lub dub

Well, great work by Cadel! After staying up and watching Cadel fall short in 2008, I was worried what might happen this time around! Fortunately, all was well and we can not talk about cycling till The Tour Down Under hits town.

I am once again well. I think I get a rather sick joy out of being sick. I hate being sick, don't get my wrong. But with such a strong background in immunology, I can appreciate being sick on so many more levels. So here is a crash course in to what goes on for you regular plebs:
On day 0 I wasn't aware I was sick, but my rhinovirus was having quite the party, procreating wildly and unchecked. But then on Day 1 my immune system cottoned on and switched on my generic defenses - fever and anti-viral interferons. Later that day, my neutrophils were flooding in as my vessels in my sinuses became more permeable and my nose consequently ran like a tap. The classic inflammatory response was evident in my sinuses and throat, though the Virus was still firmly in control.

By day 2 my lymph nodes were up as my adaptive immune response tried to get itself organised. Having not seen this foe before, it began the process of pulling apart some captives and finding their weaknesses. Meanwhile my macrophages had made the move, helping my neutrophils but awaiting further orders. The cough began, to complement my enhanced mucus secretion in order to get the gunk from my throat.

By day 3, the battle was well underway, and I still felt gross. Only now coughing up excitingly colored stuff - my immune cells and epithelial cells that hadn't survived the fight mostly. Though I was feeling worse, ground against the virus was being regained.

By about day 4 though, things were starting to change. The battle was lost for the virus, as the T helper cells started to coax my immune system to fight tactically. My Killer T cells were becoming more abundant, punching holes in my virally infected cells, causing them to die and depriving the virus of a place to live and multiply.

Meanwhile my B cells were ambushing my rhinovirus as it tried to move to a different position away from the firefight. The B cells, were throwing out sticky antibodies, pinning the virus down so that the macrophages could pull a Mike Tyson v Evander Holyfield, and gobble them up. Now any movement by the virus was met with continual harassment.

Having stomped all over the virus, my immune system continued to dominate and showboat, just to be sure. My Antibody kept being churned out, and by tomorrow, the new and improved version will start making an appearance so that I'll be forever immune to this pest. However, I'm feeling much better now. In fact, I'm back to normal apart from a bit of a lingering dry cough. The virus has gone, though my immune system waits like soldiers on leave, just cruising for a fight.

And that's it really. Picking a fight with one enemy, and beating him soundly. Fortunately, this time at least. Mr. Bacteria didn't try have a go while my troops were busy with virus. Always pleasing not to have a chest infection!

If you enjoyed me pretending my immune system was a battleground, feel free to donate to any charity of your own choosing. I hope you accidentally learned something too! I'll never do it again.

Let the insomina end

I'm not usually one to write about sport. I might give the token sentence to how much I love the Tour de France. But I don't think I've ever written long tributes to it. Well, today is your day friends! Wait, don't leave!

Before that I must quickly grumble. I've captured myself a rhino and have been a little sick. This at the first week of the term, which is okay I guess. But my new PBL group has a completely different make up than my old one. Having a couple intensive care nurses, a pharmacist and a lot of scientists has greatly changed the dynamic from my old group. Probably just as well, as I want to feel challenged. Though, for the first time I feel inadequate! Time to hit the books, which is convenient because:

Le tour is about to finish! Devastating I know. But in my mind this has been the most interesting tour for ages. If you haven't been watching it - shame on you! But I understand. It is on late, and I have taken to tivoing it and watching it over breakfast the next day.

Still, without the sideshow of Lance Armstrong, the focus this year has been purely on the heads of state. A spirited nine day showing by the Frenchman Voekler kept him in yellow for 9 days, defying his critics on a daily basis, who said he would never last in the mountains. Only yesterday, on the final mountain stage did he finally lose the coveted number one spot.

Contador, who has won the event on previous occassions hasn't really turned up this year - but keeps causing trouble amongst the three main contenders. If you have seen a little cycling in recent years, you'll know that two brothers - Andy and Frank Schleck are freakish athletes. Unfortunately for the Aussie Cadel Evans, they are his fiercest competitors, working to deny the Australian victory.

