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Friday, September 25, 2009

When I attempt to make a Differential Diagnosis during a panic attack

A couple of weeks ago I had a panic attack.It was this vague abdominal pain that won't go away.And being the doctor that I am I just had to make a diagnosis -A bunch of differential diagnosis all without any lab tests or other aids..
So,,all the racing differential diagnoses in my head finally gave me a panic attack..then i went to twitter and made a record of my thoughts..Just so that i can blog about them later..

Here goes

Had a severe panic attack compounded by abd pain,nausea.I have been sick this week.makin dramatic differential diagnoses doesn't help either from web

see.It is could be a ruptured ovarian cyst with Intraperitoneal infection leading to sepsis.could be a strangulated hernia.vaginal prolapse? from web

No wait, maybe i have had anemic hypertrophy of the heart due to constant blood loss due to hemarroids,or maybe my complication of swine flu from web
could it be sinusitis leading to sepsis causing the nausea?oh wait,Myab from web
maybe i have had undiagnosed Hypertension all this while which explains the headache..or wait, is the headache due to sinusitis? from web
Am i just a hypochondriac? or maybe psychosomatic disorder? gosh! knowing too much is sometimes a problem when you get sick.doctors=bad pts! from web
You know what my worst fear is .what if the ovarian cysts have already undergone that rare cancerous transformation and have metastasized ! from web
what if the metastasis to different areas of the abdomen is what is causing abdominal pain which random and what if the nausea is cachexia? from web
want to see what a doctor tweets when she has a panic attack? read my previous 12 tweets.Maybe i must make them into a blog entry! from web
yeah.maybe metastatic secondaries all over giving me pain ..that is one thing i hope it NOT true.could be intususeption/volvulus/strangulatn from web
see the headache could be plain frontal sinusitis/inf associated with it/migraine/temporal arteritis/Hypertension associated ..soooooo from web
yeah.I also thought about if it is a progesterone producing ovarian cyst causing me rt lower quadrant pain with nausea from web
absolutely not getting yeah, the chance of pregancy or ectopics is thankfully ruled out unless there is one of those evil twin thing from web
very very loud grumbling and bowel movement-some kind of obstruction?strangulation ?intususseption?volvulus?ovarian cyst pressing on bowel? from web
Seriously, being a doctor and being sick this whole thing sucks...the abd pain sucks,headache sucks,panic attack sucks most! from web
I am so sane and accurate when it comes to diagnosing my patients.Only when i do have to diagnose myself I go totally overboard!totally! from web
Now,see ,when i now read these tweets as i Import them from my Twitter stream.I find them Hilarious and outrageous...A progeterone producing cyst?What the hell? And suddenly it dawned on me that THIS IS HOW PATIENTS FEEL..They are stressed, they are scared and they are probably angry .I realized that when patients come to me with breast masses and other pains, they are very distressed and the fear is irrational but they can't help it ..
this panic attack help me understand their pain on a first hand basis and probably more receptive to their seeking my help..Hmmmm...
I know ,I know.I firstly apologize for abandoning my blog and going over to become a Twitter-Ho!(yes,I used the H word,for the kicks!)
The advantage of twitter is the smaller blogs-'MicroBlogging' if you may!No,actually,I think I am genetically inclined to write long long long compositions and then not even having the decency to spell check them and type them at the rate of 75 words per minute which causes the letters to exchange positions -more like Typing Dyslexia -LOL and posting them on my blog without prooofreading them-All because of I love long conversations and if there is no one around-Monologues--aka--Long blog entries.
Therefore,Twitter,with its 140 character limit forces me to become precise .It saves me time and it gives rest to my fingers and yet,It manages to allow me to keep putting my opinions out thereOne disadvantage with twitter though is that, when you just type out 140 characters,YOu may not be able to explain the whole scene,The whole history behind the tweet or the context and thus you put yourself at risk of being misunderstood.
FYi:this tiny blog entry is a crosspost onto my other blog The not so daily ramble blog from my Ecology and Health blog, and If you already subscribe to both please don't curse me for multiple posting.

Tuesday, September 8, 2009

The snake dream-yeah,Its Dream journal time again!

I have been seeing some rather freaky dreams these past few days.
Just a couple of days ago, I had this dream where i run from High school to High school trying to enroll and no one will take me and then I kinda manage to enroll, only to find out that the Teen Leonardo Di caprio is my classmate."What is so FREAKY?" ,you might ask!

See, the thing is ......
You know the 'BASKETBALL DIARIES' movie ? and the teen Leo in that movie.Yeah, yeah, the one that develops a drug addiction problem eventually in the movie ! Yeah, THAT Leo was my classmate in the dream.Not the 'Titanic' movie Leo.Just had to clarify!
So,yeah, coming to the SNAKE DREAM.
Yeah,I saw snakes in my dream..Rather, a single snake, that kept wriggling/writhing back and forth.
Btw,I saw a Leo movie before going to sleep on the night that i saw the Leo dream.
Also, I saw a David Attenborough's documentary on snakes just prior to going to sleep on the night that i saw the snake dream. Also i have been listening to this song called a DREAM MACHINE over and over these past few weeks.There is a line in that song which goes, "Rattlesnakes charmed on the dance floor, dance floor, dance floor" and then i have taken to envisioning actual rattlesnakes lying charmed on the dance floor each time i listen that line in that song.

DREAM INTERPRETATION is quite easy,you know!Things that You see in your dreams are actually things you have been mulling on quite recently prior to dreaming-Be it TV or be it daily routine things .There is no mystic interpretation required..It is plain and simple.Dreams are just our minds' way of organizing thoughts and storing memory. It goes through all recent memory and then sorts out stuff and stores some and discards others.Much like the temporary folders in our computer.
So yeah, coming back to ....

So,In this dream,I am lying on this cot which is laid out on a cemented yard which looks on to mountains and meadows.Very picturesque!I am lying down with face down intently focussed on the floor because there is a snake on the floor , wriggling around and going round and round on the cement floor. no really..It just kept moving swiftly over and over in a large wide circles.And we people are intently watching it do so, all the while making verbal commentary on how swift it is..
All of a sudden, I turn around and look at the other people and start discussing how me must build a gutter with a netted mesh cover for the snake all around the cemented patio,just so that the snake can happily keep sliding around while at the same time the people don't get scared and they don't accidentally come in contact with the snake..

I finish explaining the architectural details of this cement gutter and turn back to the floor to continue watching the snake writhing on the floor, but ,the snake is gone.I am like, "hey, where did the snake go ? It was here on the floor all this while!" and i suddenly realize that the snake has climbed onto the cot that i am presently lying on..
I get quite shocked because the snake is so close to me now and just as i speak,This snake kinda pounces on me and kinda lays a gentle smooch(I prefer to call it a smooch instead of a bite) on each of my eyes and I am starting to shout out--" It didn't bit just touched my eyes ever so softly" and
BOOM ..I wake up from my sleep..that was freaky.. coz immediately after i woke up.. i started to look for a snake under my cot--Boy!!!!

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