Today: 2 hours
Running Total: 15.5 hours
Today, the office wasn't very busy. When I got there, Dr. Kelly made a phone call to a mother concerned about her 18 year old daughter. She's been having fainting spells in the morning because she gets dizzy after waking up. But apparently it's fairly common to faint in the morning. While we waited for his 4 o'clock, we talked about what I had to read up on for this week, which was Attention Deficit Disorder (ADD), which is a subtype of Attention Deficit Hyperactive Disorder (ADHD). I found an article from the NY Times about a boy who had used a drug that usually treats ADD patients, however he didn't have the disorder and abused the drug instead. It led to his addiction and reliance on the drug and when it was no longer available to him, he hanged himself in his closet. Dr. Kelly questions whether it's an actual disorder, and since the percentage is so high, it's actually "normal" to have ADD. There is a lot of controversy with it and the way people perceive it to actually be.
Dr. Kelly told me how this week, there are a lot of patients with earaches and congestion. There was a patient who had earaches as well as coughing and congestion. There was a lot of pressure in his right ear and water in his left, but no ear infection.
Ear infections could be potentially fatal if not properly treated and could spread throughout the area surrounding the ear. It could get to the point where one whole side of the face could become paralyzed.
Dr. Kelly then explained Huntington's Chorea disease, which is a neurological disease and is distinguished in 30-40 year old people and above with involuntary movement of their limbs and then possibly dementia.
Lastly, a girl came in with hand-foot-mouth disease, with which the name seems so informal that it was hard for me to believe that it's a real infection. A mother was concerned if she can get it from her daughter, and yes she can. It's characterized by a sore throat and rashes on the hands or feet. It's also my next topic to read up on for next week. I'm excited to learn about it, it's quite intriguing.
Wednesday, February 27, 2013
Wednesday, February 20, 2013
Capstone Log 8
Today: 2 hours
Running Total: 13.5 hours
When doctors get sick, who do they go to?! Dr. Kelly has laryngitis, so today he didn't really have any patients. Instead, I tagged along with Dr. Pickering. We saw a nine year old boy who had a nasty cough and a high fever which lasted over the weekend. His symptoms showed that he has the flu, but his breathing said it could have been pneumonia. He took a chest x-ray and Dr. Pickering allowed me to see the images, front and side view. They showed that he had a lot of mucus and congestion, but definitely no pneumonia. The doctors were thinking it could be bronchitis, but nobody can really tell just by looking at x-rays.
Dr. Kelly then had a patient, a little boy who was about one. He's had a cough for the past 2 months already and uses a flow vent for when he's wheezing. Fortunately for the child, he hasn't been wheezing since the end of January, but unfortunately for me, I wasn't able to use the stethoscope to listen to a child that wheezes and compare to normal breathing. But we're glad he's healthy.
Dr. Kelly then allowed me to go with him into a prenatal with a soon-to-be-parents couple. A prenatal is basically a visit with the parents before the birth of their child in order for the parents to ask questions and get familiar with the pediatricians and actually establish a pediatrician for the new child instead of having one assigned. They asked questions about diapers, sunlight, and bringing the child out into crowded places. It was interesting to hear about what you are supposed to do and what you're not supposed to do with a new born baby.
After the prenatal, Dr. Kelly talked to me about rotavirus, which by the way, has an amazing vaccination that works stupendously. He talked to me about how rotavirus causes extreme diarrhea and it causes intussusception, which is when part of the small intestine gets pushed and invaginated into the large intestine. It causes tremendous pain and the part that gets stuck will die, causing the rest of the small intestine to die and then causing death. Most children get rotavirus several times during childhood which builds their immune system, so adults almost never get it.
For next week, I have to read about attention deficit disorder (ADD). It really is an interesting topic, seeing as how I know many people who have it.
Running Total: 13.5 hours
When doctors get sick, who do they go to?! Dr. Kelly has laryngitis, so today he didn't really have any patients. Instead, I tagged along with Dr. Pickering. We saw a nine year old boy who had a nasty cough and a high fever which lasted over the weekend. His symptoms showed that he has the flu, but his breathing said it could have been pneumonia. He took a chest x-ray and Dr. Pickering allowed me to see the images, front and side view. They showed that he had a lot of mucus and congestion, but definitely no pneumonia. The doctors were thinking it could be bronchitis, but nobody can really tell just by looking at x-rays.
