sometimes i breathe respiratory therapy blog

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My voice isn?t loud enough
2008-05-16 07:52:00
I have pulmonary function testing rounds this summer. I already took the pulmonary diagnostics class and really enjoyed it since I had an excellent professor that told great stories and I made a strong A.I first witnessed the methacholine challenge. This test is used to diagnose asthma. Methacholine is an irritant. We do simple FVC spirometry after every dose of methacholine. The dose increases after each test.We look at her FEV1, which is how much air she can blow out in one second. Majority of people will be able to blow out 75% of their total lung volume. A drop of 20% will indicate asthma.Our first patient complained of chest shortness of breath. She went through all the doses and only dropped 6%. The good news is that she didn?t have asthma. The bad news is that it could be something far worse. Asthma is a very treatable disease. She left to receive an EKG to check her heart after our meeting. Our second patient required a before and after bronchodilator test. He would perform ...
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I?m 2/5 through the program!
2008-05-07 17:29:00
So it?s been a very busy month. I?ve had continuous streams of testes back to back and now I?m free. I have about a month till summer classes start, but I?ll still continue PFT rotations during this month. I did pretty well this semester, 3 As and a B. I also recently failed a clinical final, which I had to retake again. I passed the second time so everything is good for now. The clinical final was difficult since it was on a computer. I wasn?t really use to computer testing and my PC buzzed whenever I leaned towards it (That?s my excuse for failing). So the next day, I sat in front of my computer and took the free practice NBRC CRT. I received a 68% (75% is passing). Not bad, since I haven?t taken the mechanical ventilation class yet.I've been sober since spring break. It's time to loosen up a little.
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The tales of Angry Mom
2008-04-13 17:55:00
The past few weeks have been pretty hectic. The next few are going to be more so as finals are coming up. I spent the past few weeks observing Angry Mom in the TICU. Angry Mom is a rotund middle aged parent who scares all the RTs and nurses. She especially hates students so I never went in her room. I once made the mistake of making eye contact with her and now a piece of my soul is gone. Angry Mom?s baby has been in the hospital for eight months and the doctors have been trying to discharge them for the past two with failed attempts. Angry Mom leaves ten minutes before the discharge committee meeting starts. Unfortunately, Angry Mom and dad have to work full time. Dad works night shift. They don?t ?have time? to take care of the baby. Angry Mom treats our hospital like a day care center. She?s belligerent and extremely rude to the staff. She has done things like turn up the oxygen when the RTs clearly told her not to touch it. It makes weaning the baby off oxygen more ...
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Making a difference
2008-03-28 19:49:00
That past three months in clinical comprised mainly of aerosol treatments. A good day might include one or two suctions. I know we still have a year or so before we can fully call ourselves respiratory therapists but I feel like we have the ability to do more. We are spending our rotations on the floors and talking to following RTs around. I am at a children?s hospital. I was put into the TICU just recently. The TICU is for sick patients that require special attention but do not quite belong in the ICU. Nobody knows what the ?T? in TICU stands for. Two RTs are always in the TICU back room aka the hole. One can not leave without notifying the other first. We spend a majority of our time between treatments at the RT workspace watching monitors and listening to constant droning of alarms. The other day, I noticed one of our patients sats dropped to nearly 30 (Normal should be ~97%). We ran into the room and the RT started bagging. She grabbed a suction catheter and threw it a...
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Hospital food makes me sleepy
2008-03-16 16:22:00
I usually bring my own food to the hospital whether it?s left over dinner or a peanut-butter and jelly sandwich. My lack of funding and the laziness to go all the way down to the bottom floor contributes to my decision. RT department is on the fourth floor. I have tried the hospital food a couple times for a change and found it unsatisfying overall. I had pizza and onion rings the other day for lunch and that was a mistake. I felt sluggish all afternoon. I?m not saying hospital food is necessarily tasteless and not fulfilling. I?m saying that the food is bad for you. I?m always tempted to eat the junk because it?s available and decently priced where as salad is always unreasonably expensive. I noticed that the French fries and fried chicken are available every day. I love fries and fried chicken but...not every day. We have a salad bar and healthy options are available. The lines for them aren?t very long. I?m also not saying that the hospitals should ban French fries or ...
