Saturday, February 25, 2012

Apprentice Doctor - How to Stitch Up Wounds - Overview

Whenever I'm asked what I want to specialize in someday, I answer with what most premeds probably answer - I don't know yet. However, I usually follow this up with something akin to, "but I'm really interested in surgery of some sort, or emergency medicine..." To that end, I recently followed the advice of a highly esteemed blogging colleague and purchased The Apprentice Doctor's "How to Stitch Up Wounds" kit pictured above. It came with a bunch of stuff (see below), and I'm looking forward to digging in. I'm currently gearing up to study, and I thought I'd put up a quick post as I drink coffee and wait for the caffeine to do its thing...

Lots of different stitches to learn. I always wondered how they stitched beneath the surface... 
Complete kit. See below for the breakdown.

Shown here (left to right) are two skin hooks, small pointed scissors, medium/blunt scissors,  needle holder, scalpel,  sharp probe, blunt probe, small forceps, and tissue forceps.

This is the "fake skin." I'm a bit doubtful about exactly how similar this is to human skin, so I will probably heed the advice of many and buy some pig's feet and bananas to practice on. That's right - pig's feet are supposedly the closest you can get to human skin without snagging a felony going for the real thing.

Not sure when you would use one over the other (maybe catgut dissolves better than nylon for internal stitches?) but I'm sure that's something I'll learn with the included software course.

Top to bottom (as though that's necessary...) surgical marking pen, ruler, colored string (for practicing knots?).

Here's the back panel, it basically shows everything I showed up above, but with a bit less detail. I got the gloves and thread too, but considered them insufficiently remarkable to get their own picture.

Not sure when I will get around to actually going through this - probably not until after next weekend, as I have a number of things occupying my time at the moment. Foremost are my Biochem quiz and exam scheduled for Monday and a week from Monday, respectively. Secondary to those, I am working on an online digital study resource for premed and med students. The goal is to offer all of my digital notecards that I used in preparing for the MCAT and various premed courses available for future students. It's a work in progress, but I've gotten a number of requests from students searching for affordable study resources, and I think it could help a lot of people out.

Monday, February 20, 2012

Study Locales and Optimism

I enjoy studying, but many times it's all about the location. We have a room in our apartment specifically set up for studying, and I love it. It's a quiet nook all about studying. Both my wife and I spend a large amount of our time here, tapping away at computers and swiping virtual notecards on iPads. I can choose to eat or not, have some coffee, or listen to music as I please. Best of all, there are no loud undergrads screaming over their poker game in the booth next to me at the coffee shop I thought would be quiet (last night). It was like they thought they were in their friend's basement or the local rowdy casino instead of the low-key coffee shop downtown.

Now, I know that next year I won't have my study nook. My wife and I will be living separately when I go off to med school, and I will be living as minimalistically as possible, which means no second bedroom as a study. However, this doesn't discourage me, as most med schools have a room completely dedicated to silent study. Michigan State's CHM calls their's (informally) the "Nerd Cave" - see 0:35 here. Frankly, that idea seems awesome to me. There are times when I like studying socially, quizzing friends and getting quizzed in turn, but at other times I just have to go all-out hermit, holing up for hours to really drill things into my head.

Not too much to update on the school front; still waiting to hear back from four schools, but MSU is seeming more and more like the right choice for me. My excitement is growing about finally moving on to the next step in this transformation. I'm going to love this summer of simply working and relaxing. I'll also be taking 4-6 weeks off to enjoy spending time with my wife, possibly going on some road trips to see a bit of the country. Life is great at the moment, and though I know med school is incredibly draining and difficult, I'm really optimistic about everything at the moment.

Thursday, February 16, 2012

Bike Spill and Breakfast Smashup

So, the other day I was taking my dog on an early morning run (me on my bike, her running alongside), and ended up taking quite a spill. I guess that's what happens when you go too fast on a moldy-green wooden walkway that was recently dampened by some nasty February rain. I and my bike were fine (slid maybe 10-15 feet), but the end result was a perfectly good pair of pants torn and stained to ruination, shamefully displaying my candy-cane boxers as shown below:
The best news is what came next. To cheer myself up, I decided to make a breakfast smashup of unparalleled proportions. After tossing my jeans in the washer on a soak cycle in the hopes that my wife would be able to sew shut the slit and salvage my slacks (see what I did there?), I pulled out some eggs, butter, sausage, and a previously-baked potato from the refrigerator and smashed them all together in a pan. The result was the savory clog-fest-for-your-arteries that you see here:
When I texted this picture to my wife (who has some great slow-cooker / crockpot recipes up on her most recent blog post, by the way; speaking from experience as to their deliciousness, I highly recommend them), she responded simply, "I'm going to miss you when you're gone..." Luckily, I don't do this often, otherwise that sentiment would ring much more ominous...

