Wednesday, June 27, 2012

Wake me up before you go go

Hello readers! 

First and foremost, I would like to say thank you for all of the positive feedback! I've never written a blog, let alone thought I was a good writer, so beginning this experience was a little bit intimidating for me. I'm glad that you're all enjoying my posts and I hope that you're learning something! By the time I got home from the office yesterday, I was pretty beat so I'm a little behind on posting. Today was really awesome so be on the lookout for that post tomorrow night!

Waking up yesterday morning was incredibly difficult. It was one of those days when your alarm keeps going off and you hit snooze time and time again however, you don't really know how long your snooze lasts. This causes confusion when you do wake up in your half drunken state because your clock says 7:28AM rather then 7:15AM for the time you set it. Iphone... you are a bizarre and wonderful creature. Several snoozes later, I finally read that it was 7:37AM. Panic set in because I registered that I had to be out the door by 7:45AM. So what did I do? What every person in this situation does... You pull a Loonette from the "Big Comfy Couch" and do a personal hygiene version of the 10 SECOND TIDY! I was in the car by 7:47AM. Not too shabby.... 

The reason that I was in such a panic was because we had a patient (Patient 15) who was coming in for an 8:30AM appointment and had to be at work on time. As much as I love seeing patients.... this was one that I would have rather not seen. I understand fully that I am a woman and that I have the anatomy of a woman however, that does not mean I need to see the... ahem... anatomy of another woman. Patient 15 was coming in for a pap smear. I learned after the last time I came to visit Dr. Zook that I definitely did not want to be an OBGYN because we had to treat a female patient who had chlamydia. (Shameless public service announcement.... PRACTICE SAFE SEX! If you want to be scared into doing it.... google image it. It's not pretty). 

Anyway, for those of you who don't know (most likely men potentially reading this blog), during a pap smear the patient has to remove her lower garments and a speculum is placed within the vaginal wall. At this time, a cotton swab (similar to an abnormally long one ended Q-tip) is inserted into the cervix (the lower part of the uterus) and swabbed for cells. This is then sent off to the lab to check for abnormalities. Not that this patient had anything particularly wrong with her genitals, I just would prefer to not have had to look at it. 

One patient that I found particularly interesting was Patient 10. This patient was a female in her mid forties with severe COPD. COPD stands for chronic obstructive pulmonary disease and refers to a group of lung diseases that make it difficult to breathe by blocking airways when trying to exhale. Most COPD is caused by long term smoking. Smoking is extremely prevalent in Kentucky. There are very few patients that, when I walk into an exam room, do not floor me with the smell of tobacco. This particular patient had a severe breathing episode the previous weekend and was hospitalized. She had to be supervised and put on oxygen during her stay. This patient also already had an at home oxygen system. She also suffers from degenerative disc disease between her fourth and fifth lumbar vertebrae. This basically means that as she has aged, there is weakness in the spinal disc (a soft compressible discs that acts as a shock absorber for the vertebrae) which can lead to breakdown. Because of this, she has some pinched nerves which causes a neuropathy in the medial and lateral sides of her left hand. 

Patient 13 was an eleven year old coming in for her 6th grade physical. She received four vaccinations. The first vaccination was TDAP or Tetanus-Diphtheria-Pertussis. This vaccination protects against the previously stated diseases. Tetanus or lockjaw causes painful muscle spasms and stiffness all over the body. It kills one in five people who are infected and makes it so the patient cannot open his or her mouth or swallow. Diphtheria can cause a thick membrane to cover the back of the throat and lead to breathing problems, paralysis, heart failure and death. Pertussis or whooping cough causes severe coughing spells which can lead to difficultly breathing, vomiting, and disturbed sleep. Seeing as none of these sound particularly like a party, I suggest that you get your child vaccinated. The second vaccine was the meningococcal vaccine. Meningococcal disease is a bacterial illness and is the leading cause of bacterial meningitis in children 2-18 years of age. Meningitis is a bacterial infection of the meninges or coverings of the brain. The third vaccine was the Varicella or "Chicken Pox" vaccine and this is just an update of the one that is administered when the child is an infant. The fourth vaccine is the Gardasil or HPV vaccine. This vaccine prevents HPV or  human papillomavirus as well as cervical cancer. Recent studies have shown it also protects against certain anal cancers and throat cancers as well. Both males and females are encouraged to get it before participating in sexual activity. 

Have you ever seen shows like "My Strange Addiction" where people eat chalk or other things that are not supposed to be eaten? This is a condition called PICA. It is usually present in small children or pregnant women and is due to low iron levels in the blood or anemia so they crave the metal in other substances. Patient 17 was a seven year old girl who has an obsession with putting things in her mouth. Her mother stated that she would come home and find her child hiding in a corner putting lotion in her hands and eating it off her hands. The day before, this child swallowed a penny. Fortunately, it did not block her airways and we are waiting to see if it is going to block the pyloric sphincter between the stomach and the duodenum (small intestine). If it doesn't it will pass in the stool and end up being a good story. Dr. Zook sent the child to have blood work to check for anemia because of the possibility that she would have PICA. If so, there is a possibility to eliminate some of her problems. 

 Sorry for the long winded post. I forgot how much happened yesterday! I will be posting about today, my day off, tomorrow and am very excited to tell you all about it. 

Until next time,
~Wacko Jacko~ 

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