I just finished my second work day here. My second work day here was 31 hours long. Believe it or not, I'm still upbeat. I realized a few things. One, MS-IV (medical student, fourth year) is almost as magic as MD when it comes to writing orders. Also, I still love internal medicine. My two patients are pretty typical of the range you see on the wards.
Mr. Wish has CHF, and as part of that disease, he is supposed to watch his salt intake, keeping it to an absolute minumum, I think off the top of my head, it's supposed to be less than 2 grams per day. A can of pop has about a fourth of that. So it takes some discipline.
Discipline he lacks.
Mr. Wish informed me that "yes, doc, I'm keeping a real low salt diet. I don't put salt on anything at all anymore."
I should state before going further than the reason he is in the hospital is because he gained about 15 pounds over the past three weeks, solely from the salt he "isn't eating."
So I asked him what he had for dinner, say, the night before he came to the hospital.
His answer was "we went out for Chinese." In case you were wondering, the average single dinner, without sides, at a Chinese resturant, has well over 2 grams of salt in it (not to mention upwards of 50 grams of fat)
He also firmly belives, despite taking diabetic medications including insulin, that he is only "pre-diabetic."
Some patient education is in order, I think.
The next patient...will have to wait for another post. It has been 31 hours since I've slept, and I'm going to enjoy this.