ClaireEBeth's Xanga

Thus far

Mon, 20 Jul 2009 23:00:34 GMT

So far, I've had a great month! Most of my calls I've slept 1.5 hours or less, but that's to be expected. One night I got NO sleep but held it all together and didn't have a breakdown. The next call was another story. I did get a little sleep but had to go talk to a mother at 5 am who didn't want to let the nurses replace her child's IV because they were having a hard time finding a vein. Now, this child had come in for dehydration and was NPO (nothing by mouth) at the time. He NEEDED that IV. So, I went up there and she immediately decided that I was not for her. Everything I said, she had a comeback. "Do YOU want to try?" "He's been coming here for 9 years and I'm not going to have y'all poking on him." When I mentioned that if he didn't get one, she ran the risk of him getting dehydrated again "Well, okay. We'll take that risk." So, I told her that I was going to leave a note for her primary team just so they would know why he didn't have an IV..."Well...you can WRITE your little note but I can't get in trouble because I'm an adult." Huh? I wasn't getting her in trouble! THEN she proceeded to tell me (all while I'm standing there saying, "Yes, ma'am. I understand. Yes, ma'am.") that all of us have bad attitudes, etc. That's when I just had to turn around and leave without saying anything. When I got to the nurses' station to write my note, I lost it. I broke down and started crying. It was not a fun experience, but I understand that she didn't want her baby to hurt and has dealt with a lot as he has a chronic disease and will never be "normal." I've seen her since and she was pleasant.

The other thing that I've seen since starting is how inefficient our registration process is. We had a child in the hospital who was not growing (size wise) properly, so he needed to come see me in clinic after he was discharged. I wrote on my orders "Dr. Claire in clinic on Thursday, 7/17/09 PM clinic." WELL, he didn't get scheduled for that clinic, in fact he got scheduled for a day I don't even HAVE clinic. When the mom came for the appointment they wouldn't let her up b/c she didn't have an appointment. When she said that her doctor had told her to come no matter what and could they at least call upstairs so she could talk to me, they wouldn't do it. Please, tell me...how hard is it to pick up the phone and call upstairs. If they had done that, she would have been able to come. Something just isn't right about that! It's okay...he came today for a weight check and is doing okay.

Honestly, those are the only two...well, there is one more but we won't get into that one...somewhat negative experiences I've had so far. I really love my job and know that God is going to use me to bring Him glory! How much a blessing it is to work with children and their families and to be able to overhear some families, even in their distress, proclaim their trust in God and His wisdom for their child! Wow!

Intern Life

Sat, 11 Jul 2009 22:35:45 GMT

So, I've been on the job for 11 days now...sometimes it feels like longer. I've had three calls, which means I go to the hospital around 7 am one day and leave around 1 pm the next. Whether I get any sleep depends on how many kids we admit and how much the nurses call me for patients already admitted. The first call I got 1.5 hours, second 4 hours, third...NO SLEEP! It was great fun...but I must admit, I love my job. I really enjoy the puzzle of figuring out what's wrong, seeing kids get better, really almost all things that go with it...call is just a "bonus!" It's always fun to see a kid warm up to you, to smile for you when she hasn't been the whole time in the hospital. To see a kid go from obviously feeling sick to being a normal kiddo. Then it's sad to see a child with diabetes come in for the sixth time because the blood sugar has gotten so high that the body is acidodic...this is BAD. I'm going to learn SO much this year and am really excited about it...learning medical things AND more from God. There is no way that I can do this job without Him...I get tired, and when I get tired I can get grumpy and short. I recognized this a several points on my last call, I'll definitely have to pray about this area of my life! Anyway, I'll try to post more often, especially if I have a story...but at this point, I don't!

And just so you know...I do still have a life as a busy intern! I went to the block party for our M3's on Tuesday and went to dinner with a friend to meet her boyfriend last night. Oh, and before the rotation started I went to Memphis to see Wicked with a friend...it was SUPER good! Go see it if you can!

