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!
Saturday, March 19, 2011
Friday, February 25, 2011
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!
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!
Call Day 3....my goodness! We start call at 7ish by meeting with the doc that was on call the previous day. That doc will brief my doc and I on the patients that are currently still on the floor, and then we'll "round", which is going to see each of these patients. We started at 8...at 8:20, we were prepping an OR for a c section. This lady had been on Pitocin (a drug that induces labor) for over 24 hours and wasn't making any progress..."failed induction" is indication for c section. She was given the option to wait a little while longer, but she had been in the hospital 4 days already, and wasn't allowed to eat or drink, so naturally...she opted for the c section (I would've too...I bet she was starving!) All went well during the surgery. If you've read the previous post, I did all of the same things during this procedure...helping with the entire procedure, but my favorite...manually pushing the baby out of the mother, and then helping to suture and staple to end the event. This was baby boy #1 :)
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!
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
So Friday was my first day of being on call for this rotation. Typically "on call" makes you think of people living their normal lives until their beeper or cell phone goes off. In OBGYN, you don't have that kind of time, so you stay at the hospital....for 24 hours...
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!!!
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!
So after a very long, but appreciated break, I'm back in the swing of things with school. I have finished all the classes and passed all the necessary exams....they're letting me bust into the hospital! I have 90 weeks of rotations ahead of me, but I like to look at it more in small chunks. My first "chunk" is OBGYN. I started Monday and so far everything is going wonderfully! i have been privileged to see quite a few in office procedures (pap smears, annual exams, STD screens, etc) but the real fun for me came today. The doctor I'm following has it set up as so: He shows me, then it's up to me. While I am not legally allowed to do everything I would like to do, I jump at the chance to do what I can. Today was the highlight of that chance for me so far. Until today, we had only seen gynecology patients (girl parts...ya know), but today we had a few OB patients. For the first one, he showed me how to use the doppler machine to detect the fetal heart beat. Therefore, since he showed me, the next one was up to me. The patient was super nice about everything! I assured her that if when I put the doppler on, if we didn't hear anything at first, it was no indication that her baby didn't have a heartbeat, but that instead it was my first time trying to locate one so it might take me a while. To my surprise, it only took me about 15 seconds. I was like a kid in a candy store. This huge...and I mean HUGE grin hit my face. There was life inside of her and I could hear it!!! I'm blown away by the way God created us...I think that is the biggest thing I am learning from all of this.
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...... :)
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...... :)
Thursday, February 4, 2010
Welcome to Life as a Doctor
So I spent last night from 8pm to 7am this morning in a local emergency room doing a rotation. It was by far the most exciting and educational evenings of my medical career so far...here's a summary of the patients I got to see:
1) 54 yo F presented with chest pain and HA
PMH (past medical history) of Hypercholesterol, HTN (high blood pressure), Asthma, CHF (congestive heart failure also incredibly stressed and worried about everything in Haiti...which we later found out was b/c she's from there and still has family there
ordered a CT chest w/ contrast...
--> cardiomegaly, CHF
admitted
she was my first pt....great pt...actually using her for my write up
interestingly....around 6 this morning we're called upstairs b/c she's losing it....we get up there and it was like she had ODed on opiods or something
they still hadn't figured it out when we left...but she was perfectly alert and oriented a few hours prior....maybe the husband gave her some of her regular meds before he went home and it messed her b/c she was already receiving lasix IV, tylenol, and nitropaste
2) 19yo female - can't swallow and throat hurts...DXed with strep throat monday...tongue had some erosion that almost looked like a Candida infxn but once you depressed the tonge, the tonsils were so swollen they were nearly occluding the entire throat....hence the dysphagia
3) 73yo M with rectal and penile bleeded...go pulled away from him though to go to a code blue for a
90 yo F found in asystole (flatline)...gave epinephrine and atropine, 3 rounds with chest compressions and bag ventilation throughout...
which is where stuff got awesome...CPR person got tired...Dr asked if we knew how, I said yes, he said "get your gloves on, let's go" so i gave compressions, then D gave some, and the woman after a while came out of asystole and got a rhythm back....so i'm feeling nothing in this womans femoral artery for the longest time and then finally she gets a bounding pulse with the last dose of atropine....absolutely insane!
