Well, the season of Step1 stress is finally upon me. As I have said in a previous post, many medical students begin to study for the step1 in January...I, sad to say, am not one of those students. Don't get me wrong - I bought my package for USMLEWorld several months ago, reserved my copy of First Aid for Step 1 far before the 2011 edition was on the shelves, scheduled my testing date at a preferred testing center, and have even taken a practice step 1 (well, only a few hours of a practice test if I want to be honest!). It's just that I haven't exactly been keeping up with reviewing old material like I know I should. The problem is that we're still learning new stuff, and that takes so much time to memorize and understand completely that there just aren't enough hours in the day to study everything I'd like to study. My thought is that if I do my best to master the new material as it comes, I won't have to spend as much time reviewing that material in May, so I'm actually saving myself some trouble. But I could be totally off on this, and the idea of being off on something as important as this exam is frightening! I plan to start the revision process soon (uhm, I have literally said that since January), and I'm hoping this helps to alleviate some of my apprehensiveness about this massively important exam.
I just thought that I would share a few things about my health that have changed since I have matriculated into medical school a mere year and a half ago. (Was it only a year and a half ago??? It seems like I've been studying for a lifetime...*sigh*).
To start, last year I noticed that my heart felt funny in my chest sometimes, most often it was a fluttery feeling followed by a feeling as if someone kicked me in the chest lightly. I noticed that while the fluttering episodes occurred, my heart skipped. So I went to my family doctor and she put in an order for a 24 Holter monitor to find the cause for my symptoms. I was found to have a Type I Second Degree Heart Block, also known as "Wenckebach" or Mobitz I. A little medical info on this condition: it is almost always a disease of the AV Node; it is characterized by progressive prolongation of the PR interval (the PR Interval is the time the electrical impulse takes to travel from the sinus node through the AV node and enter the ventricles. The PR interval, therefore, is a good estimate of AV node function - hence the diagnosis of a disease of the AV Node); Prolonged PR Interval is followed by a blocked P wave and thus a dropped QRS Complex, presenting as a missed beat (QRS Complex indicates when the ventricles contract and send blood throughout your lungs and body); following the dropped QRS, the PR Interval will "reset" itself by initiating an "escape rhythm", which allows the heart to beat effectively until another prolongation of the PR interval takes place, and the cycle continues. What makes this type of rhythm Type I instead of Type II is the fact that the atrial rhythm is regular; this also can be comforting to know because it means that the heart-block is generally benign, and, in essence, won't kill me. Reassuring, for sure.
Less interestingly and more commonly, I've had several bruises on my bottom from what I like to call "excessive medical school syndrome", characterized by me sitting on my ass day-after-day trying to absorb as much material as I can, therefore producing bruises on my gluts from excessive impingement of my muscles between my hip bones and my not-so-adequately-padded chair. I think all of us med students have had this complaint before, and will probably continue to until we reach our clinical years, when it will no doubt be replaced by the complaint of "tired feet" from running around trying to keep up with the doctors all day...
Then you've got the normal things that we all get from being a med student: sleep deprivation, irritibility, caffeine overload, acne, serious anxiety, feelings of depression/worthlessness, etc.
Recently, I've found that I have a new health complaint - an annoyingly chronic eye twitch. It has to be related to the stress of the impending Step1, and I have been suffering this annoyance for a few weeks now (and I don't think it will end until after my exam).
All of these conditions, these health changes, can be attributed to stress. For me, my palpitations and irritability and bruised butt are all signs of an impending exam in the near future; which equate to stressful times, for sure.
So...Why did I sign up for this life again??? ;) Let's just get past this massively important and hugely stressing exam that's in June, and I know that I'll once again realize why I came to medical school in the first place - to compassionately and whole-heartedly help people in their most desperate hour of need.
...Now if only this darn twitch would stop...! ;)
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