Dermatology

I had to give my scalp a break from my studies of scabies and lice!!! I tell you what---nothing will make you itch all over like crusted scabies. Google it--I dare you (it's too unsightly to put on the blog even!)!!

Derm has been fun, but I don't think it's my thing. We will have covered all the highlights of derm by the end of this week (a week and a half total!). From scabies to freezing each others warts to anesthetizing and cutting "lesions" off oranges--we have done a lot. There is some scary stuff in derm--things I never, ever want to have to diagnose. The skin is an amazing barrier and when it is compromised our bodies do not like it one bit! Hallelujah for granulation tissue and collagen fibers that fills in our gaps and hallelujah for people that want to go into the specialty of dermatology!!!

In other news, I've been on a book buying frenzy and just in case there is anyone even remotely interested in being any type of clinician whatsoever, let me tell you what combo of books has worked best for me:

Background: The NCCPA (the people who make the PA boards) make this handy-dandy little thing called a blueprint--that is, they make a road map for navigating medicine in 2 years. They have put together a list of diseases from each organ system that you should know inside and out--the most commonly occurring, the most lethal, etc. In order to best study through my didactic year I am making a  "disease sheet" for each of those diseases that includes "General Characteristics," "Clinical Presentation," "Physical Findings," "Differential Diagnosis," "Work-up," and "Treatment." All those sheets are going into a single notebook that will be easy to whip out when it comes time for boards studying! I am getting my information on these diseases from the following resources:

1) CURRENT Medical Diagnosis and Treatment 2013 
       "Current" is not my favorite thus far. To my odd mind it seems that the presentation of the information is muddled. . . OR to put it better: the way I broke down my disease sheets is not how Current chose to break down the individual diseases so it was hard to assimilate my own condensed version from it. But I bought it because this is the book my program is using. . . .And don't get me wrong, it's a SOLID resource.

2) Ferri's Clinical Advisor 2013
      Ferri is my fave!!! (Nice Alliteration) Literally, I am obsessed with this book!! It is FIVE books in one and a total of 1610 pages--because of this it will never, ever leave my house or my office when I'm practicing. The 5 "books" (i.e. sections) are as follows: 1) a breakdown of each disease into "Basic information" (includes etiology, demographics, physical findings, clinical presentation), "Diagnosis" (includes differential diagnosis, work-up, labs), "Treatment" (includes nonpharmacologic and pharmacologic, disposition, referrals), and "Pearls and Considerations; 2) symptoms with all their possible differential diagnoses; 3) Clinical algorithms; 4) Lab tests, what normal ranges and abnormal ranges signify, and what those ranges should be; 5) Clinical Practice Guidelines (for immunizations, periodic health exams, etc).

3) Applied Therapeutics: The Clinical Use of Drugs (10th ed.)
      This book has drugs broken down by disease and is still somewhat overwhelming to me. BUT, I was told that I needed it in my arsenal from my favorite professor so I bought it (and it just arrived today). I think it will be more useful when we get out of Derm (where all diseases need a topical steroid of some variety and an antihistamine for itching--I kid, but really. . . ). Did I mention it is 2500 PAGES and weighs 12 lbs?!?!?! (Glad I didn't go to pharmacy school!)

4) A Comprehensive Review for the Certification and Recertification Examinations for Physician       Assistants
This book goes back to my friend, the blueprint. It is a great breakdown of the diseases I need to know for boards by Organ System. It's also smaller and paperback so it's easier to carry around on a daily basis. . .

So those are my resources, FYI. I have found that there is no lack of resources in PA school. In fact, there are so many good ones that it is impossible to even lay eyes on all they have to say about each disease, much less remember what they said. You have to pick 3 or 4 and dive in--I'm learning that there will always be more resources and more information but you have to trim the fat and get to the meat of each disease and know it like the back of your hand.

2016

The first 1:48 of this clip is a trailer for the movie 2016, which is currently out in theaters. Produced by the man who produced Braveheart and many other well-known movies, this movie and the issue it addresses deserves a few minutes of your attention. The man who gives the talk that constitutes the remaining 12ish minutes of this video is Dinesh D'Souza, the author of the book that the movie is based off of. He is an author of several titles and currently the president of The King's College in New York City--I believe that he too addresses an important issue eloquently and deserves a few minutes of your attention.

To learn more about Dinesh and 2016, visit the movie's website.

Back to School 2012-2013

Even though I attended PA school throughout this past summer it really feels like "Back to school" time  for me. I love the sense of a clean slate--new supplies, a little breeze on the air that tells me maybe (just maybe) fall is right around the corner, shorter days, people running around town. It's all so clean and new feeling. It's like that scene on You've Got Mail where Meg Ryan is walking down the NY streets and sniffing the air and she has a skip in her step and she writes to Mr. NY152 and tells him about "bouquets of sharpened pencils." (I need to go watch that movie--it's just idyllic)
Anyway, all that to say: BACK TO SCHOOL TOMORROW!!! So excited to absorb a crazy amount of information that will make me an awesome PA!!!

