Friday, November 29, 2013

On Family Medicine

Shockingly the end of my time on Family Medicine has quickly arrived. What I was sure would be a relaxing, slow month was nothing of the sort. As I stood in my grandparent's guest room Tuesday night packing up my stuff, we discussed how we couldn't believe it had already come to an end. Somehow I managed to accumulate an excessive amount of stuff in their bedroom. Come to think about it, I didn't clean out the dresser or closet. I also made a trip to walmart right before bed Tuesday when I realized I had left my toothbrush and toothpaste sitting in their bathroom. Spending the month with them was very different from my normal daily life. Coming home to a house with people who are eager to hear about your day and have dinner with you is the complete opposite of me normally coming home to a dark, quiet house. Time just goes by so fast when you are enjoying it.
I had the opportunity to work with two different physicians this month who loved what they did and made Family Medicine look awesome. Actually I enjoyed Sports Medicine so much that if ER doesn't work out for me, I think I will do Sports Medicine instead. I had the opportunity to hear afib and an aortic murmur in the same day and seeing the amount of patients I was able to see allowed me quickly show progress. I really enjoyed the rotation and I enjoyed the opportunity to talk with physicians about their life and career path. It is nice to know I am not the only female doctor-to-be who is interested in working on their career before rushing off to get married and have a family(not that there is anything wrong with getting married and having a family first). And the other doctor has more debt than me! It is easy to forget when you are working with people who evaluate you that they are also human with their own stories.  Life is different away from academic medicine and I greatly enjoyed it.
I could use another month doing the same kind of thing there and I really believe it would be extremely beneficial. However, the next rotation calls and I will be moving on to inpatient internal medicine come Monday. I have already set up my study schedule and have made my goals for my upcoming rotation. I have a feeling it is going to go just as fast as the rest of my rotations this year. Hopefully I finish getting Christmas ready before Dec 25th arrives.

Saturday, November 23, 2013

Life in the Fast Lane

I was sure that this month I would have tons of time to get done everything I wanted to get done. But atlas it is the end of November and I hardly got anything done at all. I did see a dentist so I did accomplish one thing on my list. But I really thought I would finish my Christmas decor I'm making, make my sister's Christmas gift, get the house cleaned, catch up with all my old friends at home, see all of my family at home, and get healthy. Unfortunately it didn't really work out the way I planned. I am going to have to put off the gift I am making my sister for next year, I'm going to have to spend tons of time trying to get my house put together to enjoy it a couple of days before Christmas, and I am going to miss out on seeing a lot of people this month. I have successfully tried to get a little healthier. I'm still sore from my work out on Wednesday so I must be doing something right. Life is just always busy when you live it in the fast lane. Now I have an upcoming test and have to start getting busy getting done all the things for this rotation I was supposed to be doing all month. I will say that it has been overall an enjoyable month and I have learned a ton! My first couple of weeks I worked with a physician who does a lot of sports medicine and acute care. This last week I have worked with a physician who takes care of patients that are more chronic and more like the patients I am used to in my normal weekly clinics. I enjoyed the acute care a lot more, but I have still learned a lot of new information taking care of chronic patients in an insured population. The medications, tests, and options available for those with insurance are much different than those without. Since I don't have to deal with the documentation part of the medical world, I am able to see so many more patients and learn so much more by using my time to actually work with patients instead of spending hours working on documentation. After this week I will be switching over to Internal Medicine with my unit and I am looking forward to continuing on. This week with be another busy one with a couple Thanksgivings, the big football game, tests, and decorating. I'll have lots of updates coming the first week of December. Happy Thanksgiving to you and yours!

