Grey's Emotional Exhaustion

If you came here wondering what aortic dissection, placental abruption, and DIC are, hang in there. I'll get to that in a minute.

First, I have to comment on the other issues in last night's Grey's Anatomy.

Was anyone else as exhausted at the end of the show as I was? It was just one storyline after another about unrequited love. I have to admit that I generally prefer shows on the lighter side. Give me a comedy over a drama anytime. And last night reminded me why.

I was talking to someone here in the WebMD office and she said it was definitely an episode for women. Do women really like all that intense emotion?

Laughter is great medicine. Keep that in mind next time you're planning your next TV night.

The characters on Grey's have an unwieldy amount of issues. Thankfully my life -- and I hope yours -- would make for pretty boring TV. I'll take boring over out of control any time.

OK, now that I got that off my chest, let's get to the good stuff -- all the scary pregnancy issues in last night's Grey's. I actually enjoyed that part quite a bit.

First, there was the aortic dissection in the young woman pregnant with twins. The aorta is the largest blood vessel in the body and carries oxygen-rich blood away from the heart to the rest of the body.

In an aortic dissection, there is a tear in the aorta, which gets progressively worse. Blood surges through the tear and separates (dissects) the layers of the aorta. Chest pain, often accompanied by pain in the back and between the shoulder blades, is the key symptom.

It's a very serious condition, with the death rate near 50% in the first 48 hours without emergency treatment, which includes medication to lower blood pressure and surgery to repair the tear. Grey's writers were right on with the treatment.

Although aortic dissection is three times more common in men than women and more common after age 50, pregnancy is one factor that increases the likelihood of an aortic dissection. Thankfully it's still rare during pregnancy.

I really liked the storyline between the Chief and his ex (are they actually divorced yet?). There was just something really nice about it -- maybe it just seemed particularly special next to all the heartbreak.

The writers never really gave us much info on exactly what happened to her, but Dr. Addison Montgomery-Shepherd did throw out the possibility of a placental abruption as an explanation for her bleeding.

Normally, the placenta is firmly attached to the inside wall of the uterus until the baby is born. In a placental abruption, the placenta prematurely separates from the uterus. Not only is this life- threatening to the fetus because it's source of nutrients and oxygen is cut off, it can also be very serious for the mother due to loss of blood.

And a placental abruption can lead to the second complication that Dr. Shepherd dealt with last night -- DIC. This stands for disseminated intravascular coagulation (you can see now why we just call it DIC).

This is a complicated condition that combines blood clot formation and bleeding caused by a blood clotting system gone awry. Thankfully the Chief's wife had a fairly mild case of it because it can also be quite serious.

For a minute we thought she was dead until she opened her eyes when the Chief entered the room. Then we find out it was actually the baby that didn't make it.

Last night's Grey's was quite the roller coaster ride -- emotionally and medically. I guess we'll have to wait 'till next season to find out how they explain George and Burke up and disappearing.

And I am interested to see Addison's new show Private Practice. She's actually one of my favorite characters. She seems to be a bit more together than the rest of the characters, which isn't really saying a lot.

Related Links: The Health & Baby Center at WebMD

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Grey's Anatomy: Intern Exam Hell

There's nothing scarier than sitting down for an 8-hour test to determine if you're worthy of being a doctor, like the interns did in Grey's Anatomy last night.

Well, maybe sticking your hand inside a patient's abdomen for the first time during surgery is a tad bit scarier. But the medical exams doctors and doctors-to-be have to go through are a close second.

I remember sitting in a room with my fellow interns, much like George, Izzie, Meredith and the rest of the clan did on Grey's.

It was something I had worked towards for most of my life, particularly during the 100-hour work weeks I endured in the year leading up to my intern exam.

While my future as a doctor didn't rest on this one exam, my reputation certainly did. As you come up in the ranks as a doctor-to-be, you get somewhat used to taking tests that could determine the rest of your life. But it doesn't make it any less scary.

