#Eisapimp

I love dating a doctor. Well, actually - I just like dating someone as generous as E, whose automatic reaction is literally "I'll pay for it". Except I am not letting him spend money on me because he should save it for Campbell. Also, working till 11pm once a week is pretty horrific. The thought is more valuable than the actual monetary value.

I'm glad we're moving away from child development in case because I must be underwhelming my tutor. I swear he expects more answers from me but I literally don't know anything about normal child development because my own sense is so skewed from watching my brother develop. For me, it is a wonder that he understands me, that he can walk around the house and kick a ball. That's something people take for granted from a four year old. The day he learned to walk at the age of eight was bloody awesome. When he stopped dribbling, that was pretty cool too. Oh, and I'm not still over the fact that he's finally toilet trained. I'm sorry that I don't know much about normal developmental milestones, but I'm pretty proud of the ones my brother's reached.

#differentialdiagnosispls

Sooo reoccurring numbness in the middle finger on my right hand. Sometimes on the fingertip only, sometimes if it lasts long enough, it extends to cover the entirety of the digit.
It seems to only come on when I'm cold and/or flexing my wrists/elbow. I still haven't quite worked out if flexing my wrists actually brings on the numbness. I have noticed that when I'm cold, my fingertip starts to go numb, which makes me think that it's more a vascular problem rather neurological. That being said, the regions supplied by my ulnar nerve are feeling funny. Which is retarded because the median nerve supplies my middle finger. Yay, I love getting relevant problems just when we've started studying the nervous system. First, a migraine and now, this -ihopeyouhearthesarcasm-

So differential diagnosis:
- Carpal Tunnel Syndrome: which works sort of because the median nerve supplies my middle finger. But then I'd notice numbness over my index and thumb too. Also, Phalen's test doesn't bring on an episode
- Raynaud's: it comes on when I'm cold. But I don't notice my finger going particularly pale or blue. It does seem to lose some colour, but not to the extent that I'd expect it to. Also, I've never had an issue with cold intolerance before - although that being said, my toes do go numb on the occasion. But verrrrrry verrrry occasionally. And running my hand under hot water seems to reverse the numbness
- Cubital Tunnel Compression: doesn't explain the middle finger because the ulnar nerve is affected. Except my ring finger and little finger do feel slightly funny. And I've been doing side prone holds, which I've noticed brings on numbness to my whole hand in general. Must pay attention to which digits in particular the next time I do it
- spinal root problem: the dermatome supplying the middle finger is supplied by C7... I don't think anything's wrong with C7...

Funnily enough, the very first differential diagnosis that sprang to mind was vitamin B12 deficiency in the light of the fact that uh, I don't seem to be consuming meat often. Except I eat tuna almost every day... so that doesn't make sense, and recently I started eating eggs. AND I EAT MARMITE EVERY DAY. But anyway, I had to have a look at my tongue in the mirror. I don't think I see atrophic glossitis... aaaarghmedstudentsyndome.

#aura

Bloody lights reflecting off the massive screens in the dissection room gave me a migraine. It was such an interesting experience walking home, only being able to see half the world. I am grateful that I did not get hit by a car.

Also, I think I have perfected my pseudo-Vietnamese salad... which I have been eating every night.
- carrots
- lettuce
- some rice paper noodles
- coriander
- red onion
- cucumber
- dash of fish sauce
- sweet thai chilli sauce
... the magic ingredient is: CRUSHED CASHEWS. honestly... it tastes amazing.
Just as I was getting sick of it, cashews save the day.

And also, my weight has dropped another kilo. Or maybe it's because half my uterus is in the process of falling out.

Annnnd just because I'm a nerd, here are the leaving/entry orifices (I can't think of another word) for all the cranial nerves:
CNI - cribiform plate
CNII - optic canal
CNIII, IV, V1 and VI - superior orbital fissure
CNV2 - foramen rotundum
CNV3 - foramen ovale
CNVII and VIII - internal auditory meatus
CNIX, X and XI - jugular foramen
CNXII - hypoglossal canal

#pingpingpingpingping

Neuroanatomy is like a wrecking ball. That is the only thing I can say about it because it confusing as fuck. That being said, it's just so damn interesting. And I am determined not to let it win. Currently, our lecturer is a cute Asian lady with a bit of an accent. It's actually kind of comforting listening to her lectures because if I close my eyes, it actually just sounds like my mum is talking.

