A little song in commemoration of my move into one of the "crappier" jobs in medicine...
Scrubs - The Complete First Season
Sunday, August 1, 2010
Check The Poo!!!!
A little song in commemoration of my move into one of the "crappier" jobs in medicine...
Scrubs - The Complete First Season
Looking Back
Wow, I thought the end of a rotation would be relaxing, but really I'm feeling pretty stressed and cramped for time, there is just so much stuff to do before the next one...I've got a lot to do in a day or so (a day I will be post-call in). Maybe this end of the rotation stuff would be easier if I had my weekend like the other two interns, but that's the way things go sometimes. My wife and I also have the additional stressor of trying to move into a house at the same time, it's like doing 80 things at once...I feel like a plate juggler...I can't imagine what my wife feels like.
SO I thought I would do a quick recap on the babies I have here and end there stories, while I have a break...hope you are not looking for too much closure.
There's the little kid that has medical necrotizing entercolitis. He has been NPO (nothing by mouth) for the better part of 2 weeks now. We keep getting him better, trial feeding him, and going back to square one, with him having bloody stools and abdominal distention/pain. It's all very frustrating, I can't even imagine what the parents are going through. I go by and update them every morning and night before I leave. At first it was nice to answer all of their questions and put their minds at ease, but now as we go into week 2 of the same stuff, I feel useless...we are doing everything for this kid at the moment...currently though everything we are doing isn't really good enough...not for him and not for the parents anyway. When he stabilizes we'll get an imaging study and figure out if he really IS having this NEC or it is something else...it doesn't exactly present like NEC so I wish I could find out the results of that study before I leave...which leads me to my biggest frustration....I'm leaving... I won't find out what happens to him, he could miraculously get better the day I leave...or he could get way worse, only the new residents will know. The best I can do is ask one of the interns later on how he did, but I doubt they will remember. I was really hoping he would pull through this one, he might still, but I'll be left in the dark on this one.
The other child I talked about more than once was a little babe an oxygen requirement that kept increasing. I honestly had no idea why, we tried heart echo's, liver echo's, diuretics, ect ect ect...but nothing worked. We finally opted to feed her lots of protein, calories, and iron. Giving her iron would bulster her hemoglobin in the red blood cells making it easier for her to breath. Giving the extra protein was for increasing her albumin stores (a protein responsible for keeping your body water in your vessels...instead of your lungs). We put her on this little "treatment" and within two weeks she was peeing off a lot of her excess fluid and requiring much less oxygen. She even ended up feeding without the use of a naso-gastric tube (tube down the nose to the stomach) which I still can't believe. It's been really cool to see her slowly change into a baby that can go home and, for the most part, survive without any real medical treatments. Yes, she will go home on a small amount of oxygen but with the way she is improving it is likely she won't be needing it in a couple of weeks. It's really crazy that all those fancy tests and treatments we did for her and really all we needed to do was prescribe a little time and a lot of food. She's the bright spot of my NICU experience.
Besides that I have several other kids that are in the middle. None of them came here really sick at all, we are either just watching them to make sure they are not infected...or we are watching them to make sure they can eat and grow without our assistance. They will all likely go home without event.
If I had to name one moment that really stood out for me in my experience on the NICU, it would have to be that first night of call. When I was in it, I was really excited and scared...but looking back now at how un-experienced I was that first night...I really should have been much more of both. I find myself getting a little sad about leaving it behind, I've made some good friends here and I've gotten really comfortable with it...at the same time, I find it harder and harder to get up on the days I'm on call, I sometimes fumble up my thinking during those long nights for no reason (which isn't normally like me), and I come home and just feel like doing nothing (although that is sadly not an option most days)...I can say "I'm fine" all I want, but I can tell I need a break. I wish I could say that at the end of this rotation I'm A OK, but with life stacked on top of this decently demanding job, I can say I'm going to be glad for a change. The NICU's a nice place...but I wouldn't want to live there. : )
Newbie Doc
Thanks for sticking with me on this NICU ride. NEXT STOP: Poop City!!! Wooohooo!!! (GI elective).
SO I thought I would do a quick recap on the babies I have here and end there stories, while I have a break...hope you are not looking for too much closure.
There's the little kid that has medical necrotizing entercolitis. He has been NPO (nothing by mouth) for the better part of 2 weeks now. We keep getting him better, trial feeding him, and going back to square one, with him having bloody stools and abdominal distention/pain. It's all very frustrating, I can't even imagine what the parents are going through. I go by and update them every morning and night before I leave. At first it was nice to answer all of their questions and put their minds at ease, but now as we go into week 2 of the same stuff, I feel useless...we are doing everything for this kid at the moment...currently though everything we are doing isn't really good enough...not for him and not for the parents anyway. When he stabilizes we'll get an imaging study and figure out if he really IS having this NEC or it is something else...it doesn't exactly present like NEC so I wish I could find out the results of that study before I leave...which leads me to my biggest frustration....I'm leaving... I won't find out what happens to him, he could miraculously get better the day I leave...or he could get way worse, only the new residents will know. The best I can do is ask one of the interns later on how he did, but I doubt they will remember. I was really hoping he would pull through this one, he might still, but I'll be left in the dark on this one.
The other child I talked about more than once was a little babe an oxygen requirement that kept increasing. I honestly had no idea why, we tried heart echo's, liver echo's, diuretics, ect ect ect...but nothing worked. We finally opted to feed her lots of protein, calories, and iron. Giving her iron would bulster her hemoglobin in the red blood cells making it easier for her to breath. Giving the extra protein was for increasing her albumin stores (a protein responsible for keeping your body water in your vessels...instead of your lungs). We put her on this little "treatment" and within two weeks she was peeing off a lot of her excess fluid and requiring much less oxygen. She even ended up feeding without the use of a naso-gastric tube (tube down the nose to the stomach) which I still can't believe. It's been really cool to see her slowly change into a baby that can go home and, for the most part, survive without any real medical treatments. Yes, she will go home on a small amount of oxygen but with the way she is improving it is likely she won't be needing it in a couple of weeks. It's really crazy that all those fancy tests and treatments we did for her and really all we needed to do was prescribe a little time and a lot of food. She's the bright spot of my NICU experience.
Besides that I have several other kids that are in the middle. None of them came here really sick at all, we are either just watching them to make sure they are not infected...or we are watching them to make sure they can eat and grow without our assistance. They will all likely go home without event.
If I had to name one moment that really stood out for me in my experience on the NICU, it would have to be that first night of call. When I was in it, I was really excited and scared...but looking back now at how un-experienced I was that first night...I really should have been much more of both. I find myself getting a little sad about leaving it behind, I've made some good friends here and I've gotten really comfortable with it...at the same time, I find it harder and harder to get up on the days I'm on call, I sometimes fumble up my thinking during those long nights for no reason (which isn't normally like me), and I come home and just feel like doing nothing (although that is sadly not an option most days)...I can say "I'm fine" all I want, but I can tell I need a break. I wish I could say that at the end of this rotation I'm A OK, but with life stacked on top of this decently demanding job, I can say I'm going to be glad for a change. The NICU's a nice place...but I wouldn't want to live there. : )
Newbie Doc
Thanks for sticking with me on this NICU ride. NEXT STOP: Poop City!!! Wooohooo!!! (GI elective).
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