Pediatrics: Snotty Nose, Pee, Poop, and Cuteness Overload

Well, I am officially at the half way mark of my fourth rotation and in Pediatrics in rural Washington State. It has been fantastic in everyway.
First off, in stark contrast to my break-neck surgical rotation, this rotation has been hectic- but time-capped day's of 9-5 clinic, with some occassional Night Clinic (Urgent Care) and Hospital NICU check-ups thrown in for good measure. I've seriously had a BLAST and have had some great stories to tell of course, for which I apologize for not updating the blog sooner.
The best part of my job most definitely has to be the bebes! At this rotation, I've been able to go to the NICU and check in on newborn premies... I get to do the 1 week, 2 weeks, 1 month, 2 month... etc... well child check ups... and I tell ya, NOTHING is better for the soul than talking nonsense to a chubbie little baby for 15 minutes 10 times a day. That 17-year old brat in for acne medication, the demanding parent with their 4-year-old and a 1 day history of runny nose, the 7 year old that screams bloody murder because you're looking into his ears... all that stress goes away when you enter a room with a cute little baby that you get to play with for 15 minutes and then give it back before to the parent to take care of for the rest of the peep/poop/cry/ don't-put-me-down rest of the day. It's the best of both worlds! Exposure... without COMMITMENT! ;)
The kids are REALLY funny too. It's funny to see the differences in development and maturity (both mental and physical) in the kids even of the same age, from one to the next. Some kids are super outgoing and you barely get "Hello, I'm..." out before they're telling you all about how they get to be at the doctor to day, and they get a sticker if they're good, and if they get shots its ok because it only hurts for a minute and they protect you, and this is the book I have at school... lol And other kids burst into tears and cling onto their parents the second you look at them... Obviously, I relate a lot better to the former type of children :)
Some of my favorite quotes so far have been:
- "Some times when you do to the doctor they have to check your butt"
- "You smell pretty." (6 year old when I was looking in her ears...)
- "Are you a bodybuilder?" a Mom after I explained her sons pertusis treatment plan in detail and asked if she had any questions.
I've also had to get used to how things are done a lot differently in Ped's vs. my Family Practice. I was glad that I had Family Practice first before coming into Pediatrics, because I thought I'd see a lot of the same conditions - and I do- but there are noteable differences in practice. Among them:
1) No gloves... really ever... apparently they scare the kids, more than blood born pathogens scare the doctors.
2) You check the genitals of the babies without gloves
3) You can't remove in-grown toe nails, but you can give them IV's?
4) Instead of a can of pressurized nitro for wart removal, you dip a q-tip in a laddle of actual steaming boiling liquid nitrogen, a la Harry Potter, and place it on the kids foot as they screammmmmmmmmmmmmmmmmmm as loud as possible, kick you in the face, and 5 nurses are needed to hold down a 40-lbs patient. The wart removals are by far the most traumatic thing that goes on here
5) The patients agree to anything for the price of a Dora / Spiderman sticker.
6) Circumsions are done at 2 WEEKS... so far, this has been the most traumatic thing for ME in medicine.
Being rural medicine in the northwest, means that I also have a LOT of Spanish-only speaking families. I so wish I had my Blair Bear here to translate for me. I've had to get by with cherades and my broken spanish with a french accent.
And more so than Family Medicine, the volume of hyper-reactive hyperchondriac (parents) is out of control. "So nausea, vomiting and fevers? How long has this been going on?" response : "since lunch time..." (at a 2pm appointment)... well, you're kids sick... viral. What do you want me to do??? I also see a LOTTTTT of "runny nose / cough" as the cheif complaint on the chart. And these parents are SOOOOO concerned. For a RUNNY NOSE! You have GOT to be kidding me... I realize that in my up-bringing, only arterial bleeding, or loss of consciousness would have mandated a trip to the doctor - and sometimes not even then - so MAYBE I have a skewed view of things, but still... Runny Nose??? He's 5... What do you expect? Bring him back in 10 years if its still a problem.Uggg
Anywho. The Clinic itself is great! The walls are elaborately decorated with all these magical, fantasty murals, fairies, dinosaurs, wizards... A grand-mother of one of our main families donated her time to do them all. Even the hallways are done, there's not a square inch of white paint in the whole place. I will try to take pics one day after clinic to show you all just how cool this looks.
My preceptor is also, a huge part of what makes the clinic so awesome. She graduated from the same program as me at Pacific- about 10 years ago. She is knows her stuff and doesn't put up with any crap - from the patients or the parents - and they love her for it. I learn something from her everyday! She's amazing. How I keep lucking out with these fabulous rotations and even more fabouls people to work FOR but I can only hope they keep comin'! Each rotation is better than the next!
Stay tuned for more... and with a sooner interval between posts this time... I promise :)
XOXO
Mego