Pediatric Clinicals

I HATE pediatric medicine.

Personal Change Project

In December I learned that we would have a personal change project for the Spring Semester. I thought a lot about it. I thought about finishing my pilot's license (a goal I fear that I will never accomplish), but then I found out that it had to be health related - so that was out. I thought about a lot of things that I could change or do differently to improve my overall health, and believe me, the list is long. So I thought about the thing I think about most often - exercise, after all, my B.S. degree is in Physical Education. My exercise habits have had incredible peaks and troughs. My senior year in college I ran cross country and ran anywhere from 3 to 10 miles a day. I was in the best shape of my life. I then went on a 2 year stint in which I exercised rarely if at all. I then found myself in training for a leg of a triathlon and got back to running around 4 miles a day; I was in fairly good shape at the time. Then I went on another 2 year stint in which I have exercised rarely if at all.

So I have to have a personal change project that positively impacts my health. So I focused on running. I've been reading books to improve motivation and running techniques. I've thought about other habits that discourage my desire to exercise and rearranged my schedule or pattern of routines in order to align myself with a more positive outcome and decrease the prevalence of my barriers.

I had to submit my proposal this week for my change project. The change project has to be measurable, so then I have to think what health factor do I want to measure - heart rate, blood pressure, weight? So I decided on stress. I found a great rubric to measure my stress and I am going to cross reference it with my exercise habits and evaluate the effectiveness of exercise on my stress level.

Looking at things from the perspective of stress has rearranged my thinking a lot about the whole project. I had initially been solely thinking about exercise and all that encompasses, but focusing on stress makes so much more sense now. I am doing other things in conjunction with the project to evaluate my stress level. It has truly been interesting and I look forward to the end results.I've been running for three weeks now. It is getting some easier, but I'm still really out of shape. It hasn't helped that the temp's been in the 30's or that it was spitting sleet while I was running today. But I do feel better, my rubric is already indicating the positive effect that exericse is having on my stress level.

Learning to control my stress will become an incredibly important tool in the following months. I had a meeting with my advisor yesterday and we talked about a great deal of stuff. I have a lot of concerns regarding the 2nd year of the program and I needed some perspective. There are ~15 different specialties. I have chose acute care, which, incidently, is the most intense program. I asked about the course of the 2nd year and all that it involves. I asked how the intensity of the 2nd year compared to the intensity of the current 1st year and she replied that there was no comparison. She said that the fall semester will require dedicated studying at least 6 out of 7 nights a week and that I should basically plan on not having any type of social life (which fortunately will not upset my current state of affairs). As ironic as it may sound, my discussion with my advisor provided me with some clarity and decreased the extreame amount of worry and fear I have over next year (not that I don't still have an extreme amount of worry and fear).

Tomorrow begins my 3rd week of pediatric clinicals.

Another way to hold your breath til your blue in the face.

So, the first day of class we talked about the physiological changes that an infant experiences right after birth. On the second day of class we talked about suicide. So we start with birth and go directly to suicide, how's that for consistency? Yesterday we talked about schizophrenia and psychosis. And today we talked about conception and fetal development. The funny thing is this is all the same class. We are going for one extreme to another.

The lectures have all been very interesting, but I have especially enjoyed the fetal development/birth lectures. A lot of stories were relayed and I thought that I would share a funny one.

The story was told of a pregnant woman who was placed on bed rest. It seems that at 20 weeks gestation, the baby (a.k.a. the fetus), begins to make purposeful movements. This includes sucking the thumb, holding hands, or even playing with the umbilical cord. One such infant found that he really enjoyed playing with his umbilical cord, he in fact, loved to squeeze it. So, he would grasp hold of the thing and squeeze and squeeze. Now for those who don't know, the umbilical cord is the blood and oxygen supply to the baby and, consequently, when your blood and oxygen supply is cut off, one usually passes out, much like holding your breath. So this baby enjoyed playing with and squeezing his umbilical cord to the point that he would pass out. Luckily, when he passed out, he would let go and the blood and oxygen supply would rush back to his little body. They knew that this was occurring because they would watch it happen on the ultrasound - over and over again. So, the mother was forced into bed rest in order to protect her baby when he continuously passed out. At birth, the baby was found to have no difficulties, abnormalities, or mental deficits. There was however, a long line of health care professionals waiting their turn to spank the baby, the mother, of course, was first in line.

VP Shunts and Sunsets

Today did not go as I had expected. Today was my first day of pediatric clinicals. Yesterday I was in orientation all day and then spent the evening researching my pt for today. After all that research I only got to spend about 3 minutes with my pt - maybe. I suppose it wasn't all that great of a loss though, since my pt only had a UTI.

I didn't get to spend any time with my pt today because I got put on another pts case right after I got on the floor and ended up in surgery all day. I observed the placement of a VP shunt - so essentially I was in brain surgery all morning. It was really incredible. I think the reality of the situation really hit home when I saw the pt's skull shavings fall to the ground like saw dust as the surgeon drilled a hole in the pt's skull. It was quite amazing. The story is so much more than skull shavings though. I was with the pt 1.5 hours before, the 1.5 hours of, and the 1.5 hours after the surgery.

