and then there were none

December 19, 2008

i can’t believe my allergy/immuno elective is going to be over after today! it was quite the abbreviated month. as with most electives, i definitely did learn some things that will be useful (about food allergies and basic immunodeficiency workup) and i certainly got a nice amount of relaxation in. in fact, yesterday was a highlight: i saw a case of APECED, which stands for autoimmune polyendocrinopathy, candidiasis, and ectodermal dysplasia. it’s quite rare, so it was pretty exciting for me as a future endocrinologist! patients present with:

✓ falling-apart nails, rash, shortened teeth, and often hair loss
✓ hypocalcemia from hypoparathyroidism (leading to symptoms such as tetany or cardiac issues)
✓ symptoms of adrenal insufficiency (low cortisol, low aldosterone) from autoimmune attack on the adrenal gland
✓ recurrent issues with thrush and other candidal infections
APECED-esque nails from the spanish annals of internal medicine

anyway, so now you learned something today.

for the next 8 days after today, i’ll be working at the community hospital, going to baby deliveries and doing my thing at the level 2 NICU. because of my recent NICU stint, i am less terrified of this job compared with before, but i am still not completely comfortable. hopefully nothing too crazy will happen! there will be no call during this period (yay!) but there are some long days and it tends to get a bit monotonous over there. the nice reward is that i will then get 6 days off in which to recharge before i re-enter the dreaded PICU.

aaaaaaand i’m off to the gym! sadly, this will be the end of AM workouts for a while because i’ll have to be at work too early. it was great while it lasted, though.



workout: 7 miles total:
– 2.5 miles warmup @ 8:57/mi
– 3 miles tempo @ 8:00/mi
– 1.5 mile cooldown @ 8:57/mi

reading: an article on APECED, of course!

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