Dr. Kelly then had a patient, a little boy who was about one. He's had a cough for the past 2 months already and uses a flow vent for when he's wheezing. Fortunately for the child, he hasn't been wheezing since the end of January, but unfortunately for me, I wasn't able to use the stethoscope to listen to a child that wheezes and compare to normal breathing. But we're glad he's healthy.
Dr. Kelly then allowed me to go with him into a prenatal with a soon-to-be-parents couple. A prenatal is basically a visit with the parents before the birth of their child in order for the parents to ask questions and get familiar with the pediatricians and actually establish a pediatrician for the new child instead of having one assigned. They asked questions about diapers, sunlight, and bringing the child out into crowded places. It was interesting to hear about what you are supposed to do and what you're not supposed to do with a new born baby.
After the prenatal, Dr. Kelly talked to me about rotavirus, which by the way, has an amazing vaccination that works stupendously. He talked to me about how rotavirus causes extreme diarrhea and it causes intussusception, which is when part of the small intestine gets pushed and invaginated into the large intestine. It causes tremendous pain and the part that gets stuck will die, causing the rest of the small intestine to die and then causing death. Most children get rotavirus several times during childhood which builds their immune system, so adults almost never get it.
For next week, I have to read about attention deficit disorder (ADD). It really is an interesting topic, seeing as how I know many people who have it.
Wednesday, February 13, 2013
Capstone Log 7
Today: 2 hours
Running Total: 11.5 hours
Sometimes I hear the doctors talking to patients about the most bizarre things. But today was normal. When I came in, Dr. Pickering was on the phone and asked if someone was sensitive to butter. But her tone was very unconvincing. Made me laugh.
Dr. Kelly was phoning patients when I arrived; he spoke about how parents often worry about green stool in their newborn (which is absolutely normal) and eating habits (which could mean a small sore throat or simply no hunger). First-time parents are usually the most skeptical and always have, in the doctors' eyes, some silly questions.
I went in with Dr. Kelly for a physical with a 10 year old boy who still occasionally wets the bed at night, which isn't too common at his age, but not very rare either. He explained to me about a special hormone called antidiuretic released by the pituitary which is not released when you're dehydrated, therefore you don't urinate. I asked if this boys pituitary didn't release any, but he said no. Which confused me a bit, because then there's no real reason why he still wets the bed. But he's taking medication to supply antidiuretic so that it doesn't happen anymore.
We then saw a boy who came in with a sore throat, cough, and high fever. Once he said there was a cough, then we knew it couldn't be streptococcus because cough doesn't come with it, but we tested it anyways. After Dr. Kelly took the swabs, he allowed me to do the actual "lab test" to determine whether the strep was positive or negative. Gina helped me and it was pretty simple. I like performing the little tests with the tubes and the special enzyme drops and everything.
After I was done doing the test we met with a 7 year old girl who has asthma. She had a physical but we discussed her drug intake. She takes a liquid every morning for heartburn and then uses the inhaler twice a day in the morning and at night for her wheezing. She fortunately is not on steroids Dr. Kelly and I were talking about how oral steroids especially in children, can ruin bones and joints and cause several other problems. He told me a story of a lady who was in her 40's but had to get both hips replaced because her doctor prescribed her oral steroids and only those.
We talked a bit about how doctors rarely ever use the brand names for drugs, such as Tylenol, Advil, Pediacare, etc. He believes that parents should know the ingredients and know the real uses of each drug instead of giving their child Tylenol for a runny nose. Acetaminophen, ibuprofen, sudafed; these should all be in the parents' vocabulary and they should be aware of their uses.
For next week I have to learn about rotavirus, which I know absolutely nothing about. So it should be an interesting topic for me to read on.
Running Total: 11.5 hours
Sometimes I hear the doctors talking to patients about the most bizarre things. But today was normal. When I came in, Dr. Pickering was on the phone and asked if someone was sensitive to butter. But her tone was very unconvincing. Made me laugh.
