The Mrs. The Mommy. The M.D.: August 2012
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Sunday, August 26, 2012

65 Roses...

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This. rotation. is. kicking. my. butt.

It's not that I can't handle the work load, because that has been fine. But the 10+ hour days & coming in on the weekends have been tough to get used to. I miss my son. I miss home. I miss getting at least 7 hours of sleep...

And I started this post with every intention to complain, but after putting the little one to bed and reveling in the sweetness of a three year old asleep in my arms, I was reminded that despite a rough couple of weeks, I have nothing to complain about. Absolutely nothing.

I have met some great kids and families during my rotation thus far. Being at such an educational and research-based center, many families from all over the country are referred to Riley Children's Hospital when they need some of the most cutting edge treatments. Pulmonary is no different. After dealing with asthma throughout my own childhood, the lungs were always interesting to me... And over the last three weeks I have gotten A TON of exposure to the inpatient & outpatient management of asthma. But I have also gotten experience with some not-so-common pulmonary diseases as well. One in particular is cystic fibrosis.

Cystic fibrosis or "65 Roses" (what the littlest patients who cannot pronounce it call it) is a disease in which patients are born with a defective gene that ultimately effects how mucus is produced and then cleared from their body. The two organs most affected are the lungs and the pancreas. This makes CF patients more susceptible to lung infections (because the thicker-than-usual mucus gets stuck in the airways trapping harmful bacteria) and malnutrition (because the mucus clogs the ducts that supply the intestines with all the enzymes needed to digest food).

Although we have come a long was in treating the disease, there is still no cure. In 2009, the median lifespan for CF patients was mid-thirties. You can learn more about CF and how you can get involved here: The Cystic Fibrosis Foundation.

Clinicals has put faces and names to some of the rare diseases we were taught over the last two years and CF is no different. It changes how you think about the illness. You think about the kids who have to stay in the hospital for weeks at a time for a "tune up", as we call it on the wards, where they get some of the strongest IV antibiotics available to get rid of all the bacteria eating away at their lungs. Or the teens who have had to grow up faster than most and know more about their disease treatment than you. Kids who have reached the age of realizing the real implications of what it means to have CF and the subsequent depression this may cause. And the not-so-pediatric patients who still come to the Children's Hospital because with such a shortened lifespan, most adult docs aren't equipped to handle their long term management. Or the overwhelmed parents who are figuring out what this means for their brand new baby...

It's overwhelming just thinking about. As a med student I feel so insignificant at times and I have no idea what to say or do. Especially when I meet a family who has such a great load to bear.

One thing I do know is that God put us all here to help one another. But in order to do so, we must take our focus off of "ourselves/our lives/our mess/our needs/etc/etc..." so we can see what our neighbor may need.  I'm so happy that I was reminded of this so early in third year, and as I continue on, I intend to not lose sight of it.  And I hope you all do the same ;-)

Tuesday, August 7, 2012

Reflecting on My Clerkship Experience: Family Medicine

Before I get too far into Peds, I want to make sure I record everything I thought about Family Medicine (and all other rotations in the future): 

From the AAMC Careers in Medicine Clinical Evaluation 

1. Name and Location of Clinical Rotation:
Family Medicine, Saint Francis Hospital, Greenwood, Indiana

2. What did I like most about this specialty? 
  • The diversity of the patient population: infants, children, middle age, geriatrics, male, female...etc. 
  • The hours: mainly 9AM-5PM - my preceptor is a wife and mother of 3 and she made balancing it all look easy!
  • The OB component - got to observe two deliveries and lots of exciting pre-natal visits
  • The variety of diagnoses - with each unique patient population comes different common complaints
  • The amount of procedures performed and hands on requirement - biopsies, cryotherapy, varicose vein removal, etc. 
  • The long-term patient relationship and familial dynamic of the patient-doctor interaction
  • Being the coordinator of care for a patient with multiple specialist and being concerned with preventative care/total wellness
3. What did I like least about this specialty?

