Movin' On Up!

Since I've been in Atlanta, I've been looking here and there for somewhere else to live. I kept waiting for the ideal situation that maybe a girlfriend from school would come here and do rotations and we could get a 2bedroom. If you haven't ever looked into it...living in Atlanta is NOT cheap!

Since January I've been living in an extended stay hotel. It's perfectly fine for me. I figure if I can live in Dominica for 16 months, I can live in the States in practically anything. For the last 6 months, I've called it home. It has been incredibly convenient, both for moving, and for my commute to work.

At the beginning of August, I saw an ad for a 1 bedroom studio garage apartment. It looked awesome! However, I tried to stay calm about it because probably 80% of the apartments I would find online that looked great, would be either in terrible condition or in a terrible part of town once I drove to check it out. I sent an email to the person posting the ad, just figuring..."eh, we'll see what happens"...

After a few emails back and forth with the lady renting the space, we set up a time for me to come visit. I took Caroline (sister-in-law) with me to view the space. The neighborhood is great, still close to work, grocery, shopping. The best part is that it's just a man and wife that own the (very nice) home with detached garage. They have been wonderful to work with. After viewing, and loving the space..............We planned for me to move in September 1st!

I was all for moving in ASAP, but there was a girl living there at the time. Therefore, I would have to wait for her to move out. This kind of put a damper on things because my rent would be due again at the hotel on the 21st, so I would have to pay more money here....dilemma? Maybe, but God always has a way of working things out for the best!

I got an email today that I could move in on the 21st for an additional $200. I kindly emailed her back and said that I would love to but I was trying not to spend extra money. However, if she would just change my lease to start on the 21st, then I would be there with boxes in hand! She agreed (again, super nice to work with)!!! So with that...just have to get through my first week of Internal Medicine and pray that I don't have to work this weekend, so that I can pack up, move, and then unpack again!! :)

I'll post pictures once I have everything set up!

Goodbye Peds...Hello NICU

So I've been finished with my pediatric rotation for a month and have been meaning to write a post about all of the cool things I got to see. The doctor I was working with has been in the business since the 1970's or so. During that time, she became the resident pediatrician for a local news channel, and as such gained a lot of fame and appreciation with the public. Therefore, she has a lot of 'special case' patients.

The pediatric rotation lasts for 6 weeks. During my time, I tried to keep a running note of things that I deemed to be interesting cases. So here it goes:

--Umbilical hernia

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001982/

--Klipple-Trenaury-Weber Syndrome

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001205/

--Pilionidal dimple

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0003737/figure/A003253.B9746/?report=objectonly

--Coxsackie A virus (Hand-Foot-Mouth disease)

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001961/

--Scrotal fungus

--Torticolis

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001757/

--Juvenile Huntington's disease

--Functional bedwetting

--Achondroplasia

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002544/

--Patau Syndrome

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002625/

--Turner's Syndrome

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001417/

--Ringworm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002411/

--Poland Syndrome

http://www.polands-syndrome.com/

I know not everyone has a passion for medicine and illnesses, but I can't help but think that one must appreciate being able to see all of these abnormalities in the same location over 6 weeks!!!

Now that pediatrics is over, I'm doing a 4-week elective in the Neonatal Intensive Care Unit (NICU). Things are going quite well (I'm currently half way through). There are two doctor's I work with, both of which are amazing people and physicians. It's definitely fun to go to work everyday knowing that I'm going to see tiny babies, but nothing like I thought. Doctor's don't do what I call the "fun" part of the NICU work. I say the "fun" is holding & feeding the babies...but that's all up to the nurses. So every exam consists of: wash hands, open incubator (if in one), listen to heart, lungs, abdomen, feel stomach, feel head, look at vitals, walk away, wash hands and go to your computer. The majority of the day is spent at a computer, putting in orders, changing orders you previously put in, or discontinuing orders you no longer need. Therefore, while I love it..I don't know that it is for me. I love talking to people and having more patient contact, so I don't think this is my nitch.

