Tuesday, July 29, 2014

Pro-Vaccines and other medical issues

This is probably the most controversial post I will ever write on my blog, because overall I believe everyone should do what is right for them and I don't think it is my place to have an opinion about someone's personal life. The thing is that I am completely perplexed as to why these are controversial issues. My grandfather once told me that it was my duty to share my opinion about big issues within my field(medicine), because I have the education and information to form a well thought out opinion. So maybe it is all of the facebook statuses or the news articles, but I think maybe it is time to share my thoughts with others.

This is the most important part of this post and something I am actually very passionate about. I truly believe that those who chose not to vaccinate their children believe they are doing what is in the best interest of their child, but well-meaning people don't always make the right decisions. I am completely clueless why this is an issue and why with the recent emergence of preventable illness we are still arguing about vaccines.
I want to share a story about my first interaction with an anti-vaccine family. It was during my pediatric rotation and we had a 2 year old come in who had an abscess(collection of bacteria and pus) in her neck and was septic(bacteria in blood). I remember taking her history from her family and being floored when they said that she had not been vaccinated. The mother lay on the bed holding her while she wailed. Her father sit close by. They clearly loved this child dearly. But she was miserable and very sick. She had a very high fever and my supervising physician ordered tylenol to bring the fever down and something like IV ibuprofen(tordol) for pain relief. Shortly after the orders were entered the nurse came in and let us know the family had refused the medications, because they had too many ingredients in them. Everything we wanted to do medically was a struggle. We had a long discussion about antibiotics which they didn't want her to have initially and pain medications. Every time I went into that room the little girl was crying. It was heartbreaking, but not surprising. She was sick, was being refused pain relief, and had a fever of 103F. Her medical course was long, painful, and difficult to watch and when she finally was able to leave the hospital her parents were just as anti-vaccine as they were when they arrived. Something I still can't understand.
I think the most important thing when making decisions that are life-changing or life threatening is to be well informed. I am pro-vaccines and I believe it is the responsibilities of parents to protect their children from what could be deadly and dangerous illnesses that are preventable. I want to share some of the evidence based information that led me to this opinion and I hope some of you will take this information into consideration when making this very important decision.

1. While the cause of autism is still unknown, there are a large number of studies out there which debunk the vaccines cause autism myth. In addition, there have been several cases of autism in non-vaccinated children. 

2. Measles
  • In the last 7 months, there have been 18 outbreaks and 585 cases of measles in the United States. 
  • 1 in 2000 cases results in encephalitis(swelling of the brain) 
  • 20 in 1000 cases results in pneumonia
  • 1-2 in 1000 children who get measles will die. 
  • In 2012, 122,000 people died from measles globally--about 14 deaths an hour.  
  • Before the MMR vaccine, measles killed 2.6 million people a year globally.
3. Rubella
  •  Rubella causes congenital deformities in infants and roughly 110,000 babies are born with these defects every year globally. 
  • Before the vaccine, 1-4 in 1000 infants born globally were born with defects from the Rubella virus
  • Defects include deafness, cataracts, and heart issues.
4. Haemophilus influenzae type B
  • This nasty little bug is famous for causing epiglottis. A highly contagious bacteria that can lead to your airway closing off. It also causes meningitis, pneumonia, and ear infections
  • There were 12,000 cases of meningitis from H influenzae a year before the vaccine. 
  • As many as 1 in 20 cases of meningitis leads to death even with treatment and as many as 1 in 5 surviving patients who had meningitis will have long term brain damage, blindness, or deafness
  • Before the vaccine, 600-1,000 children died a year in the United States alone from H influenzae.
5. Diptheria
  •  Diptheria is a bacteria that causes a cold like illness that is accompanied by a thick coating on the back of the throat that can cause you to quit breathing. The bacteria can also attack the heart leading to heart failure or attack the nerves leading to paralysis
  • 1 in 10 children who get diptheria die and up to 1 in 5 children who get diptheria before 5 years old die.
  • Diptheria once caused 15,000-20,000 deaths per year in the United States alone until the vaccine became available.
There are a similar list of reasons for every illness we can vaccinate against. It is my opinion that every person's life is important. 1 death that was completely preventable is 1 too many. Many of the people who die from preventable illnesses are children who have their whole life ahead of them. Protect your children, your neighbors, and your love ones by getting the proper vaccinations. 

Birth Control
I will make this short. I believe that every woman should have access to the birth control of her choice and it is the responsibility of women to make good decisions. I recently read a buzzfeed post where women held up signs about why they didn't take birth control. I found many of their reasons to be based off of incorrect information and didn't quite understand how they saw the world, but I also think if you don't think BC is for you that is okay. Just don't make it your goal in life to take it away from other women. 

