Today I saw my first real patient - by myself! I thought it was a run of the mill "follow-up" and it turned out pretty interesting! I tried to be very thorough, and I got to do the physical exam too! At the end, the doc came in and wrapped it all up. She said I can see more patients by myself next week! I am really excited about clinic next week...and a little sad too because it is my last day in clinic for the semester.
Days like today give me reinforcement that I am where God wants me to be. I really enjoy talking with patients, hearing their stories and trying to help. I love working with kids - even though he was so shy, he wouldn't talk to me :-) Medical providers ask some awkward questions like "Are you having any diarrhea or constipation?" What kid wants to tell a stranger about their bowel habits???? BUT it is our job and the information helps us diagnose!
On a positive note, I will get Tuesdays off for the second half of the semester so I can study, sleep, catch up on life...you know, the essentials!
Craziness is around the corner 5 exams in 8 days - I know I will survive and the program won't let me fail out...all very comforting :-)
Tuesday, September 29, 2009
Saturday, September 26, 2009
Vaccinations
So my nephew told my sister that he just got immunized for "munkungacoyta". Well, there may have been some confusion on the name of the vaccine, but I think it reflects an overall confusion about vaccinations. By the way, he meant meningococcal vaccine.
Immunization recommendations are always changing. Recently changes have been made to the tetanus vaccination. Did you know that when you get a tetanus vaccine, it includes diphtheria? When you look at your records, you should see "Td" as the name of your tetanus vaccine every 10 years. In the last few years, they have added a new component to this vaccine - Pertussis (Whooping Cough). It used to be that your last Pertussis vaccination was ~ 10 years old, but there has been a concern about waning immunity so now when you get your tetanus shot, you should be getting a TDaP (Tetanus, Diphtheria, and acellular Pertussis). If you haven't had a tetanus shot in the last 2 years, you might want to ask your doctor about this TDaP vaccine.
Even if you don't fully break out with Pertussis, you could be a carrier to those important children in your life. Infants are particularly susceptible because they haven't been fully vaccinated yet. They don't even get their first shot until they are 2 months old, and it is a 3 series vaccine. Full immunity isn't expected until after the 3rd shot.
For those of you concerned that vaccinations may cause Autism or other developmental problems, there is no evidence that this is true. I have read many studies comparing children who got all the vaccines at once and those who didn't. There is no link. Also, without the vaccines, your children are at extreme risk for major illnesses. Whooping Cough in an infant can turn into serious pneumonia, requiring hospitalization. Meningitis can be deadly. It is important to protect your child from some of these critical illnesses.
If you have older children in school, they can be carriers for diseases, even if they have been vaccinated. I didn't realize that you could bring home illnesses, even if your immune system fought it off. Scary, huh?
No need to be paranoid though. Just get the recommended vaccines.
Immunization recommendations are always changing. Recently changes have been made to the tetanus vaccination. Did you know that when you get a tetanus vaccine, it includes diphtheria? When you look at your records, you should see "Td" as the name of your tetanus vaccine every 10 years. In the last few years, they have added a new component to this vaccine - Pertussis (Whooping Cough). It used to be that your last Pertussis vaccination was ~ 10 years old, but there has been a concern about waning immunity so now when you get your tetanus shot, you should be getting a TDaP (Tetanus, Diphtheria, and acellular Pertussis). If you haven't had a tetanus shot in the last 2 years, you might want to ask your doctor about this TDaP vaccine.
Even if you don't fully break out with Pertussis, you could be a carrier to those important children in your life. Infants are particularly susceptible because they haven't been fully vaccinated yet. They don't even get their first shot until they are 2 months old, and it is a 3 series vaccine. Full immunity isn't expected until after the 3rd shot.
For those of you concerned that vaccinations may cause Autism or other developmental problems, there is no evidence that this is true. I have read many studies comparing children who got all the vaccines at once and those who didn't. There is no link. Also, without the vaccines, your children are at extreme risk for major illnesses. Whooping Cough in an infant can turn into serious pneumonia, requiring hospitalization. Meningitis can be deadly. It is important to protect your child from some of these critical illnesses.
If you have older children in school, they can be carriers for diseases, even if they have been vaccinated. I didn't realize that you could bring home illnesses, even if your immune system fought it off. Scary, huh?
