So tomorrow is my final day here at Dr. Todd smith’s office.  I really enjoyed my time here.  Everyone is alot of fun!  I’m currently 1/4th thru my ”USMLE Step 2 Secrets” book and already I feel like I am refreshing my memory on alot of topics I had forgotten about.  Got to see a case of acute cholecystitis (gall bladder stuff) and some joint injections today.   Dr. todd ordered some fish for his saltwater aquarium and they arrived dead as a doornail.   Well, all except the starfish survived hehe  All in all, today is flying by though!  Pretty schhhweeet! 

As you can see below this post, the lovely lady posted.  She is so sweet.  Well her sweetness has gotten her a cavity and now she needs a root canal.  Lemme tell ya, I avoid the dentist at all cost cause I have had some nasty experiences with having some of my permanent teeth pulled when I had braces.  Getting my wisdom teeth cut out wasn’t fun either!  In fact, I remember having to get new stitches because I sliced my wound open by eating a poptart 2 days after the surgery!  So when your doctor says to eat soft foods….listen to him and EAT SOFT FOODS!  

In other news, I became a Studentdoctor.net mentor today so I’ll be helping people out with medical school stuff.  I’m the PBL and computer science to medicine mentor.  Cool beans eh?

Anyway, gotta jet.  Patients are trickling in now!

Hi All!!!  No, this is not Richie’s mother, it’s actually the future Mrs. Truxillo!  This is my first post so I hope you all enjoy!

I just wanted to let ALL of Richie’s Friends and Fans know what a wonderful man he is and just how much he takes care of me!  I have had a toothache for a few days now, and Richie finally convinced me to go to the dentist.  Sure enough, I was told that I have to have a root canal!!!!!  So being the amazing fiancé he is, he started looking for oral surgeons in HIS area so he could take the day off of his rotation and take care of me!  When I mentioned to him that my favorite dentist (and good friend) moved from my area to Roanoke a year ago, he immediately located her office online and said that if I can get an appointment, he would drive me the 100 miles it takes to get to Roanoke from Bluefield,  just so I can feel better about my root canal!  He’s amazing!  I love this man!

So today is one of those days where I just wanted to pull the sheets up over my head and stay in bed.  Nevertheless, rounds start at 7:30 sharp so I ousted myself out of the bed in my sleepy daze.  The water was hot in the shower, a little too hot for Captain Winky though who let me know real fast by sending a burning pain up through the rest of my body   At least I was awake then!   Murphy’s law I guess.   I dashed out of the shower, shaved, put on my scrubs and made a mad dash to the hospital.  And now, here I sit, in between patients…working on my carpal tunnel syndrome by writing this entry

A guy just walked by and held up his urine sample and asked “Is this enough?”  Of course I nodded seeing the liquid gold in the bottom of the container.  Maybe that is why I want to go into Urology…pee doesn’t bother me (Hey that rhymed!)

My newest project is going along nicely.  It’s making what we call “Virtual Real Estate” websites, commonly called “VRE” for short.  The basic jist is that you build websites based around a niche theme and then post articles about your topic.  You then integrate Google Adsense ads into your articles and generate revenue.  I have to admit though, I have this negative vibe towards advertising on pages…but you know, lately I’ve come around.  Especially after this morning…   I watched Dr. Remines search for a new spin-milled sand wedge on the internet.  He probably clicked 3 out of 5 sponsored links on the pages he visited, just because they appealed to him.  It took me awhile to realize that THIS is how the average person surfs the internet…and I am *not* the average person.   So my project has been coming along nicely.  I’m trying to get my dad started with it but he hasn’t done much yet.   But it is a viable way to make some residual income (that is passive income that you earn on a monthly basis with little work) if you don’t want to sell a product on the side thru Multi-level marketing.  I think it is much more appealing for most folks who are looking for a way to generate residual income with under a 10 dollar investment.  Anyway, I am using a program to automate some of the website building.  It’s called HyperVRE.  I’d write more here about HyperVRE but I already wrote an article on brokemedicalstudents.com.  You can check it out here.