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Keep your mouth shut
2008-03-09 18:27:00
A RT told me a story about two seniors who had their clinical rotations at this children?s hospital I am at now. They were excellent students academically and performed well in clinical. One day, the manager decided to turn down the temperature because she wasn?t feeling too well. The adjacent room (RT room), turned freezing cold. She decided to change the temperature back to normal after a while. The two students started to gossip on the bus after their day. ?Who does she think she is?? Little did they know that the manager rode the bus that day and that she was listening to the whole conversation. The manager told me that they had some nerve to even apply for a job after they graduated. Lesson to everybody: keep your mouth shut. You never know who is listening. I know gossiping can be fun and its human nature, but it can cost you a job if you aren?t careful.
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I love the Internet part 2
2008-03-07 22:50:00
I've been spending a lot of time on Drugs.com just learning the indications and contraindcations for each aerosolized drugs. I love that site. Here are some other interesting tools:Lung soundsThis site includes real recordings from people. The dummies we have in lab sound so different from real life. Breath soundsMore. Auscuultation assistantHeart sounds. Drugs at FDAThese lists of drugs are approved by the Food and Drug Administration.DrugsA extensive list of all drugs available and their uses.
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Real Age test
2008-03-07 06:27:00
http://plabox.info/real-age/This is a entertaining ?real age? program.My Biological age: 22Real age: 4.6 Average life expectancy: 74Your life expectancy: 91.4Wow. My life must be pretty boring if I could reach 91.One thing I found interesting was that if you sleep more than 9 hours, your life expectancy actually decreases. My mother always told me that sleep was the best thing ever. I guess everything has its limits.
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Let the students choose
2008-03-01 16:42:00
There are two people applying for a teaching position in our RT program. Both of these applicants have introduced themselves to the class at different times. There is only one position available. The faculty ultimately determines on which one to hire but they decided that it would be interesting if the students provided input and I think this is the greatest idea ever. The students now have a voice. It makes sense right? One of these potential employees could be teaching our class next year. I want the best of the best since I?m paying a premium for my education. The first candidate was a well dressed older man. This guy was huge. He definitely has the experience in a clinical setting but I doubt his teaching skills. The second person is a female from Florida. She is a RT professor in a college there but decided to come here because she hears great things about our program. It was definitely fun questioning each candidate. The students felt like the employer this tim...
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Spring break
2008-02-29 22:53:00
I have been really busy cramming for midterms which finally ended today. I can relax and then start working on my case presentation. I don?t plan on going anywhere really due to lack of funding but that doesn?t bother me. Here are my tentative plans for spring break: SaturdayRun a little. Drink socially. SundayRun some more. Drink alone. MondayGo bowling because it is cheap. TuesdayRun and drink at the same time?for training purposes. WednesdayGo bowling with classmates sober. ThursdaySka concert. FridayMaybe read a little. SaturdayTrain for the half marathon in a month by running 10 miles. SundayDrink and work on case presentation but not at the same time. Somewhere between my binge drinking and running, I?ll try to update this blog with some substance.
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How I lost my faith in humanity
2008-02-22 22:29:00
Simple answer: The Internet and my curious mind. Long answer: Munchausen syndrome by proxyBasically, mom makes baby sick on purpose so she could make him feel better. Therefore, it makes her feel better. She gets baby sick again and the cycle continues. Battered Child SyndromeI always thought punching babies was kind of funny, because I sometimes have a tasteless sense of humor. I never realized the true scope of BCS. People really do punch babies. Obesity epidemicApproximately 40,000 people die of hunger everyday and the biggest problem for the obese is deciding whether they want fries with their shake or not.CelebritiesOur nation is too focused on celebrity gossip and fashion. We treat them like gods. Maybe I?m just a little bitter because I?ll never reach millionaire status as a RT. I could continue ranting but the Munchausen syndrome by proxy was the one that really prompted me to write something. It?s the first time I?ve ever heard of such a thing a...