No need to be paranoid though. Just get the recommended vaccines.
Thursday, September 24, 2009
Difference between NP and PA
I have been asked more than once, "What is the difference between a Nurse Practitioner and a Physician Assistant?" I attended a lecture today on the history of the PA profession and the speaker gave a great chart comparing the 2 professions. I thought it would be helpful to share. This picture can be clicked to make it larger and easier to read:
Cool Clinic Tidbits
This week in clinic held a bunch of "firsts" for me. I heard my first heart murmur, first wheeze (lung auscultation), first visual of ambiguous genitalia, first spina bifida patient... If you aren't medically minded you might not realize how cool this is for me.
Someday I will need to identify the abnormal noises and if all you hear is normal, it might be hard to know what the abnormal noise is, when you hear it. Also, I want to work with kids and ambiguous genitalia occurs more frequently than you might think. Spina bifida also occurs frequently enough that I will treat patients with the medical complications from spina bifida.
Spina bifida is a congenital abnormality where the formation of the spine is not complete. It starts flat and then folds closed from the middle out. For these patients, it might connect in the middle but then not close on each end. Repair is not simple, even though it sounds like it might be. Paralysis is common due to damage to the nerves running the length of the spine.
I also learned in clinic this week that hives can signal a VARIETY of problems - including thyroid disease. So, if you ever have unexplained hives and your doctor wants to do a full blood panel on you, it's because it may not be an allergy or anything obvious. Hives CAN be simple but aren't always. The patient we had this week was referred from an Asthma and Allergy clinic.
This is just another example of why medicine is truly a PRACTICE - rarely are symptoms straightforward - but it also makes it fun, as long as you aren't the patient. For the medical provider, it is a puzzle that needs a new angle or some tweaking to figure out. It is also another reason why medical doctors are always learning and they may tell you they haven't heard of that "new study" you just read about. I heard today that medical science is new every 3-5 years. Scary, huh? By the time I graduate, almost everything will be obsolete, but you know what won't change? Patient care. No matter how the sciences change, human interaction and fact gathering is still the same. Treatment options may change but respect and compassion will always be the foundation.
Enough about that.
Sad to say only 2 more weeks in clinic for this semester - it also means the semester is almost half over. Wow!
Someday I will need to identify the abnormal noises and if all you hear is normal, it might be hard to know what the abnormal noise is, when you hear it. Also, I want to work with kids and ambiguous genitalia occurs more frequently than you might think. Spina bifida also occurs frequently enough that I will treat patients with the medical complications from spina bifida.
Spina bifida is a congenital abnormality where the formation of the spine is not complete. It starts flat and then folds closed from the middle out. For these patients, it might connect in the middle but then not close on each end. Repair is not simple, even though it sounds like it might be. Paralysis is common due to damage to the nerves running the length of the spine.
I also learned in clinic this week that hives can signal a VARIETY of problems - including thyroid disease. So, if you ever have unexplained hives and your doctor wants to do a full blood panel on you, it's because it may not be an allergy or anything obvious. Hives CAN be simple but aren't always. The patient we had this week was referred from an Asthma and Allergy clinic.
This is just another example of why medicine is truly a PRACTICE - rarely are symptoms straightforward - but it also makes it fun, as long as you aren't the patient. For the medical provider, it is a puzzle that needs a new angle or some tweaking to figure out. It is also another reason why medical doctors are always learning and they may tell you they haven't heard of that "new study" you just read about. I heard today that medical science is new every 3-5 years. Scary, huh? By the time I graduate, almost everything will be obsolete, but you know what won't change? Patient care. No matter how the sciences change, human interaction and fact gathering is still the same. Treatment options may change but respect and compassion will always be the foundation.
Enough about that.
Sad to say only 2 more weeks in clinic for this semester - it also means the semester is almost half over. Wow!