So far we have lost 2 babies during my time. Only one was our patient. However, he was born at 23 weeks - normal term being 40. Therefore, he was born with so many factors against him - he was not neuroligically in tact, couldn't breathe well, his liver was large but non-functioning, couldn't eat so was being fed by tube...it was just a mess. On top of that, he had a large hole in his heart. All babies have this hole in their heart when they are still inside their mom. It serves the purpose for blood to bypass the lungs. There is no need to make that trip when inside mom's belly because they aren't using their lungs. Therefore, this is a normal finding. However, once babies are born and they come out screaming, it signals the lungs to work and that hole (called a patent (meaning hole) ductus arteriosus) to close. This generally does not occur in premature babies (any baby born before 37 weeks). This baby had this problem, but his was so large, it was causing him to be in heart failure. All in all, yes, it was sad to lose a baby and extra sad for the parents. However, that baby is no longer in pain, and the parents now are not faced with the decision to send him to surgery (which could kill him) or to pull the plug and let him go. Amazing how God takes care of you, keeping them from making that decision, while always looking out for each of us.

2 more weeks of NICU, then starts Internal Medicine!

Why Pediatrics is Pricesless

I get tid bits of info sent to me as a medical student...this one really made me thing today....I went to school because my entire life I've thought God engineered me to be a pediatrician. I have an immense passion for children and helping them to feel better. Also, I love to teach (basically anything), so being able to educate families and help them stay out of the doctor's office always appealed to me. However, I'm currently in my 4th week of a 6 week pediatrics rotation...and I've been doubting it this is the plan God had for me or not. However, after reading this article and thinking about what I really want in life, this may well be it...but we'll just have to wait and see where He takes me :)

Why Pediatrics Is Priceless (by: Peter Y. Jung, MD)

An extra blue scrub top is tucked away in the lower right cabinet of the nurse's station. Every so often, after being sprayed with bodily fluid, I have to make a midday swap of my work clothes. However, it's a small price to pay to be a part of children's lives; one day the baby who spits up on your shoulder will be the same kid who runs down the hall screaming your name and clings to your leg with the dexterity of a koala. What makes pediatrics so rewarding is the long-term relationships that you build with children and their families who every day make you feel like a small hero.

Practicing general pediatrics often feels like searching for a needle in a haystack. Hidden in a sea of upper respiratory infections, reflux, eczema, and diaper rashes is a cystic fibrosis diagnosis, for example, that the astute clinician must not overlook. There are enough challenging cases to keep you on your toes to make everyday clinic interesting, but they don't overwhelm you. As a result, you'll have plenty of time each day to build new relationships and foster old ones. These relationships create the backbone of a successful pediatrician's practice.

By knowing the histories of an individual family -- for instance, remembering the grandfather who has Crohn disease or the younger sibling who has a milk protein allergy -- a pediatrician has unique insight into each medical conundrum that presents itself, no matter how big or small. The trust and relationships that you develop allow you to take a personal and tailored approach to an ill-appearing child. That can save countless hours in an emergency department or avoid an unnecessary x-ray or blood test. Knowing that a mom is meticulous and reliable gives you an extra day of watchful waiting for a fever that an emergency department doctor might otherwise work up. This saves time, money, and anxiety.

A successful pediatrician should also be an excellent educator. The better job you do teaching your families -- that fever is a symptom and not a disease, that every cough does not need medication, and that in most cases diarrhea will go away with time -- the better doctor you will be. Using an evidence-based approach to simple problems will help prevent more complex ones; by avoiding the overuse of antibiotics for routine viral infections, you can curb the rise of antibiotic-resistant bacteria and the subsequent complications that they create.

Most pediatricians do not hold master of public health degrees, but we each play a vital role in preventive medicine to protect the individual and society as a whole. Immunizations are probably the single greatest advance of modern medicine. Diseases such as small pox, polio, measles, mumps, and rubella have been extinguished to the point that most modern pediatricians have seen few if any cases of these maladies. The world has benefited from the immense power of immunizations, and pediatricians stand at the front line in protecting children and the public at large.

Pediatrics is not everyone's cup of tea. You should have a high tolerance for shrieking, crying, and the errant stream of bodily fluid that will disrupt the occasional workday. Perhaps the most difficult aspect of caring for a child is working with the array of parental personalities. Both the pediatrician and the parent may have the best interest of the child at heart, but misinformation from old wives' tales, the Internet, and Aunt Bertha can confound clear communication and good intentions. This is where the art of medicine shines its brightest: Strategic word choice and good listening can go a long way to assuaging anxiety and making sure that children receive the best care possible.

