March 3, 2011

from embarrassed to 'oh shit' in an afternoon

My physiology test is tomorrow and I hadn't studied for it until yesterday.  It's over cardiovascular and gastrointestinal physiology.  I spent well over a decade doing drug discovery for cardiovascular disease and probably three years in the gut so I figured it shouldn't be a complete surprise to me.  Plus, we had two group exercises and I basically answered all the questions for our group.  I crack open an old test yesterday and the question is:
The large conducting artery depicted above is developing an aneurysm in region B.  If flow through region C is 300 ml/min and the velocity of flow through region A is 100 mm/sec, then all of the following would be true EXCEPT:
A)  The velocity of flow through region C would be 100 mm/sec
B)  The flow through region B would be 300 mg/min
C)  Mean end pressure would be greater in region B than in region C
D)  Wall tension would be greater in region C than in region B
E)  Side pressure would be greater in region B than in region C

Uh-oh.  There's math and formulae on this test?  Ah, crap.  In that moment, I realize that all my experience is in clinical disease, not the hardcore physics of fluid mechanics.  This is just plain embarrassing.  I feel like I should reimburse the money I made in my career if I can't pass CV physiology.  I plow through the day getting increasingly more frustrated.  Then today, I wake up and go right back at.  I'm starting to get substantially more of the problems correct and feeling good about myself.  I feel so good, that I decide to go out to a late lunch with my mom for brisket since it's been awhile.  After lunch, I drop her off at home.  I notice my dad is home so I decide to peak my head in to see how's he doing.  He's upstairs and my mom goes up to see him.  From down the stairs I hear a very concerned voice, "Zack, get up here."

I go up the stairs and my dad is in bed at 2 in the afternoon.  Not the least bit normal for him.  I take one look at the pallor of his skin and he's white as can be.  I test his capillary refill and it's almost non-existent.  Intense pain is present in his abdomen and when asked the location, he points to the upper left part, right below the ribs.  Uh-oh.  I palpate ever so gently as they've taught me, starting away from the pain and moving towards the area fearing what I'll find.  When I get to the spot, he recoils in pain but before he does, I feel a very distinct swelling present.  Uh-oh.  The main organ that lives there is the spleen.  Problem is that Mr. Spleen isn't supposed to be palpable unless it has enlarged to 3 to 4 times its normal size.  Oh shit.  I become increasingly concerned now.  Splenomegaly is a very common and potentially very dangerous complication of leukemia and lymphoma.  I call his oncologist and leave a message for the nurse.  She calls back and tells me to get down to the emergency room.  So here I am with my mom while my dad is getting a CT scan from the waist up to the top of his head.  Once we get the results of the CT scan and the bloodwork, we'll go from there....

1 comment:

Denise said...

Hi Isaac - just wondering if there was an update

your cousin Denise