Friday, September 18, 2009
Week of 1st Exams
So this week existed of 2 first exams - Microbiology and Physiology. Microbiology wasn't too bad. I have been sick this week and wondered if I would hold up long enough to finish studying for both exams. The Micro exam was mostly about Strep and Staph infections. Did you know that the same Strep bug that causes Strep throat can also cause Rheumatic Fever and Scarlet Fever? In clinic on Tuesday, I also learned that both of those illnesses still occur in the US. I never hear about them so I thought they were like the measles or rubella - guess not. :-)
Physiology is very complex. If you ever wanted to know how you can be dehydrated and still have to go to the bathroom, this is the class to take. It is very interesting and, at first, I was having a hard time pulling all the pieces together, but yesterday a lot of the pieces started falling together. The exam was all short answer with a few multiple choice. A note on the multiple choice though - these questions had more than one answer so the questions was really - "circle any of the following options". You can't even narrow down your options with that! :-) The exam was hard but I felt I understood the material. I learned from this test that I need to prepare a little differently for the next exam. Live and learn, right?
Tonight I start playing on an indoor soccer team. I haven't played in YEARS - 4 or so - tonight will be interesting. Thankfully there are enough players to have a couple subs so I won't have to play the whole time. I fully expect to be sore tomorrow and maybe regret the decision to play :-)
Thankful for the weekend - ahhhh.
Physiology is very complex. If you ever wanted to know how you can be dehydrated and still have to go to the bathroom, this is the class to take. It is very interesting and, at first, I was having a hard time pulling all the pieces together, but yesterday a lot of the pieces started falling together. The exam was all short answer with a few multiple choice. A note on the multiple choice though - these questions had more than one answer so the questions was really - "circle any of the following options". You can't even narrow down your options with that! :-) The exam was hard but I felt I understood the material. I learned from this test that I need to prepare a little differently for the next exam. Live and learn, right?
Tonight I start playing on an indoor soccer team. I haven't played in YEARS - 4 or so - tonight will be interesting. Thankfully there are enough players to have a couple subs so I won't have to play the whole time. I fully expect to be sore tomorrow and maybe regret the decision to play :-)
Thankful for the weekend - ahhhh.
Tuesday, September 15, 2009
Interesting Clinic Thoughts
Today was another day of Endocrine clinic and there were a lot of interesting cases today. Yeah, we had a lot of the typical growth hormone cases but today was also the day my preceptor had hospital rounds. We saw 2 patients in the hospital this morning. The first patient is part of a research study. Neonates are screened for a lot of illnesses and genetic markers that predispose them for other illnesses. If an infant tests positive for some of these markers, the parents can choose to enter their child into a research study that monitors those particular levels throughout their lives. This child is currently healthy but because the patient tested positive for some of the indicators for serious illnesses, blood tests are done on a regular basis to catch any problems early on.
The second hospital case of the day was a complex case that started out with a large blood clot and ended up with pneumothorax (air between the lung and the chest wall that inhibits full lung expansion), surgery and a month+ hospital stay. The current tests indicate hormone deficiencies that lead to the blood clot and because it wasn't caught right away, there was a ripple effect causing the other health problems.
During the office clinic, a patient reported that their 2 children regularly get Scarlet Fever and Rheumatic Fever which I thought was interesting. I have a microbiology exam tomorrow and I was just learning about Streptococcus and how the pyogenes species can cause both of those things. I thought they were eliminated a long time ago -like the measles - because I never hear about them, but I now know that isn't true.
I love seeing how my classes parallel with my clinic experiences. It makes the textbook information more interesting and relevant.
The second hospital case of the day was a complex case that started out with a large blood clot and ended up with pneumothorax (air between the lung and the chest wall that inhibits full lung expansion), surgery and a month+ hospital stay. The current tests indicate hormone deficiencies that lead to the blood clot and because it wasn't caught right away, there was a ripple effect causing the other health problems.
During the office clinic, a patient reported that their 2 children regularly get Scarlet Fever and Rheumatic Fever which I thought was interesting. I have a microbiology exam tomorrow and I was just learning about Streptococcus and how the pyogenes species can cause both of those things. I thought they were eliminated a long time ago -like the measles - because I never hear about them, but I now know that isn't true.
I love seeing how my classes parallel with my clinic experiences. It makes the textbook information more interesting and relevant.
Sunday, September 13, 2009
A Realization from the weekend
This weekend I realized that I really need to get away more often and do things non-school related. I studied so hard this summer but didn't give myself enough time to enjoy myself. If I had continued at the same pace from summer, I would well be on my way to burn-out right now. I need to be ok with not getting all A’s and learning the information because I NEED it and not for an exam. It really is a whole new mindset.
