November 19, 1997
Slobodan Milošević Youth Hospital
First Floor: Administration

Experimental Notes:

It was obvious from the get go that these trials wouldn’t be without hiccups, and we finally hit one. As it turns out, when you have a massive stockpile of experimental sleep medication and a large, unethical adult staff working around the clock, some of them may start taking the medication themselves. 

 

By “some of them” I mean “all of them.” 

 

Including yours truly. 

 

By all accounts, Ethexotrex is a miracle drug. I’ve slept no more than 3 hours in the past 2 days with no ill effects. I feel like I can get an unlimited amount of work done. It’s amazing. While being trapped in a hospital with dozens of screaming children is only barely tolerable, not needing to sleep helps. 

 

On another note, it seems obvious that the side work I’ve discussed is obvious. I can observe the effects of Ethexotrex in adults. 

 

Males under 13 years-of-age:

89% reduction in sleep from baseline with mean Time Spent Sleeping (TSS) of 1.03 hours per night and a median TSS of 1.22 hours.

 

Males ages 13 and above:

97% reduction in sleep from baseline with mean TSS of 0.49 hours per night and a median TSS of 0.27 hours.

 

Females under 13 years-of-age:

83% reduction in sleep from baseline with mean TSS of 1.21 hours per night and a median TSS of 1.71 hours.

 

Females ages 13 and above:

98% reduction in sleep from baseline with mean TSS of 0.32 hours per night and a median TSS of 0.20 hours.

Adults 18 and above:

Given the limited experimental data available, male and female adults will be measured as a single category. Adult patients report a 72% reduction in sleep from baseline with a mean TSS of 2.22 hours per night and a median TSS of 2.01 hours.

Incidence of Side Effects:

The percentages listed below describe the occurrence of side effects among all patients. Numbers are self-reported during nightly progress checks.

 

Insomnia: 99%

Restlessness: 32%

Itching, Irritation, or Rash: 38% (Note: this category includes observable rashes and irritations as well as symptoms that appear to be psychosomatic)

Increased Agitation: 9%

Depression: 10%

Anxiety: 28%

Auditory Hallucinations: 3%

Narcolepsy: 2%

Nausea or Vomiting: 7%

Hematuria: 1%

Other: 12%

 

Notes: Side effects have remained relatively unchanged over the past few days, though I’ve noted a marked decrease in reports of restlessness across all subjects. I suspect this is due to patients gradually accommodating to the drug’s stimulant effects. There is also a statistically significant increase in reports or rash and itching. 

 

I’ve included an exam note describing symptoms.

 

Patient: Ruža Višeslav | DOB: 1/18/1989 (7y 10mo) | Gender:

Date: 11/17/1997

Subjective

Chief Complaint and History of Present Illness

The patient was examined after being brought to my office in the midst of a screaming fit. She was completely inconsolable. Though my Serbian is remarkably poor (read: nonexistent), orderlies informed me that she was screaming “it’s in my leg” non-stop for at least thirty minutes. The patient was given a mild sedative and brought to an examination room. 

 

An orderly assisted with translation during the exam.

 

Review of Systems

Reviewed.

General: Denies weight loss/gain, fatigue, fever, or chills.

ENT: Denies sore throat, runny nose, difficulty breathing, pain, etc.

CV: Denies chest pain, irregular heartbeats, sudden changes in heartbeat or palpitation, etc.

Resp: Denies cough, SOB, pneumonia, etc.

GI: Denies nausea, vomiting, diarrhea, stomach pain, etc.

MS: Denies limb pain, muscle pain, aching, crepitus, etc.

Skin: Rash on left anterior thigh. 

Neuro: Alert and Oriented X3.

Psych: Mild developmental delay.

Objective

Vitals

Temp: 96.1 F HR: 93bpm
Ht: 53 in BP: 102/76 mmHg
Wt: 47 lbs O2: 99%
R: 22  

 

Medical History

Ethexotrex 75mg QID

Physical Exam

General: Signs of injury in early adolescence. Walks with a slight left limp due to what I’d guess was a broken leg that was improperly set.

HEENT: PERRLA, EOMI. Oropharynx clear. Moist mucous membranes. Conjunctivae appear well perfused.

Chest: Chest wall is nontender.

Heart: Regular rate and rhythm without murmurs.

Lungs: Clear to auscultation bilaterally.

Abdomen: Soft, positive bowel sounds, nontender, no organomegaly.

Skin: Significant tenderness and rash on left anterior thigh. Rash itself is roughly the size of a dime and weeping, although the patience has scratched the site to the point where it’s difficult to distinguish to tell where the rash ends and the self-inflicted damage begins. If I were to guess, the patient suffered minor chemical burns, possibly phenol or lye. Due to the nature and and location of the injury, the patient was screened for sexual abuse,  which came back negative.

Genital: Normal. 

Neuro: Cranial nerves II-XII intact. Minor motor/sensory deficit.

Assessment

Diagnosis

D1: Pruritus, NOS

Plan

Ibuprofen 600mg TID.

Topical lidocaine ointment.

Follow up in two days. Sooner if symptoms worsen.