Dr. Claire

Mon, 25 May 2009 20:05:49 GMT

I have officially finished medical school! Sorry that I've been absent...guess I just didn't have much to say. I spent my last month in the ambulatory clinics for pediatrics. It's a great rotation because it's very laid back but taught me things that I'm going to need to know for my residency, which starts July 1. There were a few interesting things that I saw:
- when I went to neurology clinic there was a baby who was having trouble sitting up, crawling, etc and she was a year old...much past when she should have reached these milestones. She had not gotten any teeth yet, either. She also had this strange streaky rash. When I presented her to the attending, I told her that the rash reminded me of hypermelanosis of Ito (a neurological/dermatological condition - can also be called hypOmelanosis). The attending also mentioned Incontinentia Pigmenti but the rash didn't start as this condition usually does. So, basically, I all but diagnosed this child correctly with a rare neurological disorder.
- At one clinic, a grandmother brought her 6 week old grandson into clinic for his eyes doing funny things and rash. Well, the peditrician though that it would be a pretty typical "his eyes are crossed" concern. WELL, it wasn't. This baby couldn't focus his eyes at all and they were constantly moving from side to side. This is NOT normal. So, we sent him for a visit to the pediatric ophthalmologist and a CT scan. Thankfully, his CT scan is normal, so he shouldn't have problems with cognition, etc. The ophthalmologist, however, said his retina was white (instead of pink) and that he has ocular albinism. So, he'll be okay but will have very poor eyesight. Sad for him but also glad that is "all" it is.
- I had to treat myself proactively for scabies. Ugh...they just give me the heebie-jeebies! We have a good bit of this around here, and, so, one of the clinics keeps some Eurax on hand to use immediately after seeing a child with Scabies. it is very treatable but just makes me itch thinking about it!

In the middle of all this learning I also caught the pediatric cold...remember the cold from the ER? Well, it also exists in the clinics! The Monday after I started, I woke up with a stuffed up and runny nose. Other than my nose, I felt fine after Monday. It wasn't too bad. Then, the Friday after my clinic month ended I got an itchy throat...after about a week it developed into a sore throat and took a week to go away. Guess I should get used to this because, as an intern, I will be sick quite a bit next year. Everyone says that the first year you get colds a good bit but after that you are pretty much immune to everything. We shall see!

I've been off this month and have been enjoying it in between house shopping, which has proven unsuccessful thus far. I had my long coat ceremony last Thursday and now have my official doctor's coat with my name, M.D. on it! The next day we had our graduation ceremony and I received my diploma with my name, M.D. on it! Pretty weird if you ask me. In less than a month, I will start my orientation for residency. Pretty exciting and scary. Maybe I'll have some more good stories for you then.

Friday, April 03, 2009

Fri, 03 Apr 2009 00:24:24 GMT

Things I've learned:
- Looking in ears, especially itty bitty babies, is hard!
- I actually did learn some things on my ENT rotation
- I can recognize tympanosclerosis, fluid levels, and nasty effusions
- 120 pounds on a 4 year-old is WAY too much
- 120 pounds on a 7 year-old is too much
- Palatal petichiae is pathopneumonic for strep throat
- Little kids who suddenly start wetting the bed are quite often constipated
- Looking for a house is fun
- Thinking about buying a house a little stressful.
- Applying for a loan and temporary medical license is annoying and stressful.
- I LOVE PEDIATRICS!!!!
- I am thankful for my family and friends.
- I'm excited about my residency family
- I'm excited about WICKED in June with Sarah
- I am weak
- I can't do anything on my own
- I need God to give me strength and direct me

I started my pediatric ambulatory month on Wednesday. I LOVE it! I always get nervous going into something after I haven't done it for a while. What if I've forgotten how to do it? No worries...this is totally what I'm supposed to do. Yesterday, we had a fundraiser at a local pizza place...I sat with Sarah and some of the peds residents. So comfortable and fun! Makes me even more confident and excited about next year...gonna be fun. I'm so thankful that Sarah and I will be working together (or at least in the same program as interns don't often work together) for three more years. I'll keep you updated on the goings on of intern life!

Friday, April 03, 2009

Fri, 03 Apr 2009 00:23:57 GMT

It's a Match!

Sat, 21 Mar 2009 01:30:04 GMT

Sorry it's been so long! I am currently on my surgery rotation, which is centered around pediatric otolaryngology (ENT - ear, nose, throat); so, I typically go to clinic and the OR where I see lots of tubes places, tonsils removed, tracheas examined, and lymph nodes/facial masses removed. It's been really good. I'm getting an idea of what an effusion looks like, when to refer a child for tubes or tonsillectomy, and how to get kids to let me look in their ears!