Sunday, November 17, 2013

"Rural" Family Medicine

One of my required rotations is to do a month in "rural" family medicine in Missouri. I am doing my rotation in my hometown which I can't really consider rural with 70,000 people, but none-the-less I am really enjoying it. I have moved in to my grandparent's guest room for the month and have actually been able to be part of my family.  I go watch the little ones dance 2 times a week, go to the gym with my mother, and take care of all of those things I keep putting off like the dentist. Several times a week (when I have the time) I turn my grandparent's living room into my craft room and have watched more night time TV in the last 2 weeks than I have in the last 5 years. (I really kind of like Elementary.) Surprisingly, I feel even busier now that I am home then I did when my hours at the hospital were twice what I am putting in now. I thought I would be swimming in time, but atlas that is never the case.
Not to say that I haven't been spoiled, because I definitely have. The physician I have worked with for the last couple weeks starts at 9 in the morning, takes an hour lunch, and then finishes no later than 5 in the evening. Not to mention his half day on Thursdays.  Even with the shorter days and later mornings, I still have learned a great deal in the last couple weeks. I see more patient and see more of a variety in a day than I would in my normal adult clinic in a month. I have found one of my week spots, orthopedics. He sees so many sports medicine type patients and not only have I learned how to decide on imaging but there is a whole different world of medicines out there for people who have insurance.
Everything about this clinic makes me enjoy it. I have never found family medicine very appealing, but he makes family medicine look very attractive. Let's start with the general atmosphere. His whole staff gets along so well, works together perfectly, and share laughs constantly. Everyone is so laid back and interactive with each other and they were all so welcoming when I joined the team. And when I say team, I mean they are truly an amazing team. Each person has a role in the patient's care and it makes it so efficient. Patients don't wait very long to be seen and then are quickly on their way. There is no waiting around for hours. One of the other things I have really enjoyed is that the doctor treats his nurses and his students like his equals. He talks about his life and listens to our stories. We spent a half hour of our down time this week just talking about the differences in how be got where we are. We talked about how he came to decide on family medicine and his complete honesty was so refreshing. Not to mention it was nice to meet someone who has more debt than I do and is doing just fine. He is a picture of what I hope to accomplish one day. A physician who is able to take care of their patients appropriately, work as a team and have a good relationship with their nurses and techs, and still be able to go home to a family they are dedicated to at night.
So onward with what I have actually seen in the last couple of weeks. I saw the first patient I knew this week. I was completely awkward because it was a first for me. She was so much more relaxed about it than I was. Silly me.  Both me and the doctor I worked with this week had a couple, "I have no idea" moments this week. I had one lady come in with tingling in her hands and feet, but no diabetes and had already been tested for vitamin deficiencies. We are sending her on, but keeping track of her to see what rheum has to say. I realized seeing several patients that I remember a lot from boards that I didn't realized I still remembered. I saw several really adorable little ones. I must say the pen light I bought from the camping section at Walmart is the best investment I have made when it comes to little ones. They will let you do anything while they are shining it on the wall. I met my first autistic child. Broken bones, concussions, broken bones, concussions. Yep I'm an expert. Okay maybe not an expert, but I am much better than I was before. And then I got a lot of experience with changing meds on the chronic conditions that are common. And if you add on acute illnesses, allergies, infections, well checks, depression, ADHD, pain, memory difficulties, and strange bumps you pretty much have my 2 weeks. Did I mention I got to see a lot?
Come Monday I switch to a different physician and have to start getting up at a normal time again. I am hopeful it is as useful as the last couple weeks.

On and just 37 days and a few hours to Christmas. I am very behind!

Saturday, November 9, 2013


While my time in the pediatric clinics has been over for a little over a week now, I still remember my time there fondly. It is funny how certain things make you regress back into childhood. Like water puddles when you are on vacation, tickling, and these special tiles in the pediatric clinic. My first couple of days I didn't even notice that they were "special." I just thought they were strange colored blocks on the floor. Like abstract. But a couple days in some of the other medical students were talking about stepping on them and being afraid they had broken something. These blocks were so cool! (note: I am easily impressed and amused.) Basically it was a block on the floor that when you stepped on it the color displaced. It was like paint in a ziplock bag or something. Once I discovered these gems, I found myself looking around the hallway every time I went to see a patient to see if anyone else was around so I could step on the blocks without being judged. I am sure they are there for the entertainment of the children, but heck there are times when I am still a child at heart.

Christmas! It is another thing that makes me a child at heart and fills me with unexplainable excitement when I allow myself to start decorating. It often takes me weeks to put up all my decorations with my busy schedule, but I start early. Shopping for decoration, putting them up, hot cocoa, Christmas music. You name it, it all fills me with a ridiculous amount of joy. Right now my house is half Christmas, half fall, with a sprinkle of halloween. It is rather beautiful. By the time December 1st comes around though, my house should look something like the North Pole.

I have gone home for the month of November to rotate in "rural" family medicine and come back to my own home on weekends to work giving me a little time to decorate each week. So far my time at home has been busy and enlightening, but more on that later. Work time!