OTO and SNA

Otolaryngology and neurosurgery this week.

HOW SWEET. The next 3 weeks will actually be exclusively with adults. Which, I'm happy about. Since I'm in the pediatric concentration internship, I was a little weary about what would happen if I couldn't find a pediatric-specific job! But, U of M had it all worked out.

I'll do this week in OTO and neurosurgery, next week in GI-surgery, and the week after in cardiac surgery. All of which I'm very excited about. I only had a half day today, which was fine. It's insanely cold here and it's starting to snow (again). While I had a half day and was technically done at noon, I stayed until 3ish. 

Otolaryngology is basically head and neck cancer. We saw about 3 patients today, plus rounds with the team (RD, doctor, nurses, respiratory therapist, med students, and a pharmacist) so that added another 5-6 patients seen. While there were many diagnoses of these patients, from subarachnoid hemorrage (SAH, basically a "brain bleed") to cancer, to this interesting patient I saw today. He came in with GI bleeding, but he first and foremost had neck cancer. He had the cancer removed, but...he was on a carotid bleedout precautions. Since he just had much of the skin and muscle removed from around his carotid artery in his neck, any sudden or rough movement could make it burst. If it burst...it would only be a few seconds...scary stuff.

A lot of the work in this rotation deals with enteral nutrition, which is going to be great practice. Mayyyyybe some parenteral nutrition.

Overall, it's been a good Monday, I really can't complain. I submitted another journal article, this time this article profiled users of governmental services. So...in 2-3 months or so, I should hear back. Which I'm very excited about! 

And...I got damage done on my literature review. In addition to the endless case studies and full days of seeing patients, interns are matched up with dietitians to complete a literature review. Our (an RD and I) topic is "Determining Energy Needs of Obese Children." Basically, we're reviewing a piece of literature that compares predictive equations for calculating calorie needs. While these calculations work for the majority of individuals, they don't calculate them as accurately for people that are obese.

Think of it this way...if you do the general 25-30kcal/kg for a woman weighing 140lbs, you'd get roughly 1600-1900 calories/day. Completely do-able. If you were to do the same amount of kcal/kg for a woman weighing 350 lbs, you'd get 4000-4800!! Not so logical. So that's what this study was looking at was to compare equations, and even create equations, to better calculate their energy needs.

Free time? What free time!?