SNOW!!!!

We are in the midst of a winter storm warning. The pictures are current, but it is still snowing and is going to continue through tomorrow night. We're looking at upwards of a foot. Jake was nice enough last night and let me park in the garage so I wouldn't have to scrape this morning! Love him!

So today I had two families that just totally made my dad.

Family 1- 12 month old check up. Grandma, mom and dad were along in the room. When we were all done, the grandma took my hand and told me that I would make a wonderful pediatrician. I said thank you and then the mom said that she agreed and that they really liked me. I love hearing stuff like that. The patients are the ones you want to like you.

Family 2- 9 month old little girl in for her check up. Mom, Dad, and 3 yr old brother in the room. The 3 year old climbs up into the chair and whispers something in Dad's ear. Dad says "What did you just say?" 3 year old- "She's cute!" Mom- "Great my 3 year old is hitting on your medical student." 3 year old- "Can she check me out too?" Watch out Jake! A 3 year old is moving in! LOL.

What's a Normal Family?

The thing with peds, is that you establish a relationship with the child and the parents...so basically the whole family. Dr. S has been telling me lately that there is no such thing as a "normal" family. Everybody has shit that happens...bad grades, divorce, kid acting out, drugs, anxiety, depression...you get the drift. He told me that he used to be a lot more judgmental before he had kids. Because, things happen. You can't control every single thing about your children. And when these things happen, they happen to your entire household. Everyone experiences it...all from different viewpoints, but they all get to deal with it. Today we had two cases that I tried to wrap my head around. 1. a teenager who has been getting into drugs, truancy, failing...except an A in a science class. He's depressed...and Dr. S and the mom were talking today about sending him away to some military sort of school. My opinion? He's bored. His one A proves that he's interested in something...I think he probably thinks the rest of school is boring and a waste of time so he finds other things to do. Are they wrong? Of course. Why do I think this? One, Jake got D's in a bunch of his high school classes (including chemistry) because he was bored and didn't want to do the work. He's getting his PhD in chemistry now...I think he's bright enough. Anyways, back to this kid...yeah he's probably depressed, but I don't know if anyone has actually sat down and asked him some simple questions. Ok enough about him.
Patient 2 was a pre-adolescent who was having some behavior issues. I'm not sure what I'm getting to. But I don't judge these families. I do however judge the parents who don't immunize their children against anything. Why wouldn't you want to protect your children? The diseases that they protect against are ones that can kill you.

Ok this post was all kinds of random and if you can follow I congratulate you.

The Patients that Make it All Worth it.

There are just some patients that make it all worthwhile. The ones that make your day better, make you smile and laugh, and the ones that you want to take home. I had the most adorable 3 year old little girl who came in for her well child visit. As I've said before, 3 year old kids are my favorite. Well, Dr. S and I walked in the room, she stops talking, looks at me, points and says "Umm I like you." So Dr. S told her that was fine and he left the room. She promptly climbed into my lap, told me all about colors and that she is a girl, her daddy is a boy, what she is planning on being for Halloween (a magenta butterfly), how my necklace looks like an "O," and on and on and on. She was pretty advanced too. She was able to draw a circle and a cross (the cross can usually be done by 4 year olds) and she could hop on one foot (also 4 year old thing).

During the course of the exam for the kiddos, I try to find out who their favorite character is. Well, her's is Ariel, so when I looked in her ears, I told her Ariel was in there. For the first time in a year, this backfired on me. She wanted to look and wave at her. We had to tell her I was pretending like she pretend plays. Anyways, this little girl was just so fricken cute. She seriously made my day.

I hope when I look back on this in a few years I remember her.

What kind of things make your day better?

Christmas is Canceled

Well the present giving that is. Unfortunately, my next set of boards is going to cost a lot of money. The boards themselves cost $1700. I have to go to Philadelphia to take part of them. So I'm thinking at least $2000 for the entire ordeal. Jake and I decided with this extra expense we were just going to not do gifts with anyone this year. It really is ok considering neither one of us want or need anything. My parents are okay with it because they are coming out for New Year's to Colorado...so they look at the trip as their present. It will probably just be a little weird on Christmas morning to have zero presents under the tree. Normally, I spend Black Friday shopping for all my family members, but I'll probably still go out just because it's so much fun to me!

I'm not sure what we will spend Christmas day doing, but we'll figure out something.

Becoming a doctor is an expensive ordeal. There are so many costs other than tuition that no one tells you about. Boards are ridiculous. After all the core rotations we have to take shelf exams. In order to study for these shelf exams you have to buy all these books. Audition rotations are rotations that you do at residency locations that you might be interested in. Unfortunately, you usually have to pay for housing for a month in a new location. Money, money, money. Someday, this will pay off, but it sure seems a long long long ways away. So maybe Christmas will be canceled next year too.

Are you making any cutbacks for the holidays this year?

Pediatrics and the Swine Flu

I now have one week of pediatrics under my belt, and I have to say my life is pretty dang sweet right now. We start at 9 am and are done sometime between 5-5:30. Oh yeah, and depending on how the morning goes...I get between an hour and 1.5 hours for lunch. And because the clinic is so close to home, I get to spend my lunch at home. It's great. Jake's actually been lucky enough to have a wife who can cook for him at night. I believe I have cooked almost every night, which is amazing! What else...I get my own tablet/pc to use. It's so much better than flipping through paper charts.