So it has been fascinating to watch, the Aussie fighting hard trying not to let the Schleck brothers get away, and the Schlecks punching and counter punching their way up mountains trying to destroy Cadel.

The whole story has been complicated by their vastly different riding styles. Cadel is like a diesel, he goes and goes, but takes awhile to get up to speed. The Schleck's however have a very rapid acceleration, so watching the game of cat and mouse play out on the beautiful backdrop of the French countryside has been fascinating.

The race as a whole has been excellent this year, though I don't deny I'm a Cadel fan, and hoping desperately that after twice being runner up, this year will be his year. Although Cadel has finally got himself a half decent team, he is still the best on his team, which has left to do so much of the grunt work by himself.

After 19 days of racing, the last competitive stage (The final stage is more like a celebratory ride than a race) is about to begin. And this time it's every man for himself. The final stage is an individual time trial. Whereas the previous stages have allowed riders to work as a team in order to share the load and conserve energy. The final stage is a 40 odd kilometre race, every man for himself. Ultimately, the clock is the enemy. Cadel sits 57 seconds deficit of Andy Schleck, who holds the yellow Jersey. Schleck is not renowned for his time trialling, whilst Cadel is a road race champion. The hope tonight, is that Cadel can gain back that minute, and I know I'll be watching earnestly. If Evens can do it, there will be much excitement in this house.

So I urge you to watch it, it will be interesting to say the least. I haven't even mentioned the beautiful scenery, the tactics, the fact that this is the ultimate test of a persons physiology, and the incredible emotion that becomes evident amongst the winners and losers.

9:30 Tonight, grab a drink, settle in front of the TV and yell for Cadel.

Meanwhile, back on planet earth

I'm back in the lab. It hasn't changed at all. Feels weird to be there though. Even if I am just writing and not on the bench.

Also, passed my exams and the first semester. So If ever you need 1/8th of a doctor... I'd probably still see a very drunk regular doctor actually.

Lumpage out.

Edit: Also check this out, c/o Ashby www.lifechurchunley.org.au

Best day of my life candidate

Well, I just finished my recovery room placement. And it was perhaps the most fun and interesting time I've had in a while. I'm not really sure how to relive the experience through this blog. I realise, as I expressed in my last post, that in but a few years the whole morning will be viewed as mundane. And yet, the first time you get to see things, feel things, hear things and smell things... mind blowing.

That said, I rocked up anticipating to watch people wake up from surgery, be groggy and complain about post operative pain. And this is pretty much what I saw. A lot of pain rating, consciousness evaluation and doling out meds. Alas I didn't get to do much but ask a few questions and talk to a couple patients as a distraction. One of the nurses noticed by seeming idleness and asked me if I wanted to go jump in to theatre instead. And I certainly said yes.

I'd never been to theater before, nor seen any blood and guts glory. So I was off the chart excited. The aneasthetist was quite jovial and keen to let me do some hands on stuff.
"How much do you know about airway management?" He asked me.
"Enough to do basic life support, but that's about it."
"That'll be heaps! Now I've just stopped him from breathing so you might want to put this mask on him."
And so I did, but the guy seemed to resist it.
"Oooh we've got a fighter here! Love that!" And the Doc grabbed the mask back and fiddled with knobs. A nurse then came and got me and taught me how to scrub in. I'll be honest - I was bamboozled by the sterile gloves. They're all neatly folded and confusing, and I wasn't sure which part I should touch with my clean hands. All I've been taught from television is - don't contaminate yourself by touching something you shouldn't.
The operation was fascinating, got to watch an ACL be reconstructed. The orthopods were good teachers, and explained everything as they went. I asked questions, and most importantly didn't pass out or throw up. If anything I felt hungry.