4) 66 yo F attacked near her home, didn't let go of her purse so the criminal stabbed her with something in the arm...had to get an xray and sutures
5) 29 yo creole woman that didn't speak english...substernal pain, pain uder right breast, and pain in the pelvic region, especially after sex...ended up being nothing that they could figure out though
6) 67 yo M with severe backpain, PMH: HTN, pending prostate biopsy, nothing showed up on CT of abdomen, pelvis, or chest
7) 71yoF PMH: HTN, DM, Arthritis came in with SOB, chest tightness...had a CXR but didn't come back before we left
8) 36 yo F PMH: schizoaffective, reported listening to the spirits and voices and walking around for 3 days but she was at a bus stop and had fallen and hit her head...CT cervical spine w/o contrast, CT head or spine w/o contrast, CXR...ended up with C2 fracture (she broke her second vertebrae in 3 pieces...this is the same vertebrae that Christopher Reeves was affected by)...the freakin dens was broken in 3 pieces...it was crazy...so we needed her to lay still to preserve the spinal cord...but she had been on neuroleptics long enough that she had developed tardative dyskinesia (makes the patient twitch, almost like Tourettes) so it was hard for her to sit still...
9) 38 yo M PMH: schizophrenia, HTN, depression - having suicidal thoughts, missed his meds yesterday, girlfriend died 7 months ago...not sure what they did with him...he was still there when we left
10) 19 day old baby boy (adorable) running a fever...so protocol if they're under 30 days is to do a full septic work up, which includes a spinal tap...but it was amazing how much better it was for an infant...they don't have to use as big of a needle and the baby doesn't really feel as much of the pain
So that was what I got to do last night...first time seeing all this mumbo jumbo I have to learn really put into practice...and I LOVED EVERY SECOND OF IT!!!!
1) 54 yo F presented with chest pain and HA
PMH (past medical history) of Hypercholesterol, HTN (high blood pressure), Asthma, CHF (congestive heart failure also incredibly stressed and worried about everything in Haiti...which we later found out was b/c she's from there and still has family there
ordered a CT chest w/ contrast...
--> cardiomegaly, CHF
admitted
she was my first pt....great pt...actually using her for my write up
interestingly....around 6 this morning we're called upstairs b/c she's losing it....we get up there and it was like she had ODed on opiods or something
they still hadn't figured it out when we left...but she was perfectly alert and oriented a few hours prior....maybe the husband gave her some of her regular meds before he went home and it messed her b/c she was already receiving lasix IV, tylenol, and nitropaste
2) 19yo female - can't swallow and throat hurts...DXed with strep throat monday...tongue had some erosion that almost looked like a Candida infxn but once you depressed the tonge, the tonsils were so swollen they were nearly occluding the entire throat....hence the dysphagia
3) 73yo M with rectal and penile bleeded...go pulled away from him though to go to a code blue for a
90 yo F found in asystole (flatline)...gave epinephrine and atropine, 3 rounds with chest compressions and bag ventilation throughout...
which is where stuff got awesome...CPR person got tired...Dr asked if we knew how, I said yes, he said "get your gloves on, let's go" so i gave compressions, then D gave some, and the woman after a while came out of asystole and got a rhythm back....so i'm feeling nothing in this womans femoral artery for the longest time and then finally she gets a bounding pulse with the last dose of atropine....absolutely insane!
4) 66 yo F attacked near her home, didn't let go of her purse so the criminal stabbed her with something in the arm...had to get an xray and sutures
5) 29 yo creole woman that didn't speak english...substernal pain, pain uder right breast, and pain in the pelvic region, especially after sex...ended up being nothing that they could figure out though
6) 67 yo M with severe backpain, PMH: HTN, pending prostate biopsy, nothing showed up on CT of abdomen, pelvis, or chest
7) 71yoF PMH: HTN, DM, Arthritis came in with SOB, chest tightness...had a CXR but didn't come back before we left
8) 36 yo F PMH: schizoaffective, reported listening to the spirits and voices and walking around for 3 days but she was at a bus stop and had fallen and hit her head...CT cervical spine w/o contrast, CT head or spine w/o contrast, CXR...ended up with C2 fracture (she broke her second vertebrae in 3 pieces...this is the same vertebrae that Christopher Reeves was affected by)...the freakin dens was broken in 3 pieces...it was crazy...so we needed her to lay still to preserve the spinal cord...but she had been on neuroleptics long enough that she had developed tardative dyskinesia (makes the patient twitch, almost like Tourettes) so it was hard for her to sit still...
9) 38 yo M PMH: schizophrenia, HTN, depression - having suicidal thoughts, missed his meds yesterday, girlfriend died 7 months ago...not sure what they did with him...he was still there when we left
10) 19 day old baby boy (adorable) running a fever...so protocol if they're under 30 days is to do a full septic work up, which includes a spinal tap...but it was amazing how much better it was for an infant...they don't have to use as big of a needle and the baby doesn't really feel as much of the pain
So that was what I got to do last night...first time seeing all this mumbo jumbo I have to learn really put into practice...and I LOVED EVERY SECOND OF IT!!!!
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