Monday, June 30, 2014
Graduation.
Wait, what?
Yep, our time as students has come to an end ya'll. Still hard to wrap my head around. I went back to lex on a Wed, took a practice board exam on Thursday, and accepted my diploma on Saturday. And here I am, back at home after a week of board prep. Its so odd not knowing my next scheduled trip to KY, no more EOC exams, no more standardized patients etc... (I mean, I don't hate that, just weird.) I have been a student for so long, its hard to realize I'm not one anymore. Sure, we are all "lifelong learners" by default because we are in the medical field, but I don't have to sit at a desk surrounded by 60 people anymore.
Graduation was a happy day filled with family and friends, pictures, hugs, and clinking of champagne glasses. Isn't that what we all imagined it would be? :)
But with graduation comes big decisions and responsibilities....you mean I actually have to start paying these loans? Please, no, that is all just some huge mistake and someone else is going to handle that. No? Crap. The PANCE...we all know that #PANCEdontcare. Everyone is in the midst of board prep and that scheduled test sure is daunting in my near future. But its okay, I will get through it just like every other test. Deep breaths. Jobs...oh Lordy, this is a fun topic right now between friends (not). I feel bad for all of those staying in Lexington competing for jobs, that's rough. Fortunately, I live in a different city so it was slightly easier... more on my job later, I don't want to jinx it before I take the boards.
Saying "see ya later" to all my classmates was hard. Some of us are moving far away, others a few hours, other staying put in lex. I'm hoping we can all reunite every so often, but I know life gets in the way sometimes. I've made some forever friends in PA school and I'm so fortunate to have met my classmates which are now colleagues. I will miss you guys.
Yep, our time as students has come to an end ya'll. Still hard to wrap my head around. I went back to lex on a Wed, took a practice board exam on Thursday, and accepted my diploma on Saturday. And here I am, back at home after a week of board prep. Its so odd not knowing my next scheduled trip to KY, no more EOC exams, no more standardized patients etc... (I mean, I don't hate that, just weird.) I have been a student for so long, its hard to realize I'm not one anymore. Sure, we are all "lifelong learners" by default because we are in the medical field, but I don't have to sit at a desk surrounded by 60 people anymore.
Graduation was a happy day filled with family and friends, pictures, hugs, and clinking of champagne glasses. Isn't that what we all imagined it would be? :)
But with graduation comes big decisions and responsibilities....you mean I actually have to start paying these loans? Please, no, that is all just some huge mistake and someone else is going to handle that. No? Crap. The PANCE...we all know that #PANCEdontcare. Everyone is in the midst of board prep and that scheduled test sure is daunting in my near future. But its okay, I will get through it just like every other test. Deep breaths. Jobs...oh Lordy, this is a fun topic right now between friends (not). I feel bad for all of those staying in Lexington competing for jobs, that's rough. Fortunately, I live in a different city so it was slightly easier... more on my job later, I don't want to jinx it before I take the boards.
Saying "see ya later" to all my classmates was hard. Some of us are moving far away, others a few hours, other staying put in lex. I'm hoping we can all reunite every so often, but I know life gets in the way sometimes. I've made some forever friends in PA school and I'm so fortunate to have met my classmates which are now colleagues. I will miss you guys.
Put your back into it.
Sorry for the hiatus (again), life gets hectic sometimes.
Other than the LP, my favorite new procedures to do are joint reductions. Something so gratifying about man-handling a limb, drenched in sweat and then all of the a sudden you hear the victorious "clunk." Yay!!
I had the awesome opportunity to attempt multiple joint reductions while the patient was under conscious sedation. Some were successful, others were not, and that's okay. The point it, I got to try. I didn't have to stand in the background and watch, I got to feel the limb and manipulate it. "Feel" the logic behind certain techniques, and learn from my mistakes. That's the whole point of learning isn't it?
I cannot say enough good things about my last rotation. It was hard, like really hard. I say that not because I couldn't handle the hours, but because I was truly challenged to step outside my comfort zone. Was I 100% ready to do LPs and joint reductions? No, but I did them and I'm so grateful to have had the chance. I was never put in situations where I could harm the patient, but I also wasn't allowed to stand back and watch. And guess what? Knowing that I can handle the ER makes me so excited and it is now officially what I want to do. :)
Other than the LP, my favorite new procedures to do are joint reductions. Something so gratifying about man-handling a limb, drenched in sweat and then all of the a sudden you hear the victorious "clunk." Yay!!
I had the awesome opportunity to attempt multiple joint reductions while the patient was under conscious sedation. Some were successful, others were not, and that's okay. The point it, I got to try. I didn't have to stand in the background and watch, I got to feel the limb and manipulate it. "Feel" the logic behind certain techniques, and learn from my mistakes. That's the whole point of learning isn't it?
I cannot say enough good things about my last rotation. It was hard, like really hard. I say that not because I couldn't handle the hours, but because I was truly challenged to step outside my comfort zone. Was I 100% ready to do LPs and joint reductions? No, but I did them and I'm so grateful to have had the chance. I was never put in situations where I could harm the patient, but I also wasn't allowed to stand back and watch. And guess what? Knowing that I can handle the ER makes me so excited and it is now officially what I want to do. :)
Thursday, May 29, 2014
LP.
You guys, I did a lumbar puncture yesterday. By myself. Like, total freak out moment/one of my biggest accomplishments. Ever.
It's so funny how things come full circle. I remember assisting on my first LP when I worked in a neurology clinic before even applying to PA school. Now here I am, probably 4 years later, doing one myself. Feeling nostalgic.
To say I was a nervous wreck would be the understatement of the century. I had a feeling I would be doing one (A patient was supposed to come back in to get re-tapped because she had bacteremia growing gram - rods and a HA x 10 days) so I fell asleep the night before watching YouTube videos over and over to try and ease my nerves...My preceptor and the doc on duty gave me a quick pep talk and refresher course and off I went. Don't worry, a doc was in the room in case I was a total disaster.
