Sunday, February 28, 2010

Almost Done

With family medicine that is. I know I've been slacking at blogging. Honestly, I'm just so exhausted by this rotation, that the last thing I want to do is rehash my day. I only have this week left, and actually only have to work three days. Tomorrow, we have off. And Friday is my shelf exam. So that leaves Tues-Thurs. The bad part is that we are starting EMR....electronic medical records. The dr I work with is already slow. I am betting I'm there until 8 pm every night this week. Jake comes on Thursday. I'm excited.

I can't really think of that many stories.

I went in to see a new patient who was coming for a physical. I introduced myself. She asked if I was a state employee. I said no. She insisted I was. I said that I do not get paid and am not an employee. Then she says "I refuse to answer any question and you can absolutely not touch me." I just walked out. Strange huh?

A man came in with extreme low back pain and pain down his hamstring. He was standing, slightly bent over with bent legs and he was looking at us and rubbing the back of his leg. This was one of those things that just totally caught me off guard and was hilarious. The man is almost crying and I'm trying my hardest not to laugh. Seriously, I was biting my cheek. I wish I could show you the position because it was just odd and very funny.

I had examined an elderly gentleman and Dr. D came in to see the patient. While he's examining the patient tells him that I can't be a doctor. Dr. D gets a worried look on his face and asks why. The patient says "Well, she's too pretty to be a doctor." Awwww, isn't that sweet? Kind of. It's a strange compliment. So because I'm pretty I can't be smart too? Well, it's a good think I don't get upset easily.

And one more. Dr. D was telling me while he was a med student on his ER rotation, he worked with this female physician. She would walk into a room to see a patient and tell them that their body was like a house. If your shutters aren't working, you go to the eye doctor. If your siding is falling off, you head to the dermatologist. If your plumbing isn't working, you head to the urologist. If you need maintenance work, you go to the family physician. I am a fireman and your house is not on fire. Then she would turn around and walk out. Yeah, that was back in the day when you could choose not to see patients in the ER.

Tuesday, February 16, 2010

A Reminder to do Boobie Checks

Ladies: this is your reminder to start doing monthly breast exams. If you're not comfortable doing them, ask your significant other to do them. Don't know how? There are plenty of materials online or you can ask your doctor. They would be more than happy to show you how.

What brings on this post? Well, today I had a patient who came in for a rash. It was the worst on her chest. While I'm examining her rash, I'm thinking "Hmm she has the strangest looking breasts with all those scars. I wonder what she had done." Well, ignorant me assumed since she was so young that it was cosmetic reasons. Actually, at the ripe old age of 26 she had breast cancer, needed a double mastectomy, and had reconstructive breast implants. 26? 26???? That is one year older than me. Seriously, that is scary. It is really easy to think that breast cancer only happens to older women. We are wrong. I saw it today.

So whatever you call them: Breasts, boobies, tatas, knockers....check them out. Be kind to them and practice good breast health. And seriously, if you really don't know how to do them and can't get any information, send me an email. I'd be happy to help.

Sunday, February 14, 2010

Happy Valentine's Day

Well, it's V-day and I'm cooking meatloaf and asparagus for myself with the intent of eating leftovers for at least 2-3 days. Jake's in Colorado and he spent the day in his lab. Every time I called there was some very loud machines running. We celebrated last weekend while he was in town. I'm glad it fell on a Sunday that way I'm not out at work listening to everyone's plans and seeing all the flower deliveries. Our weekend was fantastic and it was the perfect V-day for us. Friday, I took my Ob/Gyn shelf exam and came home to a bouquet of tulips: my most favorite flowers ever! It's a bouquet of pink, red and white tulips. Let me make a shout out to Proflowers. Jake always gets me flowers from them and they are fantastic. Flowers easily last 1-2 weeks. Ok back to our weekend. Friday night we stayed in, and I made Jake a yummy dinner. Saturday morning we slept in, and headed downtown. We had lunch at Dewey's and then spent a few hours at Barnes and Noble. B&N is our favorite date thing to do. I am never bored there. Then we checked in to our hotel: The Cincinnatian. We exchanged cards and of course Jake didn't follow the no gift rule. He got me a purple pearl set of necklace, earrings and bracelet. They are beautiful!!!

Next up is dinner. We got the recommendation from one of the physicians in the area to go to Morton's. It's a fancy steakhouse. We had so much food....more food than I've probably ever eaten at a dinner. Both of us were in pain from our extended stomachs. LOL. The food was delicious. Like amazingly delicious.

So yeah, we had a good V-day. It was a really short trip though. It was the shortest amount of time we've spent together in about two years. Pretty crappy if you ask me. Oh well, November isn't that far away. We'll make it.