Monday, February 13, 2012

Doctors - What ________ Thinks I Do

For those who have already seen this a million times, my apologies. My brother shared this with me on Facebook the other day, and though I'm not a doc yet I just had to repost it here:

Photo Credit: David Christopher Aughton

5 Miles in the New Stomping Grounds

I just recently discovered some awesome trails and paths near my apartment that I wasn't aware of before. The other day, I took Naiya out for a five-mile tour of the new stomping grounds. I pedaled for quite a bit of it, but I sadly I had to use the motor to keep up with her on some of the hills; I have been having some knee problems lately that cause me to feel as though I'm being stabbed beneath the patella during certain motion ranges in the pedaling action after too much activity... Gotta get that checked out.

Anyway, here are some of the pics from that day:

Friday, February 10, 2012

Albinoblackbear = Amalgamation; Books; I Am Part

Now that I have multiple - multiple! - hours of free time most/some days, I've actually been able to read books! I just finished In Stitches by Anthony Youn, MD. While it was a little explicit for my normal literary tastes, it was also very realistic - which is why I read it in the first place. It's an engaging tale written in a uniquely-styled first person narrative, telling the story of how Anthony Youn went through the whole premed, med school, residency selection process and ended up becoming one of the nation's most renowned plastic surgeons. It was particularly interesting to me because of my recent acceptance into Michigan State's College of Human Medicine, giving me an honest look at what I might be able to expect from an education at that school. Granted, some things have changed since Dr. Youn attended med school, but a lot of the course structure is the same today.

I won't go through everything I've read lately, but I will say that I love reading. I've mainly been splitting my time between medical biographies / narratives (Something for the Pain: Compassion and Burnout in the ER by Paul Austin, MD), fantasy (The Name of the Wind and The Wise Man's Fear by Patrick Rothfuss - two books that are in my top five favorite fantasy books of all time; and Green Rider and First Rider's Call by Kristen Britain; ), and my blog list (located in the upper-left column of my blog). Speaking of which, one of my favorite bloggers, Albinoblackbear at Asystole is the Most Stable Rhythm, just recently put my blog up on her "Daily Blog Bread" list! How cool is that!? For those of you that don't know, she is basically the amalgamation formed from the smashing of me and my wife into the same female body. Seriously. I'm pretty sure we'd probably become instant best friends with her if we ever got to meet her. Doubt me? Let's break it down:

Albinoblackbear is a former RN (my wife's got two years left in her BSN RN program) who decided to go back to school as a nontraditional med student (AHEM!) in the pursuit of a career as a doctor. She loves traveling (currently doing her clinical years in Ireland; even though we are doing our studies in the US, my wife and I can't get enough of other countries, having been to something around 50+ countries between the two of us; we met when I taught her Spanish drill class, flirted some more while we co-taught an ESL class two years later, and got engaged soon thereafter) as well as all things athletic (she bikes like a crazy person and does a bunch of endurance stuff (I've lost count of the number and variety of events she's registered for at this point), while we bike for transportation and run for recreation). I could go on with more similarities, but you get the picture. It's an awesome blog that you should absolutely check out if you have the time, and exorcise something less important from your life to accommodate if you don't. The main difference between Me+MyWife and Albinoblackbear is that, on a medical blogging fame scale, she is Michael Jordan beside our Dickey Simpkins. Seriously. She's awesome. The only other truly significant difference between us and her is that she is originally from the Great White North - something for which I don't exactly envy her, given the apparent difficulty in getting into Canadian residencies.

In case you haven't noticed, I often write about things that have nothing to do with medicine, being a doctor, or learning about medicine and the process of becoming a doctor. I expect this will change next year once I'm actually in med school, but until then you'll have to bear with me as I keep writing about awesome stuff like this:

My younger brother's new blog is called I Am Part. Yes, this is the brother I talked about who blogged about his experience voluntarily living among the homeless for a few months in downtown Denver last summer. The original point with that was just to show love and care for people that have no one to love or care for them, hopefully raising awareness among the "homed" by keeping a blog about the whole experience. He does a good job of explaining it in his blog, but I'll give it a whirl here. I Am Part continues with that original theme, expanding it to show how each of our individual stories forms an integral part of humanity - a sentiment that should make us each care inherently about those around us. He even made a cool video outlining his experience, so check it out!