I am so thankful for my experience in neuro because I knew the steps, the landmarks, and the equipment, but still didn't know how it would feel to put a very large spinal needle into the spinal canal of a sick patient. When it was in the canal and I saw that clear fluid start dripping out I have never felt so relieved/proud/happy ever. I may or may not have gone into the bathroom and cried happy tears of joy. Such a good day. Oh, and the patient's fluid was clear of WBCs/RBCs and protein was back to normal so it was a good day for her too. Yay! :)
It's so funny how things come full circle. I remember assisting on my first LP when I worked in a neurology clinic before even applying to PA school. Now here I am, probably 4 years later, doing one myself. Feeling nostalgic.
To say I was a nervous wreck would be the understatement of the century. I had a feeling I would be doing one (A patient was supposed to come back in to get re-tapped because she had bacteremia growing gram - rods and a HA x 10 days) so I fell asleep the night before watching YouTube videos over and over to try and ease my nerves...My preceptor and the doc on duty gave me a quick pep talk and refresher course and off I went. Don't worry, a doc was in the room in case I was a total disaster.
I am so thankful for my experience in neuro because I knew the steps, the landmarks, and the equipment, but still didn't know how it would feel to put a very large spinal needle into the spinal canal of a sick patient. When it was in the canal and I saw that clear fluid start dripping out I have never felt so relieved/proud/happy ever. I may or may not have gone into the bathroom and cried happy tears of joy. Such a good day. Oh, and the patient's fluid was clear of WBCs/RBCs and protein was back to normal so it was a good day for her too. Yay! :)
Work Hard, Play Hard Part 11
After my Selective Rotation in FM ended, I headed back to Lexington for exams on Thursday and Friday. After our 3.5 hour exam on Friday, a BBQ at our class presidents house was absolutely necessary. If you can't fix a post-exam hangover with some burgers, hot dogs, and friends there is something wrong with you.
Quick trip back to Indy that night to pack up for my Saturday afternoon flight to Wisconsin for my sorority sister's wedding! I love college weddings, there is nothing better than being reunited with college friends who live far away for a night of celebrating love and friendships. Had some time to explore Milwaukee and go on some adventures such as kayaking and bike riding which was so fun.
Lake Pewaukee, WI
Alpha Phi Alum
Bikes along Lake Michigan
Words to live by.
Stepping out of my comfort zone.
Well, my selective has come to an end and now I'm back in the ER to complete my LAST rotation of PA school. I seriously cannot believe it. Where has the time gone?
I chose to do another rotation in the ER to gain more experience in a higher acuity setting and practice my procedural skills. I did one rotation in the ER back in December and really enjoyed it, but to be honest it was more of an urgent care setting with a sprinkle of actual emergencies. The hospital I was working in was located next to a university medical center so all the serious emergencies were sent there. I'm now in an ED which serves many smaller communities and is probably one of the biggest/more sophisticated hospitals outside of the medical centers in Indianapolis. Although there is a "Fast Track"/urgent care area, the past 2 days have been full of life-threatening, serious medical conditions.
This is overwhelming to me, but in a good way. The last few months in Indy have been "comfortable." I have been working with the same docs for several months who have basically become my friends. It felt like home and those doctors and nurses were so kind and loving towards me...which of course I loved. I was sad to hug them bye and leave my safety bubble of primary care and head back into the ED, but I knew it was the right move for me.
In the ED you are not greeted with warm, loving welcomes where everyone wants to get to know you. You basically just need to say "Hi, I'm Kaitlin, the PA student" and get out of the way. I am so fortunate to have a preceptor who will truly challenge me. She is not going to hold my hand and let me get by with "observing" things that make me nervous. She gives me a quick pep talk and sends me on my way...but all the while setting up the situation so it ends up being a good learning experience for me. The ED is staffed with several mid-levels and physicians so there is always someone who wants to show you something interesting or go over films with you. This will be a great experience and I am going to DO and LEARN so much which is great since board exams are right around the corner.
I'm also living with my parents this month since the hospital is close to them and I'm working crazy hours, so the Doug and Diane show keeps me pretty entertained when I'm not at work. This morning... Dad: Do you have Beats headphones? Me: No. Dad: Well, you aren't cool at all.
I chose to do another rotation in the ER to gain more experience in a higher acuity setting and practice my procedural skills. I did one rotation in the ER back in December and really enjoyed it, but to be honest it was more of an urgent care setting with a sprinkle of actual emergencies. The hospital I was working in was located next to a university medical center so all the serious emergencies were sent there. I'm now in an ED which serves many smaller communities and is probably one of the biggest/more sophisticated hospitals outside of the medical centers in Indianapolis. Although there is a "Fast Track"/urgent care area, the past 2 days have been full of life-threatening, serious medical conditions.
This is overwhelming to me, but in a good way. The last few months in Indy have been "comfortable." I have been working with the same docs for several months who have basically become my friends. It felt like home and those doctors and nurses were so kind and loving towards me...which of course I loved. I was sad to hug them bye and leave my safety bubble of primary care and head back into the ED, but I knew it was the right move for me.
In the ED you are not greeted with warm, loving welcomes where everyone wants to get to know you. You basically just need to say "Hi, I'm Kaitlin, the PA student" and get out of the way. I am so fortunate to have a preceptor who will truly challenge me. She is not going to hold my hand and let me get by with "observing" things that make me nervous. She gives me a quick pep talk and sends me on my way...but all the while setting up the situation so it ends up being a good learning experience for me. The ED is staffed with several mid-levels and physicians so there is always someone who wants to show you something interesting or go over films with you. This will be a great experience and I am going to DO and LEARN so much which is great since board exams are right around the corner.
I'm also living with my parents this month since the hospital is close to them and I'm working crazy hours, so the Doug and Diane show keeps me pretty entertained when I'm not at work. This morning... Dad: Do you have Beats headphones? Me: No. Dad: Well, you aren't cool at all.
Friday, May 16, 2014
And also, you're orange.
So, I would be lying if I said it was easy to remain professional at all times of the day. It only makes me human and when I see ridiculous things sometimes it takes a lot to keep my mouth shut.
Exhibit A: my first experience with a professional power lifer.
