I wanted to journal my way through the amazing life experiences I have. However, I'm horrible at actually doing it because it takes so long. Therefore, I started a blog, where I can take just a few minutes when I have the time, to get out my thoughts...so here it goes!
Tuesday, August 16, 2011
Movin' On Up!
Saturday, July 30, 2011
Goodbye Peds...Hello NICU
Tuesday, June 14, 2011
Why Pediatrics is Pricesless
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.
Sunday, June 12, 2011
Ouch!
Saturday, March 19, 2011
Family Medicine
--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!
Friday, February 25, 2011
Adios OB/GYN!!!
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!
Tuesday, February 15, 2011
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!
Tuesday, February 8, 2011
Baby Mania!
There was another lady that was similar to this, being on the pitocin for 24+ hours with no progress. However, her situation was complicated more than usual. She had something called preeclampsia, in which she had elevated blood pressure and protein in her urine. She was on medicine for it during her labor, however, the primary treatment for preeclampsia is delivery. On top of this complication, she was only 28 weeks. Babies are considered "viable" at 24 weeks, so that wasn't the concern, however, it was very apparent that the baby would have to spend quality time in the NICU after birth.....so c section it was. However, there was another section for a different doc going on, so we waited (being Sunday, there weren't as many nurses to run multiple rooms).
While waiting, we thought we could round and see some patients. We had 17 total, so I started at the top of the list, while my doc started at the bottom. I had seen two patients when my phone rang. It was my doc telling me to rush downstairs. There was a girl that came into triage ready to drop her baby in the floor....literally. I guess she just decided not to come to the hospital until the VERY LAST MINUTE. Being this close to delivering, she can't have pain meds (epidural) because it will go straight to the baby...which she wasn't too happy to hear. I rushed to get my gown and gloves on while she was screaming that she needed to push. I stood by my doc as the mom began her pushing. It definitely didn't take long...and there was the head. To my surprise, my doc said..."alright...get in here!!"...WHAT THE HECK! :) I thought to myself..."um....are you saying you're going to let me deliver this baby!?!?!?!" And yes...that's exactly what he meant! He coached me every step of the way, and kept his hands over mine, which were on the baby. I had the baby's head, then he taught me how to pull down, then back up to release the shoulders...and that's it, OUT COMES BABY! I can't explain how amazing it was! My first vaginal delivery...just something I wish everyone could experience...to God be the glory for such an amazing experience!!! Baby boy #2 was here for today
Ok...so after that excitement, I went back upstairs to see more patients. I saw one patient and headed back to the nurses station to write her progress note, and just as I put my pen to the paper to start the note...the phone rang again. It was my doc telling me that another similar lady just came into triage. He wanted me to go see her, do a history and physical, and then stay with her! She was already 6cm and it was her 3rd delivery, so we knew it wouldn't take long. So, I put up the chart I'm working on and race back downstairs. My patient wasn't hard to find my patient, just had to follow the high pitched screaming into triage, and there she was. Just like the first girl, this lady was too far into labor and was progressing incredibly too quickly to get any pain meds. It wasn't long before we had her in a L&D room and her fiance and their two little girls came back to be with her. She had a 5 year old and a 2 year old that were incredibly adorable! We turned cartoons on for them to watch, but all the wanted was to see their new baby brother :) Again, I got to deliver this baby and the placenta, with the supervision and guidance of my attending of course. I'm not sure the excitement of that could possibly ever get old :) So this was baby boy #3 for the day.
Ok, so after ALL that...we went back to the lady with preeclampsia and got ready for her c section. Everything went well through the surgery, all the cut, suction, push, suture, staple normal activity. The amazing thing was how little the baby was. Being only 28 weeks, she was a tiny little thing, but was truly beautiful. They took her straight to the NICU, so I'm not sure how much she weighed, but you could tell she was quite small...I would guess in the 5 pound range, give or take.
Well, that was the extent of my daily excitement this past Sunday, which was actually GREAT! There was a little game on tv this past Sunday...the SuperBowl as you may know..and luckily all the babies were out and I was able to chill out and watch the entire game.
The only other call I had was around 12:45 we had a woman come in with her 8th pregnancy (to deliver her 6th child), also in full labor. However, she was not progressing as quickly as the other ladies did. But, I went to see her, did my usual history and physical for her, then called my doc to tell him the deal. Nothing was worrisome at the time being, so they were going to admit her, and I went back to my room to go to sleep. Around 3:30, my doc called just to update me on her progress. She had made it to 7cm, so he was letting me know, in case she shot up to 10 and was ready to go! I drifted back off to sleep and woke up at 6:15. She decided to wait it out, so we passed her off to the next doctor that was coming on at 7am.
