Miami’s traffic doesn’t top this

5 11 2011

Image of LA traffic.

http://realestate.yahoo.com/promo/dirtiest-cities-in-america.html

Needless to say, Miami has reckless drivers though… I left with bittersweet feelings and a physical impression on my side door from someone hitting the car in a parking lot! My car was parked! Well yea, the car rental rep did warn that drivers weren’t very mindful.

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1st time in the Operating Room

30 06 2011

Sometimes I feel we got really lucky to have the opportunity to watch. The OR is like an operating theatre with music, the interactions of all the people in it and the patient who lays quietly on the table knocked out with general anesthesia.

This 1st case took almost 4 hrs long. My knees nearly buckled & the nerve in the pelvic bone did not agree with my standing.  The procedure to remove the deviated vomer bone was gross at the beginning due to chipping and hammering, but not as much as the product found in the back where the sphenoid process lay. The extracted infected material from chronic allergic rhinitus. It was almost the size of my pinky & about 2 inches long each. 2 of those were removed, they were green, fungal infected, crumbles like old cheese. The yellow infected pieces come out in 1 piece much easier.

Not sure how many times the doc went between probe, micro debridement equipment, and all the tools in the special ENT endoscopy box to remove it.

about nasal polyps.

2nd case was just going in for 1.5 hrs to dilate a congested submandibular duct, to look for a stone. I had no idea they had so many #s and sizes tools just to get the duct to become bigger & bigger.

3rd case was a partial vocal cord paralysis, this one took no more than 15 min to prep & 15 min to complete. I think the doc injected something into on of the cords to move it medially to help the pt get some voice back.





$250 just to say hi

13 06 2011

That’s almost how much my 2nd taste of coffee costed this semester today. I went to see an OBGYN today and forked out $250 from my pocket, which exactly covers the insurance deductible. From now on, everything is paid for  by the insurance up to $5,000.

$250 just to see the doctor’s face and get a cotton swab of material for culture. So easy for the doctor & so painful for the patient’s wallet and time. I felt like I didn’t get much out of the meeting to day.  Satisfaction on scale of 0 to 10… let’s say it was a 2. 😦

The truth has to be told. This is what I believe happens b/c of insurance. When I didn’t have insurance before I could call around & shop for doctors letting them know I don’t have insurance. Their office visit costs are no more than $45/visit out-of-pocket. Even my chest x-ray before costs less than what it would if I had to pay via insurance. I can only imagine the dangers & horrors once Universal Care begins to take full effect.

“in the patient’s shoes.”

———-

[Edit: January 11, 2012]

Through experience we learn. Since this blog is really meant for me and I get no feedback, I learn it on my own. $250 is typical to see a specialist. Some places are cheaper if you do shop around about $120 or so just for consultation. Obviously, if you do a bit extra e.g. get culture specimen it costs more. With insurance, the cost is lowered only a bit, you must still pay a certain amount to meet your deductible. But yes, even with health insurance doctor fees are really high. They have to pay extra help nurses, costs of leasing the building, legal fees and insurance. This is a tough on everyone.





Which bite is worse: human, dog, or cat?

28 05 2011

http://www.abc.net.au/science/articles/2008/09/10/2360705.htm. The answer is human’s.

I began my clinical rotations last week, but could not write about experiences as we were preparing for the NBME or COMP exam. Either way, there isn’t much to write about except that it will take some time getting used to standing 8+ hrs daily & missing lunch.

This is what our classroom looks like. It’s basically a huge auditorium at the Hyatt hotel that can hold all 296 or something of us students in Miami. We have no internet & no electrical outlets here to plug our laptops in. Parking costs $10 each time you drop in.

The PAP Smear experience.

I had an awfully interesting experience with the healthcare system here.  The clinic I went to today did not have as much customers as the place I am rotating at. I could see why as the receptionist was outside drinking a Monster & smoking. He ran inside as soon as he saw clients coming. The young nurse was even worse, no expressions or warmth. In fact, it seemed as though she was annoyed by patient questions. The doctor is another story ! I had to do a very personal examination today and she had the door opened while talking to me and I was only in a gown.

At first, the doctor sounded nervous & she couldn’t figure out which Pap smear kit to use explaining to me it would be awful if I had to come back and do it twice. In the meantime, I could see the nurse just outside the peek of the door with… a book?!

She came into the room looking up something. How comfortable and trusting do you think a patient can be after seeing all this? Anyhow, the procedure hurted and we weren’t offered a mirror to see what was going on. There weren’t any napkins or sanitary pads offered in the aftermath for cleaning up so I had to ask for it myself.

Hmm… U.S. needs retraining!

