Kaplan

Well, my cursory chemistry review is continuing on pace - I'm a bit over half through. I remember everything I'm reviewing, although there are a few types of problems I won't be able to do without some more in depth studying than I'm giving them at the moment. That doesn't worry me too much though; I was able to do them in school, and am quite sure I'll be able to do them again with a more in depth review after I finish this cursory sweep.

The chemistry section is somewhat naturally more given towards problems and equations than the general biology section was. I'm not sure how this will play out in the actual MCAT questions on chemistry yet (will they somehow be broadly generalized and passage based, as in biology, or will the passages involve the need to have more equations memorized). While I'm not worried about it, I am interested to find out - it could have a big impact on Physics, where I'm not half as confident in my ability to review and remember things that I never fully understood in the first place.

If the chemistry questions are largely broad-based though, then it's very likely the physics ones will be as well. And that would be good news.

As far as other studying stuff goes, I looked around the Kaplan site a bit and they have a few packages. The one I'm leaning towards costs a somewhat painful $1900 dollars to sign up for (although there's a $250 rebate of sorts). I'm pretty positive I'll be signing up for that in a few days nonetheless though, once I get my checks to post at the bank. Given the test design, this seems too helpful to not take given the opportunity.

I've still had no luck getting anyone from AU's premed office to reply to me, despite leaving a voice mail and e-mails. Fun. So I went and e-mailed my old undergraduate premed office at Vanderbilt with a few questions today. Hopefully they'll get back to me next week sometime - they've been good in the past. I'm going to wait on that before registering for the MCAT, although that needs to get done really soon too.

First Practice Test (Segment)

So I finally took a practice segment for Biology. I didn't do great, but I did ok. Or I would have apart from one set of 7 questions that I bombed. Had I gotten those though, I'd be happy (enough) to move on. So what I'll do now is review DNA/RNA again (since those 7 questions came from that area) today and tomorrow. The other few questions I got wrong were, for the most part, things I either should have got right or could have with a bit more review. But the review neccesary to cover every complete set of possible questions like that is time consuming enough it could go on for months, which doesn't work. Getting 2 or 3 more questions right by spending another month on Biology doesn't make sense when I can spend that month on Chemistry and get an extra 10 right (or however many). At any rate I'll start working on Chemistry on the 13th now, almost on schedule, and will keep looking over my Biology notes periodically.

The biggest thing I got out of this though was that it's not a science test. At all. I know I posted that earlier from reading it and being told that, but since I hadn't taken any practice segments I didn't really know what the test was like.

Of ~40 questions maybe only 8 or 10 required "know this" knowledge. The rest was largely stuff you could get from passages if you had an idea what was being talked about. So most of the questions I got wrong (apart from that section on DNA) ended up being things I could probably get right just by taking a hundred practice tests - a lot like the LSAT. A lot of the stuff I spent the last few months looking at was talked about (Lutenizing Hormones and Follicle Stimulating Hormones, for example), but it was looked at in the context of a passage and not as a "LH is created in the a) anterior pituitary, b) thymus, c) pineal gland, or d) hypothalamus". You didn't (really) have to know what LH did either, you just had to have a hang of the basic concept.

This steers me a lot towards buying Kaplans online program. Or at least looking at it closely in the next few days. It also steers me in the direction of rushing through my traditional studying in favor of spamming practice exams once I've got a very rough hang of the basics.

I'll try doing Chemistry fast in ~2 weeks, and we'll see how that goes. If it works just as well as having spent ~2 months on Biology I'll be very happy, because time's a commodity here.

Updates

No posts since January 10th huh? Wow. It's been awhile. Part of that's probably due to a week long vacation I took where I went traveling. I was "almost" sick throughout. You could think of that as either good or bad, I guess. It broke out into a real cold once I got home (which I can only think of as bad...) Otherwise things have continued to be uneventful but busy.