Dr. Kelly was phoning patients when I arrived; he spoke about how parents often worry about green stool in their newborn (which is absolutely normal) and eating habits (which could mean a small sore throat or simply no hunger). First-time parents are usually the most skeptical and always have, in the doctors' eyes, some silly questions.
I went in with Dr. Kelly for a physical with a 10 year old boy who still occasionally wets the bed at night, which isn't too common at his age, but not very rare either. He explained to me about a special hormone called antidiuretic released by the pituitary which is not released when you're dehydrated, therefore you don't urinate. I asked if this boys pituitary didn't release any, but he said no. Which confused me a bit, because then there's no real reason why he still wets the bed. But he's taking medication to supply antidiuretic so that it doesn't happen anymore.
We then saw a boy who came in with a sore throat, cough, and high fever. Once he said there was a cough, then we knew it couldn't be streptococcus because cough doesn't come with it, but we tested it anyways. After Dr. Kelly took the swabs, he allowed me to do the actual "lab test" to determine whether the strep was positive or negative. Gina helped me and it was pretty simple. I like performing the little tests with the tubes and the special enzyme drops and everything.
After I was done doing the test we met with a 7 year old girl who has asthma. She had a physical but we discussed her drug intake. She takes a liquid every morning for heartburn and then uses the inhaler twice a day in the morning and at night for her wheezing. She fortunately is not on steroids Dr. Kelly and I were talking about how oral steroids especially in children, can ruin bones and joints and cause several other problems. He told me a story of a lady who was in her 40's but had to get both hips replaced because her doctor prescribed her oral steroids and only those.
We talked a bit about how doctors rarely ever use the brand names for drugs, such as Tylenol, Advil, Pediacare, etc. He believes that parents should know the ingredients and know the real uses of each drug instead of giving their child Tylenol for a runny nose. Acetaminophen, ibuprofen, sudafed; these should all be in the parents' vocabulary and they should be aware of their uses.
For next week I have to learn about rotavirus, which I know absolutely nothing about. So it should be an interesting topic for me to read on.
Wednesday, February 6, 2013
Capstone Log 6
Today: 3 hours
Running Total: 9.5 hours
When I got to the office, Dr. Kelly was already in with a patient, so Gina asked me to hang out for a while. When he was done, he told me about how an 18 month-old boy had a case of speech delay and he barely spoke, which by his age, could mean Autism. But he believes it's not Autism, and simply just a speech delay. Everybody grows at their own pace.
We then met with a little boy named Mason who had a high fever of 104.5 as well as wheezing. The parents said to have gone to the clinic the night before where Mason was diagnosed with an ear infection in both ears and was given amoxicillin. However, Dr. Kelly checked and found nothing. And with his better and more experienced judgment, told them to stop the antibiotics because Mason was okay.
Dr. Kelly allowed me to use the stethoscope several times today to listen to the lungs of a child who was wheezing before and a child who was healthy with normal lungs at that moment. There was a big difference between the two, as for the child who was wheezing had longer exhales. But it was very cool to listen through the stethoscope. I want to buy my own.
It was great to be able to connect everything from today with what I learned about asthma from last week. The parents of Mason were concerned with asthma, which wheezing could be a symptom of. In my study, I learned that antibiotics (eg. amoxicillin) in early life can result in a higher chance of getting asthma when you're a bit older. There's no specific reason why, but it could do with the fact that you don't properly build up your immune system. Dr. Kelly explained to me how asthma happens, with the bronchioles and how air needs to be pushed out because of the inflammation, which is why people wheeze.
Dr. Kelly then talked with a patient who had shingles and explained to me how it's like chicken pox. They only come back in certain spots and in the same spot every time, which has to do with dermatomes, which I plan to read up on my own just for my own personal advantage.
He then talked a bit about Occupational Therapy, which he thinks is absolutely pointless. If a child doesn't like to, for example, get dirty, someone will suggest OT. It doesn't mean there's a problem if a child doesn't like something, it could just be part of their personality. However, an occupational therapist will always find something to diagnose, which Dr. Kelly doesn't agree on or enforce.
Richard III has an interesting story about scoliosis and I plan to read up on that as well.