It's amazing the things we are able to do and the people we are able to help. It's amazing to see the underside of someones skull. It's amazing to think how amazing and beautiful God is. We often go in search of beauty - chasing sunsets, visiting museums, planting flowers, etc. But the truth is, there is so much beauty inside of us. Watching the skull shavings fall to the floor today, I couldn't help but think about bones - their strength, their ability to grow and constantly regenerate (bones are an organ and though they are hard they are constantly changing); I was in awe of the physical manifestation of calcium - the end result of milk. I watched the pts blood and thought about the different cells that comprise it and the power that lies within them - the white blood cells and their fighting power, the red blood cells and their life giving ability, the platelets and their life maintaining function. I watched the hair fall to the ground as it was shaved from the pts head and was amazed at the tiny detail that God designed to keep us clean and enhance our bodies. I watched the lungs fight for breath as they tried to overtake the intubation tube and the power they forced on the pts heaving chest. I followed the pt to the recovery room and listened to the monitor beep incessantly, mimicking the ever beating heart and acknowledged the power that resides within each of us.

I suppose much of life is about perspective, though. The amazingly beautiful and powerful human body would have been before me whether I had stayed with the pt with the UTI or followed the pt to surgery, but it took me seeing a pts brain to acknowledge it.

Maybe we are all guilty of chasing sunsets......but then again, they are amazingly beautiful too.

Back to School

Well, today I was back at school. The break flew by, but that was mostly because I worked so much. I would have liked one more week off, but if I'd had another week off I would have worked, so I suppose in all reality it doesn't matter.

I had three classes today. We actually got to change classrooms, so I don't have to sit in the same seat all day, although I can't really figure out why they made all 129 (minus those who have dropped out) of us move to the room next door, but it was nice to have a change of scenery. My first class today was part 2 of a class that started last semester. It meets on both Monday and Tuesday mornings. It's interesting, very fast pace and exhaustive, but I enjoy it. The second class was okay, not sure what it's all about yet. My third class is all about change and ironically I am very excited by this. I first learned about it at the end of last semester and, in truth, I have thought a lot about it over break. The class focuses on how to encourage our patients to make a change in their life. Of course the best way to learn is to do, so we have to make a change in our lives this semester and then discuss it an the end of the semester. Essentially they want you to focus on something that will make you healthier - physically, emotionally, spiritually, socially, etc. Like I said, I have thought a lot about this and I have already come up with ~4 ideas (I'm sure there are hundreds of things that I can do to improve my overall health/self). I still have some more thinking on this before I decide what I want to do for sure.

Wednesday I start clinicals at Vanderbilt's Children's Hospital. I have never worked with children in a clinical setting before. On one hand I'm really excited about it, on the other I'm not so much. I hope my ped this week is just in with a broken leg or something simple like that. It's kind of funny, students in the medical field always want their pts to be really sick because they learn so much from them. I love having people with horrible problems (as horrible as that sounds). But I don't feel that way this time. It should be a very interesting 4 weeks. I hate that this it going to end up being my shortest rotation.

2008

Can you believe that it is 2008? I can't. Life often feels surreal and feels like it is happening to me rather than something that I am experiencing.

I went on a road trip to Ohio for the New Year. A friend and I went to visit another friend of ours who recently got married. We had a lot of fun just hanging out and talking, watching a stupid movie (Flicka), shopping, going to church, and watching a lot of football. It was good to spend time with good friends and bring in the New Year.

I also got to see an incredible exhibit that I have wanted to see for a couple of years. It is called "Bodies" and it is an artistic display of actual human bodies that are cut and preserved in order to show the amazing organization of our bodies. I enjoyed it immensely. There was everything you could want or imagine to see except for a cross section of the liver, the eye ball, and the heart. But I've dissected a heart and an eye ball, so all I really wanted to see was the liver. It may sound incredibly disgusting to a lot of people, but it was truly amazing and awesome (awesome in the true meaning of the word and not in the ninja turtle meaning of the word). I felt so blessed to have been able to view such an interesting exhibition.

As 2007 has come to an end, I can't help but reflect on the events of the past year. Where I was January 2007 and where I am January 2008 are totally different places. I have been blessed with a new niece and nephew - two truly amazing human beings who provide so much hope and excitement for my future. I find myself practically unemployed and back in school, something that deep down I knew I would do, but am still surprised by. I also realized that 2007 is the first year, of my entire life, that I did not, at least one day, sojourn to Oklahoma - and now my life has a recorded year without my being there. I had 2 very close friends move away. I went to 2 new and very exciting places. So many other things have come to pass that will forever define 2007 for me. This leads me to thoughts of the New Year and the opportunity for new beginnings. This causes me to ponder my goals and plans for 2008.

The future holds so much hope and excitement. We found out we are having another girl today. This will give me 4 babies. I am so blessed.