Well, that was it...on call day number 3 complete! I LOVE being around all these babies...I can't believe my life!
Sunday, January 23, 2011
I Can't Believe This Is My Life
I got to the hospital around 6:20 to make sure I was in the right place to meet my Doc at 7am. We reviewed the patients that were there from the night before with the doctor from the night before, and then we were off to see them. The patient list wasn't too bad, but there were some crazy cases...I'll tell you about my two favorites!
1) There was a very kind lady who was there to have her first child. She had come in the night before and was induced, but wasn't having much luck progressing. She ended up with some other complications, which led to her having a cessarian section. My doc told me to scrub in for the procedure...which meant that I would be pretty close to the action, but that was all I thought. Little did I know, I was about to be all in the action! I had never seen a C-section before, or a baby be born for that matter, so I was incredibly excited!!! Before I knew it, we were starting...with my doc on one side of her abdomen, me on the other, with one nurse beside me. Doc cut her abdomen, one layer at a time to avoid damage. I manned the suction. At one point, both the doc and I put two fingers in the abdomen on each side...and pulled! Seems kind of brutal, but we had to get a baby out of there! Next, doc pointed out the uterus and asked me if I could see what he was pointed at..."Is that the baby's hair!" I said...and I was right! I couldn't believe it! We were seconds away from bringing this baby into the world! I couple snips later, and the uterus was open. Doc asked me to put my hand on the mom's stomach, and then kindly reminded me that because of her spinal anesthesia, she couldn't push the baby out. So doc looks me dead in the eye and says..."ok, you're going to push this baby out....and you have to like, for real push!" Before I knew it, he was holding the baby's neck while I pushed her out! 3 big pushes later...our patient was a first time mommy to a beautiful baby girl!! The umbilical cord was clamped and I cut it. Not too long later, the placenta was delivered, and then it was time to suture this lady back together. The suturing took as long if not longer than the delivery. Then, doc put her outer skin layer back together as I placed staples across her abdomen....and that was it! I had helped deliver my first baby!
2) Baby number two for the evening came rather quickly. We knew that the mom was getting close, but being her first child, it would generally be a slow progression. I was in my call room on the 4th floor when my phone rang. It was doc...saying "Hey! Get down to L&D now!" which is on the second floor. There weren't steps near there, so I had to wait for the elevator. I got to the room right as doc was gowning and getting set to start. You could tell mom was ready to go. She was already saying had to push...she just had to get it out of her! :) Being my first vaginal delivery and not as much involvement as the c-section, I stood behind doc and watched this one. Mom and dad were super excited! The grin on dad's faced when he realized his baby was almost here was priceless. Labor is supposed to take a while when it is your first pregnacy...but this lady set a new standard for first time deliveries! Within 10 minutes, their baby girl was there, screaming, and ready for some loving! I must admit, I got a little teary-eyed with this one. Just seeing the look of first time parents, and seeing them cry got to me.
I think I was emotional after seeing the parents cry and hold their new baby girl for lots of reasons. Partly, I've just become a big softy, so them crying was enough. Partly, the idea of what the mom must have felt...carrying this baby for 9 months and in a matter of minutes, there she was, in her arms...it was just beautiful. Mostly though, I was amazed at the things God is allowing me to see and do in my life. I most definitely don't deserve any of the great and wonderful things He lets me be a part of, but I'm so thankful that he does!
Well, those were the high points of the on call night for me. I've seen a lot thus far, and that's just the first week!!!
Thursday, January 20, 2011
Oh Baby!
Tomorrow will be my real test: 24 hour shift at the hospital. I freak out at the idea of being late, so I will be there by 6:30, but My doctor is the on-call doctor for tomorrow at the hospital, which means I'm on call also! :) However, this is not the, we carry a pager and live our normal life until it goes off kind of on call. I will be at the hospital from 6:30 tomorrow morning until at least 7am Saturday morning. While I know that's going to be a long time...I'm pretty excited about it. He's the person in charge of the entire OBGYN unit...which means that most likely I will get to see my first child be born tomorrow!! Now you want to talk about miracles....can't wait to see one of God's most miraculous adventures known to man! More to come...... :)