Yesterday I woke up and immediately wanted breakfast. So instead of starting the blender at 5am to make a smoothie and waking up my roommates, I made some greek yogurt with blueberries, ezekiel cereal, and some shredded coconut. I microwaved some blueberries first to make them all juicy and melty before mixing them into the yogurt. This is my favorite technique- it is just so delicious. But then the yogurt wasn’t as cold as I wanted, so I threw a few frozen blueberries on top.
Literally 5 seconds before I walked out the door, I spilled coffee on my shirt. I always do stuff like that. Instead of changing, I just buttoned my coat. Hopefully no one noticed…
My first patient yesterday morning came in complaining of blisters on his hands for 2 months. He had even gone to the emergency department a month ago because of these blisters. As soon as I read his chart, I made a list of all the things I could think of that could present with blisters on your hands. I’m slowly learning how to become a better physician- you think ahead to all the possible things something could be, think back to all the possible causes, and anticipate the worst case scenarios. Then you ask your patient about all these things in order to narrow it down. If you have an idea of all the possible things it could be, you aren’t asking questions blindly.
After a long long long conversation with this patient, I had an idea about what I thought was causing the blisters. My professor came in to see the patient as well. He had a different diagnosis in mind for the blisters. We talked a bit about each of our ideas and then I went to do a little more research.
My original thought was that my patient had a similar condition to this guy:
Vampire and werewolf stories may have actually originated from people with this disease because they are generally very sensitive to sunlight, have increased craving for iron rich foods (blood) and have excess hair growth or thickened skin.
Really, this disease (porphyria cutanea tarda) is just a deficiency in the pathway to make the heme in your blood cells. When the precursors in the pathway build up, you get manifestations in your skin- like blisters!
My professor agreed with me that this was the probable diagnosis and said I did a great job figuring it out!! We won’t know for sure until all the tests come back, so it’s still a mystery diagnosis. Nevertheless, I left the clinic feeling pretty proud!!
The rest of the day was pretty blah. I had about 17 spoonfuls of peanut butter, managed to pull off a great arms workout at the gym, and finished with 3 miles on the treadmill.
Since this post is so incredibly boring, with the exception of my vampire diagnosis, check out the FOOD section for an AMAZING restaurant review. Well, the review isn’t amazing- the restaurant is.
Have a wonderful day!!!