So, Patty has been busy buying up every bridal magazine ever made, looking at wedding stuff.  I am getting jazzed about getting to shop for our gift registry.  I hear they give you one of those barcode scanner guns and let you go nuts.  Here is a short list of what I wish I could zap:

- a 50″ plasma TV (as if 42″ isn’t enough)
- Stainless Steel BBQ grille with bun warmer
- 1000 Thread Count Sheets
- One of those weather station things for your house
- 2 portable dog carriers
- Cool looking china with golf embossing
- A new set Golf clubs
- A ez-boy recliner
- One of those $2000 massage chairs.

Well, I could keep brainstorming here BUT, I need to go see another patient so mind and body strong grasshoppers!

-Richie

So I am here with my fiance getting ready to embark on a trip with a bunch of 5th and 6th graders to go see “Oliver!” at the Barter theather.  I’ve never been to the Barter before so it should be kinda cool.   We are also looking at places to spend our honeymoon. (random thought I know) I’d tell you where we are planning to spend our honeymoon night but the misses informed me that some of you will come looking for us and crash the party! Nothing is worse than champange, strawberries and steamy naked Paparazzi photos.    Well, all kidding aside I gotta get ready to get this show on the road.  Nothing like kids on an activity bus.  You remember those days don’t you?  Bouncing up and down in the bus like some brother in harlem with his pimped out caddy.  Screaming to your neighbor next to you because everyone is talking so loud.    Anyway, gotta run!  Theater and taco bell awaits me!

So yesterday morning, I rolled out of bed and went to do rounds. There was no one to round on that morning (a rare occurance indeed) so I informed Dr. Todd that I would be helping my best friend, Jade, move. I spent the morning moving assorted heavy items into a big UHaul. When additional help arrived (AFTER we had moved all of the heavy stuff already…of course) I showered, put my scrubs back on and headed back to the clinic to see patients.

We had a young female patient who presented with Diplopia (double vision), secondary ammenorrhea (absent periods), headache, and extremity motor weakness (unable to push against resistance like normal). Of course, the wheels started turning and my differential diagnoses came pouring out of the head. “What could cause Cranial Nerve III problems, ammenorrhea, motor weakness and headache?” I thought…well maybe a pituitary adenoma (tumor in the pituitary gland), Myathesnia Gravis or a brain stem lesion of some sort. Well the MRI showed nothing but unilateral mastoiditis…hmmmmm. Medicine is such a humbling experience because as soon as you think you have your diagnosis nailed down with Board-like precision, something out of the ordinary comes around. Nevertheless, it’s an interesting case indeed.

After seeing patients, the surgeons and the internal medicine guys (and then me, the lowly medical student) went to play golf at Pipestem resort! We played captains choice and ended up in a tie in the end. I hit a couple decent shots including a 40 yard sand wedge, 2 feet from the pin to win the hole. Sank a 25 ft. putt on another hole. Unfortunately, my long irons were shanktastic Oh well! Dr. Remines played real well though, as he was 2 under par on the front 9! Wednesday afternoons rock, at least for this rotation…

My weight has plateaued again Even with good exercise, as such I have cut back on carbs greatly. Eating brown rice, wheat pasta and drinking diet soda almost exclusively now.

Ok…off to see another patient. Mind and body strong grasshoppers!

Live from the clinic -Richie

So here I am on a sunny Tuesday morning in between seeing patients here at Blue Ridge Internal Medicine.  My parents came into town this weekend for two reasons, the first being to see me and the second, to meet the future in-laws! 

 Everything went off without a hitch though my wallet was a casualty when my mom accidently washed it (I have a bad habit of leaving my wallet in my pants when I take them off hehe.)  Dad and I played golf at fountain springs on Monday.  We were able to get the round in, in less than 4 hours.  It was awesome and very well maintained this time around.  Dad shot an 85 and I shot an 87.  I putted better than I have in the past couple years but I had a nasty tail on all of my iron shots that made them space out about 15 yard to the right of my target. 

My dad also started his golf website this weekend.  Check out http://www.thegolfdad.com for his insights on his life and golfing.

I’m working on getting my two other projects:  www.brokemedicalstudents.com and www.brokedoctor.com off the ground this week.   I have a new tool which I will review soon that is helping immensly.  I’ll let you all know how it goes when I get a few sites up with the tool. 

