MTX & Leucovorin

Hello. I'm still alive, though barely, with a lot on my mind, and a little confused.

1. 58 is actually a good place to be. Yes oncology can be abit foreign to me, but there's still a lot to learn. The nurses are VERY NICE, and are so willing to teach. Even the assistant nurses! I don't mind coming back to work in this ward! This certain staff nurse can be very hard on us(and the junior staff nurses), but her words really make us think!

2. MTX & Leucovorin is currently my 'research topic'. Cos' i have a patient on mtx for chemotherapy. Leucovorin(folinic acid) is for rescue, like how i'm suppposed to take folic acid the day after i take my mtx(which i don't, that's why i have stupid unrelenting mouth ulcers which started to resolve only after i reluctantly took 2 days' dosage of folic acid)...

3. Thank goodness i know what is transaminitis. Cos' staff nurse asked me about it, due to the need to use paracetamol sparingly in a patient with Hodgkin's lymphoma with hepato-biliary sepsis. ALTs and ASTs in the hundreds. I blurted out the cause was MTX, which was for another patient. And besides, only oral mtx affects the liver. It only dawned upon me later when i was serving another patient that sepsis was causing it! I rescued myself fortunately for the mistake. Hah.

4. I have a patient with right brain tumour. He has OCD, and has been doing things like washing his hands for 2 hours, showering for over an hour with a whole bottle of Hibiscrub, wetting the bed 5 times and the floor 4 times in a night, tying and untying his pants and claiming he needs to shit for 4 hours, and thereafter falling asleep on the commode, pressing the call bell till it spoilt, threatening us if we turned off the call bell, scolding us with vulgarities, applying axe oil till his PJs were wet, and applying barrier/QV cream till the whole tube was gone. OCD... Really! My colleague was pissed because she claimed she has never been scolded by a patient. *sigh* Can't stand her. She left our patient exposed naked for all to see by leaving the toilet door opened etc. *omg* I could've killed her. I don't blame my patient. He has a brain mass to contend with, so heck!!!

5. So many new drugs to add to my list! Haliperidol, quetiapine, esomeprazole, ceftriaxone(in lectures yes, but never really read about it), metronidazole, morphine(impt!!!), Acarbose etc etc etc... More work for me!!!

6. Exam timetable for semestrals are out! We have 5 days after our last day in the ward as study break... 5 papers, 7 modules. Pfft! I loathe studying psychology and sociology. Omg... I feel like i'll drown in everything!!! As if we don't other more important things like pharmacology and bio to study...