I've been really lucky in managing to gain 3-4 weeks work experience at a GP's surgery about half an hour from where I live, doing a variety of things, sitting in on consultations, working with the district nurses, helping with the diabetes clinic, observing minor ops and sitting in with the "lumps and bumps Friday" clinic (which I'm looking forward to the most, pussy wounds and all that jazz haha!)
So I had my first day yesterday, woke up bright and early to find it would be a bad hayfever day, so I spent the day trying to be professional and friendly whilst snotting and sniffling in front of everyone, which a was great...
I sat in on consultations all day and the Dr that is supervising and helping me apologised for a "boring day", poppycock, it was so interesting! I'll just go over a few things I observed during the day.
A patient came in with a throat infection, but, he also had apparent sun damage on his scalp, and so his scalp was checked for rough patches - Actinic Keratosis, which are patches of thick, crusty skin, common in fair skinned people. They can be considered pre-cancerous, but the patient had a lovely smooth scalp! :) However he was concerned about a small sore red patch on the side of his scalp. It was red, and had an ulcerated centre. This turned out to be a BCC, a Basal Cell Carcinoma, which is the most common cancer, apparently you could leave it alone for a few years and it wouldn't cause you any harm, however it is still considered malignant and so the patient was referred to the hospital for further tests etc. The photo is just an example of sun damage commonly seen in the elderly!
Next was a a case of fluid retention in the ankles in an elderly woman with chronic kidney disease. This is due to the kidneys no longer being able to filter out fluid from the blood and turn it into urine. The patient was told to elevate her legs when sitting, but she didn't want to, poofs aren't her thing! The patient just wanted reassurance on when to take her water tablets! :) Spot of fluid retention around the ankles on the right there!
Next was a 26 year old male who had what presented as type 2 diabetes, which is really uncommon in a man his age. He was a big lad, 140kg, and his weight was increasing despite him telling us he ate 3 healthy meals a day.The previous night he experienced confusion, "not making sense" and felt muddled. Turns out he had a blood glucose level of 22.4! 5 hours later it was back down to 5, so he must be producing his own insulin for us to see that much of a change. So it was thought he might have Maturity Onset Diabetes Of The Young, but he has been referred to a diabetes specialist at the hospital.
Also saw some polyps which was really interesting, a nice scar from where a man had his pancreas and spleen removed, spot of tennis elbow and a very large boil on a mans behind that needed to be removed and packed at the hospital.
All in all, it was a nice start to my work experience, the majority of patients that were seen were elderly and there was more focus on the management of age related changes. I'm back in on Monday where I'm going down to the minor ops clinic! woop woop!
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