Anyway, I need to jet, more patients to see!

-Much love, Richie

Finally, I got a new website up and coming. I’ll be working on converting the old content while adding the new stuff. This format will allow me to make updates on the fly too when I am not at the computer. Much needed! So go ahead and register if you like. Good things are coming! Wootage!

-Richie

On March 31st, I asked my girlfriend Patty to marry me. I waited near sunset to pop the question. She said yes! Though,
I think she was totally expecting it! However I think she was still super happy! I mean look at that 3rd picture! That’s the
face of a girl who knows she’s totally loved We are shooting for a wedding date in late spring of 2008, right around my graduation from medical school. Anyway here are the pictures! Enjoy!

Otherwise things are going well! I’ll write more about rotations soon. I am currently on psychiatry rotation so expect many stories
to materialize from that!

…and it doesn’t smell like fermented Taco Bell for once!

My
inpatient hospitalist rotation ended last week. I enjoy the thought process behind internal medicine but it just doesn’t
quite grab me the same way Urology does. Why urology you say? That’s an entirely different update altogether! Maybe I just
enjoy pee and restoring people’s sex lives with the assistance of that lovely little blue pill. Regardless, I’ve been a good
little H&P scut monkey for the past few weeks and I’ve gotten the hang of writing solid patient notes. I started Pediatrics
today. It made me realize how thankful I am for people that sacrificed to go into Pediatrics as their specialty. At one
time (as some of you long time fans remember years back) I worked at a pediatrics clinic as a volunteer and loved it. Now, I’ve
gotten to the point where I need more than just colds, flu, stomach viruses and strep throat cases to keep me enthralled.
I guess all specialties have their saturation point but doggonit, urology seems to be the soggiest, most pee-soaked specialty
of them all to me.

Things are going quite well between Patty and I. We’ve gone thru the whole “Meet the Parents” ritual and seem
to have done well on both sides! I was worried that I was going to have to take a polygraph test when I met her family but it
all went off without a hitch pun heavily intended there. Anyway, I am falling asleep. Patty wants me to update this site
more because I have been a slacker on it. Anyway, I’ll reward you all with a picture. Here is Patty and myself

Time for Richie to get his sleep so he can get up and make rounds on time tomorrow.

So
it’s been a crazy few weeks. I finished my family medicine II
rotation and started my inpatient hospitalist rotation this
week. Nothing could quite prepare me for who I would meet one
Thursday evening. Anyway, I could divulge every lavish detail
but then you all would go crazy trying to find out who she is
hehe Maybe someday folks! Nevertheless, you have my lovely
girlfriend to thank for this web update as she told me “Richie,
you NEED to UPDATE your WEBSITE!!! People are missing you!”

So hints about my new girlfriend. She’s NOT in the medical
field (thank God hehe) she is a music teacher. She has a beautiful
voice so expect a duet to show up on the MP3 site and iTunes
soon. She does not live in the same town as me, yet does not
live very far away. Yep, that is all of the hints you get! ;P
Yes I have pictures, but I am not posting the ones you want
But I will post some pics….

So…we were walking together in the mall, and as we passed
the Bed, Bath and Beyond store, I felt my left nut threaten
to fall off and leave me. It was a close call I tell ya. You
see, as men inch closer and closer to married life they have
to make concessions..like using soap when they shower! Let me
tell you, my shower has gone from a “bachelor shower”
to a “pampered goddess wash.” Little things have started
popping up in my house and I am taking notice. Even now, my
body smells like some victoria’s secret concoction…not that it’s a bad thing but when you are used to bathing in Irish Spring
(luck of the Irish mi’ lad!) it’s a change And no, we are not living together! So to illustrate, here are some examples.

Anyway I am very tired today and I need to go into work and see some patients. I read some last night on oxygen dissocation curves and stuff. That’ll make anyone sleepy I went to get my white coat and I had a little note in my PDA which I will scan some other time since I am a wee smidgen pressed for time

But yeah, Richie’s been bitten by the lovebug pretty bad this time. I doubt it is curable but at least it is not contagious.
More to come soon because I am sure I’ll be back in the habit of daily updates hehe.