I'm still waiting on a reply from the premed office concerning the maintenance and status of my file there. Technically it's only been two or three days, since I sent my e-mail on a Friday and they don't work weekends. To me though, it feels like it's been closer to a week. Which is frustrating. My current frame of mind is that I'm going to just put the application/file on second priority (although it's still, obviously, important). What I want to focus on is the MCAT. If I take it and score well, things will work themselves out with or without good support from the premed office. The worst case would be I have to postpone my admittance a bit. Conversely, if I don't get a good MCAT, it really doesn't matter if my file is in good order or not because I won't get in anywhere.

Speaking of the MCAT, my Biology reviewing is going well. It's almost finished, in fact. I aim to wrap that up by February 12th - taking a little biology section practice test from Kaplan. If I do reasonably well on that, I'll move along to Chemistry which I hope to complete reviewing by the end of February (not much time, but it's probably my strongest subject to make up for that). If I can stay on schedule with those two, things will be going fairly well.

I have to sign up (again...joy) for the MCAT. I'm hoping to hear back from the premed office first, but if I don't I'll just go ahead with that anyways towards the end of this week or the start of next week.

And lastly, regarding HIPAA and patient privacy, I simply haven't had the time to look into what I can and can't legally post. I still would like to check into that at some point, but I'm occupied enough with MCAT work, job work, and trying to sleep that it's not likely to happen soon. So I have two choices. I can either take this off the internet and turn it into a personal log which no one would ever see, or I can keep it up and just not include anything that could even remotely be construed as a violation. I'm sure no one is reading this but me anyways, so it probably doesn't matter, but I'll take the second choice for now. I enjoy having this up even if I am the only one who looks at it.

A Patient I /Can/ Talk About:: Me!

So today was an interesting day. It was an off-day from work, which I started with my "morning" coffee around 7:00pm. I told the lady there I'd just woke up, and she asked what I did. When I told her where I worked she went off on this awkward rant about how she didn't like my hospital... and I was a bit too dazed to reply well. If I hadn't gotten up I'd have probably worked harder to explain how everyone at the hospital tries the best they can to get everything done quickly but well, and how hard it is to do everything both quickly and properly, but how we really do try for that. As was, I just wanted my coffee and a quick exit.

Anyways. Later after "breakfast" I came back home when it was all dark, and tripped over an empty litter-box in my hallway. I caught my arm/shoulder on the wall falling, heard a bit of a crack, and felt a lot of pain (that quickly subsided in a minute or two). Normally I probably wouldn't do anything about it, but I was a bit nervous since I have a history of shoulder dislocations, as you probably know if you've been following this blog, and wanted to be positive I didn't keep it out over night if something /was/ wrong, even though I was pretty sure it was just in pain but otherwise ok (the biggest clue was I had full range of motion, with pain, and in all my previous dislocations I certainly haven't).

I really didn't want to go to the ED because I know first hand how busy they are, and how many unnecessary cases they get, and I felt kind of awful becoming one of those.... but I ended up going anyways. I have a vacation coming up, and I didn't want it spoiled by an actual injury.

Well, needless to say I was ok (which is fortunate, but was unpleasant at the same time, if that makes any sense. I'd kind of have rather had a minor discernible problem). Everyone was nice and worked well to get me in, and it was fun seeing things at the ED from the side of a patient for a change.

I guess the take-home message here is that I should try to be a bit more mentally accomodating of people who come in with complaints that make one go ::sigh:: It's really easy to get tired of them after you run into enough, and to start looking at people as room numbers. But everyone really is a person, and you shouldn't let yourself forget that. They probably did think they should be in the ER, even if you can't really understand why.

As for the shoulder, it's ok. I got some extra-strength motrin and just a few pills of hydrocodone to last a day or two. Hopefully it will all right itself by then.

As an aside there was another patient earlier this month or last that I'd like to talk about but, obviously, I can't. I'm going to read up on HIPPA and privacy stuff, and see if maybe it would be ok to talk about a hypothetically similar case that doesn't actually have anything to do with the real one, but manages to broadly convey what I was feeling. Because it created an interesting ethical situation and left quite a mark on me.