I walk in the room and was just insanely shocked at the orange factor. Literally, the man was orange. Not like a glowing tan, but Cuties oranges orange. I thought for a second holy cow this man alone keeps tanning beds in business. Nope. HE INJECTS SELF TANNER (Melanotan). Is this real? Yes, it is and actually very common in power lifters. I live under a rock and just thought they tanned a lot. More than this, he admitted to EATING handfuls of testosterone, growth hormone, thyroid hormone, you name it he ate it. He did not have the resources or time to compound the medications (ordered from china) into the proper tablet or injectable so he simply ate the powder form.... So, why was he in our office? ABDOMINAL PAIN!!! I was coming out of my skin on the inside as I politely nodded my head and talked to him about this incredibly reckless passion of his. Thankfully, my preceptor took over the interview because he had insight as to how to handle the situation. The patient refused any testing or blood work until after his competition so we basically just let him leave with a PPI and a follow up appointment.
I was upset about this and continue to think about it. Did we just let a ticking time bomb walk out? What if he has a perforated ulcer? He is bleeding? Will he come back? It just really bothered me. I learned a good lesson though about establishing rapport and building trust. My preceptor did not lecture him on his horrible habits, but instead just talked to him like it was totally normal to ingest handfuls of hormones from China. The patient trusted him and I really do feel like he will come back for a more thorough work-up. Looking back, it was clear that the patient knew more about synthetic hormones than we will probably ever know and he knew the potential risk he was taking. It was also clear he had zero intention of changing his routine. He didn't need us to talk down to him or tell him what horrible things he was doing, he already knew. He needed someone who cared about him and would be supportive. My doc did just that and I think he gained himself a new patient and someone he can truly make an impact on once this competition is over. The patient is retiring from lifting after this competition so hopefully he can realized how much harm he was doing to his body....and also that he is orange.
Exhibit A: my first experience with a professional power lifer.
I walk in the room and was just insanely shocked at the orange factor. Literally, the man was orange. Not like a glowing tan, but Cuties oranges orange. I thought for a second holy cow this man alone keeps tanning beds in business. Nope. HE INJECTS SELF TANNER (Melanotan). Is this real? Yes, it is and actually very common in power lifters. I live under a rock and just thought they tanned a lot. More than this, he admitted to EATING handfuls of testosterone, growth hormone, thyroid hormone, you name it he ate it. He did not have the resources or time to compound the medications (ordered from china) into the proper tablet or injectable so he simply ate the powder form.... So, why was he in our office? ABDOMINAL PAIN!!! I was coming out of my skin on the inside as I politely nodded my head and talked to him about this incredibly reckless passion of his. Thankfully, my preceptor took over the interview because he had insight as to how to handle the situation. The patient refused any testing or blood work until after his competition so we basically just let him leave with a PPI and a follow up appointment.
I was upset about this and continue to think about it. Did we just let a ticking time bomb walk out? What if he has a perforated ulcer? He is bleeding? Will he come back? It just really bothered me. I learned a good lesson though about establishing rapport and building trust. My preceptor did not lecture him on his horrible habits, but instead just talked to him like it was totally normal to ingest handfuls of hormones from China. The patient trusted him and I really do feel like he will come back for a more thorough work-up. Looking back, it was clear that the patient knew more about synthetic hormones than we will probably ever know and he knew the potential risk he was taking. It was also clear he had zero intention of changing his routine. He didn't need us to talk down to him or tell him what horrible things he was doing, he already knew. He needed someone who cared about him and would be supportive. My doc did just that and I think he gained himself a new patient and someone he can truly make an impact on once this competition is over. The patient is retiring from lifting after this competition so hopefully he can realized how much harm he was doing to his body....and also that he is orange.
Tuesday, May 6, 2014
Kale is so hot right now...and other medical trends.
Kale is currently a very trendy food item, and my preceptor is allllll about it. It has become a running joke at the office and any kale related article, recipe, news story, event etc. is brought to his attention. He recently told me, "life begins and ends with kale." I think he was half kidding.
So we got to talking about other trendy health related topics people want to discuss or self-diagnose themselves with. (Disclaimer: Just because these things made my trendy list doesn't mean they aren't real problems people struggle with every day and need to be treated for.) Shout out to WebMD for making this list happen ;)
1. TSH; "I'm tired and have dry skin, I need my thyroid checked." Yes, you might. You might also need to go to bed earlier and use some lotion.
2. "Low T;" Thanks to all the TV commercials about this the men are coming in groves to get their "low T checked out." Honey, just because the bedroom is a little less magical doesn't mean you need to start shooting up with some T.
3. Celiac disease; You guys, this a real disease with real lab and diagnostic tests needed to make the diagnosis. Just because you order gluten free pizza at your trendy upscale cafe doesn't mean you have celiac disease, it means you are choosing not to eat gluten.
4. Tylenol addiction; this one is my favorite. "I don't want to get addicted to Tylenol, I think I need that hydromorphooxydilaudicontin." UGHHHH. No. Stop, that isn't real and we can tell you are making that up.
5. Pancreatic related anything; Not sure where this one came from but it has happened twice this week...People calling concerned about pancreatic cancer and pancreatitis when those severe problems were nowhere NEAR being a consideration.
Geez, medical trends are so much less glamorous than crop tops and midi skirts.
So we got to talking about other trendy health related topics people want to discuss or self-diagnose themselves with. (Disclaimer: Just because these things made my trendy list doesn't mean they aren't real problems people struggle with every day and need to be treated for.) Shout out to WebMD for making this list happen ;)
1. TSH; "I'm tired and have dry skin, I need my thyroid checked." Yes, you might. You might also need to go to bed earlier and use some lotion.
2. "Low T;" Thanks to all the TV commercials about this the men are coming in groves to get their "low T checked out." Honey, just because the bedroom is a little less magical doesn't mean you need to start shooting up with some T.
3. Celiac disease; You guys, this a real disease with real lab and diagnostic tests needed to make the diagnosis. Just because you order gluten free pizza at your trendy upscale cafe doesn't mean you have celiac disease, it means you are choosing not to eat gluten.