For next week, I have to study on childhood leukemia. Like the book My Sister's Keeper. Can't wait to broaden my knowledge on the matter, considering that my family has a history of cancer.
Running Total: 9.5 hours
When I got to the office, Dr. Kelly was already in with a patient, so Gina asked me to hang out for a while. When he was done, he told me about how an 18 month-old boy had a case of speech delay and he barely spoke, which by his age, could mean Autism. But he believes it's not Autism, and simply just a speech delay. Everybody grows at their own pace.
We then met with a little boy named Mason who had a high fever of 104.5 as well as wheezing. The parents said to have gone to the clinic the night before where Mason was diagnosed with an ear infection in both ears and was given amoxicillin. However, Dr. Kelly checked and found nothing. And with his better and more experienced judgment, told them to stop the antibiotics because Mason was okay.
Dr. Kelly allowed me to use the stethoscope several times today to listen to the lungs of a child who was wheezing before and a child who was healthy with normal lungs at that moment. There was a big difference between the two, as for the child who was wheezing had longer exhales. But it was very cool to listen through the stethoscope. I want to buy my own.
It was great to be able to connect everything from today with what I learned about asthma from last week. The parents of Mason were concerned with asthma, which wheezing could be a symptom of. In my study, I learned that antibiotics (eg. amoxicillin) in early life can result in a higher chance of getting asthma when you're a bit older. There's no specific reason why, but it could do with the fact that you don't properly build up your immune system. Dr. Kelly explained to me how asthma happens, with the bronchioles and how air needs to be pushed out because of the inflammation, which is why people wheeze.
Dr. Kelly then talked with a patient who had shingles and explained to me how it's like chicken pox. They only come back in certain spots and in the same spot every time, which has to do with dermatomes, which I plan to read up on my own just for my own personal advantage.
He then talked a bit about Occupational Therapy, which he thinks is absolutely pointless. If a child doesn't like to, for example, get dirty, someone will suggest OT. It doesn't mean there's a problem if a child doesn't like something, it could just be part of their personality. However, an occupational therapist will always find something to diagnose, which Dr. Kelly doesn't agree on or enforce.
Richard III has an interesting story about scoliosis and I plan to read up on that as well.
For next week, I have to study on childhood leukemia. Like the book My Sister's Keeper. Can't wait to broaden my knowledge on the matter, considering that my family has a history of cancer.
Wednesday, January 30, 2013
Capstone Log 5
Today: 2.5 hours
Running Total: 6.5 hours
Tiring, tiring day indeed. But in the end it's all worth it and I absolutely love going to the office and learning new things and seeing the children. When I arrived, Dr. Kelly and I discussed the milestones I read about for last weeks homework. We talked about the development a bit and how children constantly mimic and learn from everything that's around them. He described how neurological development starts at the very top and works its way down. When infants are brought into this world, they use only their eyes to look around, then they slowly start turning their heads, and then their torsos. They discover their hands and fingers, their belly-buttons and their feet and toes, then they crawl and walk and then run. However, they later on become aware of their genital parts, which is why they start to potty-train at an older age instead.
After our small discussion, we saw a girl who was sick; wheezing with stomach aches and headaches and a temperature of 102.7 degrees, which is relatively high body temperature. After the regular process, Dr. Kelly told me to look at the bottom of her eyelids, which showed a red/pinkish color, different than normal. That color indicated that she did indeed have a viral infection, most likely the flu. Interesting to see how simple symptoms, like discolored eyelids, can pose as signs of an infection.
After seeing the girl, Dr. Pickering had a question about a boy with reoccurring hip pains. They did tests however, and it showed that nothing was wrong. Dr. Kelly said he was normal and it was fine, no signs of inflammation. What he did explain to me however, was that children usually get muscle pains here and there or maybe a painful infection. It then goes away. But when a small pain comes back within the same vicinity of the previous ache or pain, then they perceive it to be the same thing that was there before, so it's half psychological that they feel that way. They can scream in agony, claiming that something hurts, but in reality, it's perfectly healthy. Their past experiences heighten their sense to feel what it was before, when it's really nothing at all. (I also think it's an attention-grabbing technique), but I'll still spot some sympathy.