Friday, February 12, 2010

Week 1 of Family Medicine

I know I've been a slacker and haven't posted in awhile. I just haven't had any great stories. I finished up OB/GYN and just can't even believe 4 weeks went by so fast. The rotation was amazing; it's everything I hoped it would be and I am 100% sure I want to go into this.

I am one week into my second family medicine rotation. I have to say that I work harder and longer hours on my family rotations than anything else. I leave my house at 5:45 am, meet Dr. D at the hospital to round on our patients, then drive to our office and see patients until 5ish. Then I have to stay another hour to go through labs and phone messages. To be honest, I don't like it. It's really hard coming off the rotation that I love love love and going to one I'm not really interested in. I'm never home. The silver lining is that I get one day off a week. The doctor I'm with is great, and I'm working hard, not letting him know for a second that I'm not happy, but ugh. Our mornings typically consist of diabetes and hypertensive patients with a mix of a few other things. I'll write about some frustrating stories.

Story 1- female in her thirties who has been sick for over a week. She's had a terrible cough and her lungs are really wheezy. We give her two nebulizer treatments and her lungs sound the same. Dr. D really wants her to get a chest xray. She is self pay and doesn't want to spend $12 on an xray. So what does she decide to do? Head on over to the ER. Where she is then admitted. *BOOM* That was the sound of my head exploding. Really? Who is going to pay for that $5000 visit? Oh the taxpayers of Ohio, that's who. That is just so frustrating to me. Dr. D was less than pleased too.

Story 2- a 35 year old male who weighs over 320 lbs. He stopped taking his blood pressure medication a few months ago because he ran out and didn't want to refill it because he doesn't like to take pills. In the office, it was pretty high. He told me he didn't mind dying (not in a suicidal way, just in a lazy I just don't want to take pills way). Yeah dying is the easy part. The hard part is having a stroke and being in the hospital post stroke not being able to move or speak. We talked him into restarting his meds.

It's really frustrating to take care of people like this.

Tuesday, February 2, 2010

My C-Section

Dr. P, the doctor who took me to Brazil is back. She had gone back to Brazil and pretty much missed my entire rotation. I was really frustrated that she was gone since I feel like she is truly training me to become an Ob/Gyn. She told me today that by teaching me so much she feels like she's doing a service to women's health since one day that's who I will be taking care of.

She had a c-section scheduled today and this morning before we headed to the OR she told me that we were going to "do this." Not quite sure what that meant I just followed along. When we got in the OR, she told the surgical assistant that I would be taking her place. Actually, I did 98% of the c-section up until the time to imbricate (restitch the uterus over the first line of stitches). I made the entire incision, used the Bovey, cut the muscle, fascia, peritoneum, uterus, pulled the baby out, cut the cord, pulled placenta out, and stitched up the uterus. I was just amazed how much I got to do. While I was stitching up the uterus, I was going through one side, reloading the needle and going through the other. She stopped me and asked why I was not going all the way through. Well the surgical assistant last night wouldn't let me do it that way and I explained that to Dr P. Her response: "Excuse me, but I believe I taught you that way and I will be telling him that." Whoa. Yeah, surgery was over and she went and found him and told him exactly that. Shit...I don't want any drama. I wasn't trying to cause problems.

I got lots of compliments today. It makes me feel really good when everyone keeps telling me that I will make such a great doctor. It makes me feel even better when it's Dr. P. I know when I do something wrong because she has zero issues with telling me. The compliments from her are priceless to me.

Oh yeah, I tried to do my first laparoscopic tubal ligation. Notice I said tried. This was damn near impossible for me. Like the world's hardest video game. I was holding the camera in one hand and trying to clip the fallopian tube with my other hand, all while watching a screen. Since the camera and tool to clip are in different planes, it makes things much more difficult. I had to hand it back over to Dr. P. I can admit when I'm unable to do something. It stinks, but I really was fumbling.

Monday, February 1, 2010

Can I Close My Legs?

Well I delivered another teenager's baby. I feel like these deliveries are always the most entertaining for me. I broke her water and then she asked how long her legs would have to be open for the delivery. Her mom told her for as long as it took her to push the baby out. I would love to tell you I'm joking but seriously the girl was shocked that she had to push the baby out. It was like she just found out the stork doesn't magically drop the baby off. Fast forward to delivery: once the baby's head was out and she could see she just kept saying "eww eww eww." I could tell she did not want us to put the baby on her chest, but tough luck little girl, that's how we roll since the baby is still connected to you via the umbilical cord. So now she's totally grossed out that her gross baby is on her chest. She looks up at me and says "Can I close my legs now?" Umm, no, the baby is still attached and your placenta is inside. I always offer the new mommies the option to see their placentas. As I'm delivering her placenta I say "I imagine that you do not want to see your placenta." Her eyes got all big as she shouted "NO," then covered her entire face with her hands so that she would not see anything. I got her all cleaned up and finally she was able to close her legs. I hope she can continue down the "closed legs" path.