4. Tylenol addiction; this one is my favorite. "I don't want to get addicted to Tylenol, I think I need that hydromorphooxydilaudicontin." UGHHHH. No. Stop, that isn't real and we can tell you are making that up.
5. Pancreatic related anything; Not sure where this one came from but it has happened twice this week...People calling concerned about pancreatic cancer and pancreatitis when those severe problems were nowhere NEAR being a consideration.
Geez, medical trends are so much less glamorous than crop tops and midi skirts.
Sunday, May 4, 2014
Back to my old stomping grounds.
Is this my 2nd to last rotation? Stop it. That can't be real. Graduation is in 49 days you guys. Holy....
Anyways, I'm on my "Selective Rotation" which simply means I get to pick a rotation/specialty I have already done and repeat it. I chose to repeat Family Medicine, but with a twist. I have the same preceptor I had for 8 weeks back in the winter on one afternoon a week, but the other days I am with someone new, but at the same location. That sounded confusing, but it really isn't. What it means is that I didn't have to start all over and have familiar faces and places which puts my little anxiety ridden heart at ease. The last time I did Family Med, it was honestly more like Internal Med managing chronic diseases of an older population. This time, it is more "acute care" family med in a walk-in style. I love it. I love not knowing if a chief complaint of "shortness of breath" is simply a cough and asthma or someone who is in atrial flutter and needs a work-up to rule out PE as well....yes, that happened. I love not knowing what I am going to walk into...I need that variety to keep things interesting and exciting.
I am also with the world's coolest preceptor. He lets me be the DJ and play anything from Hootie and the Blowfish to Snoopp Dogg. He has a fake fireplace in his office and Christmas lights because he doesn't like overheard fluorescent lighting. Hello!?! Ladies everywhere have been trying to tell department stores this for years...fluorescent lighting is a bad deal. Finally someone who understands....
Stay tuned, its going to be a fun month!
Also, I registered for my board exam and no one was over here with champagne glasses and snacks, whats up with that guys?
Anyways, I'm on my "Selective Rotation" which simply means I get to pick a rotation/specialty I have already done and repeat it. I chose to repeat Family Medicine, but with a twist. I have the same preceptor I had for 8 weeks back in the winter on one afternoon a week, but the other days I am with someone new, but at the same location. That sounded confusing, but it really isn't. What it means is that I didn't have to start all over and have familiar faces and places which puts my little anxiety ridden heart at ease. The last time I did Family Med, it was honestly more like Internal Med managing chronic diseases of an older population. This time, it is more "acute care" family med in a walk-in style. I love it. I love not knowing if a chief complaint of "shortness of breath" is simply a cough and asthma or someone who is in atrial flutter and needs a work-up to rule out PE as well....yes, that happened. I love not knowing what I am going to walk into...I need that variety to keep things interesting and exciting.
I am also with the world's coolest preceptor. He lets me be the DJ and play anything from Hootie and the Blowfish to Snoopp Dogg. He has a fake fireplace in his office and Christmas lights because he doesn't like overheard fluorescent lighting. Hello!?! Ladies everywhere have been trying to tell department stores this for years...fluorescent lighting is a bad deal. Finally someone who understands....
Stay tuned, its going to be a fun month!
Also, I registered for my board exam and no one was over here with champagne glasses and snacks, whats up with that guys?
Work Hard, Play Hard Part 7,8,9,10
Whoops, I forgot to post pictures the last few months of me actually having a life sometimes. May not be a normal life, but I'm trying :)
Lots of birthdays have been celebrated including my dads, my niece who turned 2, and my moms. Which means lots of treats and cupcakes :)
Congrats on your special day, Chelsea and Jeff! Such a fun wedding at the Mavris.
Go to cure-all for post exit exam panic attacks....see above.
Ya'll might know this babe as the Instagram sensation White Coat Wardrobe, but I know her as Steph...my PA school partner in crime who does her nails during lectures.
Reunited with the girls during EOC days. Wine night at Bella Notte.
Even though we haven't celebrated my birthday yet, I did pick up this pretty little thing. Meet, my new beach cruiser, Roxie.
Craft Brew Fest in Bloomington, IN was held in a mill (so fun!)
Brittany and I at the brew fest.
Its Wedding Season!! Happy Bridal Shower, Alexa!
Laughter is the best medicine, Part 2.
People continue to amaze me with the things they say...sometimes trying to be funny on purpose...other times, just not. Kids on the other hand are just awesome. And basically everything they say is awesome too, especially if they are 4 years old.
1. Me: Do you like to read?
4yo: No, I like popsicles.
2. Me: How old are you?
4yo: 2012.
3. 5yo: I would prefer if you did not look in my ears, feel my tummy, or give me shots.
4. 7yo: I just won the spelling bee.
Me: What was your winning word?
7yo: Grass. (Remember when life was so beautifully simple? I would love to win an award for spelling grass correctly.)
5. 4yo: Mom, do you think the Easter Bunny will bring me a ninja?
Mom: Nope, I think the Easter Bunny is going to bring you sidewalk chalk.
Parenting 101: Don't worry, she has no risk of lead exposure. We eat all organic food with no GMOs.
ummm what?
1. Me: Do you like to read?
4yo: No, I like popsicles.
2. Me: How old are you?
4yo: 2012.
3. 5yo: I would prefer if you did not look in my ears, feel my tummy, or give me shots.
4. 7yo: I just won the spelling bee.
Me: What was your winning word?
7yo: Grass. (Remember when life was so beautifully simple? I would love to win an award for spelling grass correctly.)
5. 4yo: Mom, do you think the Easter Bunny will bring me a ninja?
Mom: Nope, I think the Easter Bunny is going to bring you sidewalk chalk.
Parenting 101: Don't worry, she has no risk of lead exposure. We eat all organic food with no GMOs.
ummm what?
Follow Along.
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Happy Sunday! Hope everyone has had a relaxing and fun weekend. Since I go to UK and have come to love some of the southern traditions I'm kind of bummed I didn't get to prance around in a big hat sipping mint juleps to celebrate the KY derby. Maybe next year.