I then got to cut stitches and staple the wound closed. I then followed the patient through to recovery and all was well. But then a doc from theatre came out and grabbed me again, offering me the opportunity to drop a tube down the next guys airway. It was sooo cool. I've seen it done on ER lots of times, but to actually jam the tongue down with the metal dealy, see the cords and then pass a tube through them - so cool! Best of all, it went in first shot, in the right spot. The surgeon then let me remove the screws from the guys metal plate and staple the wound closed. "I was working on the jeep yesterday, so this feels familiar." I said to the surgeon whilst removing the screws. He laughed. Man, it was blood on your hands type fun. So fun!

I'd wondered what surgery was going to be like, and I really enjoyed it. I always thought I'd end up doing a pseudo science/medical job. I thought surgery would be a bit too much time at work. But who knows!

I'm happy today!

Ummm, is that normal?

"It's useful as an introduction to shake a patient's hand when meeting him or her. Apart from being polite, this may help the diagnosis of dystrophia myotinica, a rare muscle disease in which the patient may be unable to let go." T&O'C

I like medical books. They always contain these hilarious anecdotes of speculative value. I wish I could fill my thesis with observations like these. Oh well!

I'm excited, and it's sad. My first semester of medical school has been entirely theory. Very little in the way of hands on. It would be fair to say that I could have acquired more hands on experience at an over zealous church, of interesting denomination. But that's okay! Because this wednesday I get to do my recovery room placement. My understanding, is that I'll get to do such exciting things as:
Calculate volumes remaining in bags, and
Suction spittle and or emesis related products.

Nah, it won't be that lame. There will be the opportunity to keep peoples airways open so they don't die. This will amuse me because the person will be unconscious initially, and I've always wanted to see what happens when people wake from unconsciousness.

The thing is, I'm keenly aware that this will soon become mundane for me. I remember the times when we got undergrads in to the lab. They loved doing mundane things like loading gels, or pouring off supernatents. And now I'm that guy! And I'm excited about it! Groan!

I guess it's a good idea to at least be keen at the start though! Starting off bitter would be a bit silly. Fingers crossed I don't kill anyone, because that would be a serious blow to the psyche at this formative stage.

What I find ridiculous though, is that this is the first time I get to wear scrubs. And that's sadly the most exciting part of all! Even though there will be countless opportunities in the future... I'm really looking forward to it. I guess it's that moment where you start connecting that dream you had as a kid to reality. I hope it will be at least a small fraction of the goodness my mind has built it up to be, and that the patients will all be as good looking and interesting as those on Grey's anatomy.

Sailing on 'the live forever'

I'm watching stage one of the Tour de France, and I looove it.

Now that we've got the obvious out of the way, I think you should know. I have seen my future. Sort of. It's shocking.

I found myself in a waiting room in Flinders private Hospital, and I saw my future. My GP, referred me to go get my blood pressure monitored for 24 hours. I've never gone to a GP frequently enough to have a GP that I could claim to be my own. The advantage of getting sick once every three years I suppose. But my GP is suitably zealous, and keen to confirm the coatyness of my white coat hypertension.
"As a medical student, you'll enjoy it on another level!" She promised me. And I hoped I would.

As I sat in the waiting room of the cardiac clinic, I got to look around at my fellow visitors.

Old people.

Lots of them.

"I'll just take you through for an ECG, and then you'll meet with the doctor."
I heard that phrase a lot, spoken loudly and clearly. And then another old person would get called upon and the process would repeat.

Finally, after half an hour of having the life sucked out of me by old people admiring my young flesh I was called upon!
'Why am I here again?' I pondered to myself. This endless questioning continued as the nurse began to explain to me what blood pressure was. Very simply, slowly and loudly. Oh dear.
'I'm young!' My internal monologue screamed.

In the end it was okay. Except being woken up every half an hour by the BP cuff inflating. Results will be in in a couple of weeks, but I had a few peeks at the device and I seemed to be floating between normal and the bottom end of high normal. I suspect I shall live through the night.

Man, the French countryside is pretty. But it's looking a bit drier this year. Has a bit of a South Australian feel to it actually!