A Small Update

Thought I might write a bit more, since some time has passed. I got my stethoscope, but my books haven't arrived yet. It came with soft ear-tips, a back-up pair of soft ear-tips, a pair of hard ear-tips (haven't used them, and hopefully never will), a name tag, and two paediatric attachments - the bell and diaphragm. I quite liked the smaller diaphragm, and am yet to see why a larger diaphragm is more useful than the smaller one - the adult-sized diaphragm is not changeable though, probably because of my engraving. Speaking of which, I thought the engraving was done well, quite happy with it :)
One thing the Medshop description fails to include of the C&R Trikoph, is that the rims are non-chill. I was pretty worried about this actually, since every stethoscope except this one had "non-chill rims" in its description, but yep, rest assured.
I'm yet to have any other stethoscopes to compare the steth directly with, so I don't think I'm quite qualified to make a recommendation for this based on acoustics. From what I can hear, the acoustics seem pretty good; nice differentiation between parts of the sound, and it seems quite loud. I'll comment about this once I get another yardstick to compare it with. Also, if you ever come around to purchasing your first stethoscope (like I was), don't worry if the ends of the steth seem to put a lot of pressure on your ears, and even if it hurts to use it at first. After about an hour (cumulative) of usage, my ears seem to be getting used to it, and it's not really painful now, but merely slightly uncomfortable (which I hope will subside very soon as well).

I had my first abdomen physical examination for ICM this week, on a patient who could barely speak English (thankfully, our tutor spoke whatever language he was able to speak), which hindered communication somewhat. He was really nice though, very compliant and happy to sit through whatever I was doing. Other than that, nothing really remarkable occurred this week... except for today, when 2(!) lectures were suddenly cancelled. That was a bit of an eyebrow-raiser. Oh, and only one more week till UMATo9! The tension is palpable (get it? get it? naww yeh k that was lame) Signing out,

What a day.

Today, I managed to miss Macarthur (which was one stop from Campbelltown). Let me explain - there's no direct train from where I catch the train to get to Macarthur - our uni's unofficial train station. So today I would catch a train to Campbelltown, the station everyone thinks is the end of the southern train line, and catch a train from Campbelltown to the 'real' end of the southern train line - Macarthur. This train doesn't stop at Macarthur though, it heads all the way to Moss Vale, which is approximately 40 kilometres away. Me being me, I managed to miss that one stop, and ended up at Menangle Park, the next stop. Herewith, upon finding the next train was an hour away, and thinking that one stop would be approximately 2km or so, I hatched the brilliant idea to walk back to Macarthur. Boy, was I wrong. The road that appeared to follow the train station turned left...and then turned left again...and there was no end in sight. So after 20 minutes I arrived back at the station, caught the train back to Macarthur, and was on my way.

Our first real anatomy practical was pretty super (abdomen/groin region) - having surgeons/surgical registrars were pretty cool, they were really knowledgeable and knew how to teach (very important, one would think), so yeh pretty awesome. Only bugger was that whenever they'd ask some questions about stuff, they'd draw a blank look from us and in general, we felt very stupid. We also did some surface anatomy, though only for a half hour or so.

We also got exam results back - I passed with a 60 average, but as a result, was in the bottom 3rd of the cohort. Still satisfied though, gave it a fair amount of effort and will be looking forward to improving that result. I felt that my mark was quite equivalent to my effort in the HSC, maybe a little more (so, ATAR of about 98 as a guesstimation) - obviously theres not really any comparison, since there are so many other factors that come into play, but that could give an idea as to what to expect. Looking for a 70+ in the finals so I can even up with a Credit average for the year, so I've got a big task ahead of me... *nods*

Our first physical examination for ICM was also pretty interesting...pity our patient though, who persevered with us (well, only one of us was performing the examination, but I digress) for an hour as we learnt how to percuss (tapping the abdomen, listening for the resonance of sounds to indicate hollowness and the presence of liquid and solid) and to palpate (fancy word for using our fingers to search for organs), and were assured (or amazed?) at our tutor's statement that the entire examination should take, at most, 5 minutes. Which reminds me, I should be writing up some notes so I can recollect what she said about signs and symptoms...

