Geriatrics - Week 3

So I'm enjoying my rotation and I'm learning that it's a pretty laid back rotation. My attending gives me more than enough time to work on my paper which is great. Although, I did waste some of that extra time by going home and taking a nap.

This morning was study time/paper writing time, so I made sure I didn't wake up before 9 o'clock this morning. Surprising, I was actually in the mood to work on it.

This afternoon I had clinic. There weren't too many geriatric patients coming in today. I saw a total of two. One was for follow up on blood pressure. She had variable readings in her last couple of visits. So we're keeping a close eye on it by having her check it 3-4 times per week along with checking her pulse to see if she's getting hypotensive or hypertensive before adjusting her medications. She also mentioned that she's seeing a chiropractor for her back pain. They recommended, of course, a natural muscle relaxant. I didn't even know there was a "natural" muscle relaxant. She said it was called "303". I googled it and found out it's made of 3 ingredients: valerian root, passion flower, and magnesium.

The other patient who is 78 yo was a follow up of blood work. She's been having elevated WBCs for the last year and a half. She also had platelets in the 500s. But RBC is normal. Her WBC varies between 12 and 16. And she's asymptomatic. My attending was initially thinking CLL. I haven't seen a CLL patient before and I didn't think the WBC was high enough for it to be CLL.
So we told the patient that this may not be anything, but it might be leukemia. The attending recommended seeing a hematologist, but the patient said to do what she thinks is best. So, instead we'll just follow up with repeat CBC in 6 months and the attending knows a hematologist who can do her a favor by looking at the labs and see what he recommends. That way she doesn't have to come in to see another doctor.

After that, I was given the rest of the afternoon off to work on my paper - which I actually did this time. I kinda just want to get it over with and finish it before the week is over.