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.