"I wish that being famous helped prevent me from being constipated."- Marvin Gaye I'm about to embark on my last difficult rotation of my medical school career, the dreaded Surgical Sub-Internship (or Sub-I). On this rotation I'm supposed to act like a true intern, and am supposedly given more responsibility and carry more patients. For those of you not in medical school, surgical rotations are notorious for having the longest hours and some of the most intense residents/attendings. A few select students fall in love with surgery every year, but the majority of us just count down the days until we don't have to come in at 4:30 AM six days a week. As a third year, one of my most important tasks was asking a question. Not just any question, mind you, but the most important one of all. Specifically, it was my task to inquire about every surgical patient's colon activity. That's right: "Have you passed gas or had a bowel movement?" Every single day, every single patient - the same question. Despite seeming silly or awkward, it is important to ensure that your patient is able to move their bowels. Constipation after surgery is both common and uncomfortable. However, now as a fourth year I'm expected to know what to do when my patient can't move their bowels. Thus, it's time to review the types of laxatives. Mush or Push Laxatives used in the hospital primarily help patients by either making their stool easier to pass (by softening or breaking it up) or by encouraging their body to move the stool out. It's important to know which category a laxative comes in, because you often have to give more than one. You should never give two from the same category before adding the other. I've heard the idea simplified as "Mush or Push". Either you soften/loosen the stool or you help them push it out. Usually we give a patient one laxative from each category. This is a little chart I made that lists the most common agents used in the hospital and what category it falls under. This will hopefully be the first in a series of mnemonics and learning tools that I've used. I was one of those students who always needed a trick to learn a concept, and charts/mnemonics stuck with me better than any other way. Hope you find these as useful as I do! How do you study best? Are you a mnemonic person like me? Let us know in the comments!