I also got email notifications that my stethoscope had been sent via Aus Post today, and my order for textbooks from India (about $50/textbook inc shipping) got processed. Also got my Talley and O'Connor clinical examination book yesterday, and found out that I really did not have any book-contacting skill anymore :\ Lots of bubbles and even a few jagged edges. Bleh. So yeh, exciting couple of days :)

Back to School...

Well it's been a relatively uneventful but (as usual) very quick holiday, even though this one lasted a whole month. My call for extra temporary students for my little part-time tutoring thing pretty much failed, helped by my site's web server downtime (a week or so), and managing to hit one interested person, but not having his message until a few days ago (and thus pointless, because by then I had things arranged for the last few days of the holidays). I spent most of my holidays away from medicine, trying movies (a korean mystery named Mother), music (Adele's 19 album) and even going back to some books (John Marsden's Letters from the Inside is, in my opinion, worth a mention). One thing I did not stray away from was stethoscopes. Worrying about which stethoscope to get is probably equivalent, in med school, to worrying about which pens to buy for the HSC. But, frivolous as it was, I spent hours upon hours doing as much research as possible into the little pet topic of interest amongst med students. And finally, after all the blood, sweat, toil and tears, I made a decision: the Australian company 'Cumpers & Robbins' Trikoph (??) Cardiology (!) Stethoscope (a very important point to note) in Navy blue colour (an important decision, or so I heard, which I made in about 10 seconds). At $160, it certainly wasn't cheap (found a 10% discount voucher - 'Supporter5' for the store, Medshop Australia, which dropped the total cost plus shipping to $151) but it was certainly within my price range. Amongst others, I had the Littmann Master Classic II (single-head, single-lumen, standard diaphragm), Spirit Cardiology (single-lumen and standard diaphragm) and the good old Littmann Classic II SE, for which I was particularly enticed when I saw the 'FREE PENLIGHT' offer at Medisave.

Some key pointers from people I asked (doctors, cardiologist registrars and a few others) and what I gathered online about stethoscopes:
- Soft ear-tips apparently make a world of difference.
- They last a while. A long while. But they often 'grow legs' when unsupervised.
- One of my cousins is doing well as a doc with a Littmann Classic II.
- Brand-name appears to have minimal effect on steths, but Littmanns are far and away the most popular (by which reasons, I have not found out)
- The cheapest cardiology steths (from a decent brand) are better-sounding than the most expensive classic steths. I'm not too sure about this, and it will be one of the key things I'll be testing for with my steth.
- Single lumen vs double lumen tubing - contradictory anecdotes about this, but double lumens are quite standard in cardiology stethoscopes (although mine doesn't.....)
- Floating Diaphragm, Tunable Diaphragm, Floating Tunable Diaphragms, Bells, Paediatrics Diaphragms and Bells, etc etc. - Apparently, only C&R and Littmann have floating diaphragm factories. Hmm... this allows you to vary the frequencies of sounds you hear depending on the effort you push on the head of the steth. Once again, contradictory anecdotes found on the net regarding whether this is a good or a bad thing (having zilch experience, I'm sitting on the fence in regards to this)
- Length of tubing - Once again, contradictory anecdotes, some say longer allows you to not invade the patient's 'private space', whilst others say shorter allows you to hear better - I would side with the shorter team, since 22 inches (relatively short amongst all the 27 inch ones) is pretty much the length from your ears to the slightly bent arm anyway. Having said that however, I don't think it is a crucial difference - its hard enough to find 22 inches as it is.

I found that there was virtually no information for brands other than Littmann or Welch-Allyn, so, in the spirit of the medical student guinea pig, I will be reporting the results of my Trikoph stethoscope, and see whether it measures up to others (via the help of some colleagues).

You may ask 'why a stethoscope in the middle of the year?' to which I would reply 'because I didn't need it in the first semester', to which you may reply 'you don't need it in the second semester either' to which I would reply 'my friend said we did, and I want to get one soon anyway'. I was also shopping for books and might get a penlight - not just for med, but for computer repairs and upgrades (quite handy to see where jumpers are without taking out the disk drive - if you don't know what jumpers are, ignore this whole thing). But for now, am looking forward to another exciting semester of hard-core medicine, so sayonara holidays!