The Pharmacy experience

I went to Walgreens to get my prescription filled. I vow to not go there again unless necessary. Which pharmacy has the 15 minutes and out offer? I’d like to go there next time. The reason was because the Pharm tech did a horrible job servicing just 3 people today. He told me it would take about 10-15 minutes, I ended up waiting 45 minutes! The problem was he talked too much & couldn’t do things right. He filled a guy’s expensive prescription without telling the customer his 30 ml meds were on backorder and they didn’t have any, so the tech went ahead and filled it for 10ml. The customer said that was a “waste of his time and money because he can’t use it”.

The tech filled my prescription with another brand also without letting me know he didn’t have the one I wanted, even though technically it was the same generic  drug. It would have been courteous nonetheless to notify the customers before filling it.





Miami news :(

6 05 2011

http://miami.cbslocal.com/2011/05/06/man-found-shot-to-death-at-miami-bus-stop/

http://cbsmiami.files.wordpress.com/2011/05/fbi-crime-table.pdf

Stories like this makes you want to stay in Dominica. People walked around with machetes over there but it isn’t even half dangerous as it is in America. USA? Why?





Craving green veggies

4 05 2011

I’ve been craving vegetables ever since I was in Dominica. The ones that I do get there are usually eaten by bugs & the restaurant owners still use them. Namely Golden Dragon. It’s nice they have veggies but never have I seen good vegetables without holes in them.

This is wheat Mama brand noodles. Tasteless… but healthy?

How it rains in Miami when it rains.





Welcome to Miami!

2 05 2011

Goodbye Dominica

Before I start, I have to say Hope Restaurant in Dominica treated their consumers to really good quality shrimp during our last 2 weeks of school. The only thing was they added too much ground black peppers.

I still can’t believe I made it. Usually around mini 3 and finals, I’d lose energy and feel so tired that it always feel as though I’d fail the final exam. Just a quick flashback: one week flew after another. The last thing I remembered was going thru ICM exam in which I walked thru several rooms confident that I was able to perform clinical examinations until I hit the scenario room. The scenario room left me wondering how many pts I actually earned because I remembered the last thing on my mind was having to explain why I picked a wrong option causing me to lose almost 15-30 seconds of my time. Then I had to do a liver span check and all I could remember was the patient put one of his fingers to help me locate the top span and my other finger was on the lower margin, I froze:

Oh crap, where is my ruler? It’s over on the preceptor’s desk. “ I froze again with my finger still on the lower liver span: “Oh no! He doesn’t have his other hand to help me hold the spot.” So although I had the liver span, I didn’t report it because my mind was still concerned that I didn’t have an accessible ruler & the patient’s hand was missing.

At least I answered the bonus question at the end.

Mini 3 came slamming 2 weeks after and cumulative final 1 week after.  One can only imagine how happy we are to make it this far.

Puerto Rico

At the airport, I asked my fiance if he would get mad if I don’t go thru the backscanners. Surprisingly, he supported my decision. I OPTED OUT! The staff at Puerto Rico was very polite and explained what they were going to do. So, I guess it isn’t the process that was intimidating nor is it just TSA, but it really depends on the individual. If you get a badass staff vs. a courteous one it makes a world of a difference in your experience altogether.

I suppose it was very easy because I already had an idea of the sequence of events that would happen and because everyone else went thru the naked scanners.

The only reason why I opted out was because I didn’t want any more radiation concentrating on my face. Having melasma run in the family does not help.

The coolest part of Puerto Rico was the Police Bugle dog that went around sniffing luggages for drugs and things. It was awesome and was the cutest dog I’ve seen for a while. So useful.

Miami

Onto a new post.  We made it! Another journey begins and I feel ecstatic so many changes are happening. Friends getting married, being back home eating American food and smelling nice again. For the next 6 months Miami will be home.

If you look carefully around you in Miami, you will notice a lot of cars have dents in them.  The rental car people told us there are lots of Cuban drivers around here so we can’t really be careful & increasing insurance is a good idea. There are hardly any asian groceries around town, but I did find 2 of them so far.

Customer service here is great and people are nicer than in Los Angeles in general.  Spanish speakers are almost everywhere.

Weather?

It is mostly sunny but when the rain clouds come over, it pours down really hard. We are also entering hurricane season from June-November.  I better buy another umbrella.

I also thought I could escape the mosquitoes, we have them here also (but not as many as in Dominica). And a lizard came into our home today. We just can’t leave the mosquitoes, lizards, and rain behind.  (O.o)

I am counting down in less than 24 days will have to take the COMP exam.  Back to studying I go.

Freecell game status: 172 out of 1 million complete.