And all the hard work is no guarantee that you'll ace the exam.

I'm pleased to report that I got the top score among all the internal medicine interns in my program. It was, I guess you could say, my Cristina moment (but maybe Meredith will kick her butt even though she understandably spaced out during her first attempt at the test).

Potentially life-changing tests don't stop there. We'll have to wait around another few years(or whatever that is in TV time) for Grey's interns to sit for their board exams to see if they're worthy of donning the board-certified surgeon title.

As for me, my next opportunity to prove myself is coming up quickly. Internal medicine physicians must take their board certification test every 10 years to show their worthiness - and mine is later this year.

Time to break out the books...again.

Related Links:

• More Tests = More Anxiety
• Some Medical Interns Still Overworked
  

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ER Wedding: Whole Lotta Kissing Going On!

Last week on ER Abby and Luka finally tied the knot in a very romantic, surprise wedding.

After the wedding, it seems that something magical was in the air. Dr. Dubenko (surgeon) got a little intoxicated and shocked Neela with a kiss. While recovering from that, Neela headed for the bathroom and passed Sam snogging with her date, and finally ran into Hope and Morris in a passionate embrace.

When Neela finally made it to the bathroom, she came across her new surgical intern, Mai Ling, who was crying. When Neela asked her what was wrong, Mai Ling told her that she always cries at weddings. Amid her tears, she surprised Neela by stepping in and planting a very sexy kiss right on her lips.

Is there something about weddings that brings out desire and romance?

We asked our resident sex therapist, Dr. Louanne Cole Weston:

"Weddings are a time of new beginnings," Dr. Weston says. "They're loaded with strong emotions that are idealistic and hope fills the air. People inhale that optimism -- sometimes even those who are somewhat jaded. The music and ceremony are stirring. And, honeymoons evoke that ideal picture of passionate sexuality. Of course, these projections sometimes don't match the reality, but some great Broadway musicals have been built on such hopes."

Hmmm...no wonder the Wedding Crashers were so successful!

Have you ever hooked up with anyone after a wedding? Tell us about it!

Related Links:

• Love Lessons Ripped from the Headlines
• Couples Coping Support Group

Technorati Tags: ER, weddings, romance

Grey's Slapped With A Toxic Megacolon

Christina's difficulty with marriage -- or at least weddings -- didn't really do much for me.

The young woman with placenta accreta brought back memories of my Ob/Gyn rotation years ago in medical school. Then there's Addison's infertility and the low hormone issue in the man that had no desire to have sex with his wife (turned out it was a tumor on his adrenal gland).

But what most intrigued me was Meredith's step-mom's mysterious condition. I call it mysterious because it's a difficult storyline to follow from a medical standpoint.

I know I've dissed some of the medical storylines in the past -- but I promise it's all in fun. But that's not what I'm doing here.

I'd just love to know how Grey's writers got from point A to point B.

First, Meredith's step-mom comes in with hiccups that won't go away. At first I thought the writers had created a storyline based on Jennifer Mee, the poor girl who had hiccups for nearly two months and eventually needed an implant to get them to go away.

Then Meredith's step-mom had an endoscopy to help determine the cause of the hiccups and apparently developed a rare complication of that procedure -- bacterial endocarditis.

OK, I can follow that part. But where did the toxic megacolon come from? I'm not sure where the writers came up with that, but I'd love to know. If you figure it out, let us know.

In toxic megacolon, the colon becomes distended and inflamed. And then her colon perforated, which led to a bloodstream infection (sepsis) and she died.

After hearing that his wife had died, Meredith's father slapped Meredith. Now that was quite shocking and made for a great story. This series of events is why I chose this storyline as my favorite this week.

So which story line intrigued you the most? And the strange kiss in the stairwell between Addison and the man she didn't really know (no matter how intriguing it was) doesn't count.

Related Links:

• WebMD Video: Severe Sepsis
• Managing Pre-Wedding Jitters
  

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