God did not make us to consume ourselves with facts and figures. Yes, it is all important for our future patients, but I am confident that I will learn the information in time. It is why we are sent on so many rotations! The 2nd year students have said again and again how much they have forgotten from their first year. You might think, “Then what is the point!?!” I will say I have experienced how much easier it is to learn and remember something after it has been covered once. The 2nd years can now teach themselves (or remind themselves) of what they had been taught in their classes as they use the information in their rotations. I am encouraged to know that I will not be expected to remember 100% of what I am learning the moment I step into rotations :-) The more you use something, the easier it is to hold on to the information for future practice.
This week will be a busy week but I am so thankful for the time I spent with family. I studied too, don't get me wrong! The weekend was all about balance. Friday night was the party. Saturday I saw my 11 year old nephew play flag football (he won, by the way)! I studied for a while, went out to eat with my dad and sister. Then my sister and I got pedicures to celebrate her birthday (which was over a week ago). The rest of the day was dedicated to studying and hanging out with my sister. Today, I went to church, studied in the car and went out for lunch. After lunch, I was at the airport and headed home.
I have been told that airports are good places to study....I will caution you on a couple things. If you are a people-watcher, it is NOT a good place to study, and if you have too many materials, there could be a space problem in being able to handle all the necessary study materials. Thankfully, I was able to secure an isle seat on the plane but there isn't even a lot of room to get a laptop out on a plane (and be able to type on it).
Overall the weekend was awesome! I am so glad I went, but now I need to shift gears to the upcoming week. I really need to be efficient this week!
God did not make us to consume ourselves with facts and figures. Yes, it is all important for our future patients, but I am confident that I will learn the information in time. It is why we are sent on so many rotations! The 2nd year students have said again and again how much they have forgotten from their first year. You might think, “Then what is the point!?!” I will say I have experienced how much easier it is to learn and remember something after it has been covered once. The 2nd years can now teach themselves (or remind themselves) of what they had been taught in their classes as they use the information in their rotations. I am encouraged to know that I will not be expected to remember 100% of what I am learning the moment I step into rotations :-) The more you use something, the easier it is to hold on to the information for future practice.
This week will be a busy week but I am so thankful for the time I spent with family. I studied too, don't get me wrong! The weekend was all about balance. Friday night was the party. Saturday I saw my 11 year old nephew play flag football (he won, by the way)! I studied for a while, went out to eat with my dad and sister. Then my sister and I got pedicures to celebrate her birthday (which was over a week ago). The rest of the day was dedicated to studying and hanging out with my sister. Today, I went to church, studied in the car and went out for lunch. After lunch, I was at the airport and headed home.
I have been told that airports are good places to study....I will caution you on a couple things. If you are a people-watcher, it is NOT a good place to study, and if you have too many materials, there could be a space problem in being able to handle all the necessary study materials. Thankfully, I was able to secure an isle seat on the plane but there isn't even a lot of room to get a laptop out on a plane (and be able to type on it).
Overall the weekend was awesome! I am so glad I went, but now I need to shift gears to the upcoming week. I really need to be efficient this week!
Friday, September 11, 2009
A Weekend Away
This weekend is my brother-in-law's 40th birthday, and he lives in another state. A couple weeks ago I decided to fly out for the surprise party, even though I knew I had 2 tests the following week. Well, here I am in Arizona. The surprise party was a great success, and I even got to hang out with my roommate from undergrad! I also got to see my 3 nephews and niece. They sure are growing fast!
It is fun to see them mature, but I have to say that my current rotation in Endocrinology makes me look at children differently. I am constantly thinking about growth patterns and behavior, wondering if it is age appropriate. I guess this is just the beginning. The more you know about something, the more you want to apply it to the world around you.
