Groggy and half way interested in a dream, I woke this morning to JD putting on his socks at the end of the bed and for some insane reason decided to jump out of bed to make him a Denver omlet for breakfast. I had about 4 hours of sleep, unlike my usual 9 - 12 hours, but woke a hungry hippo again. Unfortunately within 2 minutes of eating my deliciously cheesy omlet, I watched it plummet down the drain, hardly digested. Oh bother - I hit "3rd trimester" and get morning sickness again! The worse news - the petechiae is much more noticeable than the results of the 8 or 10weeks of first trimester vomiting. Although I knew the multitudes of non-blanching red dots around my eyes, mouth, and under my chin came from the emense vomiting I was doing (a strong Valsalva maneuver!), I still ran through the differential diagnosis - do I have a platelet deficiency, ITP/TTP, anemia, liver/kidney problem, etc? Haha, I can just hear my attending saying, "No silly medical student, the pretest probability isn't high enough to warrant further testing at this point."
Of course, after emptying my entire stomach plus more (a second episode of just gastric juices), I had woken the kicking monster in my tummy. Falling back to sleep wasn't easy with him punching the bed! Ugh, I hope this doesn't become a daily thing again! Perhaps I just need more sleep...
Currently, I am working in the Doernbecher Pediatric Emergency Department. It's fun, but tough! I don't remember as much Peds as I had hoped (last rotation in Peds was July '09). For my 4 night shifts thus far (6pm - 2am/4am Thurs - Sun), I've already picked up on some lessons I had forgotten.
1. Kids are resilient with an amazing ability to recover.
2. Babies who we thought were going to surgery or the ICU because they were so lethargic, jaundice, or inconsolable can bounce back in 2 hours after rehydration with IV fluids.
3. Little ones with cancer are strong, much like their involved parents.
4. Taking an accurate history from a 10 year-old can be quite the challenge! I suppose vague pain of any type is difficulty to describe when its the first time you experience it.
5. Trauma in this population is always sad, as is watching their teary-eyed parents. You can't protect them from everything.
6. In the ED, think first of the worst diagnoses, rule them out, then consider the most likely.
7. Don't leave the lawnmower out unattended - your son might lose a toe.
8. Don't play fetch with the dog and a stick when you're toddler is near - he might lose his eye.
9. Trust a parent's intuition about their child.
Well, this may be a short post as I need to prep for tonight's shift as well as do a little review with my standardized patient (JD) for my up-coming Step 2 CS exam. Slightly scared but excited to get this >$1000 test over with (not counting the hotel and airfare cost to Houston, TX)!
P.S. Had 3 visitors yesterday that wanted to come in and explore/find a snack. Luckily, a neighbor yelled to get my attention while doing dishes to warn me to close my open front door! When I approached, they stopped, appearing scared, and backed down the steps just enough for me to close the screen door. Once closed though, the 3 raccoons made no hesitation as they roamed around the porch exploring, peering into the house with their paws on the screen door for about 5 minutes!
1 comment:
I totally understand the "parents can't protect your child from everything" cases. I get those a lot in Juvenile court and parent's always trying to bail their kids out, when really, the kids need to bear the consequences of their mistakes. Not quite the sick child/helpless parent scenario... but dealing with kids (and momma bird) is entirely different than dealing with just adults.
Sounds like with all that kicking, little Tyrone is going to be quite the athlete. Keep up the hard work with studying and work! It'll pay off. :)
PS:
I should mention that I'm scared of raccoons. I had one chase me down when I went to school up in Bellingham.
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