So I dont have much to say about this rotation as I was simply a fly on the wall for 4 1/2 weeks. I would love to forget this rotation all together, but because I said I would discuss all of them I will say some things in particular the living situation.
For this rotation, I ended up getting the shaft and sent to Lagrange for 4 1/2 weeks while Adam stayed in Lilburn. Now understand I am used to being away from Adam as we went to different colleges plus I worked every weekend BUT when you are married its different somehow. As you can tell I was really excited about going to Lagrange and staying at this ghetto fabulous apartment with my TWO MALE roommates and roaches the size of my thumb. I only saw 3 (2 in my bathroom and the final in my room). The last one crawled in my room from the living room and went up the wall, this was my LAST night in lagrange. I spent the last 4 days commuting.
My preceptor was a total jerk who was a physician assistant and then went back to school to become a doctor. Needless to say, he told me daily how he thought he knew a lot until he went to MED school. Imagine how much fun I had. He also played the guitar in the office and IMDB'd all the time. Our conversations would go, Sara do you know so and so (some OLD actor) and I would say um no or maybe. He would then get on the computer and show me pictures of such actor. Or he would start singing/playing his guitar and ask if I knew the song, which I never did of course and then back to the computer.
I was very happy to be done with this rotation and hope to never see this man again. So just like there was no 13floor in wayside story, there was no Internal medicine outpatient.
Hope all is well in the blog world!
Tuesday, January 19, 2010
Saturday, January 16, 2010
Aunt Sara
Olivia is about to have her baby and I think we are all ready for him to get here. I am still not over the fact that Olivia is using the name I have picked out since I was her age, but I am no longer bitter/upset. I am especially excited because I am allowed to help deliver. I have a bag packed and ready to fly to Toccoa when the call comes. She is due Feb 2, but her midwife said this week or next. I just hope I get there in time and mom does not call while I am in the OR.
thats all for now
Pediatrics March/April 09
Suwanee Pediatrics was where I spent my second rotation and where I learned that I do NOT want to work in peds. I was at this rotation during the allergy and asthma season and that is all I saw. I did however learn to love this rotation but it sure was rough in the beginning. I saw more patients in one day than in any other rotation and the doc was never there on time and we were always HOURS behind. Pediatrics is one of the lowest paid specialty in medicine so the doctor overbooked her office (3+ pts in one time slot). Every morning I got there I put patients in rooms, sent them to the lab, and saw them before the doc got there.
I didnt see anything really fun, but I did have twins I will never forget. They were 4yr old boy & girl that I had to do their well child checkup (again something I did a TON of). They were freaking cute. During the exam, I was listening to the girls heart/lungs and the little boy lifted up his shirt and said "me". I learned that 4 year olds were my favorite. They were very interested in me and my stethoscope.
The biggest thing that come from this rotation was the nurse practitioner. I knew the time would come when I would have to justify my decision to become a PA, but I did not want to have this conversation with her. I should preface that she was very insecure about herself and that was probably why she asked/said what she did. She felt that she knew soo much more than a simple PA as she was a nurse before she become a NP. I have big issues with this comment as the duties of a nurse and how they are trained are much different than a nurse practitioner/PA/MD. Dont get me wrong I know plenty of nurse practitioners that are very smart but she was just a bad example.
I did however not get sick during this rotation which is amazing as the office had no place to wash hands or alcohol anywhere. I carried a small bottle in my pocket and used it like crazy.
I didnt see anything really fun, but I did have twins I will never forget. They were 4yr old boy & girl that I had to do their well child checkup (again something I did a TON of). They were freaking cute. During the exam, I was listening to the girls heart/lungs and the little boy lifted up his shirt and said "me". I learned that 4 year olds were my favorite. They were very interested in me and my stethoscope.
The biggest thing that come from this rotation was the nurse practitioner. I knew the time would come when I would have to justify my decision to become a PA, but I did not want to have this conversation with her. I should preface that she was very insecure about herself and that was probably why she asked/said what she did. She felt that she knew soo much more than a simple PA as she was a nurse before she become a NP. I have big issues with this comment as the duties of a nurse and how they are trained are much different than a nurse practitioner/PA/MD. Dont get me wrong I know plenty of nurse practitioners that are very smart but she was just a bad example.
I did however not get sick during this rotation which is amazing as the office had no place to wash hands or alcohol anywhere. I carried a small bottle in my pocket and used it like crazy.
Saturday, January 02, 2010
Internal Medicine Inpatient Feb/March 09
Internal medicine inpatient was my very first rotation and it was at Piedmont hospital with the Kaiser practice. It has been the ONLY rotation where I worked with actually physician assistants.
I was lucky to not be there on my own I had Sara Baktiarnijad. (who knows how to spell it she told everyone just to say Bakti. although its not hard to say once you know it).
So "the Saras" as we were called walked in to our first rotation with fear and excitement. Our coats were clean and so full of pocket sized books/palms that they weighed every bit of 10lbs. And dont forget the stethoscopes around our necks. We were OFFICIAL and ready or so we thought. We made it through the first day and then they gave us our own patients to see. As the rotation progressed our coats weighed less and less. We became more confident and comfortable and eventually bored, ready to go on to the next rotation.
This rotation was one of my favorite rotations to date. I loved seeing the patients in the hospital which is also my weakness as I get attached. My favorite part was beeing able to order a lab and get it back fast and determine the next course of treatment.
There were 3 key patients during this rotation that I will remember forever.