1. Wear your seat belts. For the love of all things, just wear the damn thing. You are putting yourself and everyone else in the car at risk if you don't wear it. Not to mention the poor paramedic who has to try to save your life or the poor police officer who has to notify your family. Wear it!
2. Look for motorcycles! And for the bike riders, don't drive recklessly. Don't try to beat lights or swerve around cars. Some of the worse traumas I have seen in the last year have been people who were on a bike. 
3. Firework safety. Dynamite is dangerous. No seriously, it could kill you or leave you mangled or permanently disabled. Please use your common sense.

Drinking and Driving
1. Don't do it! 
2. 28 people die a day due to drunk driving in the US.
It is heart breaking for everyone involved. Call a cab, sleep in your car, call your mom. Whatever you need to do, but don't get behind the wheel of a vehicle if you have been drinking.

Other Notes
  • Quit smoking. This both is a personal and medical issue for me. For the last year, my grandfather has been battling lung cancer. He is only in his 60s. He quit smoking 10 years ago, but he was a regular smoker for almost 30 years. Do your lungs, heart, blood vessels, brain, and family a favor and put down the cigarette
  • Everyone needs a living will. Tomorrow is never guaranteed and there should be something put in place if you are unable to make your own decisions. 
  • Put your child in the proper car seat. The new recommendation is for you child to be in a rear-facing car seat until they are 2 years old.
  • Along those lines, do not leave your child in a car or your pet. No matter what. Even if it is only going to be a minute or 2. When it comes to this it is better to be overly cautious.
  • Be kind to each other. This doesn't really come from my years in medical school, it is just something that will make your life and the lives of those around you happier.
So that's it. My thoughts and information on the current issues that we talk about everyday. I hope the information is well received and that one day these will no longer be controversial issues. 

Friday, July 18, 2014

Bucket List

One of my assignments when I was graduating high school was to come up with a 30 before 30 list. 30 things I wanted to do or accomplish before I turn 30. While I am several years away from 30, I took a look back at my bucket list from when I was 18. It is funny how things change as you get older. Your outlook on life changes and with any luck you get a little wiser.

 I have had a lot of different experiences over the last several years, both good and bad, that have shaped me into the person I have become and my bucket list had definitely changed. Some of the goals on my 30 before 30 list I have completed like:

1. Give a great speech at graduation
8. Read the Harry Potter Series

Others still remain on my bucket list:
10. Establish a scholarship
13. Visit Rome, Paris, Spain, and Hawaii
18. Run a half marathon
27. Scuba Dive

While some seem to be a little ambitious
 11. Learn to speak Spanish and Italian
12. Work in a foreign country
23. Get out of debt(by 30??? Maybe by 40)

Still others I have completely changed my mind
5. Complete a pediatric residency
20. Spend a month in New York

So I thought I was due for a new bucket list.  I love the whole idea of the bucket list. It gives you some goals and things to work for and it is a list you write down to look back at 5-10 years later and see how different your priorities were at the time.
My goals before 30 are simple:
1. Get into EM Residency
2. Fellowship
3. Sleep

So maybe this is more like my before 40 list:
1. Go Scuba Diving. Anywhere really, but I would love to scuba dive at the Great Barrier Reef(who wouldn't?) or Hawaii. This has been on my bucket list for as long as I can remember. Part of this goal is to also see a sea turtle in the wild.
2. Go Sky Diving. My brother went sky diving last November and absolutely loved it! To be honest, I have no idea if I could actually jump out of a plane, but I like the idea. Ideally I'd like to fulfill this goal with my brother at my side. You know, kind of a bonding experience.
3. Go kayaking. I have no idea why. It just looks like a lot of fun.
4. Hike the Inca Trail. 4 days of total beauty(and sweat).
5. Puerto Princesa Underground River! Perhaps I should just say all of the new 7 wonders of the world. But definitely this one!
6. Disaster Medicine: anywhere. I absolutely love the idea of disaster medicine and everything I hear about it is awesome. You are truly making the best clinical decision you can make in an emergency situation and you can help a lot of really desperate people in a single day. One of the main reasons I got into medicine was to help people and what better time than during a disaster situation!
7. Go on a Road Trip. I'm not super picky on this. I have a lot of different places I would like to visit, but this is more like getting into the car and just driving and see where I end up.
8. Visit a Volcano. When my sister and I were 8-12 we spent the summers with my grandparents and my sister had a major fascination with Volcanoes. So of course as the little sister I also got interested in Volcanoes. So this is a sisters trip to fulfill a childhood dream.
9. Sail around the San Francisco Bay. I have lots of travel wishes that I could write about, but this one is more of a repeat. In 2009, I went to San Francisco for a wedding and had an amazing time. It is such a beautiful place(with no parking) and while we did take a quick boat ride around the Bay, I would love to just sail for a full day.