Anyways, I was asked how one can "follow" the blog, and admittedly I didn't know the answer. So I checked out what all the serious bloggers use and it seems Bloglovin' is the best option. So, I registered the blog on Bloglovin' and you simply go to Bloglovin.com to sign up for regular updates. Hope that helps!
New posts to come to wrap up Peds and move on to my "selective rotation" which is Family Med/Acute Care.
Happy Sunday! Hope everyone has had a relaxing and fun weekend. Since I go to UK and have come to love some of the southern traditions I'm kind of bummed I didn't get to prance around in a big hat sipping mint juleps to celebrate the KY derby. Maybe next year.
Anyways, I was asked how one can "follow" the blog, and admittedly I didn't know the answer. So I checked out what all the serious bloggers use and it seems Bloglovin' is the best option. So, I registered the blog on Bloglovin' and you simply go to Bloglovin.com to sign up for regular updates. Hope that helps!
New posts to come to wrap up Peds and move on to my "selective rotation" which is Family Med/Acute Care.
Monday, April 14, 2014
Diabeating.
What, you have never heard of this kind of child abuse before? I learned about this term last week and my preceptor and I had a good laugh about this. Especially because Taco Bell is on the list of places in which you may take your child to diabeat them and it happens to be his favorite. Anyways, all jokes aside, childhood obesity is a big problem...no pun intended.
Sure, you hear about it on TV and Michelle Obama has her big campaign about healthy eating, but until you really see how weight affects these kids socially as well as physically it doesn't really register. My poor sweet patient last week was actually removed from public school because he was getting into verbal confrontations with his peers due to bullying. Yes, he has other social issues that I'm sure contribute to the bullying, but his weight is a major factor. I wanted so badly for him to have a thyroid issue (that sounds bad, but can be fixed with a pill) or something to attribute his weight to....all labs were normal. He swears he only eats popcorn once a week and drinks water, but his home life is unstable at best you know that just simply isn't true. It breaks your heart, really.
How is a kid supposed to be healthy when mom/grandma/aunt/cousin/every other family member who is "mom" (whole different issue, I won't even go there this time) keeps the fridge stocked with Kool-aid and Dr. Pepper? Hello, I would drink it too! If I don't have any self control how is an 11 yr old going to be able to say hmmm yeah forget the delicious purple Kool-Aid a nice glass of tap water sounds delightful. NOT GOING TO HAPPEN, DUH. Parents have to get with the program to help their sweet babies. I understand that eating healthy is expensive, and that Dr. Pepper is delicious and so are Doritos....but just, stop. Stop buying it. Period. Your precious child is suffering inside and out because they 1. Do not have a good example to follow from their parental role models 2. Do not know how to make healthy choices 3. Get diabeaten every night when you take them to McDonalds 4. They consider video games exercise (Yes, I have had kids tell me they play video games for exercise). These 4 problems can be fixed so easily if everyone just jumps on the healthy bus and puts down the remote controls and the nuggets. Don't get me wrong, I love a good nugget like the rest of America, but moderation is real ya'll. Maybe nuggets once a week instead of every night? Also, I know seafood is super healthy but I don't eat things that swim so I feel ya little ones on not wanting to eat salmon or other forms of cat food. Chicken, turkey, pork are all things that can be cooked outside of a deep fryer my friends.
Sorry, that was an extensive rant. I have just participated in far too many referrals for nutrition consults in the last 2 weeks. It really isn't okay. And thank goodness for RDs and nutrition specialists who can help these families make lifestyle changes to help their kids. I can't take watching these kids hang their heads in disgust over their weight, it truly is the saddest thing.
Sure, you hear about it on TV and Michelle Obama has her big campaign about healthy eating, but until you really see how weight affects these kids socially as well as physically it doesn't really register. My poor sweet patient last week was actually removed from public school because he was getting into verbal confrontations with his peers due to bullying. Yes, he has other social issues that I'm sure contribute to the bullying, but his weight is a major factor. I wanted so badly for him to have a thyroid issue (that sounds bad, but can be fixed with a pill) or something to attribute his weight to....all labs were normal. He swears he only eats popcorn once a week and drinks water, but his home life is unstable at best you know that just simply isn't true. It breaks your heart, really.
How is a kid supposed to be healthy when mom/grandma/aunt/cousin/every other family member who is "mom" (whole different issue, I won't even go there this time) keeps the fridge stocked with Kool-aid and Dr. Pepper? Hello, I would drink it too! If I don't have any self control how is an 11 yr old going to be able to say hmmm yeah forget the delicious purple Kool-Aid a nice glass of tap water sounds delightful. NOT GOING TO HAPPEN, DUH. Parents have to get with the program to help their sweet babies. I understand that eating healthy is expensive, and that Dr. Pepper is delicious and so are Doritos....but just, stop. Stop buying it. Period. Your precious child is suffering inside and out because they 1. Do not have a good example to follow from their parental role models 2. Do not know how to make healthy choices 3. Get diabeaten every night when you take them to McDonalds 4. They consider video games exercise (Yes, I have had kids tell me they play video games for exercise). These 4 problems can be fixed so easily if everyone just jumps on the healthy bus and puts down the remote controls and the nuggets. Don't get me wrong, I love a good nugget like the rest of America, but moderation is real ya'll. Maybe nuggets once a week instead of every night? Also, I know seafood is super healthy but I don't eat things that swim so I feel ya little ones on not wanting to eat salmon or other forms of cat food. Chicken, turkey, pork are all things that can be cooked outside of a deep fryer my friends.
Sorry, that was an extensive rant. I have just participated in far too many referrals for nutrition consults in the last 2 weeks. It really isn't okay. And thank goodness for RDs and nutrition specialists who can help these families make lifestyle changes to help their kids. I can't take watching these kids hang their heads in disgust over their weight, it truly is the saddest thing.
Wednesday, April 9, 2014
A softened heart.
Ummmmm children are precious little angel babies and I love them. Yes, my peds rotation has me brainwashed into wanting a litter of kids.