Sunday, February 5, 2012

My Electric Bike

I ride an electric bike, and I ride it everywhere - to class and work every day, regardless of weather, and it performs beautifully. It plows right through two-foot snow drifts under its own power, even with my feet dragging through the snow, and with a combined bike-plus-rider weight of 225 lbs, that's no mean feat. While the price tag (approx. $1,200 out of pocket or received as gifts for everything shown in this post; about $900.00 for the lithium electric setup and no thudbusting/airzound frills) might appear to be quite prohibitive, this bike is actually SAVING me money. Here's how:

The bike is a cheap, generic bike I've had for years, so my base cost wasn't too high (nothing). Since converting it and putting my car into storage six months ago, as of this post I have traveled 1,061 miles on it. I've only had to replace one tube (rear) once, and both tires easily have another 1,000 miles left in them. The bike has performed really well, and with the combined savings on gas, maintenance (hooray for no oil changes!), and insurance, I save about $200.00 per month. Since 6 x $200 = $1,200, this means that the bike paid for itself in six months, and that every day from here on out is pure gain. Direct drive motors like this one are projected to last about 5-8 years with regular usage, and at the rate I've been going it'll be about 8 years before the battery dims to only 75% of its charge capacity. In other words, this should carry me well beyond medical school, saving me about $2,400 per year of consistent use.

Component Breakdown:

The Motor: Aotema 750 Watt Front-Mount Direct Drive Motor. The peak wattage of this motor is around 1,200 watts, and something tells me it may go above that from time to time; I've blown three fuses so far... The little tag you see duct-taped to the spokes is the sensor for the speedometer. On flat ground, I average 20-25 mph without pedaling, but with a slight decline (or some fierce pedaling on the highest of 12 gears) the motor will get me up to just under 30 mph - just within legal limits for an unlicensed motorized bicycle.
The Battery: Weighing in at 5.44 lbs alone (6.01 with the mount and cords), the 36V12AH LiCo Water Bottle Mount Battery from AmpedBikes is the best choice you can make in a 36V battery. Sealed Lead Acid (SLA) batteries of equivalent size and power tend to run over 30 lbs and come in huge, bulky blocks that you have to strap onto a rear rack; think car battery. They also tend to poop out when the temperature drops much below freezing, leaving you stranded in the snow halfway home from work on a cold, blizzardy night.

Lithium batteries, however, just can't help being lightweight and awesome (and expensive). With this battery on dry, flat road I get about 20 miles to a charge (about 17 in winter, more due to added clothing (think drag - the air resistance type, not the big-city-Saturday-night-type), weight (stationary inertia!), and lower tire pressure (coefficients of friction - hooray physics!) than to the temperature, which has almost no impact on lithium battery performance), with recharge times taking about 4-5 hours from a bone-dry battery. At my local electricity rates, it only costs about $0.04 for a full recharge using the included charger, which means that I've only paid about $2.35 in electricity for all 1,061 miles so far.

Most interestingly, $2.35 is actually WAY cheaper than it would cost to purchase the food to account for the extra calories that my body would require to power the bike 1,061 miles by pedaling. I would also be willing to bet that the power plant released less pollution in generating the electricity to charge my battery than my body would have with the equivalent end-product waste after eating those required extra calories... I'll be honest - environmental friendliness was more of an added bonus to this plan rather than a driving motivation, but it definitely came out in a way that would please the most avid of tree-huggers. Anyway, back to the breakdown:
On the battery holder is a keyhole to lock the battery to the frame. It's more to make sure the battery doesn't pop out of the holder while I'm riding; I take the battery in with me when I lock the bike up to a rack, just to be safe.
The battery connects to the motor controller via a secure, four-pin screw-on connector. It's never come off, even on the most violent terrain, and is close enough to water-tight that I never have to worry about it in the rain. That screw-like cap you see on the side of the battery at the lower-right is actually the fuse cap - also water tight.
The Throttle: The throttle came with the brakes (see below) in a kit with the motor and motor controller. It's a thumb throttle, and features three bright LED lights: red designating on/off status, green indicating a full charge, and yellow indicating a low battery. Sometimes when I'm going uphill or accelerating quickly, the yellow indicator will flip on as the motor draws a high current from the battery, falsely indicating a low battery charge. As soon as I'm over the hill (or begin to pedal), the light switches right back to green.
The Motor Controller: The motor controller came with the motor kit and is pretty simple; it takes the current from the battery and modulates it based on input from the throttle and brakes before sending the correct signal to the motor. The best thing about it is that it works for 36V or 48V setups. So, If I ever wanted to off-road it in the 35-40 mph range by just getting a different battery, I could.
The Speedometer: Thanks to my awesome wife's bountiful generosity, I have the Bontrager Trip 5W. I have to say, I've never found this speedometer lacking. It's backlit for nighttime viewing, and the units are as customizable as you could hope. It even keeps track of the temperature so I can feel that much tougher when my face skin begins to crack and I see the readout display the temperature as -15 degrees Farenheit, knowing that it probably feels more like -30 with the windchill as I blaze down the snowy road in my electric glory.
The Thudbuster: Whether you're hitting the trails or the train tracks, some healthy seat suspension is a welcome comfort. I can't tell you how many times I got completely racked by an unexpected pothole as I rode down the street at night before I got this bad boy, the Cane Creek Thudbuster. Now, such things have been rendered trivial by the awesome elastic compression suspension shown below.

