Well, I go in spurts with writing so I apologize for any delay. I just thought I would pass on the education that I received during our noon conference lecture while we all ate lunch.
The topic was constipation and some of you may think this is a boring process, but not so with children. Constipation can be an active process for some but definitely not all children or adults.
First of all, there is the poop dance best described as a child walking on their tip toes and squeezing both of their gluteus maximus muscles together to withhold from pooping until the urge to defecate has passed. Sometimes, a child will hold onto furniture with their arms, stand on their tip toes, and stay in that position until the urge passes.
We learned that after a long stent of holding feces, there can be something that forms called a "fecolith" A.K.A. "poop rock" that sits near the rear exit and prevents passage of stool, until there is such a large build up and the anal sphincter muscle is stretched and nerve endings are stretched beyond working that stool is passed unknown to the child. This is called encoparesis.
Some of you may be wondering "why would someone try to withhold stool when it can get so bad?" Well, it could be that there was something that had made passing stool painful in the past and many other problems. The important thing is that there is treatment and it is not the fault of the child regarding constipation.
So interesting notes: I learned a very interesting term "ileal brake ". There are three parts to the small intestine: 1st- duodenum, 2nd- jejunem, 3rd- ileum. The ileum is the last place where nutrients are largely absorbed especially fat! (Interestingly about 99% of fat is absorbed from food!!) So when a person eats a meal high in fat content, the food gets to the ileum and the transit of the food slows down remarkably to increase absorption, therefore causing an "ileal brake". They recommend eating diets low in fat if constipation is a problem. They also recommend drinking plenty of fluids and once regularity isn't as large of an obstacle, high fiber foods can be implemented.
I hope you feel enlightened and to quote our speaker "have the scoop on poop"!
Thursday, March 13, 2008
Tuesday, February 26, 2008
Rewired?
Something has happened in the process of doing a month of autopsies that has disturbed me. Let me explain my schedule a little. In the mornings, I always check in the autopsy suite to see if there are any bodies for autopsy. If not, then I am assigned to either looking at slides most of the day, dissecting organs that have been removed from live people a day prior, or taking a small piece of an organ that has just been removed from a person mainly to see if all the cancer was removed.
Most of the mornings I have had an autopsy and the bodies were cold to preserve the tissue. Well, one day I went from an autopsy TO helping out with the organ staining to see if the cancer was removed. The staining happens in the same hallway as the surgeries are taking place. This is so we can report back to the surgeon to let them know if they got it all or not. Then, the surgeon knows how to proceed with the surgery.
Well, I think I got used to the "cold" autopsy organs so when I was looking at the organs fresh from surgery it was really alarming because they were warm! I think the warmth brought back the reality that the organ was from a live patient and made things a little too real. During the process of medical school, it becomes kind of like second nature to do examinations and to become a little disconnected so that a body part is a body part and not attached to a person.
Anyways, through this whole process I was disturbed because I realized that I've become rewired in my thinking- good or bad?
Most of the mornings I have had an autopsy and the bodies were cold to preserve the tissue. Well, one day I went from an autopsy TO helping out with the organ staining to see if the cancer was removed. The staining happens in the same hallway as the surgeries are taking place. This is so we can report back to the surgeon to let them know if they got it all or not. Then, the surgeon knows how to proceed with the surgery.
Well, I think I got used to the "cold" autopsy organs so when I was looking at the organs fresh from surgery it was really alarming because they were warm! I think the warmth brought back the reality that the organ was from a live patient and made things a little too real. During the process of medical school, it becomes kind of like second nature to do examinations and to become a little disconnected so that a body part is a body part and not attached to a person.
Anyways, through this whole process I was disturbed because I realized that I've become rewired in my thinking- good or bad?
Monday, February 11, 2008
slightly serious note
Well, it is the season of Lent and in previous years I have given up pop, desserts, and any combination thereof. After a convincing sermon on Sunday, Ryan and I decided that we would try and give something up this year for Lent. Our goal is to stop complaining and to stop criticizing others. In the less than 24 hours that we have had to attempt these two tasks, it has been a great challenge.
I had a wonderful argument in my head as I drove to work this morning with the lady who cut me off and then drove so slowly in front of me. I thought of all the ways I could help her improve her driving and then was gently reminded that I was to give mercy and not critique in these next days. So instead of laying on my horn as I is my usual response, I gripped the steering wheel a little tighter and prayed that I would remember all the times I drove like an idiot and needed mercy.
That's it for now, I'll keep you updated. There were more challenges throughout the day, but in light of not complaining, I'll keep them to myself and be grateful for another day:)
I had a wonderful argument in my head as I drove to work this morning with the lady who cut me off and then drove so slowly in front of me. I thought of all the ways I could help her improve her driving and then was gently reminded that I was to give mercy and not critique in these next days. So instead of laying on my horn as I is my usual response, I gripped the steering wheel a little tighter and prayed that I would remember all the times I drove like an idiot and needed mercy.
