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! :)
Thursday, May 29, 2014
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?
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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.
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