I met another adorable little boy(similar to last week) who is allergic to amoxicillin, but that doesn't matter because he gave me a flying kiss when he left. However, Dr. Kelly did say that although people may be allergic to a specific medicine, they'll still prescribe it if it's absolutely necessary, which concerns me a bit. Wouldn't that only make things worse? But I trust the Ph.D.
A boy later came in with a wart on his knee. I was given the joy of sitting in the room as Dr. Kelly shaved the wart with a scalpel and then froze it with liquid nitrogen. Dirty work in the office, but somebody has to do the job.
After that, we met with two boys whose growth charts were compromised. It showed that they completely stopped growing and were actually shrinking. And the way it was shown is supposed to say that they were losing weight as well as not growing any taller, which is impossible unless there is a serious condition they have. But they were both perfectly normal, just a bit rowdy. Goes to show that nobody is perfect, and somebody messed up the growth chart from a previous checkup.
To end the day, Dr. Kelly told me a story of a very inspirational woman who, with her team, discovered the ultrasound technique to produce images. Amazing lady.
For next week, I have to read up asthma and everything about it. Please excuse the length of this post, I got slightly carried away.
Running Total: 6.5 hours
Tiring, tiring day indeed. But in the end it's all worth it and I absolutely love going to the office and learning new things and seeing the children. When I arrived, Dr. Kelly and I discussed the milestones I read about for last weeks homework. We talked about the development a bit and how children constantly mimic and learn from everything that's around them. He described how neurological development starts at the very top and works its way down. When infants are brought into this world, they use only their eyes to look around, then they slowly start turning their heads, and then their torsos. They discover their hands and fingers, their belly-buttons and their feet and toes, then they crawl and walk and then run. However, they later on become aware of their genital parts, which is why they start to potty-train at an older age instead.
After our small discussion, we saw a girl who was sick; wheezing with stomach aches and headaches and a temperature of 102.7 degrees, which is relatively high body temperature. After the regular process, Dr. Kelly told me to look at the bottom of her eyelids, which showed a red/pinkish color, different than normal. That color indicated that she did indeed have a viral infection, most likely the flu. Interesting to see how simple symptoms, like discolored eyelids, can pose as signs of an infection.
After seeing the girl, Dr. Pickering had a question about a boy with reoccurring hip pains. They did tests however, and it showed that nothing was wrong. Dr. Kelly said he was normal and it was fine, no signs of inflammation. What he did explain to me however, was that children usually get muscle pains here and there or maybe a painful infection. It then goes away. But when a small pain comes back within the same vicinity of the previous ache or pain, then they perceive it to be the same thing that was there before, so it's half psychological that they feel that way. They can scream in agony, claiming that something hurts, but in reality, it's perfectly healthy. Their past experiences heighten their sense to feel what it was before, when it's really nothing at all. (I also think it's an attention-grabbing technique), but I'll still spot some sympathy.
I met another adorable little boy(similar to last week) who is allergic to amoxicillin, but that doesn't matter because he gave me a flying kiss when he left. However, Dr. Kelly did say that although people may be allergic to a specific medicine, they'll still prescribe it if it's absolutely necessary, which concerns me a bit. Wouldn't that only make things worse? But I trust the Ph.D.
A boy later came in with a wart on his knee. I was given the joy of sitting in the room as Dr. Kelly shaved the wart with a scalpel and then froze it with liquid nitrogen. Dirty work in the office, but somebody has to do the job.
After that, we met with two boys whose growth charts were compromised. It showed that they completely stopped growing and were actually shrinking. And the way it was shown is supposed to say that they were losing weight as well as not growing any taller, which is impossible unless there is a serious condition they have. But they were both perfectly normal, just a bit rowdy. Goes to show that nobody is perfect, and somebody messed up the growth chart from a previous checkup.
To end the day, Dr. Kelly told me a story of a very inspirational woman who, with her team, discovered the ultrasound technique to produce images. Amazing lady.
For next week, I have to read up asthma and everything about it. Please excuse the length of this post, I got slightly carried away.
