Monday, May 11, 2009

Go figure

Swam at Life Time Fitness in the outdoor (25 meter) pool.

400 swim, 200 kick, 400 pull
8 x 50 drill/swim @ 1:00
3 x 100 @ 1:30 moderate, held 1:20
3 x 100 @ 2:00 moderate, held 1:17 or better
8 x 50 race pace @ 1:00, held :35-:36
200 easy

Called back to the hospital last night by one of the hospitalists to see an elderly woman from a nursing home who was found unresponsive. She had been eating dinner alone when the monitor picked up a fast heart beat, triggering a call to the "rapid response" team. When the nurse arrived, her heart rate had normalized, but she was still unarousable. Immediately everyone's attention shifted to a possible cardiac problem, this despite the fact that she had a known seizure disorder and a subtherapeutic dilantin level on admission. My diagnosis, as a cardiologist, was that she had suffered a seizure and was postictal, thus explaining both her unresponsiveness and her incontinence. The diagnosis was confirmed later in the evening when she had a second, witnessed, seizure. At which point someone ordered another dilantin level.

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