Follow up

Hi,


Relatively relaxed week this week. I spend some more time in HIV clinics, follow up the rabies-bitten patient who I spoke to last week, and present a case based around Fordyce's spots for my end of rotation assessment. 


In the HIV clinic I am with a different consultant to the one I was placed with last week, and this one is also gay. Somewhat more flamboyant than the person I was with last week, his entire patient list seems to consist of middle aged HIV positive gay men who have a crush on him. When I say it seems to consist of, I mean that every single patient who we saw together was a middle aged, gay, HIV positive man. HIV positive people have several outpatients appointments each year, to make sure that they are still doing well with their disease and drugs (it is very important that they take the drugs every day to stop resistance occurring), which means that the patients get to know the specialists very well. Patients switch between consultants to find one that they like; for example all of the HIV+ afro-Caribbean people are managed by a large, jolly Jamaican woman. Obviously all of these middle aged HIV positive gay men like flirting with this flamboyant consultant, who is very informal with his patients. I can tell why they like him though, he is very complimentary towards them, almost towards being inappropriate, though they clearly love it, and love him for it. The patients range hugely (though always keep within the male, gay, middle-aged category). There are high powered bankers, through to homeless down and outs. All are treated with the same glamorous, dazzling fashion. It looked great fun to be a patient of his, and I know that if I had HIV I would want to come to him (though I don't quite fit into the necessary bracket...)


The rabies-man (hopefully a name that will prove to be incorrect) has refused any medical treatment for his bites. He has decided that chromotherapy is all he needs to balance his bodies energies and push the rabies virus out. I really hope that the dog didn't have rabies, as this is one person I don't want the medical profession to be saying 'told you so' to. Perhaps the worry should be if he doesn't get rabies, and spreads the word that colour-therapy can cure rabies, meaning many other people might be exposed...

Rude jokes and general 'banter' should probably be kept for class mates, rather than your examiner...

At the end of the modules we have to present patient cases to the rest of the year. I was presenting someone who I saw in a sexual health clinic who came in and told me, and I quote "I've got lumps on me knob". It turned out that these lumps were just a normal physiological phenomenon known as Fordyce's spots, just large sebaceous glands on the shaft of the penis. The consultation was pretty simple, until he started squeezing these spots to show us what would come out of them... Pretty gross... Either way, I somehow accused the consultant I was presenting to of using prostitutes in front of my year - pretty embarrassing result of a 'witty' quip, but hopefully I won't get kicked out for it.

End of sexual health rotation, pretty uneventful week, and I will keep you up to date with how things go next week in my orthopaedics rotation! My final rotation, and the one with my end of year exams in it!