Adam and I have had a lot of conversations about children lately... Do we want to have children? If so, when? How many? To be honest, I am not one of those people who feels they were "born to a be a mother." I have never had much experience or exposure to kids.I lack motherly instincts and children make me so nervous. I look at them like they are these little fragile objects that I'm afraid to touch or I will break them. I never know what to do to make them happy and take it personal when I make them cry. Yes, I have a gorgeous niece who I adore, but didn't know if I wanted children of my own.
Well, I'm not even 2 weeks into Peds and now I'm 85% sure I want children, which trust me is a big increase. The love between a mother and child when the child is in such a vulnerable place (dr's office) is pretty indescribable. I want that love and my heart aches to hold all the babies. It is so exciting to watch the kids reach big milestones and become a "big boy who goes potty."
Bottomline, I am just absolutely loving pediatrics and it has really opened my eyes to the joy and innocence of children and now my mom will likely have grand kids someday so I'm sure she is pumped.
Also, the attitudes these babes have KILLS me. The sassier they are at a young age, the better. Makes me laugh so hard.
Example:
Me:"Okay, open real big and say AHH."
4yo: Opens big, no tongue, no AH.
Me: "Can you say AHHH please?"
4yo: looks at me like I'm incredibly foolish and says, "Um, no. I'm only 4." Watch out for this one, world she's coming for ya.
Adam and I have had a lot of conversations about children lately... Do we want to have children? If so, when? How many? To be honest, I am not one of those people who feels they were "born to a be a mother." I have never had much experience or exposure to kids.I lack motherly instincts and children make me so nervous. I look at them like they are these little fragile objects that I'm afraid to touch or I will break them. I never know what to do to make them happy and take it personal when I make them cry. Yes, I have a gorgeous niece who I adore, but didn't know if I wanted children of my own.
Well, I'm not even 2 weeks into Peds and now I'm 85% sure I want children, which trust me is a big increase. The love between a mother and child when the child is in such a vulnerable place (dr's office) is pretty indescribable. I want that love and my heart aches to hold all the babies. It is so exciting to watch the kids reach big milestones and become a "big boy who goes potty."
Bottomline, I am just absolutely loving pediatrics and it has really opened my eyes to the joy and innocence of children and now my mom will likely have grand kids someday so I'm sure she is pumped.
Also, the attitudes these babes have KILLS me. The sassier they are at a young age, the better. Makes me laugh so hard.
Example:
Me:"Okay, open real big and say AHH."
4yo: Opens big, no tongue, no AH.
Me: "Can you say AHHH please?"
4yo: looks at me like I'm incredibly foolish and says, "Um, no. I'm only 4." Watch out for this one, world she's coming for ya.
Tuesday, April 1, 2014
From one end to the other.
So, since my lost post (sorry I am the most inconsistent blogger of all time), I have started and finished geriatrics and started pediatrics. From one age spectrum to the other.
Brief summary of geriatrics as follows:
I did not have the "typical" geriatrics rotation as it got changed last second. It was actually more comparable to internal medicine, they just assigned me to all the elderly patients. I worked in the hospital setting on the internal medicine team seeing consults and post-op patients and managing their chronic medical problems while in the hospital. While I did see a couple cases of delirium, it was more healthy older adults who were there for elective hip replacements....However on some days I would get a stroke patient with underlying dementia, or have some caregiving issues, chronic wounds etc. All in all it was a pretty low key rotation hence the lack of blog posts. I was at Methodist Hospital and had another great experience there, just a wonderful hospital.
Although I will say one thing; their new healthy initiative to get people to eat better is a great idea, buttttttt kind of a debbie downer. If I want to get a Kit-Kat dang it that should be possible. If you want a grilled cheese in the cafeteria, it will be more expensive than the baked salmon that will leave you smelling like cat food all day. Now that's just rude. Oh, and then they park the Ritter's frozen custard cart out front, is that healthy? Nope but it sure is delicious and needs to return more frequently.
I went back to Lexington for my geriatrics exam and Part 1 of our exit exam for graduation. Geriatrics exam was fine, but boy was that exit exam EXHAUSTING. Like, drenched in sweat exhausting. And margaritas with chips and queso were totally necessary afterwards. And a puff of albuterol to go along with that. We find out sometime this week if we passed, and I'm keeping my fingers crossed because my asthma can't handle another round of that torture. No, thank you PA school that was not nice.
Well, I have just started pediatrics and I was terrified. I honestly looked at kids like animals or aliens because I just have ZERO experience with them. I have a little precious angel niece but I see her for a couple hours at a time every couple months or so and that's about all the experience I have. After day one, I am in love. These little babies are just so innocent its hard not to find joy all throughout the day. Sure, my ears are ringing from all the screaming and crying but they are only sad for a second and there is NOTHING a Thomas the Train sticker can't fix. Looking forward to all the days to come with these kiddos.
Brief summary of geriatrics as follows:
I did not have the "typical" geriatrics rotation as it got changed last second. It was actually more comparable to internal medicine, they just assigned me to all the elderly patients. I worked in the hospital setting on the internal medicine team seeing consults and post-op patients and managing their chronic medical problems while in the hospital. While I did see a couple cases of delirium, it was more healthy older adults who were there for elective hip replacements....However on some days I would get a stroke patient with underlying dementia, or have some caregiving issues, chronic wounds etc. All in all it was a pretty low key rotation hence the lack of blog posts. I was at Methodist Hospital and had another great experience there, just a wonderful hospital.
Although I will say one thing; their new healthy initiative to get people to eat better is a great idea, buttttttt kind of a debbie downer. If I want to get a Kit-Kat dang it that should be possible. If you want a grilled cheese in the cafeteria, it will be more expensive than the baked salmon that will leave you smelling like cat food all day. Now that's just rude. Oh, and then they park the Ritter's frozen custard cart out front, is that healthy? Nope but it sure is delicious and needs to return more frequently.
I went back to Lexington for my geriatrics exam and Part 1 of our exit exam for graduation. Geriatrics exam was fine, but boy was that exit exam EXHAUSTING. Like, drenched in sweat exhausting. And margaritas with chips and queso were totally necessary afterwards. And a puff of albuterol to go along with that. We find out sometime this week if we passed, and I'm keeping my fingers crossed because my asthma can't handle another round of that torture. No, thank you PA school that was not nice.