Wednesday, January 23, 2013
Capstone Log 4
Today: 2 hours
Running Total: 4 hours
Great day in kiddie land. When I got there, Dr. Kelly and I talked a bit about influenza and the different types. He then had a physical with a 16 year old male so I wasn't allowed to go, but instead I went with Dr. Pickering because she had a patient with headaches in the back of her head, which isn't too common. Reminds me when I used to get terrible migraines and had to take an x-ray because they couldn't figure out what was wrong. I never really did know what was wrong. No mass growing in the little girl though! Just some bad fever headaches. She was happy that the ER did the MRI already and that the girl was able to sit through the whole process. Dr. Pickering also talked with me a little bit about influenza, which is actually a very interesting topic and a lot more serious than people perceive it to be.
I went with Dr. Kelly to see his next patient which was a 15 month old little boy named Quin and let me just say that he was absolutely adorable. He was sick last week but is getting better now and he's healthy and he's so cute and I want to steal him.
We then saw a little boy who fell on his arm a couple days ago, and it's been hurting so they took an x-ray and he unfortunately fractured his wrist :/ I felt so bad for him because when Dr. Kelly touched it and bent his arm a certain way then he started crying and screaming because it hurt so much. And I know how he feels too because I broke my arm in 6th grade.
To close the day Dr. Kelly talked about the different things doctors look for in exams - in both toddlers and adolescents, and certain milestones they expect at certain ages. He lent me a book called "What To Expect The First Year" and told me to read some of it. I'll try to really get in depth with knowing those milestones and know what doctors actually look for when physicals are performed.
I was going down the elevator and a lady saw me holding that book and gave me a dirty look. I hope she didn't think I was pregnant or anything.
Running Total: 4 hours
Great day in kiddie land. When I got there, Dr. Kelly and I talked a bit about influenza and the different types. He then had a physical with a 16 year old male so I wasn't allowed to go, but instead I went with Dr. Pickering because she had a patient with headaches in the back of her head, which isn't too common. Reminds me when I used to get terrible migraines and had to take an x-ray because they couldn't figure out what was wrong. I never really did know what was wrong. No mass growing in the little girl though! Just some bad fever headaches. She was happy that the ER did the MRI already and that the girl was able to sit through the whole process. Dr. Pickering also talked with me a little bit about influenza, which is actually a very interesting topic and a lot more serious than people perceive it to be.
I went with Dr. Kelly to see his next patient which was a 15 month old little boy named Quin and let me just say that he was absolutely adorable. He was sick last week but is getting better now and he's healthy and he's so cute and I want to steal him.
We then saw a little boy who fell on his arm a couple days ago, and it's been hurting so they took an x-ray and he unfortunately fractured his wrist :/ I felt so bad for him because when Dr. Kelly touched it and bent his arm a certain way then he started crying and screaming because it hurt so much. And I know how he feels too because I broke my arm in 6th grade.
To close the day Dr. Kelly talked about the different things doctors look for in exams - in both toddlers and adolescents, and certain milestones they expect at certain ages. He lent me a book called "What To Expect The First Year" and told me to read some of it. I'll try to really get in depth with knowing those milestones and know what doctors actually look for when physicals are performed.
I was going down the elevator and a lady saw me holding that book and gave me a dirty look. I hope she didn't think I was pregnant or anything.
Wednesday, January 16, 2013
Capstone Log 3
Today: 2 hours
Running Total: 2 hours
First day on the job(shadow)! I actually learned a lot more than I expected for the first day and it was a very hands-on experience. Pediatricians have quite the busy schedule, so I jumped right in and we were running back and forth for the most part. I was allowed to see patients with him and observe the things that the children came in for, ranging from stomach aches to burned fingers to superficial staph infections and so much more. I did small errands for the doctor and I worked with a nurse for a bit. I was able to behold and partake in the evaluation of a urine test and a strep throat test, both of which are easily conducted. A boy with phimosis was prescribed a steroid antibiotic and a few children were given flu shots and whooping cough shots. Several parents called stating their child has a fever with such-and-such symptoms, which I learned, helps to evaluate whether the fever will go away soon, or whether there is an infection. It was very interesting to see what happens behind closed doors. Since it's flu season, my mentor requests that I read up a bit on influenza to broaden my knowledge about it and we can talk in depth next week.
Hope I don't get sick.
Subscribe to:
Posts (Atom)