A quote from one of Dr. Mahdavi's physical exam books that he used during medical school, copyright 1981! Although a lot has changed in medicine in the last 30+ years, the art of physical exam has remained the same.
"Life is short, the art long; opportunity fleeing; judgement difficult; experience fallacious."
- Hippocrates
First Aphorism
Wednesday I was allowed to examine my first patient since starting clinical rotations. I completed my first 4 year old well child check! Since then I have completed several well child checks and did 50% of a visit with a high risk teen who recently overdosed on prescription drugs, is using several illicit drugs and is sexually active. Although she appeared to be uninterested in anything I had to say regarding safe sex practices, visiting plan parenthood, or quitting drug use I am hopeful she heard something and will make at least a small change.
Last night I attended a benefit for the Touro Student Run Free Health Clinic at the Empress Theatre in Vallejo. Following the screening of The Waiting Room the director and several hospital staff held a discussion panel, really glad I attended and was able to spend the evening with Geoff, Kat, Makani and Donovan. http://www.whatruwaitingfor.com/
Friday is here again, two weeks of rotations under my belt. Feeling like my white coat belongs on my back, stethoscope has a home around my neck and I am doing what I have been waiting for. I am so grateful for all the support my friends and family have given me on this journey and will continue to give me. I am one lucky gal!
Now I am off to pack for my move tomorrow morning and to cook dinner for my friends who are giving me their time and their bodies to help move all my stuff!
Friday, February 22, 2013
Wednesday, February 20, 2013
Quote for today
"Don't judge each day by the harvest you reap, but by the seeds that you plant."
-Robert Louis Stevenson
-Robert Louis Stevenson
Tuesday, February 19, 2013
Interviews
Today I am back on campus to help with interviews for the class of 2016. It feels so good to sit in Panama Red Coffee shop with Makani and parallel study. When I walked into the coffee shop this morning I received a warm welcome from the morning group that has watched us progress through our education every morning at 6:00 am when we met for group study. I have become a member of several families here in California, I have visited with two thus far this morning and I am looking forward to seeing all the faculty today as well. Life is good!
Friday, February 15, 2013
Quote of the day
" We are what we repeatedly do. Excellence, therefore, is not an act but a habit."
-Aristotle
-Aristotle
Thursday, February 14, 2013
Week one
Well I have made it to Thursday afternoon of my first week. My brain is tired, my low back and legs are sore and my feet feel like a hammer has been taken to them, but I made it. I have a four hour shift tomorrow morning then I think it will be time for a good nap before I meet several classmates for dinner.
I am trying to find the balance between being in clinic for 8+ hours/day, commuting, inputing all the patients I have seen into Typon each day, studying for EORs, reading about the diagnosis I am seeing in clinic and sleep. Tonight I am putting this all aside to meet Geoff and Kat in the city for dinner and hopefully a nice nap on BART on my way in!
I signed my lease for the month of March and will be moving to Brentwood in 1.5 weeks. I have a lot of work to do on my apartment this weekend to prepare all my belongings to be in storage for the next year.
Today I saw my first circumcision, the most traumatizing part for this 6 week old was having his arms and legs tied down to allow for the procedure.
Things I have learned this week:
1. Undiagnosed/untreated ADD or ADHD can lead to other mental health problems like depression. We saw a 14 year old this week who has been experiencing decline in his grades since 3rd grade, he is made fun and only felt like he was performing to his maximum when playing soccer. This kid wanted to do better for himself but didn't know how. Dr. Mahdavi traditionally starts by treating the ADD/ADHD and then will reassess the depression in a few months.
2. Seeing 30 patients a day= a lot of time on Typhon inputting patients at the end of the day. I now understand how physicians forget patients. In my notes I don't have any patient identifiers (name, record number, etc...), and I dont remember a lot of kids I have seen the past few days based solely on my notes.
3. Standing all day= one exhausted girl!
4. I miss my PA school friends.
I am trying to find the balance between being in clinic for 8+ hours/day, commuting, inputing all the patients I have seen into Typon each day, studying for EORs, reading about the diagnosis I am seeing in clinic and sleep. Tonight I am putting this all aside to meet Geoff and Kat in the city for dinner and hopefully a nice nap on BART on my way in!
I signed my lease for the month of March and will be moving to Brentwood in 1.5 weeks. I have a lot of work to do on my apartment this weekend to prepare all my belongings to be in storage for the next year.