Too bad the palate for medicine is every person you meet! It is a good thing too. People are easy to come across and therefore experience is NOT hard to get! On the other hand, it is hard to meet anyone without seeing a mole and thinking, "The shape is symmetrical. The color is good. It doesn't appear abnormal." Or when I went walking with a friend and a woman jogged by. Even my friend commented on the "awkward" gait of the jogger. My immediate thought? She has a problem with her hips and should see someone before she does excessive damage to her joints. :-)
Oh, well. I do enjoy solving puzzles and medicine is just that - a HUGE puzzle. Sometimes you think the pieces go together, and you don't find out for years that the pieces aren't quite right. It is the nature of medicine and science. Our understanding of it is constantly changing. Sometimes it seems disorganized and confused. Patients think doctors aren't giving the best care because of certain methods or medications, but really I think it boils down to the most recent study that doctor agrees with (or knows about). It is really difficult to stay on top of the most recent recommendations, drugs and therapies. Honestly I think most doctors do the best they can, and because medical science is always changing, they may not agree with the most recent research, yet. It is hard to jump on board of EVERY new research study right away. Some people want a little proof first - if I were the patient, I know I would!
Ok, enough of a tangent.
I will squeeze in as much time to study as possible this weekend! I know it will all work out and the tests will come and go, whether I am really ready or not. :-) I will do the best I can!
It is fun to see them mature, but I have to say that my current rotation in Endocrinology makes me look at children differently. I am constantly thinking about growth patterns and behavior, wondering if it is age appropriate. I guess this is just the beginning. The more you know about something, the more you want to apply it to the world around you.
Too bad the palate for medicine is every person you meet! It is a good thing too. People are easy to come across and therefore experience is NOT hard to get! On the other hand, it is hard to meet anyone without seeing a mole and thinking, "The shape is symmetrical. The color is good. It doesn't appear abnormal." Or when I went walking with a friend and a woman jogged by. Even my friend commented on the "awkward" gait of the jogger. My immediate thought? She has a problem with her hips and should see someone before she does excessive damage to her joints. :-)
Oh, well. I do enjoy solving puzzles and medicine is just that - a HUGE puzzle. Sometimes you think the pieces go together, and you don't find out for years that the pieces aren't quite right. It is the nature of medicine and science. Our understanding of it is constantly changing. Sometimes it seems disorganized and confused. Patients think doctors aren't giving the best care because of certain methods or medications, but really I think it boils down to the most recent study that doctor agrees with (or knows about). It is really difficult to stay on top of the most recent recommendations, drugs and therapies. Honestly I think most doctors do the best they can, and because medical science is always changing, they may not agree with the most recent research, yet. It is hard to jump on board of EVERY new research study right away. Some people want a little proof first - if I were the patient, I know I would!
Ok, enough of a tangent.
I will squeeze in as much time to study as possible this weekend! I know it will all work out and the tests will come and go, whether I am really ready or not. :-) I will do the best I can!
Tuesday, September 8, 2009
Clinic Day Cancelled
So I was supposed to be in clinic this week but it was cancelled because my preceptor didn't have any patients scheduled. It is sad because I am losing opportunity for experience BUT I am enjoying an extended Labor Day weekend.
I got a lot of studying done this weekend and have been baking cookies for the christian group on campus. They are having a lunch on campus tomorrow and asked people to bring cookies. I don't get to make cookies very often and it is fun to have a reason to make them. Living alone, it isn't good to make anything sweet without a place to take it. Although, I have found my class welcome recipients to free food :-)
With the few extra hours to study, it is nice to catch up on lost hours of studying from last week. First 2 exams of the semester are next week. Can't fall too far behind!
I got a lot of studying done this weekend and have been baking cookies for the christian group on campus. They are having a lunch on campus tomorrow and asked people to bring cookies. I don't get to make cookies very often and it is fun to have a reason to make them. Living alone, it isn't good to make anything sweet without a place to take it. Although, I have found my class welcome recipients to free food :-)
With the few extra hours to study, it is nice to catch up on lost hours of studying from last week. First 2 exams of the semester are next week. Can't fall too far behind!
Sunday, September 6, 2009
Labor Day Weekend
With the extended weekend, I drove to my parent's house to hang out, study, see friends and go to my home church. It has been a great weekend. I might not have studied as much as I should have but there is still time :-) and that is my goal for this afternoon!
First exams for the semester are around the corner and I really do need to get organized with all of these classes. 8 classes that don't overlap much makes life a little complicated...but it will all work out.