That's it for now, I'll keep you updated. There were more challenges throughout the day, but in light of not complaining, I'll keep them to myself and be grateful for another day:)
Sunday, February 10, 2008
The Carew Side
It's been an incredibly long time since I've posted so here it goes:
I started a pathology elective this past week which involves autopsies for at least half of the month. I didn't know how I would do, but was willing to try to be brave. The first case didn't actually happen until Tuesday and with my luck we had to wear masks for tuberculosis protection. These are not regular masks because it felt like I couldn't exchange any air because the mask was so thick. So knowing the morning was going to be rough, I ate an extra snack, but it wasn't enough.
I started to feel hot, a little suffocated from the mask, and a slight nausea- all symptoms I have had for previous passing out episodes so I quickly excused myself and sat in the hallway . . . removed the mask, cooled down, and felt better. Being the stubborn person I am, I went back, I lasted about 15 minutes, and then the same hot, suffocated, and nauseated, went back to the hall sat down, got a little sweaty, but regained control and went back. I should have given up honestly. So the last time I observed for only 5 minutes before the hotness and suffocating feeling swept over me. I practically ran out, ripped off the mask, tore off the surgical gown hoping to get cool, and laid flat on the floor. I was drenched with sweat, unable to talk for fear opening my mouth would allow vomit to escape, and was passed by 2 separate people in the hallway who didn't ask if I was okay. I laid there for about 5 minutes and then decided I had a rough morning and went home for the day:)
Oh the joys of medical school! I figured the Carews will truly appreciate the same feelings I had that day.
I started a pathology elective this past week which involves autopsies for at least half of the month. I didn't know how I would do, but was willing to try to be brave. The first case didn't actually happen until Tuesday and with my luck we had to wear masks for tuberculosis protection. These are not regular masks because it felt like I couldn't exchange any air because the mask was so thick. So knowing the morning was going to be rough, I ate an extra snack, but it wasn't enough.
I started to feel hot, a little suffocated from the mask, and a slight nausea- all symptoms I have had for previous passing out episodes so I quickly excused myself and sat in the hallway . . . removed the mask, cooled down, and felt better. Being the stubborn person I am, I went back, I lasted about 15 minutes, and then the same hot, suffocated, and nauseated, went back to the hall sat down, got a little sweaty, but regained control and went back. I should have given up honestly. So the last time I observed for only 5 minutes before the hotness and suffocating feeling swept over me. I practically ran out, ripped off the mask, tore off the surgical gown hoping to get cool, and laid flat on the floor. I was drenched with sweat, unable to talk for fear opening my mouth would allow vomit to escape, and was passed by 2 separate people in the hallway who didn't ask if I was okay. I laid there for about 5 minutes and then decided I had a rough morning and went home for the day:)
Oh the joys of medical school! I figured the Carews will truly appreciate the same feelings I had that day.
Thursday, December 13, 2007
Last interview
My friend, Emily, and I drove down to Nashville, Tennessee on Sunday after realizing that her husband wouldn't be able to make the trip with her. So Sunday we checked into the hotel and Emily went to the dinner with the pediatrics residents and I headed off to dinner at Qdoba with myself. The restaurant was on Vanderbilt's campus and the first thing I noticed was all of the Coach, Dooney &Burke, and Louis Vuitton (sp?) purses. I told Ryan that if I were to go to Vanderbilt that we'd have to do some shopping;)
Anyways, Emily had her interview most of Monday and so I took her car and explored Nashville. I was able to get some more Christmas shopping done which seems to be a theme for my interviewing trips. I also drove through Brentwood- a fabulous, large scale home area. That evening, Emily and I explored downtown Nashville and saw the BB King's house of blues, Wild Horse Saloon, and many others. Emily begged to go sing karaoke, but I assured her that she would regret it (totally kidding, Em would never do it!). We ate at the Big River Brewery and then drove back to campus and had dessert at a French bakery. It was so much fun.
Tuesday I had my interview and Emily was kind enough to stay to drop me off at the hospital since Ryan wasn't going to be in until the afternoon. I had a great day meeting the chief residents, program directors and having an 1 1/2 tour of the hospitals. Vanderbilt's campus is large but all within close walking distance.
Tuesday evening Ryan was able to join me for the residents' dinner. We had a good time and then I drove Ryan around for a tour.
Wednesday was a bizarre day spent with a real estate agent- it's an incredibly long story although hilarious so you'll have to ask Ryan or I about it:)
That's all . . .
Anyways, Emily had her interview most of Monday and so I took her car and explored Nashville. I was able to get some more Christmas shopping done which seems to be a theme for my interviewing trips. I also drove through Brentwood- a fabulous, large scale home area. That evening, Emily and I explored downtown Nashville and saw the BB King's house of blues, Wild Horse Saloon, and many others. Emily begged to go sing karaoke, but I assured her that she would regret it (totally kidding, Em would never do it!). We ate at the Big River Brewery and then drove back to campus and had dessert at a French bakery. It was so much fun.