Sometimes in the routine day-to-day of things, it is easy to forget that every visit counts; that each teaching moment may save an unnecessary test; and that each shot prevents a possible death. However. when you feel the familiar clutch of a child on your leg, you remember why you chose this job, and you gladly take your blue scrub home to be washed so that you're ready once again for whatever comes your way.

Ouch!

Don't you just love those mornings...so unsuspecting, when you get up and get ready for church...drive there all excited to have some awesome worship and hear what God has for you that day...only to realize, as it smacks you in the face, that it's exactly what you needed and exactly what you'd been struggling with all week...month...or even longer???

The guy preaching in church today said he heard a quote from Time Magazine this week that said "the defining factor of our culture today is stress and anxiety"....yep...not generosity, charity, overcoming odds, helping our neighbors, progressing as a nation, or anything else positive like that...just STRESS and ANXIETY!

As much as I hate to admit it...I'm a worry-crazed woman at times. It's amazing how fear and anxiety can completely consume you if you allow it. It's like when you're home alone and you hear a noise...it doesn't take long for you to convince yourself that there is someone else in the house and they're coming to get you...before you know it you're upstairs hiding in your room with the door shut! The power of the mind is amazing....but the power of God is far more phenomenal!!!

Most people struggle with this...all sorts of things we worry about on a daily basis: money, our future, our relationships or lack thereof, our schedules, our jobs, our families, our health....the list could go on and on...The beauty though is that there's nothing to worry about at all!!! The Bible has a lot to say about this life. The one topic it talks about the most is money (i believe)...but I would be willing to bet (since I'm not certain), that worry and anxiety are pretty high on the list of things that God talks to us about....here are some examples....

“Do not be afraid, Abram. I am your shield, your very great reward. ” -Genesis 15:1

"Do not be afraid, for I am with you; I will bless you and will increase the number of your descendants for the sake of my servant Abraham.” - Genesis 26:24

"Do not be afraid of them; the LORD your God himself will fight for you.” -Deuteronomy 3:22

"Have I not commanded you? Be strong and courageous. Do not be afraid; do not be discouraged, for the LORD your God will be with you wherever you go.” -Joshua 1:9

The list could go on an on...in fact...I looked it up on www.biblegateway.com (love this website) and found that there are 106 times the phrase "do not be afraid" is in the Bible...and that's just one way of saying it!

I know it's tough...and I'm talking to myself the most, but letting go of the everyday stresses and worries that we as humans so desperately hold onto is critical for our faith. I feel like this is a "soap box" issue for me so I could probably go on and on about it for a while...but I'll end with just a few things I wrote down from church today that really hit home with me:

--Fear only attacks the things you care about...if you didn't care, it wouldn't matter.

--There is a huge difference in "Believing in God" and "BELIEVING GOD"

Believe God for what he says, take him at his Word (Bible)...he will never leave you, never forsake you...he's got your back...ALWAYS...even when times are hard

--Fear never tries to change your belief in God...it only tries to change the believability of God.

--Fear wants you to believe in Gods ways and what he calls you to do...but never act on it.

--Fear doesn't want you to change your belief in God, it just wants to make it meaningless -- fear doesn't care if you're a Christian...it just doesn't want you to act like it.

The pastor gave a great example...when we freak out about things we're dealing with...we never jump to...Oh, well this sucks, I'm an atheist now...but oh how easy is it to completely forget that God is right there with us...and that he will carry us through whatever we are struggling with...