Also, I honestly think the reason why E. and I get along so well is because he's just so apathetic about everything, which is why when I get angry, he just laughs at me.

#needcider

Just had a cider last night while reading JK Rowling's thriller/mystery novel 'The Cuckoo's Calling', which she penned under a pseudonym. It was the perfect end of the first week of class. There's just something so satisfying about reading while drinking an ice cold beverage and for some strange reason, anything alcoholic just makes it even better.
I fear that I am getting too dependent on the consumption of cider for a relaxing evening...

#shouldhavejuststayedstrong

Pours out heart and tries to be a bigger person.
Response: cool story bro (or something to that effect).

Ughhhh I disgust myself.

#realmature

Today we had a lecture on examining the twelve cranial nerves. Cranial nerves IX and X are responsible for the gag reflex and one of the various methods of testing this is to simply put a tongue depressor on the back of the tongue and put the end of a wooden stick at the back of the throat. When the lecturer said "Some of you have had this tested, but via different means", my friend and I burst into peals of laughter at the back of the lecture theatre.

While we're here, I might as well revise through the tests for the cranial nerves:
I (olfactory nerve): test sense of smell in each nostril
II (optic): confrontation (visual fields), Snellen chart (visual acuity), opthalmoscopy (fundi)
III (ocularmotor), IV (trochlear) and VI (abducents): pupil size, shape and symmetry, light and accomodation reflex, lid drooping present? eye movements
V (trigeminal): responsible for sensation (of pin-prick, light touch and temperature) in three divisions - (i) opthalmic nerve branch (ii) maxillary nerve branch (iii) mandibular nerve branch AS WELL AS motor (jaw opening and closure, jaw jerk and corneal reflex).
VII (facial): facial muscles so make them grimace, close their eyes, wrinkle their forehead AND taste in the anterior 2/3rds of the tongue
VIII (vestibulocochlear): test hearing in each ear by blocking one ear and whispering a number, which you then get them to repeat OR put a watch up to their ear and see if they can hear it. Can also use the Rinne test (using a tuning fork, see if they find the noise louder in front or behind with the tuning fork resting on the mastoid bone - obviously, should be louder when the tuning fork is directly in front of the ear) or Weber test (putting the tuning fork on the patient's forehead and asking them if they feel an equal vibration in both ears)
IX (glossopharyngeal) and X (vagus): palatal movement (saying aaaah and seeing if the uvula moves), the gag reflex, swallowing
XI (accessory): controls sternomastoid and trapezius muscles sooo test sternocleidomastoid by getting the patient to push their forehead forward against your hand and the trapezius can be tested by testing their force against resistance to their shoulder shrug
XII (hypoglossal): controls tongue, so test resistance to force, get them to poke tongue out and inspect the appearance

There is a whole wikipedia page devoted to mnemonics devoted to the cranial nerves. Some of them are quite funny:

• Only Owls Observe Them Traveling And Finding Voldemort Guarding Very Ambiguous Horcruxes

Some are just inappropriate:

• On Occasion, Olsen Twins Try Anal Fucking And Great Vaginal Sex Hammering

#mindblownwithwonder

Despite my initial misgivings, I really enjoyed the craniotomy. Definitely one of those med school moments which I will remember fondly because let's face it... we're not going to be able to crank out one of those unless we're going to become neurosurgeons or pathologists doing an autopsy. I know that some people found the noise rather offputting, but I personally found it reassuring that the sound of the mallet hitting the skull sounded like hammer on a concrete. I feel so grateful that we were created with something so resilient to protect our brains.
And once we peeled back the calvaria, we saw the dura mater exposed with the meningeal arteries coursing through it. We didn't get to see the superior sagittal sinus (which I was quite disappointed about), but we did see a few arachnoid granulations. Once the incision was made through the dura, we got to see the arachnoid mater glistening under the fluorescent lights. Here, we got to use a knife to make a sagittal cut and another coronal slice to get a wedge of brain out to better examine the deeper structures.
It amazes me that something so unassuming controls all the functions of our body. Just... wow.