1. Mr. Grandpa - the first day I saw him he was in full blown heart failure and his oxygen level was extremely low. He also had severe asthma and aortic stenosis. We started him on high dose diuretics and the next day he lossed 1500cc of fluid. I explained to him he lossed a liter of coke and 1/2 of another. He continued to improve although the aortic stenosis was really severe and he needed a new valve. I saw him everyday for over a week- again attachment.
2. Mrs. Pancytopenia- this lady I got 45 minutes before the end of my shift the end of the 2nd week and she remained my patient until I left. She had pancytopenia (low platelets, low white & red blood cells) but we couldnt not figure out why. I spent a lot of time researching on my one and reviewing her history. Kaiser has electronic medicial records so I can review every appt and mediciation that she has been on. I remember, every other day I would go in and say your platelets or rbc are too low and you need another transfusion. You see we would get them up via transfusions and then the levels would drop after a few days. My daily history question was if she had any new bruises.
3. Mrs. Vancomycin - this was such a lovely old lady. She had a staph infection in one of the valves of her heart that spread to the prosthetic in her knee. The first day I met her and got her history. She told me how she had this pain in her knees that seemed to go away while she was on antibiotics for the staph infection and that it returned when she stopped the antibiotics. She was back in the hospital bc she was not feeling well. I was concerned that the staph was in the prosthetic and asked my attending (Dr. Kim a really large 6'4 200 lb korean man whose eyes closed when he talked). We got the surgeon involved and it was true the infection was in her prosthetic. She needed to put on vancomycin but was allergic to it. We had to de-sensitize her to the vancomycin a new concept for me. She developed Red man syndrome which is a side effect of vancyomycin. And just like it sounds she was lobster red all over. She wished to continue and just take some benedryl. I remember going in to talk to her after the surgeon came and told her that he was going to take both legs. She was really upset and didnt like that surgeon. I dont know what happened but the plan was to remove the prosthetics and try to replace them.
well thats kaiser IMOP sorry its long but as you can tell I really liked the rotation.
sara
I was lucky to not be there on my own I had Sara Baktiarnijad. (who knows how to spell it she told everyone just to say Bakti. although its not hard to say once you know it).
So "the Saras" as we were called walked in to our first rotation with fear and excitement. Our coats were clean and so full of pocket sized books/palms that they weighed every bit of 10lbs. And dont forget the stethoscopes around our necks. We were OFFICIAL and ready or so we thought. We made it through the first day and then they gave us our own patients to see. As the rotation progressed our coats weighed less and less. We became more confident and comfortable and eventually bored, ready to go on to the next rotation.
This rotation was one of my favorite rotations to date. I loved seeing the patients in the hospital which is also my weakness as I get attached. My favorite part was beeing able to order a lab and get it back fast and determine the next course of treatment.
There were 3 key patients during this rotation that I will remember forever.
1. Mr. Grandpa - the first day I saw him he was in full blown heart failure and his oxygen level was extremely low. He also had severe asthma and aortic stenosis. We started him on high dose diuretics and the next day he lossed 1500cc of fluid. I explained to him he lossed a liter of coke and 1/2 of another. He continued to improve although the aortic stenosis was really severe and he needed a new valve. I saw him everyday for over a week- again attachment.
2. Mrs. Pancytopenia- this lady I got 45 minutes before the end of my shift the end of the 2nd week and she remained my patient until I left. She had pancytopenia (low platelets, low white & red blood cells) but we couldnt not figure out why. I spent a lot of time researching on my one and reviewing her history. Kaiser has electronic medicial records so I can review every appt and mediciation that she has been on. I remember, every other day I would go in and say your platelets or rbc are too low and you need another transfusion. You see we would get them up via transfusions and then the levels would drop after a few days. My daily history question was if she had any new bruises.
3. Mrs. Vancomycin - this was such a lovely old lady. She had a staph infection in one of the valves of her heart that spread to the prosthetic in her knee. The first day I met her and got her history. She told me how she had this pain in her knees that seemed to go away while she was on antibiotics for the staph infection and that it returned when she stopped the antibiotics. She was back in the hospital bc she was not feeling well. I was concerned that the staph was in the prosthetic and asked my attending (Dr. Kim a really large 6'4 200 lb korean man whose eyes closed when he talked). We got the surgeon involved and it was true the infection was in her prosthetic. She needed to put on vancomycin but was allergic to it. We had to de-sensitize her to the vancomycin a new concept for me. She developed Red man syndrome which is a side effect of vancyomycin. And just like it sounds she was lobster red all over. She wished to continue and just take some benedryl. I remember going in to talk to her after the surgeon came and told her that he was going to take both legs. She was really upset and didnt like that surgeon. I dont know what happened but the plan was to remove the prosthetics and try to replace them.
well thats kaiser IMOP sorry its long but as you can tell I really liked the rotation.
sara
Friday, January 01, 2010
Happy New Year
So I have decided that in 2010 I would start a blog. Everyone else seems to have one and after watching Julie & Julia last night it might be fun. Although of the blogs that I have read its either about peoples children or adventures in a far land. I realize mine will not be very exciting as I have neither of those. But I will write about my adventures be them small and mundane to some.
I want to write about my patients that I have come across in rotations and those yet to come. I dont want to forget them and this is a way that I wont and who ever reads this may find entertaining.
so here is my first entry.
sara
I want to write about my patients that I have come across in rotations and those yet to come. I dont want to forget them and this is a way that I wont and who ever reads this may find entertaining.
so here is my first entry.
sara
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