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Dealing with CF physically and emotionally
2008-02-16 15:07:00
I spent the past week talking to my CF patient about my assignment. It?s funny how all the CF patients in the hospital know each other. I chose this girl as my case study because she is full of life. The other day I met another CF who was admitted to the hospital due to attempted suicide. I think all CF patients know that their life expectancy is ~36 (nearly half of the average person). CF patients deal with their illnesses differently physically and mentally. Physically, this boy has one of the best breath sounds I?ve ever heard from a CF. There is barely any digital clubbing and he seems well nourished. He is a 17-year old and overdosed on some type of pain medication. They pumped his stomach and dropped him at the floors. He told me that the moment he turns 18, he would refuse all his treatments. That one line made me sad the whole day. He demanded chest physiotherapy by hand and answered all of my questions with one word responses. When I first walked into his roo...

Clinical case study
2008-02-09 06:25:00
I have to write a case study on a chosen patient every semester. I decided my patient yesterday. My decision was out of process of elimination really. My partner and I are the only ones at a children?s hospital out of the class of 40. I didn?t want to any of the parents. I decided to write about a 19 year-old cystic fibrosis patient. CF (Cystic fibrosis) is pretty interesting. The average life expectancy of someone with cystic fibrosis was ~20 years back in the 1950?s. Now people diagnosed with CF have a average life expectancy of 36.8 years. Spending time at a children?s hospital, I?ve seen plenty of CF patients, some in worse conditions than others. My knowledge about CF is pretty limited. We have only really focused on chronic bronchitis, emphysema, asthma, and bronchiectasis so far in my disease course. I specifically chose this girl because she?s close to my age and very friendly. She also didn?t make fun of me for not knowing which drug matched with which nebulizer. ...
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Busy at a children?s hospital
2008-02-02 00:40:00
My updates are pretty much limited to once a week. Outside of school and clinical, I?m training for a half marathon (13 miles). So I have four tests in a span of a week coming and it is testing my nerves. Clinicals have been excellent. I?m learning something new everyday. I learned how to suction yesterday, and I found it pretty easy. My next task is to learn how to draw blood. I apparently need to practice more because the dummies we have in lab can?t seem to cooperate with me. Since I am at a children?s hospital, ABGs on the floors are rare. ABGs are invasive and they do not generally like the idea of having students practice sticking needles in kids, especially when the parents are standing there. So today I?m going to talk a little about why I want to work in a children?s hospital, hopefully Children ?s Healthcare of Atlanta one day. Although the pay in pediatrics is notoriously less than a regular hospital, it still does not deter me. I have also been told that chil...
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MDI vs SVN
2008-01-25 23:54:00
CFC (Chlorofluorocarbon) is a chemical compound found most inhalers. CFC is a propellant used for meter dosed inhalers (MDI). The FDA wants to phase out CFC for HFA by December 31, 2008. A SVN (small volume nebulizer) aerosolizes drugs with a gas source. The SVN basically turns any liquid into aerosol. Shorter treatment time:MDI equals puffs while SVN takes about 5-10 minutes. A shorter treatment time equals less labor costs for the hospital.Winner: MDI Portability:A SVN needs a gas source. A MDI already has a propellant (CFC or HFA).Winner: MDI More drug delivered to the lungs (deposition):Studies have shown that MDIs with spacers are equivalent to SVNs in drug deposition (which is about 10% total drug delivery).Winner: Tie Coordination:Patient technique is very important with a MDI (slow deep breath with inspiratory hold). Patient coordination is not required for a SVN.Winner: SVN Extra equipment:A MDI really needs a spacer to be as effective as a S...