One experience I've had that I totally did NOT expect was being there when we made the diagnosis of probably cancer. A little girl had come to clinic because she had a lymph node that was enlarged and not getting better on antibiotics. The doctor said that when he saw her he though it might be a brachial cleft cyst, though I immediately thought, "this is not good." Well, upon physical exam, we found MULTIPLE lymph nodes in her neck area (you generally aren't supposed to feel lymph nodes, though children can have small moveable ones, as can adults...I do, but they have been there for years and aren't changing) as well as supraclavicularly (above the clavicle (collar bone) - these are almost ALWAYS pathologic (there because something is wrong). The supraclavicular ones were particularly large and tender to touch. We immediately called radiology to see if they could scan her NOW! They got her in and even before she returned, the radiologist called the clinic to give us his quick opinion...even before an official read was done. This is unusual. Well, sure enough, she had tons of enlarged nodes in her neck as well as a large mass in her chest, located in the mediastinum, which is the area the heard occupies. The mass was not obstructing her airway (GOOD!) but was pushing things out of their ordinary position. I was given the job of entertaining her while Dr. R talked to her parents. She was very inquisitive. We had already told her that she was going to have surgery to test one of the nodes and see exactly what it was. Then I got to learn all about what she's interested in, etc. What a job! Obviously, her parents were upset but when I saw them later that week for surgery, they were better. The pathology came back as Hodgkin's Lymphoma. Now, no cancer is good...but if you had to choose one, HL is one of the ones to choose (especially as a child). It has a cure rate of 85-95% depending on the stage. I think her stage is Stage II...she's already gotten a round of chemo and her mediastinal mass (the one in the chest) has shrunk probably in half. Amazing! Going into her node biopsy, that was the most fearful I've been so far in medicine...the anesthesiologists were really concerned about her airway and kept saying that if she stops spontaneously breathing, it could collapse and we could lose her airway...they even brought in the chief of anesthesia and one of the general peds surgeons to look at the scan. They were less concerned, so I felt better...but you better believe I was praying going in and during that surgery! She's doing well and seems to still be pretty spunky! What a great learning experience for me.

Most recently, we had our Match Day festivities. Match day is the day where all medical students who are entering residency next year find out WHERE they will be doing residency. It is a very complicated procedure. Starting in October, we interview at different locations for a position. Then in February, we have to submit a rank order list, saying the places we would want to go and in what order we prefer; the programs do this as well with the candidates. A complicated computer program ensues (it's kind of like sorority rush!). Then, at the same time across the country, everyone finds out where they go. Quite exciting! This year we had a pre-match party at a local pizza place. I had lots of fun and enjoyed hanging out with friends.
This is me and Sarah waiting of some good pizza...never came so I settled for plain old supreme! The next morning the alumni council sponsored a breakfast for us. It was at a really nice country club.
My dad came with me. Then we went to the student union and had the ceremony. Quite exciting to find out where people went. We had people go as far west as Utah, as far North as New York (this girl was the most excited), and west as Massechusetts. I am going to be staying at UMC to work in our pediatric hospital, Blair E. Batson Children's Hospital! It will be great. Three other people from my class stayed here...
Sarah, me, Yakela, and Josh (who is soon to be a father of TRIPLETS!!! After the ceremony, my family and I went to a local "drive-in." It's really a pretty nice restaurant, especially at dinnertime. I got a grilled chicken salad, daddy got a redfish sandwich (SO good), mama a turkey sandwich, and Philip and Kenna got a hamburger. We really enjoyed eating outside and visiting!

Such a fun day! Now I've only got two months until I graduate. I've been trying on long white coats, making out my schedule for next year, and looking at houses. Lots of changes coming! I'm so grateful for the direction God has given me, the friends I have, and to see what He has planned!!!

A Month of Ethics

Mon, 16 Feb 2009 00:01:33 GMT

I am currently learning some ethics! I've had several friends jokingly say, "Finally!" This is a class that is offered every year to fourth year medical students. It's been a bit more time consuming than I realized it would be but it's interesting. The past two weeks we've been studying numerous ethical theories, all of which basically cannot stand alone...you almost can't subscribe to ONE theory and have all your decisions stand up. Even in a (fictional) world where everyone believed that the Bible is God's word, not everyone interprets (correct or incorrect) the Bible to say the same thing; so, even a Deist ethical theory doesn't really totally work.

ANYWAY, we watched Gatica last week...interesting movie. Makes you really think about the implications of genetically engineered children. Even if the child is built to be as perfect as possible, that doesn't rule out something bad happening or someone who wasn't "engineered" being worthy of the same opportunities.

At the end of last week, we had the opportunity to go to a conference about sharing our faith in the professional realm. I didn't go because I had a dentist appointment (I know...lame) but that meant I had a lot of reading to do instead. Some of the things that were said, I don't really know if I agree with. Most of the articles DID allude to the importance of faith in healing and well-being. However, the place of this for ME was a bit unclear. Most of the articles stated that it was okay for doctors to pray with patients as long as the doctor wasn't the one praying. In general, I don't and probably won't pray with many of my patients; however, I do think that there will be cases where I will feel lead to pray with them AND be the one to pray. I know some people won't feel this way, but I think that I would be so much more comfortable and confident in a doctor who is willing to pray with me and for my child. The argument against physicians NOT praying in the room with patients is that it is seen as forcing beliefs on a patient (but they should have ASKED for the prayer) and giving the patients a false sense of trust in the doctor...that praying may lead them to accept what the doctor says without any other consideration. What do y'all think? I'd be interesting to hear some of your opinions, as someone who would be on the patient side...maybe I could even bring it up in my class!

