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I'm just curious.... I am taking an NRCME online course right now for DOT. I start my new position in Occ Med and UC soon. How long did you study the NRCME materials after taking the course before you took the exam? I did a NRCME practice test before even knowing any of the material and got a 61%, so I'm not too worried about the test at the moment..... Just kind of want the test phase out of the way.
I am looking ahead on my schedule to see what awaits Monday. Have a DOT exam on a 53 yr male who sees my partner and a GI doc. Listed as primary biliary cirrhosis with NO alcohol involvement and esophageal varices. Have not met this patient yet but have concerns and am researching. BMI 32, normo if not low tensive but not hypo, nonsmoker. GI lists Child Class A and MELD 9 - researched that since not in my daily vocab - very lowest on scales of mortality with 2 yr survival at 85% The esophageal varices worry me the most. He has 2+/ 2 channel varices on nadolol to reduce risk of bleeding. My first DOT impaired behind the wheel thought --- sudden coughing fit and varices rupture and he bleeds out and wrecks the truck into a school bus full of kids. Turns out he works for the railroad but goes out on the tracks in company vehicles and big equipment. GI says "don't lift heavy things"..... ummm, helpful - not. What does that mean - 20 lbs?.... I know it increases intrathoracic pressure with lifting and risks the varices. What is the actual risk? Natalie Hartenbaum's book doesn't address this particular issue. Looking for some GI colleagues or DOT junkies to throw out some advice. I will undoubtedly be calling the GI doc who will have zero understanding of DOT........................ Trying to work ahead and avert issues.......................