Blood and guts

Well, how is life going here? It’s going okay. I am in praktik now up in Rigshospitalet in the “creepy ward” where an infamous movie has taken place. Let’s just say it like that. Brain tumors of the good and bad and the ugly kinds, aneurisms, vascular malformations, head traumas, hydrocephalus (too much brain fluid), people with holes in their skulls.

There are actually all kinds of repercussions for these kinds of problems. Of course, there’s the personality stuff–they get all googly and weird on you, get up in the middle of the night and wander around in their underwear talking about shrimp fishing or what have you. People with issues in their frontal lobes have personality disturbances and one of the areas they get disturbed is with their social boundaries. “Hæmningsløs” is what it’s called in Danish. People with tumors on their hypofyse (don’t ask me what this is called in English, I have no idea) have a tendency to have endocrinological/hormonal problems. One typical problem is with ADH–anti-diuretic hormone, which makes them pee tons. If they keep it up, they can pee to death because they lose all their electrolytes.

Then there are varying forms of parese (temprary paralysis). Hemiparese is one half of the body vertically, while paraplegia is from the waist down and tetraplegia is from the neck down). We don’t usually have the ‘plegias on our ward because we only have intracranial issues, while the neighboring ward has the spinal issues. There can also be reduced mobility/strenght in an arm or a leg. There can be facial pareses, where the patient loses feeling or motor control of one side of their face, including the mouth, throat and eye muscles. That means they often have trouble eating, drinking, and speaking, and that they can’t close their eye. There’s special eye-care to keep the eyeball moist, since if it dries out it’s extremely painful and just not that wonderful, and a special eye bandage with a plastic lens which keeps in condensation overnight.

There are patients who have to be fed through feeding tubes, and a few patients who have had “parenteral nutrition.” Parenteral means outside-the-intestine, and it refers to a nutritional substitute/weird goop that you get intravenously in a central line.

Fun stuff. Actually, it’s very interesting and exciting. When we first started–”we” are two 6th semester students, and then me and another 3rd semester student–it seemed like we would have to fight over patients, and there was talk about us getting to start with having our own patient and then maybe later going up to having 2. Yeah, right. There’ve been a few days were I’ve had three patients, or 2 who are really complicated–parenteral nutrition, central lines, drops, catheters, parese, all kinds of advanced stuff, half of which I’m not even allowed to do. So then I just have to do what I can and call one of the other nurses when I get to something I don’t understand or can’t handle on my own. But it *is* exciting and I really like it, which is good.