10. See all of the US "things to see" like the Grand Canyon, Statue of Liberty, Nigeria Falls.

11. Write a book. I have no idea what I would write about, but I have always wanted to write a novel of some kind. Maybe during Novel November one year.
12. Establish a scholarship. Paying for med school has not been the easiest thing to do and I truly believe that anyone who has the ability should be allowed to follow their dreams even if graduate school is entirely too expensive. I received several private scholarships my senior year of high school to help pay for my first year and I hope to be able to help someone else in the future the way people helped me.
13. Build my dream house. I have been working on my dream house for years. The most important thing is the master bathroom(of course!). But I'd like to have a large kitchen with 2 stoves, a walk out basement, a craft room, a library, and guest rooms to have family stay on holidays. That is the short of it. I could probably write a blog post just on my dream house!
14. Go Technology free for a week. One week of no internet, no phone, no TV. Live off the grid for a few days. Preferably on a beach.
15. Play Messy Twister. What a fun idea! I equally like the dart board with paint filled balloons idea.
16. Get my pilots license. One of our family friends(Stan), once told me the natural progression is to go from snorkeling, to scuba diving, to sky diving, and then to flying the plane. So of course this only makes sense!
17. Spend a week laying on the beach(I think that speaks for itself)
18. Spend a full day baking lots of yummy things from scratch! Like breads, cookies, cake, cheesecake, and something totally different!
19. Make baby/children's quilts and donate them to the local children's hospital.
20. Be my ideal weight. I just think that as a future physician you just have to have on your bucket list. The odds are probably better that I will see 100 if I'm my ideal weight.

One of the things I love about this bucket list is that there are things on there that were never on my bucket list before, because I'm not as afraid as I use to be. I have no idea if I will get through my list before 40, but I'm hopeful and I'm sure I'll add more things along the way!

Wednesday, July 16, 2014

Aunt Katie time

I became "Aunt Katie" in March of 2012 to Merideth Ann after a long day in the waiting room. Now a little over 2 years later she is a walking, talking little human who steals my heart every time that I am with her. My sister and her husband had tickets for a starlight show here in town and had asked me to keep Meri all day so they could have some couple time and then go to their show. I was very excited, because this would be the first time we would have one-on-one time together. Over time our plans changed a little. This is my last year of medical school and my last guaranteed year here in the KC. The probability that I will be packing up and moving half way across the country this coming spring is pretty high and so my sister decided that she would rather have a day together to get in some sister time.
We structured our day around what would be fun for a toddler and had an amazing time. We started at Fritz the railroad restaurant where Mer was completely at awe with the trains that ride around the restaurant delivering food. From there we went to the Chocolate factory where she got to watch them make fudge and pick out a train chocolate sucker before heading off to check out some of the shops.
After a needed nap, we headed out for the splash park. I had no idea there were free splash parks around the city, but they are a great idea and she had an amazing time. She has absolutely no fear and her and daddy got soaked. We finished up our time with the parents having dinner and watching Frozen(she absolutely LOVES frozen).

Once we had the adults out of the house and on their way to the show we set to work making homemade salt clay. She had a great time helping me dye the clay different colors and we of course used it to build a snowman.

I have a large craft room filled with a number of different things including 50 different colors of paint. So when we were done with the clay we headed upstairs to pick out a couple of colors for hand painting.

After hand painting we took a bath and did shaving cream painting while washing off. We finished the night with a story and a second round of Frozen.

The day was wonderful. There was no stress, she says the funniest things, and overall we mostly just laughed. It has been amazing watching her grow over the last couple of years. If come May I find myself packing to pursue my dreams, I am going to miss having days like that, but for now I will enjoy the time I have and try to create memories with her while I can.

Friday, July 4, 2014

The Dating Chronicles of a Lady with Dreams

Note: If you are a 20-something who is married and has children, I'm happy for you! We all chose our own paths and no path is better than the other. This is just about my path. I have thought a long time about writing this post, in fact my sister encouraged me to write it months ago, but out of fear I didn't. But overtime we all conquer our fears.

When a woman turns 20, she catches the "I'm going to die alone" bug. No one is immune. It doesn't matter if you have plans, dreams, or goals. If you had planned on having children in your 30s or wanted to wait until traveled the world to "find the one." You magically start thinking that all babies are adorable and if you don't hurry up and get on with it then you are going to end up alone. I have watched this happen all around me and maybe even a little before I turned 20 I caught the bug.

