Saturday, February 9, 2008

watch out sick people

I knew yesterday would be a good day when I got up on time, and the sun was coming out and would actually be visible because there wasn't the thick mess of haze that is usually around whenever it's not snowing.
We were pretty busy in clinic, which is always good (especially for my PA because he gets paid a percentage of what the pt is charged). Saw the usual sick little kids, but not as much as previous weeks. It was kind of odd in that we saw 2 women for injection contraception, 2 HUGE body-builder competitor guys (which was fun because we did little procedures on each of them), and pts ranging from 9 months to 89 years.
The first body builder was kind of old (barely younger than my parents) but in ridiculously huge shape. I'm not kidding that his bicep was bigger than my thigh (which is saying a lot). Anyway, he had some hip and thigh muscle pain, a few pre-cancerous lesions on his head and leg to burn off, and decreased hearing. So after I did his exam, checking for a disc herniation, the nurse spent quite awhile cleaning out all the junk from his ears (it was a miracle! He could hear!) Then PA burned off the skin things (good thing I already forgot what he called them). But what was even better was he had his 17 year old daughter with him who he finally after all this mentioned had been in a car accident and he wanted her to be checked out (but couldn't schedule an appointment for her). The story was, over a week ago the smart kid was with some other smart kids at about 11 at night jeeping up in some hills somewhere, went off a huge snow drift, and the jeep landed on it's front end. She was fortunately smart enough to put on a seat belt. So now she's complaining of severe back pain. When we examined her, she had a major bruise all around her neck/back/shoulder, like a seatbelt bruise, only BAD. She was super tender, so he was all worried about a compression fx, so we checked her in and sent her to get Xrays. No fx, but her spine was all out of alignment, like, bad. Her cervical vertebrae were totally straight, instead of being curved like they should be naturally, and her back muscles were spasming so bad the vertebrae were pulling out of alignment to both sides. She's going to get chiropractering for awhile (and of course PA gives everyone Lortab! Great idea for a high schooler!)
For how many pts we saw, we still got an 1 1/2 hr lunch. First pt after lunch was an older lady who fell off the edge of her bed the night before because she passed out! She hit her head and had a big ol bruise on the top of her nose, and about a 3 cm lac above her right eyebrow. He had said that he would let me suture when we got a pt, but I figured since this was a forehead, he wouldn't want me to do it. I figured wrong. He put in the first stitch to approximate the edges (since it was shaped like a backwards L) then let me do the rest. I must say, I'm pretty good :) He said it looked good and she looked at it and thought it looked great so, I guess I'm just a natural. I better go into plastics. So not a big deal, but it was fun (saved me from more sore throat/influenza/bronchitis pts!)
My favorite pt was one of the last of the day; this little old lady with a UTI, who came with her daughter and granddaughter. They were all joking around, and she started talking about why she won't get married (then PA told her to find an old guy with a bad cough and a lot of money; she thought that was pretty funny). She's pretty healthy overall and hardly takes any meds. My favorite part of the visit was when they asked him how old he was and when his birthday was, she told him his sign, the signs of all her kids, her husbands, and what signs go together. Don't see too many 80+ year olds who are pros at astrology.
Other than that, PA also let me see my first few pts all on me own, so I did the history (which all the charting is on le computer, so I had to figure that out) and the exam, then go present to him what I thought it was and how to treat. I was starting to worry that he wasn't ever going to let me do anything on my own, but apparently that's not the case! Fortunately, I even did everything right, knew the right diagnosis, and the right antibiotic to give, so hopefully he trusts me (which maybe he does too much because he didn't really go over the exam or my charting at all! Scary). He just seems like he's way more concerned about staying on time sometimes that I worry he won't let me do anything, unless there's a lull (but this was towards the end of the day and he kept saying he was kind of tired).
Anyway, so yesterday was a little more fun. I didn't say anything too stupid this week, and actually felt like I answered most of his questions a lot better than previous weeks. He's pretty chill but is really willing to answer all my questions, and explain everything, plus quiz me on meds and dx, etc. This week's assignment is hypothyroidism...again, should be easy since we haven't had endocrinology yet!

1 comment:

Marissa said...

It sounds like you are becoming quite the pro. That's awesome.