although the family was so understanding about the whole situation, I had a lot of guilt about almost killing her (since I write all the chemo on the service). Now everytime I write for Ifosphamide, I think of her and start sweating.
I need a vacation...
posted by antatosh @ 8:49 PM
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