Time Flies

I can't believe this week went so fast! Even though my days are long with a very long commute they seem to go by so fast. I am seeing lots of patients solo which is such a relief. I'm in no way ready to be on my own in the real world, but at least I seem to be able to squeeze the important things out of pts even if I have beat them with my stethoscope - no I don't really do that. I get so caught up in the questioning that a couple times I forgot to do a physical exam - what a dweeb cheese I am! I feel like such an idiot when this happens, but hey, I'm on a learning curve. I have lots of things I need to review and remember. I have a hard time with Pharmacology and ordering and interpreting labs. (guess I should not have crammed pharm the night before all year long - oops). This week I heard a couple murmurs, did a pap and breast exam all by me onesy (and even found pathology!), I am also starting to see more complex patients. What's even better is most of the patients I have seen this week I will see again! The doc I am working with seems to thank me for my help - which I find a little odd. He gets really behind on his paperwork and uses my notes to dictate on patients which is fine. Maybe I find it odd since in my last rotation when I was the Bandaid/Xray retriever I never was thanked or told I was doing well. I hear this a lot now which is a nice offset to before - even though it's not necessarily warranted.
I am so grateful Shawn has been encouraging me through all of this. He told me to hang in there during the last 6wks and reminded me I chose the right path going to PA school, now I am finally able to say that too!

The end of an Error

I had a little extra bounce in my step last week. I finished my first rotation (or error for a crappy preceptor). This would have been enough for me to be excited, but even more so, the end of my ortho surgery rotation means time to move on to a preceptor who actually cares about students and doesn't find women inferior (I hope). I have to admit, this rotation wasn't all bad, like the whole 5th week when my doc was out of town, I spent 3 days in OB and got to assist with a couple C-sections (pretty darn sweet!) and do lots of measuring of pregnant bellies and listening to little heart beats, I also got to go with two other ortho's saw some Hip replacements (6 in one day to be exact), a knee replacement, lots of knee scopes and a ORIF of a distal radius fracture (open the wrist to put in a plate to hold the end of one of the forearm bones together with plate and screws). I even got to see a PA actually do something in the OR - like suture and be an integral part of the team, not just another person in the OR. And another great thing about my ortho rotation, there was a pizza party in my honor the last day, not to mention many business lunches at nice restaurants. So see there were some positives that came from this rotation - even if the doc made me visibly cry during one of the last surgeries I assisted with (so much in fact my face shield fogged over and was collecting tears like a reservoir), I think he even mentioned something about me "not cutting it" and how "ortho may not be for you because you have to have physical strength and know how to do what I tell you to." So after writing a candid email to the clinical team, I moved on to Internal Medicine.

I had thought internal medicine would be my arch nemesis, and it may turn out to be just that - but I'm not stuck in a hospital but in a very low key, slow paced clinic with a first time precepting doc. Yesterday was my first day, kind of a short day with only 4 patients since i had to go to a mandatory computer training for software that won't be up and running until my last week in the clinic. Hmmm... But anyway, even though there were only 4, they were a great 4 - including an exam entirely in Spanish and a well baby visit. Today I got to see a pt in the hospital post liver and kidney transplant, AND... a couple patients by MYSELF; a pt with dizziness and a new pt establishing with a new PCP. I may have been long in my exams, and I may have missed a few questions, but I went in all by myself! yay! I also got to do the exams of more complex patients. It was a great start and a much better rotation so far!

More change

We were going to have steak tonight and watch the Cubbies play (who couldn't extend their streak to 10 in a row), but as Shawn opened our yummy steaks a fly flew out of the package - ewww!! Just another reason not to eat red meat - even organic meat. So we will be eating BBQ chicken instead.

Today I saw a cool surgery - an ACL reconstruction with an autograft. So the pt had a torn ACL and meniscus, so the surgery started out like a scope, then the anterior (front) of the knee was cut open very carefully, and then the middle third of the patellar tendon was harvested with a small chunk of tibia on one end and a little piece of patella on the other. The graft is manipulated and drilled for the suture in each end while the drill holes are made in the tibia and femur. A guide wire technique is used to thread the graft into place to form the new ACL and then is anchored in with screws. Here's two links to give a better idea: http://www.nytimes.com/slideshow/2007/08/01/health/100230Anteriorcruciateligamentrepairseries_index.html
http://www.emedx.com/video/VideoPages/ACL%20Surgery.htm (video)

I found out today that one of my rotations has already changed. I was suppose to be in TX for 3 months for back to back rotations and now I will be in TX then ID. IDAHO??! So bummed as I am since I practically had all the logistics settled for being in TX for 3mo then KS for 3mo, I am trying to look at the bright side of things. I will only be 61/2 hours from Shawn so I can see him every other weekend instead of only once or twice in TX. This will also be good for the doggies. So, that being said, I am bummed b/c I have heard that the rotation I would have had in TX was awesome, and now I have to rethink logistics but I will be closer to home, so yay! Hopefully none of my other rotations will flip flop on me.