So I haven't Stopped Studying

Not yet at least, this time. This is, needless to say, good.

What's more interesting than the fact that I'm still studying is that while I'm studying I run into stuff I've been seeing/doing at work, which makes it a lot easier to remember things. I've been recording/tracking the blood and protein returned in urine tests, for instance. Then I studying I learned that what those are looking for (among other things) are possible defects in the glomerulus of the kidney (which is supposed to "filter" out large molecules). You get an "oh, neat" moment when you read about stuff you've been doing. And then it becomes even more interesting to do as well.

The other day when the pace slowed down for a bit in the ED I also got taught what an x-ray of a patient with pneumonia looks like, some basics of ekg reading, and a four-step outline for treating hyperkalemia in patients.

Fun stuff.

What I Learned (2)

Takotsubo Syndrome: Commonly referred to as Broken Heart Syndrome because it's a condition typcially precipitated by severe emotional stress, Takotsubo Syndrom is a sort of cardiomyopathy that is hard to detect on an EKG because it mimics the readings that would be expected of a STEMI (a type of heart attack - ST elevated myocardial infarction).

In Takotsubo Syndrome however, the left ventrical of the heart gets bent out of its proper shape. It's a (relatively) recent diagnosis, originally discovered by researchers in Japan (Takotsubo means octopus pot, a reference to traps used to catch the creatures and, in this case, the shape assumed by the deformed cardiac muscle), but is being seen somewhat more commonly in other countries now that people know about it. If the patient survives the initial attack, the condition is usually temporary and resolves itself over a period of several months.

I ran into a case of this. Very sad that the person had it of course, but I think the idea that you can actually get broken heart syndrome/die from a broken heart is really fascinating.

In other affairs, I've changed my MCAT study approach from trying to knock out my worse subject first (Physics), to trying to start with things I'm better at (Biology, and I'll do Gen. Chem after that). With the hard stuff first, I was making very slow progress. With slow progress I'd constantly see how much other material was left to cover, and I'd freak out even more, which would further slow my progress down until I "took a break" (read, stopped). The idea here is to simply knock out what I know I can knock out, and then do the hard stuff last (but hopefully still have over a month for it).

So far, this new approach has been going very well. I've gotten a lot of Biology review done in the last few days, and if I can keep it up things look to be going great. The biggest catch is to not get /too/ caught up in the details. It's a fine line - the MCAT expects me to know a lot about respiration, for example, but it doesn't expect me to know all the details of the proteins involved in the ETC, or all about ubiquinone, or every individual reaction that takes place in the Krebs Cycle. It's easy to get side tracked into trying to re-memorize all of that like you might have for a normal exam, but that's not a good use of time (and will put undue stress on you as well, because memorizing that many details isn't a simple task).

Anyways, I hope you all had a happy Thanksgiving if you're reading this (and if you're from the US). I had the day off and got to spend some time back home, which was nice. I'll post again later.

What I Learned (1)

Children get lots of ear infections. I know I used to as a young kid, and in general I've seen several people come in complaining of that lately. I never thought about it until a few weeks ago, but I realized that at "some" point I'd more or less stopped getting ear infections entirely. Why was that?

It turns out that children have smaller Eustachian tubes (little tubes linking the pharynx to the middle ear) in their ears than adults, and that the tubes are more level than in adults as well. These conditions combine to make it hard for fluid to drain from a child's ear - especially when the tube is partially filled with mucus or another substance. This creates an ideal condition for bacteria to be trapped, starting a middle ear infection (otitis media).

This isn't actually the first thing I've learned from my job, but it's the first thing that hit me as ::Oh! So that's why that happened!:: I think I'll try to put down future stuff on here occasionally that I find interesting. Especially since there's not too much else I can go on about without violating patient privacy laws or simply getting painfully repetitive.