Well, I have just started pediatrics and I was terrified. I honestly looked at kids like animals or aliens because I just have ZERO experience with them. I have a little precious angel niece but I see her for a couple hours at a time every couple months or so and that's about all the experience I have. After day one, I am in love. These little babies are just so innocent its hard not to find joy all throughout the day. Sure, my ears are ringing from all the screaming and crying but they are only sad for a second and there is NOTHING a Thomas the Train sticker can't fix. Looking forward to all the days to come with these kiddos.
Monday, February 17, 2014
A Couple Zebras.
"We look for horses not zebras." "Common things occur commonly." yeah yeah, we've heard it before. But, my friends, sometimes zebras do happen. Even in Family Med.
1. Mastoiditis: YAYYYY, how many test questions have we seen about this?! My exam master is obsessed with this question I swear. Well, I finally saw it. This poor lady presented to the ER with ear pain that felt like "I was being stabbed in the ear with a hot poker." Whoever saw her in the ER, looked in her ear, said it was red, told her she had TMJ and sent her home with pain meds.... Boo. Fast forward 24 hours and we see her. Her ear was not "red" it was flaming on fire with smoke rolling out of it. Yes, I'm dramatic but you get it. I have never seen an ear look like this. Holy cow. She was exquisitely tender in the mastoid process and in terrible pain. Doc was pretty certain she had progressed from otitis media to mastoiditis. Tx: Augmentin 875mg BID X 10 days.
2. Colon CA: Okay, this doesn't sound like a zebra, but when it shows up at an urgent care visit as epigastric pain it seems pretty unlikely. This lady was in her 50s and presented with epigastric pain x 4ish days which was getting worse. No N/V/D. No weight loss. No melena. But I just didn't feel right about it. Had a "feeling" something was wrong. She was in real pain and you could tell she wasn't being dramatic. Tried to tell me it was from a bad Arby's sandwhich because her husband had one too and he didn't feel well. But that had been days ago and she had no GI upset symptoms, just pain. Also, brother died of pancreatic CA in his 50s. So, we didn't know exactly what to do, but ordered stool culture work/up just in case she did have some type of infectious thing from bad food (knew it was unlikely but just needed to do something) and a CBC to see if she had signs of an infection. Her hemoglobin was 6.7. She was then directed to the ER who did a complete work up, gave her a blood transfusion, and the tumor was found on CT. She was admitted for surgery during the same stay. What a whirlwind for that patient...come to urgent care with stomach ache, end up at hospital getting a biopsy and scheduled for bowel resection. :( I keep thinking of her and hope she is recovering well.
Med Students.
Let's be honest, as PA students when we hear we are going to be paired with a med student on a rotation we get a little nervous. At least I do. I always worry (shocking) that they will know so much more than I do, or I will look stupid 24/7. In all reality, I have loved my time working with med students. They have a wealth of knowledge and we can really learn a lot from them. Although we are all trained in the same medical model, their didactic years are much more in-depth than ours whereas our education seems to be more clinical and patient based (just my opinion). Sometimes I feel like we are more comfortable around the patients, whereas they are more comfortable academically in terms of discussing the latest and greatest treatments, forming crazy differentials with diseases I have never heard of etc. Bottom line: we make a good team. And isn't that the whole point anyways? I have been with a med student my entire Family Med rotation and I learned so much from him and her! So thanks Chris and Lauren if you ever read this :)
Laughter is the Best Medicine.
So, in medicine you hear the most ridiculous things imaginable. Sometimes from patients, sometimes from co-workers, and shoot sometimes from yourself. All of us in healthcare are kind of messed up with a pretty weird sense of humor. I figured I would make this a regular thing and post some of the hilarious things I hear during the day. Because yes, some of them are so good I write them down. This is not meant to be disrespectful at all, just to add a little humor to an otherwise very stressful career. And hey, at the end of the day if you can't laugh about the little things, you just aren't doing it right.
Just a few to get ya started...
"Buncha clowns up there in Washington fighting like dogs over a bone." (Veteran)
"I looked at her with her big, fat butt and thought you aren't gonna hurt me." (pt describing fight with daughter)
Patient: "I'm meeting with a dietician and she wants me to use that fake sugar in the pink packet. But when I put that in my coffee I can tell my sugar drops out so I have eat a dozen donuts. Seriously, the other day I felt my sugar drop and ate a large bag of cheese popcorn and a box of nutter buddies and that fixed it." (Diabetes 101)
"I don't think she has a UTI, I think her G-spot is infected. You know it makes fluid and that fluid gets shot back up in there." (Boyfriend telling me what is wrong with his gf)
"After you took care of the hemorrhoid it looked like 2-pac got shot up in there." (Nurse to doc)
Just a few to get ya started...
"Buncha clowns up there in Washington fighting like dogs over a bone." (Veteran)
"I looked at her with her big, fat butt and thought you aren't gonna hurt me." (pt describing fight with daughter)
Patient: "I'm meeting with a dietician and she wants me to use that fake sugar in the pink packet. But when I put that in my coffee I can tell my sugar drops out so I have eat a dozen donuts. Seriously, the other day I felt my sugar drop and ate a large bag of cheese popcorn and a box of nutter buddies and that fixed it." (Diabetes 101)
"I don't think she has a UTI, I think her G-spot is infected. You know it makes fluid and that fluid gets shot back up in there." (Boyfriend telling me what is wrong with his gf)
"After you took care of the hemorrhoid it looked like 2-pac got shot up in there." (Nurse to doc)
Play that funky music? Please don't.
Okay, after about 3 days at my rotation I started noticing the songs that are played as "background music" over the surround sound are largely inappropriate. I could not help but laugh out loud while I was in the room with a patient when "I'll make Love to You, like You Want me To" starts playing. HELOOOO!?!? is no one hearing this? What if I was doing a rectal exam at that exact moment? I would have literally died.