This week my on-campus Bible Study starts, and I have been asked to organize the food for the meetings. Since I have never even attended one of the official meetings yet, it is hard to know what to provide, or how much. I have a call in to another girl in the group for advice. I know you can't please everyone but it would be nice if the majority of the group is happy with the order :-)
I have been told that this group is primarily women and the few men who are brave enough to come. The goal for this semester is to get more guys to come. It would be great to have a more balanced group! The group meets every other week and they try to bring Christian medical professionals to share about how they incorporate their faith into their practice. I think it will be interesting to hear about the different professions these people work in! It feels like it will be forever until I graduate, but it will pass one day at a time.
In undergrad, I remember that first night in the dorm room and thinking, "I have 4 years of this? I will never make it!" But I did and here I am 11 years later in grad school. The time has passed quickly and so will this experience. I will probably feel like I didn't learn ENOUGH and it passed too quickly. Nature of life, right? It all passes so quickly and one day you wake up wondering how you got that old. :-) The only thing we can do is focus on each day as it comes and make the most of every moment. If I keep wishing for the end of the next phase, I will die without ever enjoying the life God has given me. It doesn't mean we can't dream and pray for things we imagine for our future, but we can't live in the future. It may not really come to pass the way we imagine. God is in control of it all, and we need to allow Him to work in our lives in ways we couldn't imagine!
Ok, I guess I got off on a tangent. :-)
Enjoy your Labor Day Weekend!
First exams for the semester are around the corner and I really do need to get organized with all of these classes. 8 classes that don't overlap much makes life a little complicated...but it will all work out.
This week my on-campus Bible Study starts, and I have been asked to organize the food for the meetings. Since I have never even attended one of the official meetings yet, it is hard to know what to provide, or how much. I have a call in to another girl in the group for advice. I know you can't please everyone but it would be nice if the majority of the group is happy with the order :-)
I have been told that this group is primarily women and the few men who are brave enough to come. The goal for this semester is to get more guys to come. It would be great to have a more balanced group! The group meets every other week and they try to bring Christian medical professionals to share about how they incorporate their faith into their practice. I think it will be interesting to hear about the different professions these people work in! It feels like it will be forever until I graduate, but it will pass one day at a time.
In undergrad, I remember that first night in the dorm room and thinking, "I have 4 years of this? I will never make it!" But I did and here I am 11 years later in grad school. The time has passed quickly and so will this experience. I will probably feel like I didn't learn ENOUGH and it passed too quickly. Nature of life, right? It all passes so quickly and one day you wake up wondering how you got that old. :-) The only thing we can do is focus on each day as it comes and make the most of every moment. If I keep wishing for the end of the next phase, I will die without ever enjoying the life God has given me. It doesn't mean we can't dream and pray for things we imagine for our future, but we can't live in the future. It may not really come to pass the way we imagine. God is in control of it all, and we need to allow Him to work in our lives in ways we couldn't imagine!
Ok, I guess I got off on a tangent. :-)
Enjoy your Labor Day Weekend!
Thursday, September 3, 2009
More about Clinic this week
So I saw a patient this week that has Turner Syndrome. If you don't know what that means, I will give a brief description - The average person has 2 gender specifying chromosomes (XX or XY). Sometimes cell division doesn't happen quite the way it should, and you can have a child with XXY or XYY or, in the case of Turner Syndrome, X-. This means that there is a chromosome missing and the child is born as a female, but there are often complications as well. Like a Down Syndrome child, children with Turner Syndrome can have very distinct features: short stature, low-set ears, and a short neck, among other features.
This patient was also mosaic which is interesting from a genetic stand point, and I just learned about it this past spring in my Genetics class. Basically it means that some of your cells test with one set of DNA, and your other cells test with an altered set of DNA.
http://www.turnersyndrome.org/index.php?option=com_content&task=view&id=27&Itemid=123
Because of the short stature, these kinds of cases are often seen in the Endocrine clinic. As these patients grow up, they often have trouble with puberty hormones and will continue seeing an Endocrinologist to be monitored for those hormones as well.
