I'm not a clotter

Today I had the day off because my preceptor had some board review thing he had to go to...so instead I slept in, then wandered into my own doctor's office to get some good news:
I do not have prothrombin gene deficiency G20210A.
You see, this is good news because both my mom, sister and maternal uncle have this genetic mutation that makes them susceptible to clots, and therefore more predisposed to deep vein thromboses (and as a result, pulmonary embolisms). My mom has already had a PE...which is how we found out this happy little mutation runs in our family. But, enough about that, because today I learned that I'm safe. Phew.
Moving on....

As a shout out to Curtis, I'm going to give yesterday's patients a "theme"...and it is:
"Grossest pelvic exams ever."
As you can imagine, that is all the detail I'm going to go into.

My preceptor was really helpful yesterday while we were at the family practice at Kaiser. He was totally not letting me get away with anything and was pushing me to be faster, but in a nice, "this is to help you" kind of way. It is helpful to have a bit of a fire under my ass because I felt like I had kind of stalled in my learning over the last few months. I mean, I know I'm still learning a ton, but I guess I'm getting frustrated about how much I still DON'T know! I don't feel like I am almost halfway though my rotations...but I am, and that scares the bejesus out of me.

Perhaps I need to be spending a little bit of time at home studying (I fell off that wagon during rotation 2).

Jen

Still Alive

Well, apparently I have a lot less free time than I used to during my surgical rotation because my number of blog posts has decreased significantly.

Today was all urgent care, and after a disaster of a day yesterday (nothing like going to do a pelvic exam and realizing that there is no lubricant on your mayo stand...I think the nurse set me up for failure), today was a bit of redemption.

I saw 6 patients in total:
1) 21 yr old women with severe abdominal pain that warranted a CT to rule out appendicitis...turned out to be constipation.
2) 10 year old boy who fell on his back off some playground equipment. Correctly diagnosed that it was probably just a thoracic spine contusion, but my preceptor wanted an x-ray to r/o a fracture, which I had been too hesitant to order (I thought he was being a bit dramatic, as kids will do). X-ray was normal though, so that was good.
3) 70 year old male with upper respiratory infection. Easy as pie.
4) 29 year old female with anxiety disorder complaining of bumps on her tongue. Turns out she is on Lamictal (for her bipolar disorder) and has been warned over and over about Stevens Johnson type reactions, and she had read too much stuff on the internet. She had a super duper mild glossitis (tongue irritation) that was due to a viral URI she was having. I reassured her like a pro. A+.
5) 16 year old male with recurrent strep throat...always a confidence builder when a little 10 dollar test gives you the diagnosis.
6) 33 year old female complaining of a lump on her lady parts. I had no idea what it was. Plus, I couldn't work the damn table. I failed that appointment, but didn't beat myself up over it, so that in itself is progress.

That is all for now. Things are generally going well, but I've lost a little bit of confidence because the HIV stuff is quite complicated and difficult, and I haven't made much progress in conducting patient appointments on my own. Family practice is awesome though, and I'm getting better at urgent care.

I'm getting excited about Coeur d'Alene as I have my housing all set up, and I'm going to be shopping for snow tires and winter wear soon! I'm looking forward to spending some time in a new setting and even though I'll miss CJ, I'm feeling pretty positive about it.

Then again...ask me the day before I have to leave.

Jen

Earning My Wings

I will keep this short...so short, in fact, that I'm going to use bullet-points:

• I really dig my new rotation. I spend 1/2 my time at the HIV clinic at the health dept. and 1/2 my time doing fam practice/urgent care at Kaiser. I really enjoy both, but actually think I enjoy the kaiser work the best---shocking, really.

• My new schedule requires an hour-plus commute which means I'm leaving the house at 6:40am and not getting home until 6 or 7pm. I'm f-ing exhausted.

• My preceptor threw me into a few appointments by myself the last few days and I apparently did ok, because he is giving me a lot more freedom lately. It is actually taking me a little while to get back into the routine of MEDICINE after suffering the intolerable stupidity that is surgery, but I'm getting there...

• Gay men are officially the best patients ever. This is a large portion of the patients I see at the HIV clinic and they are almost all so happy to let me practice on them, even when it involves poking and prodding in uncomfortable places. I could not be more grateful.

• My preceptor is pretty much fantastic. His co-workers are pretty darn fantastic too. I couldn't ask for more.

• Did I mention that I'm tired? I've taken up a daily coffee habit.......I held off for so long, but now must have my daily tall, 2 pump sugar-free vanilla, extra-room americano. If only I still worked at Starbucks.....

I love you all. I especially love keeping up with everyone's blogs, even if I don't always have the energy to write in my own. Keep on keepin' on!!

Jen