#andnowitallstarts

Ah class. There wasn't much tomfoolery by the course convenors. It was whambamslam lectures on the first day back from summer break. And tomorrow, our very first craniotomy. I don't know what to expect. Firstly, it'll be hard stepping back into the room with its intense smells and bright lights, let alone cranking open the part of someone's body that used to house all their thoughts, longings, loves and fears. Some part of me is morbidly curious and I suppose I'll be able to fulfil that curiosity tomorrow. Once again though, I am incredibly grateful to all those people who donated their bodies to the medical school and to their family members.
Anyway, it was straight into lectures and my goodness, do I hate neuroanatomy. I secretly envy everyone who did a neuroscience degree before doing medicine because right now, the brain just looks like a smoosh of coiled structures with some random conduits in the middle.

On the bright side, I've managed to switch streams into the one with my friends and without the 6pm finish on a Friday. Downside: it seems that everyone has moved into the flat upstairs and they made such a ruckus having a party. Fortunately, I am not above being that mature student who is willing to tell them to kindly shut the fuck up on a Monday night.

It only makes me miss E. (or rather, the quietness of his flat) even more. Every time I come back from a weekend away with E., I wish that perhaps I hadn't continued my education and stayed as a pharmacist. Although given that at times the job description has frustrated me, at the end of the day, if I was coming home to E., I would've been happy enough. There is nothing more satisfying than talking while hanging off the side of a bed, with our feet dangling in midair after drinking a cool cider. After six Valentines Days/anniversaries that we have been together for, this was only the second one that we have managed to spend together. Chowing down kebabs on Friday from a Chinese barbecue place was oddly satisfying, but obviously an anniversary wouldn't be complete without a fine dining experience. Ten courses over three and a half hours was an exercise in self control (in trying not to guzzle your small portions in one bite) as you would try to make sure that you and your partner would finish each course at the same pace. It certainly was a weekend of eating, with us finally venturing to the Sunday market. Usually, we go to the Saturday market, but for some reason, we have always eschewed the Sunday one. It was quite fun actually this weekend doing things without much planning and fortunately, we lucked out in that we were able to get many things done, such finally visiting the elusive cafe and punting down the city's iconic river. The Sunday market was delicious and different from the Saturday one, and I may even go as far to say that I may happily give up salmon pies for whitebait fritters and potato pancakes. Even more satisfying was seeing E.W. catch sight of E., walk over and stand beside him for about a minute, then giving up when E. did not acknowledge her presence. Personally, I would've been nice had she decided to initiate conversation, but hey, whatevs.
E. transforms me into one of those fat contented cats that purr beside the fireplace. I honestly can say that as each year passes by, he only gets better at making me feel that way. I only hope that I too, am doing that as well as he is.

#digress

Now that class beckons and I only have a week of holidays left before I commit myself to the grind that is study, I've realised that I actually don't know what to do with myself when I have spare time. How on earth did I manage to occupy myself for days on end when I was home for a month? I have three days off this week from work and I actually don't know what to do with myself.

On the topic of study, I woke up with a cold sweat this morning because I thought I had forgotten all the names of the carpal bones. And the tendons running through the flexor retinaculum. Anatomy, you are a bitch. 

Also, it's going to be a bitch reducing my spending once again - although it does help that I am spending $70 less a week on living costs, compared to last year. Except last year I was being fed some pretty darn good meals. Except this year I'm not eating much by choice. So I can't complain reaaaaaally... I'm going to get sick of lettuce, I feel. 

I'm looking forward to Valentine's Day this year, for once. Maybe because for once, we'll actually be together in the same city. Sometimes I think we function better living apart because we don't waste time and actually get to do things that we're wanting to do. I honestly don't think I would've managed a PD if E. was in the same city because I'd be doing other things with my spare time instead of poring over my notes. Living apart makes me appreciate any time spent together much more, instead of getting used to his presence beside me daily. That being said, I don't think I could ever tire of him. Stale relationships only become so if you stop trying. And I have no intention of ever stopping.