Genetics. We all have our own set of DNA that has made us most of who we are today. The more I learn the more I am truly AMAZED that any of us live past the age of 1...day old. The fact that any of us developed normally and function every day, is truly an act of God. We can see His grace on our lives every day. The fact that our cells continually divide normally and after all our cells have been replaced (this happens regularly!), we still look like we did before. God made our bodies to regenerate themselves without changing our physical appearance...unless you want to count wrinkles :-)
I am also amazed by how basic treatments can off-set major cellular defects in our bodies. For example, Type I Diabetes. These children have little to no insulin production in their bodies and a simple treatment of insulin shots helps them live normal lives. I know the day to day monitoring probably seems complicated and frustrating for those people, but it keeps them ALIVE. Modern medicine can do amazing things.
This patient was also mosaic which is interesting from a genetic stand point, and I just learned about it this past spring in my Genetics class. Basically it means that some of your cells test with one set of DNA, and your other cells test with an altered set of DNA.
http://www.turnersyndrome.org/index.php?option=com_content&task=view&id=27&Itemid=123
Because of the short stature, these kinds of cases are often seen in the Endocrine clinic. As these patients grow up, they often have trouble with puberty hormones and will continue seeing an Endocrinologist to be monitored for those hormones as well.
Genetics. We all have our own set of DNA that has made us most of who we are today. The more I learn the more I am truly AMAZED that any of us live past the age of 1...day old. The fact that any of us developed normally and function every day, is truly an act of God. We can see His grace on our lives every day. The fact that our cells continually divide normally and after all our cells have been replaced (this happens regularly!), we still look like we did before. God made our bodies to regenerate themselves without changing our physical appearance...unless you want to count wrinkles :-)
I am also amazed by how basic treatments can off-set major cellular defects in our bodies. For example, Type I Diabetes. These children have little to no insulin production in their bodies and a simple treatment of insulin shots helps them live normal lives. I know the day to day monitoring probably seems complicated and frustrating for those people, but it keeps them ALIVE. Modern medicine can do amazing things.
Social Activity
Last night the 1st and 2nd year students planned an outing for us all to hang out. Because the 2nd years weren't on campus this summer, we (the 1st years) didn't get to meet many of them. It was a lot of fun to meet and not talk about school...ok, we talked about school A LITTLE but what can I say - It is a HUGE part of our lives right now.
When I applied to PA school, people told me - you won't have a life. You won't have any time to do ANYTHING but study and that really isn't true. I am writing this blog, right? :-) In actuality you make time for the things you find important. People in my class are married with kids or pets. Some live over an hour from school and yes, they commute EVERY DAY...I think they are crazy, but I don't really like to drive in traffic. I avoid it at all costs! But it is proof it can be done. People make life work around the things in their lives that can't budge.
For example, I am a Christian and feel that church attendance is really important. I am also involved in a couple Bible Studies that meet weekly. I feel it is actually time that I NEED away from the grind of studying and school. Over the summer, I needed a break from the Anatomy lab! Now, I just need time away from the monotony. There will always be more to learn, more to study and by the time we graduate, most of what we learned will be inaccurate. Ok, maybe not "most" but there is a large part that will be replaced with the "new research."
I am sure you get tired of reading about the new scientific study that NOW says eggs are good for you, when a few years ago, they told you not to eat them because they could kill you with all that cholesterol! Well, people in the medical field deal with that on a daily basis. Drugs that yesterday were the "best on the market" are now deadly and cause cancer.
What I have learned over time is that when we call something a "science", it means it is always changing because new methods of research are either proving or disproving past discoveries. It is constantly being refined and sometimes flipped upside down. So why do we call something a science when we really mean it is precise...don't we really mean it is a "math"?
Math? Hopefully 1+1 will always equal 2 (unless you are one of those computer geeks who wear teeshirts that try to disprove this) :-) The area of a circle of a particular size will always be just that. Sure, new methods come out for different learning styles, but the answer is still the same!
History? That probably won't change - unless we find hidden artifacts or novels that bring about new facts.
English? Always changing but even "old" communication styles still work - Thou art the most skillful in the land!...see, you understood :-) Sometimes I can't keep up with new lingo like all the chat abbreviations (ttyl, lol, brb - the ones I actually know).