I had had a high school sweetheart that I had been sure I would end up with, but alas that ended shortly into my med school career. When I ended that relationship, I had no regrets. I knew we were headed down very different roads and had nothing in common. He was a safe first, long relationship. So while I'm glad I had the experience, I am also happy with my choice to move on. I spent a year after the end of our relationship with friends, experiencing college life, and dealing with family issues.

At 20, I became obsessed with finding "the one." The rest of my life went on the back burner. All I knew was that I wanted to get married desperately and my new biggest goal was to have beautiful children. When I look at the my family and culture, I am not surprised so many young women get "the bug." 20 is when your friends from your hometown start getting engaged and having children. It is when your family starts asking about your love life and lack thereof. It is when society starts pressuring women to get on with it already. I attended 4 weddings during that year and just as many if not more baby showers. And heard countless times, "I just don't understand why you're single."

Shortly after my 20th birthday, I made a bold move and confessed my interested in a nice guy who was several years older than I was. But he had been through hell and back in his relationship life and after a few weeks of friendly conversation I was back to page one.
In the winter of that year, I decided to have a casual relationship. While the whole couple of months seemed very casual to me, perhaps it was very different for him.  I was in a point in my life where I didn't really know what I wanted and the pressure at school made life difficult. When he told me he loved me, I couldn't say anything. I knew I didn't feel the same and that I didn't want to lie. He became upset and over the next couple of days refused to talk to me. Out of no where, a weird feeling of desperation set in and I lied. Perhaps it was lucky for me that the damage had already been done.

Things weren't much different when I turned 21. I had taken care of many of my family issues, I was healthy, and I had finally found my stride in school, but on a relationship level I was still looking for "the one."

My mom always encouraged me to date, I think she was afraid I would die alone too. When she took me out for my 21st birthday, she invited several of the guys who worked for her. I set my eyes on the one who seemed the nicest(I'm a sucker for nice guys) and after a few weeks I settled into a relationship with an emotional distant guy who liked his space. Our relationship moved entirely too quickly and within a couple of months he had moved in. I think if we both had to do it again we would have waited, but I also think we would both agree that it wouldn't have worked out anyway.  Throughout our relationship, I became more and more committed to my career. I had suddenly realized that I was capable of being an incredible physician. While I had been upfront about the time required to pursue my career, even for a guy who wasn't sure about relationships to start with it was too much time.

We were together just about 18 months and it was an interesting journey(for both of us.) We were 2 people from 2 very different worlds and even if my future self had told me that it would never work out, I would do it again. It was through that experience that I got to where I am now.

So let me now answer all those questions about my love life that people like to ask...

I just turned 24 a little over a month ago and I am entirely too young to have a family. Over the last year, I have done incredible things and have proved to my self and my peers that I have an amazing career ahead of me and I think that is pretty good for 24.
I've decided it is okay not to have a family in your 20s and in fact it is okay not to have children at all. I want to live the life I want to live and not the one others think would be good for me.
I like being single. When I come home, there is no one to feed, no one to make feel better, no one to clean up after and after a 12 hour day at the hospital, it is nice to come home and lay on the couch. No one is mad about my socks on the floor or my 15 textbooks on the coffeetable.
Am I opposed to love? No. In fact I look forward to the day I find someone to share my life with. I still get weak at the thought of that guy I once knew. But I'm not in any big rush and I don't structure my day around the idea I might meet someone while I'm grocery shopping. (I mean honestly, how many amazing available guys do you run into in the milk aisle?)
My number one goal in life is to do everything I can to provide my future patients with the care they need and deserve.
So maybe a year from now I'll be in a strong committed relationship or maybe I will be trying to get my pilot's license(I'm getting that either way). In the end it will all work out and I won't die alone. And maybe, just maybe, when I do commit myself to someone again, I will be able to support them and compliment who they are. Because I think a relationship is much different between 2 people who need someone else and 2 people who simply want to be there.

Wednesday, July 2, 2014

A New Chapter

11 months ago, I started my "core" rotations: Psychiatry, Pediatrics, Family Medicine, Internal Medicine, OB/GYN, and Surgery plus I smuggled Emergency Medicine into the mix. It has been an amazing journey and I have had an incredible amount of opportunities, but I am happy I have officially finished them up. I planned on taking yesterday off to do all the things that I haven't had the time to do over the last few months: clean, pay bills, do laundry, run errands. It turns out that I have let so many things stack up that one day was just not enough. Come tomorrow I will start studying for my Step 2 USMLE exam. A month of studying, healthy eating, exercise, and a normal sleep schedule is just what the doctor ordered.
Last year when I studied for my Step 1 exam, I used the time to disconnect from electronics, spend more times outside, and take some "me" time. I look forward to having the same opportunity over the next few weeks. Come August 1st I will be starting my Pediatric Emergency Medicine rotation. Senior year is officially here!