4. Did this clinical rotation give me a good sense of what practice in this specialty would be like? 
Yes, I think that I got a great sense of the variety within Family Medicine.

5. Did my interests, values, skills and/or personality "fit" with this specialty? If yes, in what way did they "fit"? If no, why might they not be compatible? 
YES, not only is family medicine a way to allow me to pursue a variety of my MANY interests, but it would give me the time with my family that I definitely want, a lot of avenues to pursue interests like my desire to serve local youth outreach, medical/wellness writing, and public health. 

6. What are the possible practice settings for specialists in this field? Which of these settings interest me(*) and do I know enough about them? 
  • Clinic*
  • Community Hospital - Inpatient, OB*, ER shifts
  • Academic* 
To gain more exposure to more clinical settings, I can do a Family Medicine externship or an away rotation during fourth year. 

7. What information do I still need to find out about this specialty? 

  • How one's practice may vary between a more urban or rural setting. 
  • Loan forgiveness programs available for family medicine residents.
8. Has my perception of this specialty changed based on my clinical rotation experience? 
Definitely, I was very intimidated by the idea of having to be well trained in handling so many different conditions, but family medicine is very big on the patient-doctor partnership and finding the best treatment for the patient's lifestyle. I also, respect the fact that when my preceptor felt that a condition may be out of her scope of expertise, she had no problem referring out to a particular specialist. 

9. Did my clinical rotation experience influence the likelihood of choosing a career in this specialty? If yes, how did it influence me? YES!!! I really had not considered Family Medicine at all prior to my rotation and now it is definitely a BIG possibility. 

10. Right now, on a scale of 1-10, how interested am I in this specialty as a career option? 9!!!

11. Other comments or reflections about this rotation or specialty: 
I enjoyed every day of this rotation :-) 

Wednesday, August 1, 2012

After 25 Years...

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Today is my 25th birthday!! YAY!!! A whole quarter century...

I feel so blessed because every year of my life gets better than the year before. As my 25th bday was approaching, I thought about the biggest lessons that 25 years has taught me. Some of these may sound cliche, but they have been life lessons for me none-the-less and it's my birthday, so you have to read them ;-)

Ok, here goes:

15. There is always, ALWAYS something to be thankful for.

14. Me time is CRUCIAL. Sometimes it's good to just sit and think.

13. "Pray like it depends on God, but work like it depends on you."

12. Don't miss out on life stressing about the day to day hustle...If you are a student like me, have a huge long term project at work, or working towards a goal, don't forget that life is still going on and take the time to enjoy it!

11. True love (familial, friendship, marriage) requires WORK. People are messy and no one is perfect, not even you. Forgive and love. Then repeat.

10. Dream big. Then dream bigger. And when you think you have gone as far as you can go, try and go a little bit further because you can.

9. Choose your friends wisely. You only need a few. Note: You can tell who your real friends are by those who are happy for you when you succeed. (I'm so fortunate to have some awesome friends!)

8. Every stumbling block does not have to be a crisis. Prepare a plan B as best you can and then leave it in God's hands. Pastor Ramsey told us that "Jesus was God's plan B when things fell through with Adam" < MESSAGE. So don't stay discouraged when things don't go as planned!

7. Be honest about what you want, no one will ever know what you need if you don't speak up.

6. Know your worth. Because when it is all said and done, no one will preserve it but you.

5. It takes a lifetime to establish your integrity and character but only takes a minute to compromise it so make good choices!

4. Words have power. Use them to build yourself and those close to you up.

3. Don't apologize for who you are, stick to your principles, and allow people to love an authentic you.

2. Pour yourself into helping others - in big ways or small. It will take your mind off of you and you will realize that you have so much to be thankful for.

1. God has no limits. Try Him. You will see.


I look forward to learning so much more :-)

I'll be in clinic today, but I plan on celebrating (i.e. eating cake) all weekend!

Have a great day everyone!
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