GI

I started the GI/surgery module this week, which has also turned out to be sweet old lady week.  I started off hanging out with the SLP and observing Betty's barium swallow.  After watching her swallow liquids and some pudding it was determined that she had some esophageal tightness that was blocking food and liquid from going all the way down.  I'm not totally sure what the prognosis is going to be for that, but I think she was just relieved to finally get an answer.  Apparently she chokes all the time, especially at restaurants where she feels pressure to eat quickly.  She's even had ribs broken on more than one occasion where she has had to receive the Heimlich Maneuver. Sad.  Anyway, it was actually really cool to see her swallowing via the fluoroscopy, and see just where everything was getting stuck.

Today I saw June with the GI bleed, who was receiving 2 pints of blood to replace what she lost.   She has been on coumadin for a while, and with the recent addition of aspirin to her cardiac care regimen, she ended up having this upper GI bleed.  I learned something about this diagnosis that I thought was really interesting-- when a BUN level is way high coupled with a normal creatinine, it can be indicative of an upper GI bleed and a way to diagnose the problem when there isn't overt vomiting of blood.  Anyway, June got some blood and is good to go.  She was even feeling perky enough to draw on her eyebrows this afternoon (who knew they made gray eyebrow pencil?).