Want a good story in the Bible about fear...and overcoming it...check out 1 Samuel 17 (http://www.biblegateway.com/passage/?search=1%20samuel%2017&version=NIV )

Family Medicine

So as usual, it's been a while since I've written anything. I am currently in my Family Medicine rotation, which lasts 6 weeks. Family is your typical primary care physician. They see patients in all walks of life, from newborns to the elderly. I've already completed 3 weeks and have 3 to go. It's not as exciting as ob/gyn was, but there is always something more to learn...so I'm taking each day as a new adventure and trying to learn as much as I can along the way. I see a lot of patients with chronic problems, such as high blood pressure, cholesterol, and diabetes. We also see a lot of mentally handicapped patients. Here are a few of the interesting patients I remember from the last three weeks:
--10 year old that had swallowed a game coin from Chuck E Cheese - he was quite proud of himself might I add
--Anterior shoulder dislocation due to raking leaves (see Mom...I always knew yard work was no good) :)
--a lot of Cerebral Palsy patients, who I'm learning are some of the strongest, both physically and in their will, and also some of the sweetest patients
--a poor man came in with an O2 sat of 84 when he got to us, shaking, freezing. We put him on O2 immediately, but his body wouldn't hold it, so we call for an ambulance. He was in the hospital for a little while, but unfortunately did not make it. He was elderly and had been battling pneumonia at home for days before coming to our office
--a lot of patients getting B12 injections for weight loss
--a 2 day old newborn there for her newborn exam...she was so tiny, even wrapped in her infant snuggie

Also cool, my doc is starting an allergy program in his office. As part of the training for the nurses, I got a free allergy test. Turns out I'm allergic to more than just pet dander like I thought. The pet panel lit up immediately, with positive readings in dog, cat, horse, and apparently guinea pig...who knew! I'm also allergic to bahia, kentucky blue, and fescue grasses, pecan and hickory trees, house dust, and one of the two types of dust mites. Always better to be educated about yourself I say, so at least I know now :)

Three more weeks...then I'm off for 2 weeks of vacation. Bring it on!

Adios OB/GYN!!!

My last week of ob/gyn was this week. All of the excitement started Tuesday with my last day of call. It wasn't too extensive though, but at least I got one last c-section under my belt before getting out of there!

Then today was the last day. I had to give a presentation, which I did on Endometriosis. I was naturally a little nervous (I get mildly nervous with any public speaking event). However, the presentation went really well. It was just in front of one other student, my friend Linda, and two of the clinic doctors, one of which was the one I worked with for the last six weeks. Luckily I wasn't grilled on too many questions, and those that were asked, I knew the answers for! :)

I would be lying if I didn't admit that I'm going to miss ob/gyn. I wasn't sure how much I would enjoy it...but the moment I saw a baby being born, I was hooked. It was an overly obvious reminder of just how amazing God is and how he works miracles in our lives on a daily basis. I was also spoiled with a wonderful attending physician. He certainly set a high standard for the ones I will have to follow.

Up next: Family Medicine for 6 weeks. I must say, I'm not nearly as excited about family med as I ended up being for ob/gyn, but I'm up for the challenge of the next chapter of this journey! So bring it on people...flu, diabetes, and high blood pressure...bring it on!

i LOVE my love

Call Day #4 was yesterday, Valentine's day (It was an incredibly slow day...nothing to write about). Therefore, Chris came down this weekend so we could celebrate V-day together. It was phenomenal! He took me to "Bone's", a steakhouse in Buckhead (www.bonesrestaurant.com). I admit I was a little uneasy at first. I don't tend to go to such fancy places often because I'm happy with a steak from Outback! :) However, it was Chris' treat for me and he "just wanted me to feel like a princess"...well he easily surpassed that! The food was exquisite! I got a filet and Chris had a tbone. The service was amazing as well...the waiter greeting us with, "Good evening Mr. Pitts, and madam", showing us a wine list, to which each waiter carried an iPad with ! Despite being full after dinner, we shared a piece of pecan pie a la mode. I'm quite certain it was the best pecan pie I've ever eaten. If you've ever seen me eat pecan pie, I'm quite annoying about it. I LOVE the filling and crust, but despise the large pecans on the top. However, with this one, they finely chop the pecans, and soak them in something so wonderfully flavorful that I would eat them alone. Then, the pie was rather hot and topped with ice cold vanilla bean ice cream!

After dinner, we drove down to this awesome little venue called "The Variety Playhouse". Chris had gotten tickets for us to see Kathleen Madigan, a comedian. Neither of us knew much about her, but I remembered seeing her on one of the first seasons of 'Last Comic Standing', so she must be decent! We were pleasantly surprised. She was indeed, quite comical!

It was a WONDERFUL valentines day...I'm so grateful that I've found my valentine, and I get to keep him for the rest of our lives!