Note: the Thudbuster above is covered by a protective black sheath, the "Crudbuster," and can be removed and washed if it gets nasty from road salt or mud.
In the above picture, I'm not pushing down on the bike seat. The Thudbuster functions on a four-pin pivot system. Those four metallic circles are pivot points, allowing the seat to ease down and to the back under added strain by compressing the stiff blue rubber discs in the middle.
In this picture, I'm putting most of my weight on the seat, simulating the added weight perceived by the bike seat when I've hit a bump. See how the seat has shifted down and to the back, compressing the blue rubber discs? You wouldn't believe the comfort this affords when transitioning from street to sidewalk at 20 mph... Oh, and notice the awesome shirt that I'm wearing? Complete coincidence, that, but awesome nonetheless.
The Brakes: You can't use regular brakes with an electric bike. A lot of the time I have to break really fast and don't have time (or the where-with-all) to remember to release the throttle with my thumb before I brake. These brakes are integrated into the electric circuit, connecting to the motor controller to effectively cut the power to the motor when squeezed. This way if I forget to release the throttle when I brake, the motor won't continue to propel me toward a fiery death while the breaks do nothing but squeal ineffectively.
The Light: My bike sports the Bontrager Ion 2 light, again thanks to my wife (who needs to write in her blog!)who gifted it to me for my birthday last year. It runs on three rechargeable AAA batteries that blast a bright 7-hour beam of illumination capable of completely obliterating your retinas. It's got some serious brightness, and even easily detaches from the mount if you're worried about some sketchy dude from your neighborhood swiping it while it's chained to your front porch.
The Mirror: I have to admit, I have no link for this mirror, but here's a link to one just like it. I bought it for about $10 from the local bike shop, and it was probably the best $10 of all the cash I've dropped on this bike, given that it has probably saved my life at least a dozen times. When you've got the wind whipping past your ears, it can be tough (strike that: impossible) to hear cars approaching from behind you, inevitably resulting in a near-miss when you neglect to check your blind spot and try turning left only to narrowly escape a bumpy ride beneath the phantom car's tires. Not so when you've got a handy mirror to help you watch your back.
The Flaps: They might seem trivial, but ride a mountain bike to work at 20 mph in the middle of a rainstorm just once, and you'll be singing a different song. I got the SKS Beavertail Fender Set, and though I had to trim them a bit due to my fat mud tires, they haven't disappointed me yet.
The Horn: This is the newest addition to the bike, and therefore it had to be manually added to the overview picture up top. I got this Delta Cycle Airzound Compressed Air Horn for Christmas and recently made room for it on the handle bars, and am I ever glad I did! This baby lets out a blast up to 115 decibels! According to this website, that's as loud as a "Loud Rock Concert or Sandblasting." It's definitely louder than any other car horn, and more than loud enough to be heard by cars that get too close for comfort - or for the random skateboarder or biker who has headphones in and is blasting the tunes while weaving around on the sidewalk in front of me when I'm trying to pass...
Aside from the sheer ripping volume put out by this horn, the next best thing is that the pressurized air bottle is refillable using a standard bike tire pump. You simply lift the white button and underneath there's a regular nozzle for the air hose. Pumping it up to 80 psi gets about 50 half-second bursts of earsplitting noise.
So that's my electric bike: my main mode of transportation and the most fun I've ever had going to and from work each day. Environmentally, fiscally, and recreationally conscientious, my electric bike is one of the best decisions I've made in the last year. If you have any comments or questions about anything, feel free to use the Contact Me page, or simply comment below.

Thursday, February 2, 2012

Be The Match - National Marrow Donor Program

Thanks to this post by my esteemed blogging colleague Mc(future)MD (seriously, check her out if you have the time... good stuff) I was informed about Be the Match - the Registry for the National Marrow Donor Program. It's potentially a pretty big committment; about one in 500something are matched in their lifetime, so slightly lower chance than getting into med school. The "big committment" part is because giving bone marrow is much more difficult than giving blood. Either they stick a needle into your pelvis and suck out the marrow, or they give you a drug which makes your body produce many more cell-producing cells (too lazy to look up the exact name at the moment) in your blood stream, which can then be filtered out by hooking you up to a big machine. In that one, only small needles are involved, but you feel quite ill for a few weeks.

Anyway, as a result of the above blog post, I chose to sign up. I like helping people, and if I'm a match for someone, it could literally mean the difference between life and death for them. Who knows - maybe I'll be a match for someone sooner rather than later and I'll get to help save a life before I even become a doctor! If you want to help in a potentially huge way, please consider registering to Be the Match. It's easy, as the below pictures show. Four buccal swabs and you're done! Click here for more information on how to sign up: About Be the Match.

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