I guess this is why we are told never to stop learning. Nothing is completely static - so why not pick a field where it changes almost every day? You won't have to go out looking for something new to learn, it will come to you! :-)
When I applied to PA school, people told me - you won't have a life. You won't have any time to do ANYTHING but study and that really isn't true. I am writing this blog, right? :-) In actuality you make time for the things you find important. People in my class are married with kids or pets. Some live over an hour from school and yes, they commute EVERY DAY...I think they are crazy, but I don't really like to drive in traffic. I avoid it at all costs! But it is proof it can be done. People make life work around the things in their lives that can't budge.
For example, I am a Christian and feel that church attendance is really important. I am also involved in a couple Bible Studies that meet weekly. I feel it is actually time that I NEED away from the grind of studying and school. Over the summer, I needed a break from the Anatomy lab! Now, I just need time away from the monotony. There will always be more to learn, more to study and by the time we graduate, most of what we learned will be inaccurate. Ok, maybe not "most" but there is a large part that will be replaced with the "new research."
I am sure you get tired of reading about the new scientific study that NOW says eggs are good for you, when a few years ago, they told you not to eat them because they could kill you with all that cholesterol! Well, people in the medical field deal with that on a daily basis. Drugs that yesterday were the "best on the market" are now deadly and cause cancer.
What I have learned over time is that when we call something a "science", it means it is always changing because new methods of research are either proving or disproving past discoveries. It is constantly being refined and sometimes flipped upside down. So why do we call something a science when we really mean it is precise...don't we really mean it is a "math"?
Math? Hopefully 1+1 will always equal 2 (unless you are one of those computer geeks who wear teeshirts that try to disprove this) :-) The area of a circle of a particular size will always be just that. Sure, new methods come out for different learning styles, but the answer is still the same!
History? That probably won't change - unless we find hidden artifacts or novels that bring about new facts.
English? Always changing but even "old" communication styles still work - Thou art the most skillful in the land!...see, you understood :-) Sometimes I can't keep up with new lingo like all the chat abbreviations (ttyl, lol, brb - the ones I actually know).
I guess this is why we are told never to stop learning. Nothing is completely static - so why not pick a field where it changes almost every day? You won't have to go out looking for something new to learn, it will come to you! :-)
Tuesday, September 1, 2009
Clinic - Day 2
Do you ever have one of those moments where you meet a friend of a friend in a seemingly random place? Today I was working in the Endocrine department of the hospital and met a 4th year medical student from my school. We worked together throughout the day. At the end of the day, we headed to a departmental meeting to talk about difficult cases, and I heard this person talking about her travel experiences during a break in medical school. The story sounded familiar so I looked down at her badge and saw her last name....GASP!!!!...this is the sister of a GREAT FRIEND of MY sister...follow that? :-) It is crazy!
To help you realize the enormaty of this in my mind:
My sister met her friend when we lived in CA (we left in 1988), and now her friend lives in Florida. They kept in touch and are still great friends to this day. Such great friends that when the friend's sister got married, my sister flew to Florida to attend the wedding. This wedding happened recently, and the name on the badge is now her maiden name. Anyway, my sister told me to look this person up on campus, but I wasn't sure how to find her! God intervened and placed us in the same rotation at the same time! It was awesome to talk with her - I love when stuff like this happens! It is like walking through a large airport in another state and running into a good friend :-)
Other than that, it was a good day of clinic too. We had some interesting cases of Growth Hormone Deficiency and Turner Syndrome. I am learning a lot about the pathways of how hormones affect different parts of the body. More to come in ISBM this semester.
To help you realize the enormaty of this in my mind:
My sister met her friend when we lived in CA (we left in 1988), and now her friend lives in Florida. They kept in touch and are still great friends to this day. Such great friends that when the friend's sister got married, my sister flew to Florida to attend the wedding. This wedding happened recently, and the name on the badge is now her maiden name. Anyway, my sister told me to look this person up on campus, but I wasn't sure how to find her! God intervened and placed us in the same rotation at the same time! It was awesome to talk with her - I love when stuff like this happens! It is like walking through a large airport in another state and running into a good friend :-)
Other than that, it was a good day of clinic too. We had some interesting cases of Growth Hormone Deficiency and Turner Syndrome. I am learning a lot about the pathways of how hormones affect different parts of the body. More to come in ISBM this semester.
Subscribe to:
Posts (Atom)
