#med3

[asprinkleofcaffeineandkindness]

NICU Day 3

Today was my call day so I was at the hospital from 6:30am-10:30pm. We spent a lot of time with premature babies and “tiny babies” (any baby less than 1000 grams). Overall, it was pretty uneventful, mostly a lecture based day but it was a nice end to our time with neonates. My call began at 5:30 so I snuck away to the pediatric inpatient ward for a couple of hours before returning to the NICU. Thankfully, I had a really friendly year 1 resident on my previous inpatient team , who happily let me follow her for those hours and took me to see their new admissions. 

Highlight of the Day: 5 month old with dextrocardia and hypoplastic left heart syndrome that I got to examine. The most adorable, active, cheerful baby i came across all week, with a smile that literally melted my heart.

Seeing these children in the pediatric unit, being able to talk to them, talking to their parents, all the reasons I wanted to pursue medicine were right infront of me. It’s amazing, the sense of purpose I feel when I’m around these children, no matter how sick they are. I feel myself gravitating towards them, whether they’re cranky or scared, because I feel such an urge to help them, make them feel better in whatever way I can. I couldn’t be more excited for my decision to choose pediatrics.

[asprinkleofcaffeineandkindness]

NICU Day 2

lecture was cancelled, and I’m not on call today so that may be playing a heavy bias but, today was a lot nicer. The day went by quicker and it felt more productive. 

Highlight of the Day: Neonatal jaundice never seems to bore me for some odd reason and today we spent an hour and a half in an outpatient jaundice clinic talking about all the different causes and issues surrounding the topic. So I really enjoyed that.

Ick of the Day: Nothing honestly, there was a lot less poop today and no vomit so it was a ick free day! Yay!

Lesson of the Day: If you are a Med 1 or 2, I implore you, know your pathology. After being on the wards for a couple of months now, I cannot stress the importance of learning the different diseases from every organ system. I know it can seem tedious and without the context of a patient, lots of medical students find the subject frustrating because it appears to have very little understanding and more route memorization, but it is SO essential. No one (or very few) doctors actually expect you to come up with a diagnosis on the spot during rounds, when you are getting pimped, but they expect you to at least have a logical general class in mind of the diseases you are considering.

Case in point: There was a LGA baby in the NICU being investigated for his omphalocele, macroglossia and hypoglycemia (amongst other things). When our attending asked for a differential, I mentioned Beckwith Wiedemann (props to first aid) and he was clearly impressed. Mind you, I have barely had ANY time to study since starting with inpatient Peds, and whats been saving my butt is literally my knowledge from Step 1 pathology. So just do pathology right the first time, you WILL look like you know your shit, which is good enough, buying you time to Uptodate and actually learn your shit :)

[asprinkleofcaffeineandkindness]

NICU Day 1

The hospital we rotate in during NICU days is literally a baby producing factory... on steroids. I saw 19 babies (+ 12 poop filled diapers that varied in color from black to green) within 2 hours today, and that was just one section of the floor. 

Even though we only get three days in the NICU and post natal care unit, I really like that our clerkships are structured so that we get a small sense of the different components of each speciality. Neonates are so tiny, and surprisingly not as whiny as I thought they’d be. But they are definitely not my cup of tea. I miss the pediatric inpatient unit so much, particularly toddlers or preschoolers, in any shape or form. Whether sick or not, they have a completely different energy surrounding them and I really missed that when working with neonates today. The neonatal care units have a totally different vibe to them, compared to general pediatrics. Everything’s a lot calmer, quiet and peaceful in the post natal ward with the healthy babies and the sick babies in the NICU are honestly too heartbreaking for me to see every day. And to add to that, there is a lot less talking... and a lot more cooing and oohing and aahing. 

Highlight of the Day: I heard a murmur on a 1 day old baby! No idea what kind of murmur it was.. but I heard it! Also... I saw my consultant push a newborn’s undescended testes that was stuck in his inguinal canal, into his scrotum. Still recovering from the shock of how normal it was for him to do that..

Ick of the Day: The consultant was examining a baby, but there was so much poop that it got onto the side of his finger. He then proceeded to wipe it on the side of the baby’s blanket and picked up his pen and started writing. I died...gloves were invented for a reason people... 

Lesson of the Day: Breast feed your children. Just do it. And if you aren’t going to do it, good luck trying to not anger the neonatologist looking after your baby.

[asprinkleofcaffeineandkindness]

Pediatric ED Day 1

I’m literally so exhausted every day. And we’re only halfway through the clerkship.

We stood in the ED from 7-2pm literally, with no break. No water, no sitting down, no food. I don’t know how these people do it x.x

Highlight of the Day: We saw croup, Trisomy 18 and Pompe’s disease all within an hour of our first day.

Ick of the Day: There was a child that had three episodes of vomiting before coming in, and was continuing to vomit every thirty minutes or so. Give me baby poop, blood, diaper rashes, crying babies... but that smell of vomit... atleast the nurses gave me understanding smiles when I went straight to their station to grab a face mask. 

Pediatrics. I love you. I don’t know why it took me so long to discover it, but I’m so glad I eventually did. 

Anyway, time to learn all about stridor in upper vs. lower respiratory tracts (even though the only thing I want to do right now is pass out on my bed) so my evaluators can continue to tick Exceeds on the knowledge criteria on my evals x.x

[kandrialedesma-blog]

Family photos. 👨‍👩‍👧‍👦 #med2 #med3