Day 2

Started off today at nine and worked seven hours. I went over sleep studies in the morning with dr lee. I can now read these sleep studies and properly diagnose a patient with sleep apnea. Also dr lee lectured me on OSA (obstructive sleep apnea). Again the biggest thing to look for in terms of risk factors is definitely obesity. There is a staggering chart I will use in my presentation demonstrating the fattening up of our country. We went over treatments for sleep apnea as well as what happens if left untreated (elevated chance of cv event and fatality). Then Dr. lee took me to the ICU. That has been my dream since I was a kid to work there, these patients are very very sick. First I freaked out the nurses when I sounded and talked like my dad, then I saw patients on ventilators, dialysis etc. One guy had an lvat a device that contracts the heart starting in the left ventricle. ( dick cheney has one). Then I sat through a picture on discharges and hospital transitions. There are several staggering statistics when it comes to patient awareness as well as readmittance. Then I met dr. Joseph Viroslav. Just to get a sense of how long hes been around my dad was a fellow when Viroslav was on staff at utsw. Dr Viroslav is the breathing part of the sleep and breathing disorder clinc. His patients are very chronically I'll. I saw two with ALS and one with polio. The patients with ALS can be depressing as they are almost completely immobile and very dependent on caregivers. We changed the tracheostomy tube as well as the feeding tube on one patient. An extremely painful process for the patient and not for the weak of stomach. The patient with polio had some major compliance issues, it is amazing how many patients dontlisten to their doctors and can wind up getting killed because of it. So today overall took a step from more light hearted work in the sleep clinic to very seriously Ill patients in the ICU and in virsoslav's rotation.