Based on the 15 chapters of reading we had to do for the first day of class, you may not hear from me for a while! :D

Happy Sabbath!!!

Ahhh A day of REST!! The Lord is good!

I am not resting today, unfortunately. I have finals this week and 5 of them necessitates studying and a visit to the lab. But I had a wonderful morning of worship and awesome fellowship at lunch and life is good!
The best thing is that this time next week I will be RESTING (truly resting) in Columbia, at home, with family. (And I will be done with Semester 1 of PA school!!! Time Flies.)

Enjoy your rest. Enjoy family. Enjoy time with Jesus.

My Midas Touch

Romans 7:21
So I find it to be a law that when I do right, evil lies close at hand. For I delight in the law of God, in my inner being, but I see in my members another law waging war against the law of my mind and making me captive to the law of sin that dwells in my members. Wretched man that I am! Who will deliver me from this body of death? Thanks be to God through Jesus Christ our Lord! So then, I myself serve the law of God with my mind, but with my flesh I serve the law of sin. 

My Midas Touch is sin and chaos. I can have the closest, most pure, joyful moment with the Lord and turn right around and take my convictions and butcher them. I fail to exhibit the grace and mercy I have been given and I can almost hear the Devil giggling with glee. My nature remains sinful and it is all too easy for my eyes to slip from Him. The Devil loves my weakness and preys upon it skillfully, confusing me at every turn and disguising evil in lambskins, then salting the wounds of my sin with guilt. Yet every time I am drawn back into sweet communion, back to my safe haven, and my cup is replenished. The Lord is merciful and He delights in me and desires my attention and affection despite sinful midas touch.

Kingdom Love

R.C. Sproul is a famous preacher and theologian. His son followed in his footsteps and became a brilliant minister. Yesterday I saw a link to a FB wall post that he (R.C. Sproul Jr.) wrote about his wife, whom he lost this year. I was incredibly, deeply blown away. 
Here it is:

The Kingdom Notes: Celebrating Alone
by R.C. Sproul Jr.

It was hot and humid that day, August 1, 1992. I stood, and waited. Beside me stood several of my closest friends, and nearby was my father. All of us, however, had our eyes glued to

 the same spot, anticipating. The music changed, heralding the arrival we were all waiting for, me most of all. The doors swung open, and there she was, on her father’s arm. Slowly, stately, they made their way up the center aisle and soon he placed her hand in mine.

Jesus redeemed me. His life, death and resurrection assured me adoption by my heavenly Father. I will one day see Him as He is, and I will be like Him. Apart from this, however, despite a lifetime of showering me with blessing upon blessing, He had never blessed me as He did this day. House and wealth are an inheritance from fathers, but a prudent wife is from the Lord (Proverbs 19:14).

I knew then what I know well now, that this woman was so much more than I deserved. She was a living, breathing reminder of the gospel, that God gives well beyond my due. For nearly twenty years His grace graced our home in and through her. I woke up each morning astonished at what God had done for me. I went to bed each night beside His grace. I did not get the opportunity to plan a grand twentieth anniversary celebration. We will neither repeat our honeymoon cruise nor hold hands on the Champs Elysees. Instead I will travel to the cemetery.

I will, almost certainly, cry. I will certainly ache from missing her. I will remember those two days that have so shaped me- our wedding and her home going. But my prayer is that I will celebrate. I have much to give thanks for. I am thankful for the twenty years we had together. I am thankful for the eight children we had together, for how faithfully she mothered them, and how powerfully she shows in them. I am thankful for the family and friends she brought into my life. I am thankful for how she was used to help me grow in grace and wisdom, that I am a better man because of her. She spoke God’s wisdom into my life, while modeling it in her own.

All of this gratitude, however, pales in comparison to the one thing I am most grateful for. Because I love her I wanted to take her on a special trip for our anniversary. Because I love her I give thanks that she is somewhere infinitely more glorious than any place I could take her. My queen is not sailing to exotic ports but is casting down her golden crown around the glassy sea. She won’t stroll through Paris with me, but is walking hand in hand with Jesus on streets of gold. She is enjoying her greatest anniversary ever. Which is the best I could wish for for the woman I love.

My anniversary is, like every day, a day for giving thanks. He gave me more than I deserve in giving me her. He gave her more than she deserves in giving her Him. And one day He will bless me in the same way. Rejoice, and be exceedingly glad.

What a kingdom love is that?!?! Many would say that being a) a Christian and b) married are two of the most restraining things in the world. My friends, they are not. They are beautiful and joyful and they are the most life-giving things you will ever find.