Today I saw my first circumcision, the most traumatizing part for this 6 week old was having his arms and legs tied down to allow for the procedure.
Things I have learned this week:
1. Undiagnosed/untreated ADD or ADHD can lead to other mental health problems like depression. We saw a 14 year old this week who has been experiencing decline in his grades since 3rd grade, he is made fun and only felt like he was performing to his maximum when playing soccer. This kid wanted to do better for himself but didn't know how. Dr. Mahdavi traditionally starts by treating the ADD/ADHD and then will reassess the depression in a few months.
2. Seeing 30 patients a day= a lot of time on Typhon inputting patients at the end of the day. I now understand how physicians forget patients. In my notes I don't have any patient identifiers (name, record number, etc...), and I dont remember a lot of kids I have seen the past few days based solely on my notes.
3. Standing all day= one exhausted girl!
4. I miss my PA school friends.
Monday, February 11, 2013
Survived Day One
Today was my first day of clinical rotations. I think because I didn't have to move last week and instead went on an awesome vacation I hadn't become really anxious about starting rotations until last night and this morning. As I parked at Sutter Delta Hospital at 7:30 (30 minutes early) I realized this was about to begin. I became overwhelmed with emotions, I maybe teared up a bit, then came the strong desire to vomit. I was texting Michael about this urge and his response was something like this: think about all the things you have accomplished in your life, Texas 4000, Alaska, etc... To which I responded, all these things also made me want to vomit at some point. And his response was: then everything is right in place. This made me realize that wanting to vomit only represented how much clinical rotations means to me. If I care enough about something to be nervous to the point of feeling the need to vomit then I am simply nervous about messing up something I really care about.
My first day was awesome and I didn't vomit! Dr. Mahdavi is warm and welcoming, as is his office staff. He clearly cares about his patients and they care about him. After a morning full of patients Dr. Mahdavi took me for a tour of the hospital and bought me lunch in the cafeteria. Where I saw a classmate who is working with a surgeon in the hospital, he started his day off with a hernia repair. I observed all day, saw 26 patients and had many questions. At the end of each day he would like me to choose a patient that I found particularly interesting and we will discuss in depth. Today we discussed prescribing promethazine as a cough suppressant. I had more questions about migraines, he asked me to wait until tomorrow for that discussion. Tonight I am working on connecting internet so I can start the input process of all the patients I saw today and research migraine headache management in children. Every single patient I see for the next year has to be entered into an online tracking program called Typhon. My goal is to keep up with the load daily so I dont have to spend 8 hours on the weekends catching up.
Things I learned today:
1. A lot of children have asthma and allergic rhinitis
2. Childhood obesity is a problem ( I knew this before today), and like adults most patients are unsuccessful at controlling their intake and exercise in order to lose weight. It is more complicated in children than adults because asking a child to change their diet requires that the entire family make the change as well.
3. Due to the rising levels of childhood obesity, non-alcoholic fatty liver disease (NAFLD) is becoming more common in children ages 8-14, these children may require a liver transplant by the age of 30... the only way to prevent this is lose weight and decrease intake of fatty foods. What are we doing to our kids.
My first day was awesome and I didn't vomit! Dr. Mahdavi is warm and welcoming, as is his office staff. He clearly cares about his patients and they care about him. After a morning full of patients Dr. Mahdavi took me for a tour of the hospital and bought me lunch in the cafeteria. Where I saw a classmate who is working with a surgeon in the hospital, he started his day off with a hernia repair. I observed all day, saw 26 patients and had many questions. At the end of each day he would like me to choose a patient that I found particularly interesting and we will discuss in depth. Today we discussed prescribing promethazine as a cough suppressant. I had more questions about migraines, he asked me to wait until tomorrow for that discussion. Tonight I am working on connecting internet so I can start the input process of all the patients I saw today and research migraine headache management in children. Every single patient I see for the next year has to be entered into an online tracking program called Typhon. My goal is to keep up with the load daily so I dont have to spend 8 hours on the weekends catching up.
Things I learned today:
1. A lot of children have asthma and allergic rhinitis
2. Childhood obesity is a problem ( I knew this before today), and like adults most patients are unsuccessful at controlling their intake and exercise in order to lose weight. It is more complicated in children than adults because asking a child to change their diet requires that the entire family make the change as well.