Anyways, I have now brought this to the attention of the nurses and my doc (who is 65 and doesn't even know the songs and/or care) and we have had some long laughs. Another favorite is Bruno Mars who casually sings the lyrics "Your Sex Takes Me To Paradise." I can't even. Even.
I spend a good portion of my day singing inappropriate song lyrics with the nurses while at work...time well spent? I think so. I just wonder what the little grandmas think when they hear these songs...hopefully they can't hear them at all.
Now Hiring: New playlist manager. Please and thank you.
Anyways, I have now brought this to the attention of the nurses and my doc (who is 65 and doesn't even know the songs and/or care) and we have had some long laughs. Another favorite is Bruno Mars who casually sings the lyrics "Your Sex Takes Me To Paradise." I can't even. Even.
I spend a good portion of my day singing inappropriate song lyrics with the nurses while at work...time well spent? I think so. I just wonder what the little grandmas think when they hear these songs...hopefully they can't hear them at all.
Now Hiring: New playlist manager. Please and thank you.
New Home, New City
With my new rotation came a new home and a new city. We are now living in Carmel, IN and words cannot describe how happy I am. I am FINALLY living with Adam which is so much fun. We can now do normal married things together like let the laundry pile up for weeks, go to the grocery store together, make new meals, try new restaurants, sleep in on Sundays without the pressure of knowing Adam has to leave. It is simply wonderful. And hilarious. We've never lived together so if I thought I knew him well before I was mistaken. Why does he leave piles of clothes behind the bathroom door? Why does he insist on buying orange juice that is so expensive we could buy 2 jugs of the other kind? Why does he watch shows with the volume up so loud I'm getting hearing loss? He cracks me up.
With a new home comes new visitors!! We have had such a great time with friends and family coming to visit. My mom, dad, brother and Ali came for dad's birthday, Adam's parents came this weekend, our KY friends came a couple weeks ago and I just love it. Entertaining and opening your home to others is just the best. Not to mention that means champagne and treats so I'm all for that.
Exploring Carmel and all its little quaint shops has also been fun. We have been to a ton of restaurants and have our new fav pizza place (Boom Bozz), our go-to quick meal spot (Zoup!), our swanky spot (divvy), our sushi spot (Kona Grill), brunch spot (Patachou) and our laid back/bar/awesome food/can watch sports spot (Matt the Millers). Basically we have just been eating. I don't hate it.
With a new home comes new visitors!! We have had such a great time with friends and family coming to visit. My mom, dad, brother and Ali came for dad's birthday, Adam's parents came this weekend, our KY friends came a couple weeks ago and I just love it. Entertaining and opening your home to others is just the best. Not to mention that means champagne and treats so I'm all for that.
Exploring Carmel and all its little quaint shops has also been fun. We have been to a ton of restaurants and have our new fav pizza place (Boom Bozz), our go-to quick meal spot (Zoup!), our swanky spot (divvy), our sushi spot (Kona Grill), brunch spot (Patachou) and our laid back/bar/awesome food/can watch sports spot (Matt the Millers). Basically we have just been eating. I don't hate it.
Treats at Cooper's Hawk Winery.
Hello Family Med!
Hello again friends,
Yes, once again I have been on a blogging hiatus. Sorryyyyy. I have been in Family Med for the last 6 weeks or so with a preceptor in Indy. He is a older man and we get along just fabulously. He is sarcastic and gives me grief all day which makes the days fun and interesting. He is an amazing teacher and a big advocate for preventive medicine.(Which, in my opinion, we will slowly see go down the tubes with government healthcare...less and less will be approved or be considered "not cost effective." Anyways, I won't go down that road, lets all just get along.) I spend two afternoons at an urgent care clinic in Zionsville which I love. My doc also has a PA who has worked with him for over 20 years who I also adore. The first month I was mainly with the doc but lately I have been splitting my time. The PA does half acute visits and half follow-ups which is more my cup of tea. I can only handle "Diabetes, lipids, BP" checks for so many hours a day before I start to black out.
What this rotation has taught me is that I NEED variety. I always thought I would specialize because I am so incredibly Type-A and feel the need to know everything about what I am doing so it can be perfect, but now I'm not so sure. I thrive off the urgent care visits and acute visits because you never know what you will see. I love doing small procedures and freezing things off, sewing things up etc. So, maybe a specialty isn't what is best for me....its exciting to see my likes and dislikes continually change throughout this year. Only problem is I should've had my elective and selective rotations picked out weeks ago...whoops. Hey you can't rush your career and I'm working on it. Hoping for sure to do one in Urgent Care and then maybe Derm? ER? GI? eek! The opportunities are endless. Bets on what my first job will be?
Yes, once again I have been on a blogging hiatus. Sorryyyyy. I have been in Family Med for the last 6 weeks or so with a preceptor in Indy. He is a older man and we get along just fabulously. He is sarcastic and gives me grief all day which makes the days fun and interesting. He is an amazing teacher and a big advocate for preventive medicine.(Which, in my opinion, we will slowly see go down the tubes with government healthcare...less and less will be approved or be considered "not cost effective." Anyways, I won't go down that road, lets all just get along.) I spend two afternoons at an urgent care clinic in Zionsville which I love. My doc also has a PA who has worked with him for over 20 years who I also adore. The first month I was mainly with the doc but lately I have been splitting my time. The PA does half acute visits and half follow-ups which is more my cup of tea. I can only handle "Diabetes, lipids, BP" checks for so many hours a day before I start to black out.
What this rotation has taught me is that I NEED variety. I always thought I would specialize because I am so incredibly Type-A and feel the need to know everything about what I am doing so it can be perfect, but now I'm not so sure. I thrive off the urgent care visits and acute visits because you never know what you will see. I love doing small procedures and freezing things off, sewing things up etc. So, maybe a specialty isn't what is best for me....its exciting to see my likes and dislikes continually change throughout this year. Only problem is I should've had my elective and selective rotations picked out weeks ago...whoops. Hey you can't rush your career and I'm working on it. Hoping for sure to do one in Urgent Care and then maybe Derm? ER? GI? eek! The opportunities are endless. Bets on what my first job will be?
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