A little bit disillusioned
2008-01-19 17:08:00
The first day of clinical was very exciting. I was a little nervous and a little tense. The second day was mostly of nebulizer treatments and suctioning (same as the first day). I followed different RTs around on different days. Both were very well educated and enjoyed their jobs. I?m just a little disillusioned by how many problems there are in a hospital. I never really paid attention in clinical last semester because I was only there for four times(four hours each) and most of the time was spent starring at a chart. I?m talking about all the smokers and overweight people in healthcare. Out of the eight RTs I met in the meeting room for the morning shift, six were overweight. The RT I followed around on the first day started smoking when she was thirteen. She told me that she needed to step outside for five minutes and wanted me to stay put. It was cold outside. I instantly knew that she needed a cigarette. Granted, smoking wasn?t label unhealthy when she was that y...

Clinical day 1; second semester
2008-01-15 22:40:00
After spending eight hours in the pediatrics floor unit, I feel great. I have a sense of accomplishment. I?m a little bit worn out and I?ll probably sleep like a baby tonight but I have some studying to do first. The most memorable task I performed today was really just setting up the Vest and administering a MDI with a spacer: not too difficult but I have to start somewhere. I?ve never met a cystic fibrosis person before today. There were two: one was in horrible shape and the other one was just fine. The boy in bad shape couldn?t handle the Vest. The girl needed the Vest tid (three times per day) and had much better breath sounds. I?m still having a little trouble with breath sounds. I get distracted too easily and there are too many sounds. I haven't adjusted my ears to filter out the crying yet. We suctioned a lot of patients today and my task was just to hold the kids. Surprisingly, most of the moms were friendly. I was expecting a lot of difficult parents because...
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Classes I?m taking and first week impressions
2008-01-12 16:10:00
Pulmonary DiseasesThe professor has a thick accent but I could understand all of her words. The book actually seems interesting and so does the class. Even though it is a 9a.m. class, I am alert and attentive. Respiratory Care PharmacologyI had this professor for RT Anatomy last semester. It was tough. Pop quizzes are back and I?m not too happy about that. He wrote our very informative pharmacology book. This will probably be the most difficult class this semester. Respiratory Care Procedure IIIf last semester was any indication on how difficult this class will be then I should be fine as long as I don?t slack off for the final test this semester. Last semester covered MDIs and aerosol delivery devices and this semester will cover IPPB, CPAP, and other airway maintenance devices. Pulmonary DiagnosticsAlso known as the Pulmonary Function Test lab: The class is composed of students performing PFT tests on each other and interpretation of the results. It?s fairly amusing but...
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Second semester; first day of class
2008-01-07 23:19:00
Today consisted of three classes and a lab. The classes were all introductions to the course and syllabus. The pulmonary function testing lab was interesting. We tested each other using spirometers the size of a television set. Seriously, these things were huge. A spirometer measures the amount of air moved in and out of the lungs. We determined our slow vital capacity, forced vital capacity, and mandatory maximum voluntary ventilation. For SVC, hit the slow button at the beginning of the test. Instruct the patient to ?breathe in and out normally for a few breaths then take a slow, big breath as deep as possible. Then breathe everything out smoothly/slowly as long as possible. ? For FVC, you pretty much do the same thing as SVC except hit the fast button during max inspiration and tell the patient ?to blow out as fast and as much as possible.? For MVV, the fast button will be used. Time the patient for 15 seconds and tell him or her to ?breathe in and out fast.? Afte...
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Pharmacology book scares me
2008-01-01 00:12:00
I had to purchase a pharmacology book today. This pharmacology book scares me. Two of my professors wrote this book. I was told from friends that ?he who writes the book for his own class will be a super difficult class.?Pharmacology itself sounds like a difficult class. One glance at this book and I started to panic. I?ll attempt to read some tonight. The price of the three-textbook package was $135, which is not that bad of a deal. I?ve read articles explaining the economics of college textbooks. I still don?t fully comprehend the reason why new editions are put on shelves annually with little change to the text. What makes me an unhappy person today is the fact that I had to drive to another school to get this book. Good deals online were rare and our own college does not contain this book. It was a long drive. I also ran over a huge puddle and it looks like I went off-road with a Corolla.
