9:00 am started the day off in the outpatient clinic with Dr. Chen Kuei-Feng (Dr. 陳桂峰). The clinic was very busy; it almost felt like the pace I saw in the TCM department every patient was seen for about 2-3 minutes. Dr. Chen commented that it was possible as most of the patients he has followed for a long time and are in for chronic disease management (hypertension, diabetes mellitus, and hyperlipidemia most common). During the clinic Dr. Chen took time to familiarize Bor-Han and I with the ICD-9-CM International Classification of Disease method of coding and with the drug coding used by the hospital. We also got a review on calcium channel blocker side effects as a few of his patients came in with peripheral edema from Amilo (amlodipine besylate), a long acting calcium channel blocker. There was also a case involving the long term use of NSAIDs to manage joint pain that has resulted in gastric ulcers; Dr. Chen mentioned he had recently switch the patient over to a COX2 NSAID but it has not done much to stop the gastric ulcers. Other interesting things included a discussion about the importance of having patients with high blood pressure keep a daily long of blood pressures as it is more reliable compared to office blood pressure readings due to possible White Coat and other factors.
Later on we end up following Dr. Feng Wen-Kai (Dr. 馮文楷) and later Dr. Tu Chung-Chih (Dr. 涂崇誠) in the ultrasound room as they performed echocardiograms. We ended up learning about some of the basics of echocardiograms including the visualization of the different heart valves and the assessment of ventricular and atrial size. We also got a good introduction about how to correlate chest x-rays, EKGs and echo results to physical exam findings to get a good grasp of a patient’s condition. At the end of the day Dr. Tu, mentioned that he will be doing a pacemaker placement on Wednesday and invited us to observe.
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