3. Due to the rising levels of childhood obesity, non-alcoholic fatty liver disease (NAFLD) is becoming more common in children ages 8-14, these children may require a liver transplant by the age of 30... the only way to prevent this is lose weight and decrease intake of fatty foods. What are we doing to our kids.
Wednesday, February 6, 2013
Didactic Year...Check!
Well it is official, pending one exam result I have completed my didactic year of PA school. Yesterday morning I finished my last final, went to lunch with classmates, then after class went out with classmates. I had to say goodbye to all the amazing friends I have made over the past year and a half, I will no longer be spending 40-60 hours a week cooped up in a classroom or study room with my classmates. I am not sure I have processed this yet, but imagine the first week of rotations will bring it into light.
Last night I met with a family about renting a room from them in Brentwood, CA for the last month of my first rotation. Jackie was very welcoming and reminded me a lot of my mom. The commute from their house to the practice in Antioch will only be six miles. However my air mattress sleeping will begin early in my rotation life as the room is not furnished!
Michael sent me this video, absolutely amazing. Hoping my life will be this fluid over the next year.
http://vimeo.com/58291553
Last night I met with a family about renting a room from them in Brentwood, CA for the last month of my first rotation. Jackie was very welcoming and reminded me a lot of my mom. The commute from their house to the practice in Antioch will only be six miles. However my air mattress sleeping will begin early in my rotation life as the room is not furnished!
Michael sent me this video, absolutely amazing. Hoping my life will be this fluid over the next year.
http://vimeo.com/58291553
Sunday, February 3, 2013
The purpose of this blog
The purpose of this blog it to allow you, my friends, family, and mentors to follow me throughout my clinical year. I am unsure what each rotation will bring, but this is where I will tell you about each one. For the next 12 months I will be moving every six weeks to a new city to learn from a new preceptor. Every 12 weeks I will return to Vallejo for end of rotation exams (EOR).
Tomorrow marks one week until I start clinical rotations on February 11. My first rotation will be in Antioch (which is local) working with a pediatrician. Although I won't be moving next week like the majority of my classmates there is still a lot of preparation. I have had to buy a new wardrobe, I can no longer wear jeans daily. I am trying to prepare my body for the huge change that is about to take place. Instead of sitting for 12+ hours a day behind a desk, I will be on my feet seeing patients all day. I am trying to prep all my belongings for the move to a storage unit, but keep it organized so I can access what I need to during call back weeks. In addition I am trying to determine what bare necessities I need to survive while moving around the country.
On Wednesday evening I am leaving for a much needed vacation with two of my best friends. We are headed to Tahoe for my first snow skiing trip ever! I am looking forward to some relaxation time.
As of today this is my schedule for the next year:
Tomorrow marks one week until I start clinical rotations on February 11. My first rotation will be in Antioch (which is local) working with a pediatrician. Although I won't be moving next week like the majority of my classmates there is still a lot of preparation. I have had to buy a new wardrobe, I can no longer wear jeans daily. I am trying to prepare my body for the huge change that is about to take place. Instead of sitting for 12+ hours a day behind a desk, I will be on my feet seeing patients all day. I am trying to prep all my belongings for the move to a storage unit, but keep it organized so I can access what I need to during call back weeks. In addition I am trying to determine what bare necessities I need to survive while moving around the country.
On Wednesday evening I am leaving for a much needed vacation with two of my best friends. We are headed to Tahoe for my first snow skiing trip ever! I am looking forward to some relaxation time.
As of today this is my schedule for the next year:
- Block 1: 2/11-3/22: Antioch, CA: Pediatrics
- Block 2: 3/25-5/3: San Luis Obispo, CA: OBGYN
- Call backs/EOR exams
- Block 3: 5/6-6/14: Boston, MA: Mass General Hospital, Cardiology
- Block 4: 6/7-7/26: Fairfield, CA: Surgery
- Call backs/EOR exams
- Block 5: 8/5-9/13: Las Vegas, NV: Internal medicine/hospitalist
- Block 6: 9/16-10-25: Hoopa, CA: Primary care (on an Indian Reservation)
- Call backs/EORs
- Block 7: 11/4-12/13: Truckee, CA: Emergency Room
- Block 8: 12/16-1/24: Austin, TX: Dr. Fullerton- Physical Medicine and Rehabilitation
- Call backs/EORs
- Public Health Field study
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