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Happy New Years
2007-12-30 20:30:00
My attempt to drink a little bit less over the break has been a failure. It?s not my poor ability to escape peer pressure but maybe my inescapable urge to avoid boredom that has tempted me. Majority of my break consisted of ping pong and alcohol (sometimes both at the same time). School is going to start in about a week and my brain feels like it has not been challenged for a long time. My life lacks structure at the moment. It feels awkward waking up in the PM and doing whatever I feel like whenever I feel like. But I?m sure I?ll complain once I am in school for a week about the difficulty and lack of sleep. I will be starting at a pediatrics hospital this semester and I am pretty excited about it. It?s actually pediatrics where I want to work eventually. I?ll go into details about why in another post some day. I want to wish everybody here a safe and fun New Years Eve. Don?t drink and drive?etc. yadda yadda.I also added Breathing through School in the blogroll. It?s a...
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Shadowing a RT at a children?s hospital
2007-12-26 18:29:00
I decided to spend the other night with a RT. This guy is a teaching assistant or some sort of aide. He opens his department to all of the students and loves teaching. I admire his passion but never bothered to visit him at the children?s hospital. School consumed most of my time and I already spent clinical time in another hospital. I have been on break for a week and decided that I was bored. The first thing I immediately noticed while walking into the hospital the decor was really colorful. The other thing I noticed was the advanced equipment. Charting was digitized and signing your name just requires a fingerprint scan. Signing into a computer was completed with a proximity badge: very cool. We saw three patients; one with breathing problems that needed to be suctioned, another with croup (I think), and a little girl with brain tumor. The first patient had a mom that was very bossy. I guess that is one downside about working in pediatrics: the parents. It was kin...
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I love the Internet
2007-12-22 17:04:00
Despite how much porn there is on the Internet , there are some genuinely decent people in the world that share their knowledge on the Internet.These are some of my favorite sites for RTs:VideoJug is Wikepedia with videos. This links to a Pulmonologist goes into general info about the lungs and diseases.This intro to chest radiology is better than the whole chapter in my book.There is an EKG simulator here that makes interpretations much easier. Staring at static squiggly lines on a paper is a hard way to learn.Oxyhemoglobin Dissociation Curve Interactive Tool. Find the P50 by alternating the PaO2, SaO2, pH and PaCO2.As my studies continue, certainly I?ll discover some other interesting finds for RTs. I?ll keep you posted.
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Equipment Theory for Respiratory Care: 4th ed
2007-12-17 21:37:00
Rating: 3.0/5Pros: Good pictures. AARC clinical practice guidelines are useful.Cons: Boring diagrams of equipment. The end chapter quizzes are sometimes incorrect. This book covers a wide range of equipment for a respiratory care practitioner. It provides ample details on troubleshooting equipment and detailed AARC clinical practice guidelines on when and how to use each device. Even though this book lacks any color, the photographed pictures are of excellent quality. The diagrams on the other hand are uninteresting.The main problem with this textbook is that all the equipments covered delve into too much detail. I was told that it is more important to understand why to use the tool than how it works. Also, many of the equipment in this text are outdated. Admittedly, the flow charts look useful but I rarely look at them. If the equipment doesn?t work, it usually ends up to ?replace item.? Most tools in the hospital setting today are disposable.The optional workbook with t...
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I'm 1/5 through the RT program!
2007-12-14 23:29:00
It has been a tough semester, and it is only going to be more difficult next semester. I ended with a 3.5 GPA for this semester. It should have been higher. I received a 98.3 in one class?so infuriating. I spent a majority of my high school and college career sleeping in classes that I never really cared about. So this semester, I actually attended every class and read the material. I guess it wasn?t enough. My overall grade is slightly higher than usual, but I?m still really dissatisfied with that 89.3.Unfortunately, not everybody made it. This program is not easy and studying alone without friends for motivational support makes it even harder. I look up to the classmates that can work and the mothers in the program who are doing well in class.Anyways, my plans for the break are pretty lax. I may go snowboarding for a day. There may be a couple parties here and there. I?m expecting a lot of late nights at the Waffle House. I will keep in touch with some of my classmates (the ones I...
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Insomnia 3: Me 0.