Tuesday I had my interview and Emily was kind enough to stay to drop me off at the hospital since Ryan wasn't going to be in until the afternoon. I had a great day meeting the chief residents, program directors and having an 1 1/2 tour of the hospitals. Vanderbilt's campus is large but all within close walking distance.
Tuesday evening Ryan was able to join me for the residents' dinner. We had a good time and then I drove Ryan around for a tour.
Wednesday was a bizarre day spent with a real estate agent- it's an incredibly long story although hilarious so you'll have to ask Ryan or I about it:)
That's all . . .
Friday, December 7, 2007
Ohio
My trip to Cleveland was eventful! I flew in early on Tuesday morning which gave me plenty of time to to explore a little. I didn't go to far from my hotel because there was a great shopping mall close by. I was able to get a ton of Christmas shopping done, take a nap, and run before I had to start getting ready for my dinner with the residents that night.
This is when it get "hairy". I was blow-drying my hair as I have been trained by my hairstylist with a round brush. So I had a section of hair wrapped around the round brush and blow drying away. I noticed in the mirror that it looked like a 1-inch circle of orange paint had dropped on my head. Of course I was thinking, "what kind of jank hotel is this that paint falls from the ceiling?" Then, I noticed this awful burnt smell and yes I was slow to put two and two together. Well the orange spot was was a burnt spot of hair . . . I was left with 1 inch square sectino of hair that is now only 1 inch long. So I have a small attempt at a mohawk. I stopped blowdrying my hair for a while and sat on the couch in my room to convince myself that it wasn't the end of the world:)
As for the actual residency program, I had a great dinner with 3 of the residents and another applicant. It was a cozy group. The next day I spent meeting chairpersons of medicine, pediatrics, and then med/peds. There was only one other applicant because one person was driving from Maine, her cell phone died, and she was stuck in the snow 1 1/2 hours away . . . crazy. I had 3 interviews which seems to be the norm. One interview was a little more intensive than I had before.
I will tell you a little about the program because it was different than any of the other programs I've visited so far. They accept 6 new interns each year. The hospital's mission statement to to give excellent care to everyone regardless of ability to pay. They are the county's hospital and do a lot of care for the poor, but at the same time people who can pay and have great insurance choose to go there because of the great care they receive. In general, very cool program, maybe a little small for my liking:)
I need to go and get stuff ready for a get together, but I hope everyone is having a great day!
This is when it get "hairy". I was blow-drying my hair as I have been trained by my hairstylist with a round brush. So I had a section of hair wrapped around the round brush and blow drying away. I noticed in the mirror that it looked like a 1-inch circle of orange paint had dropped on my head. Of course I was thinking, "what kind of jank hotel is this that paint falls from the ceiling?" Then, I noticed this awful burnt smell and yes I was slow to put two and two together. Well the orange spot was was a burnt spot of hair . . . I was left with 1 inch square sectino of hair that is now only 1 inch long. So I have a small attempt at a mohawk. I stopped blowdrying my hair for a while and sat on the couch in my room to convince myself that it wasn't the end of the world:)
As for the actual residency program, I had a great dinner with 3 of the residents and another applicant. It was a cozy group. The next day I spent meeting chairpersons of medicine, pediatrics, and then med/peds. There was only one other applicant because one person was driving from Maine, her cell phone died, and she was stuck in the snow 1 1/2 hours away . . . crazy. I had 3 interviews which seems to be the norm. One interview was a little more intensive than I had before.
I will tell you a little about the program because it was different than any of the other programs I've visited so far. They accept 6 new interns each year. The hospital's mission statement to to give excellent care to everyone regardless of ability to pay. They are the county's hospital and do a lot of care for the poor, but at the same time people who can pay and have great insurance choose to go there because of the great care they receive. In general, very cool program, maybe a little small for my liking:)
I need to go and get stuff ready for a get together, but I hope everyone is having a great day!
Monday, December 3, 2007
Interview #3
So this update will be brief because I am supposed to be flying out to Cleveland early tomorrow morning. Ryan and I drove back from Michigan on Sunday, made a brief stop at our youth group, and then headed downtown to Bertolini's to have dinner with the IU residents. Ryan and I sat next to a few residents that I hadn't met before and got some really great advice. Ryan really enjoyed himself and felt extremely comfortable which is a bonus.
Today, I had another day of meetings with chairpersons of medicine and pediatrics departments. I had three individual interviews and a couple of tours. I'll be honest that I really had a great time today minus the longest distance walked in my too-high heeled boots. Ryan and I were both really excited with how well this interview had gone.
Well, more to come. I have an interview at Case Western Wednesday.
Today, I had another day of meetings with chairpersons of medicine and pediatrics departments. I had three individual interviews and a couple of tours. I'll be honest that I really had a great time today minus the longest distance walked in my too-high heeled boots. Ryan and I were both really excited with how well this interview had gone.
Well, more to come. I have an interview at Case Western Wednesday.
Subscribe to:
Posts (Atom)