So what do I do in pediatrics? See a bunch of healthy kids for their well child exams and a bunch of sick kids. My favorite well child exams are the babies and the 3 year old kids. I love the babies because they are fun to play with, although as soon as I pull out the otoscope (look in ears) they begin to wail. The 3 year old kids just crack me up. They are into everything, bounce around the room and manage to tell you everything all at once. I'm just glad I get to leave them to their parents.

This clinic in particular has a wealthier and more diverse group of patients than I am accustomed to. For example, in the last week I have had patients from Russia, England, and Israel. I also have had two sets of lesbian moms (one set adopted the child and the other set used a sperm donor, used one mom's eggs and the other mom's uterus. Did you get that?). I'm also pretty happy with the acceptance that I have received from the parents. Typically, the wealthier the family, the less likely they are to allow you to touch their child. Now I know this isn't a black/white situation, but it tends to follow this path. However, I have had zero problems with parents, in fact, these parents are even more interested in me and my education process.

Alright, what everyone is waiting for...the swine flu. To be honest, I'm pretty sick of hearing people FREAK THE HECK OUT over it. And I also believe, that many people do not have all the facts. When people say the doctor says they have the swine flu, it is a most likely situation. For example, in the state of Colorado, there is only one lab in the entire state that is testing for the swine flu. The only places that are taking swabs from patients and sending it to this state lab are hospitals. You have to be an admitted inpatient to receive this test. So why are the doctors saying that you have the swine flu? Because that is what is currently circulating. If you have the correct symptoms (by the way, you need a fever for this diagnosis) then you are being diagnosed with the flu, probably the swine flu. Again, for everyone freaking out, I have been exposed to about 10-15 patients a day with this. I have yet to get it (hopefully I didn't just jinx myself). Wash your hands....a lot. Wipe down the grocery cart at the store. Get the flu and swine flu shot. For those of you with little babies at home, the CDC is advising you to get the shot not the nasal mist. I really encourage everyone to read the CDC's website for information. And before anyone gets huffy puffy at me about this, I am aware that people with low immune systems are more likely to have complications.

Oh yeah one more thing...the recommendations on when to go back to work/school are 24 hours without a fever without Ibuprofen/tylenol.

Ok, I think that's it.

I'm pretty lucky!

I thought I'd put up a picture of me and Jake to celebrate my good news! This was from our anniversary celebration!

I don't think I've mentioned it on here, but I am going back to Colorado this weekend to complete my 4 week pediatric rotation! I'm so happy that the school was willing to let me do this again. The best part is that the clinic I'm rotating at is 5 minutes from Jake's and it's across the street from the hospital, so my travel time will be awesome! The thing that will be the strangest for me is that this office is not accepting new medicaid patients. All of the offices I have worked for are CHC's which means they are federally funded and accept ALL patients. I'm interested to see the differences in the office.
I need to keep making a good impression. I got this rotation because the last doctor I worked with in CO literally picked up the phone, called this pediatrician on his cell phone and asked if he would be willing to take her medical student. She told him that I was really good, and voila, he said yes. Seriously, the way to go far in medical school is to know people and make good impressions. That's how I got to Brazil, and that's how I got this next rotation. So yeah, I'm pretty lucky.

Surprisingly, I Like It and Some Humor

I have surprised myself. I really enjoy my inpatient part of my rotation. The geriatric patients are so sweet and I love seeing them getting better! Most of the time, these patients get admitted because they are having "behaviors." These behaviors include things like: trying to choke a family member, grabbing a loaded gun and going through the window chasing a UPS man who is coming to kill your wife (who died a year ago), punching staff members at nursing homes, becoming extremely argumentative, hoarding things at home, accusing family and neighbors of stealing, and inappropriate sexual comments. Why do they act like this? Well, they usually have dementia, however most of them are being medicated and while they get worse, their family doctors just keep increasing the dose of their medications. Adverse effects of over medicating are irritation, agitation, and violent behavior. Simply tapering their medicine makes them so much kinder and sweet. I really really like seeing them get better. It is rewarding.

What's the hardest part of the geriatric patients? Since most of them have dementia, their short term memory is just shot. They tell you the same three things ten times in fifteen minutes. That's really sad, and frustrating when you're trying to get specific information from them. It's really hard to look at them and think that could me or Jake in 60 years. Scary.

Ok, this rotation has definitely left me with some laughs. This is more just for my own sake so that I don't forget them.

"Well, Christ, he had four testicles. And it was the Holy Grail."
"Vampires, dead people's ashes, the spirits in the cemetery, they all talk to me."
"The sky lab has created a pill that makes you fifty years younger."
"Hey, you got whiskey in there?"- to me as I walk in with my coffee cup.
"Jesus tells me to behave."
"You better keep your pants on."- to Dr. S as we walk out of the room
"Are you going to go put some clothes on?"- to me as I left the unit
"You're such a beautiful girl." - a few of the ladies told me this everyday. It made me feel really good.
"What are you, his sister? You look identical."
"I kept taking my cane and poking him in the foot. He was sleeping and not listening to me and well I get paid to talk."
Dr. S- "what year is it?" patient- "1970."
"Leave me alone. I'm sick of this crap. I exercise every day and I DON'T WANT TO DO IT."- this was after speaking to the sweet patient that she was in the morning. 1 hour later...totally different attitude.