2007-12-09 03:28:00
I haven't been able to sleep right for the past three nights. This is unbelievingly annoying since I usually sleep the best during the winter.I don't eat heavily or ingest any caffeine late at nights, and I believe I maintain good sleep habits. Theories that may have contributed to my insomnia;Preventative tuberculosis medication:Doubt it. I haven't had any side effects from the drug yet so I think I'm fine.New pillow:Maybe.Finals next week:Very probable. There is good stress and bad stress. Finals next week brings bad stress.So I did my studying today and I plan on sleeping early. Good luck on finals everybody.
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Job opportunities for RTs
2007-12-08 17:05:00
More than 4 out of 5 respiratory therapists work in hospitals.There are other job opportunities available for RTs besides the hospital. I don?t have much detail about these jobs but I have general information about them from my professors.I personally would like to end up at a hospital one day but these are some areas that you might consider:Public Health Service:I made a post about this earlier since I also applied. The best analogy I have for this job is that you are a soldier for the government who will get drafted to fight respiratory problems instead of wars. It comes with some decent benefits. Sleep study:Most sleep study companies hired their own people and train them. Now they are looking for RTs. It?s night shift of course, but I hear pay is not bad.Ventilator sales:It?s not exactly sales but pay is based off commission. A sales person will sell ventilators and RT equipment to different hospitals around the world but knows nothing about the equipment. It would be your jo...
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Early New Year?s Resolution
2007-12-05 22:05:00
I?ve never made a New Year ?s resolution before because I?ve never really cared. Most resolutions are not kept or about losing weight. I consider myself realistic and pretty fit. I?m taking a preventive medication for tuberculosis. I?ve been told from my professors and a physician to limit my alcohol intake because it can severely damage the liver. That makes me sad.As a college student, it is still socially acceptable to drink myself stupid. I would like to take advantage of this fact and build up my resistance so I won?t end up a wimp later in life. I?ve been practicing with beer and cereal for breakfast instead of milk (joking). My drugs of choice include; Guiness and rum (not mixed together).Yet I am also health conscious. Taking care of my body is important to me although I occasionally drink and eat fast food. I have to take this pill once a day, everyday, for the next nine months?holy crap.My New Year?s resolution: I will not have more than 1 drink a week while on the medicati...
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Department of Motor Vehicles vs Department of Public Health
2007-12-03 22:36:00
I visited the DPH today for my preventative tuberculosis medication. I decided to take this medication because I tested positive for the PPD skin test with a negative chest x-ray. Being a student in healthcare, especially respiratory therapy, I?ll be exposed to TB more often. I don?t want it to become active. It was my first time visiting and I found it comparable to the DMV (last month for a license renewal). Both had long wait times with announcers that said, ?Now serving X at window Y? and provided a sense of impeding doom in the waiting area. Here is a quick comparison: Total wait time:I made an appointment for the DPH while I waited in line for the license renewal. Wait time for the DPH was 30 min while the DMV?s total time was nearly an hour. Then I found out that I went to the wrong building for the preventative medication so wait time should have been zero. An idiot is me.Winner: DPHGeneral check-in front desk:DMV: ?How can I help you?? "Great." "Fill this form ...
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The final test before finals
2007-11-30 23:45:00
I have four classes and five finals (one extra clinical final). Next Wednesday is my last test before the finals. The test covers: medical history and the interview (I?m not sure why we didn?t cover this the first week of class), chest radiographs, and electrocardiograms (EKG sounds cooler than ECG). Needless to say, I think the medical history and interview is pretty simple. Most of it seems like common sense; dress appropriately, introduce self properly, converse in a friendly tone. The radiographs and EKGs on the other hand are causing some trouble. I found an excellent tutorial here on chest x-rays if anyone is interested. I think x-rays are really interesting. It?s amazing what technology can do. Yet, why is an x-ray so expensive? I remember paying $75 for one a couple months ago for a TB test. I need another one next year. That $75 was my hot wings on Friday money. I digress. Since there are no chest x-rays on the test because printed x-rays don?t show up well, I hav...
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