Friday, April 24, 2009

Back to basics

Lifted weights last night. Swam with a headache and shared a lane with Lynne, next to Steve, Tom, David and Kirk. Clint coached but spent most of his time with the fitness group.

1000 warm up
4 x 25 kick fast @ :35
800 swim, negative split at the 400; we all decided to pull, I split 5:06, 5:04
4 x 25 kick fast @ :35
600 swim, every fourth 25 fast; felt good on this one
4 x 25 kick fast @ :35
400 swim build to fast, went 4:52; might have been a bit faster but I had trouble seeing the clock
4 x 25 kick fast @ :35
300 swim, middle 100 non-free; I think I went 1:07 and 1:10 on the free 100s
4 x 25 kick fast @ :35
100 easy

I was called to the ER at noon for what was thought to be a STEMI (aka ST elevation MI, aka heart attack). The cath lab team had been summoned, and one of the nurses was about to administer an expensive anticoagulant. The patient was an older gentleman with COPD and pulmonary hypertension, a consequence of too many cigarettes for too many years. He required oxygen at home 24/7. He had been hospitalized many times over the past year, usually for management of his lung disease. His primary complaint today was that of swollen feet and a swollen belly. When I walked in the exam room he appeared comfortable and proceeded to tell me a few bad jokes which I will not repeat. Instead of proceeding on to the cath lab, I obtained a history from him, examined him, and reviewed his old records. His ECG was not diagnostic of a STEMI, despite the computer-generated (and often times incorrect) interpretation printed at the top of the initial tracing. The cath lab team was sent on their way and the patient admitted to the hospitalist who had discharged him earlier in the month. I suspect I saved him close to $20,000 in hospital charges.

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