On a more fun note...my best friend in med school had her baby on Feb 5...a whole 2 days before my b-day. She just couldn't hold out. Things went well. She did not have to have a c-section, which four hours prior to his arrival was a big possibility. Luke is just precious!!!

I went to her house the other day and visited with her...as well as cuddled with Luke, changed THREE diapers, and finished feeding him while she tended to urgent business. I even got to eat dinner with them. It totally made my day! Sarah has been such a blessing to me these past years and I am SO excited that she and Jason are getting to enjoy the blessing of a child.

Up next...certifying my rank order list (I might as well go ahead and do it!). Match day is March 19...at this point, I'll know where I'm going to do my residency. Then in May I get my long coat (I've already tried it on...kind of different!) and my degree...Claire N, M.D. WOW!

Picture Fun

Thu, 29 Jan 2009 15:40:55 GMT

I've been tagged for a picture meme. Lori tagged me to pick the 6th picture in my 6th photo folder. Well, I cheated a bit b/c my 6th folder doesn't have 6 pictures...only one! So, I went to the next folder and picked the 6th picture. This is a picture of my precious cousin, Violet. On Thanksgiving, I thought it would be fun to make sugar cookies and have the kids decorate them. I think they enjoyed it and the adults said they thought it was fun, too!

Doing What I'm Not "Supposed" to Do

Tue, 13 Jan 2009 21:09:23 GMT

On Saturday I was on call with my medicine team. Of course, we had a pretty busy day. We didn't stop until I left at 8:30 and even then, my residents continued to work until 4am. One of the admissions we got was a guy with a newly discovered lung mass who needed to have a biopsy. So, I went down to talk to him, get his story, and get the admission orders going. As I was leaving, he just grabbed my hand and started saying "Help me. Help me. Help me!" I could tell he was scared (who wouldn't be!?) and just thought, "I have to do something for this man more than tell him we'll do our best." So, I went out of the box...I did something that I'm not "supposed" to do. First, so that it would really be okay, I asked him if he went to church. When he said yes, I told him that if he wanted someone to pray with him, I would...if he wanted that. He then responded that he did. So, even though I work at a state institution and we have chaplains who are "supposed" to pray with patients, I prayed with my patient. Sometimes being obedient to what God wants you to do means going out of the box. What a blessing to me...and now, I have a connection with that patient that other people don't have. I feel like he trusts me and knows that I want the best for him. Pray for Mr. J and that he'll have the peace of God and courage for what lies ahead.

Catch up Time!

Fri, 09 Jan 2009 00:57:24 GMT

Sorry it's been so long. I was off during the month of December and it was WONDERFUL! I spend two weeks just doing things around my apartment and preparing for our Christmas music. I had the privilege of portraying Mary during the music. It was really neat and made me think about all that Mary went through, still trusting God to be faithful, sovereign, and just. She knew He was (is!) merciful and gracious...and she was a part of His plan of grace. How awesome is that. She would be a part of bringing redemption to her people and many generations to come. Here are pictures if you want to see...be sure to read the captions. They tell the story and the words to some songs.

After that I drove home and then traveled to Louisville, KY for an interview. While there I was able to spend some time with my aunt, uncle, and their son and his family. It was a really nice few days. Then I spent a little over a week at home. I just love going home and am so thankful for my family. My parents have been (and still are) such great examples to me of what a husband and wife should be, obedience, and so much more (like fun, friendship, service,...). We just kind of hung out, cooked, shopped, watched movies, and FINISHED a puzzle. We always start one but usually don't finish before I have to leave...I was DETERMINED we would finish!

The Saturday after Christmas I came home and went to a wedding. Now a days, weddings just make me anticipate mine that much more. How neat will it be to have someone to share my daily life with, someone who wants to know what's going on, someone to serve God TOGETHER with...I think it'll be great (along with some work, I'm sure!). I was able to see a high school friend and we had a good time just chatting and dancing at the reception. Then I had a baby shower for a medical school friend. Once again, things like this just get me anticipating the future...but I'll be patient. God's timing is perfect!

Now, I'm on my medicine rotation. That means that I am on one of the teams in the adult hospital. I'm on Q4 (every 4th night) call. We've already had a couple of very eventful calls. We've had 3 code blues, capped both nights (took as many patients as we can), and had a couple of deaths (unfortunately). I really enjoy my team, though. God has really be good to me through these past two years and put me on good teams. I really can't think of a team that has been bad...at least resident wise. That was one of my concerns but I shouldn't have worried. Even though medicine is not what I want to do, and I miss my kiddos!, I'm enjoying this month, mostly because of the people on my team. I think I'll be able to learn some things. I'm off tomorrow (after 7 days straight including two periods of working 36-37 hours), so I'm looking forward to NOT setting an alarm!