Monday, November 9, 2009

Great Day!!

So my Monday morning started off knowing that TCU is ranked #4 in the BCS AND that ESPN's College GameDay will be broadcasting from my alma mater's campus on Saturday. Good start to the week, eh? Then traffic was light on the way in and I had time to get some hot tea from Starbucks before getting to work.

The morning was nothing exciting, but nothing terrible either. After lunch though was when it got really good. I did a well-child visit on a very chatty 6 year old boy with his rather humorous father in the room. It took some time because this little guy wanted to tell me story after story, and any question I asked him resulted in another story being told. Needless to say the history and physical took a bit longer than one usually does. One of the great things about being a student is I can take that time because they aren't expecting me to be super fast when it comes to seeing patients. After making it through all that and presenting to my preceptor she asked me to get some information for the father. As I went back in the room to give it to him he asked me if I was planning on going into pediatrics. I told him I was keeping my options open and wasn't really sure what I wanted to do. He told me if I did decide to work with kids he was sure I would be great at it - he could tell by the way I interacted with his son. Ooo-wee! I almost asked him to tell my preceptor the same thing but thought that my be kinda tacky (and who knows he may have mentioned it!)

So, I'm on cloud 9 right? Then, as my last patient of the day, I see a patient who probably has Kawasaki's Disease. It's funny because I remember learning about it in class and thinking I would never see a patient with it - Boy was I wrong! Kawasaki disease is interesting because scientists don't yet know what causes it. Pretty much it presents as a high fever lasting >5 days, red/swollen lips, rash including the hands and feet, conjunctivitis (irritation of the eyes), and enlarged lymph nodes in the neck. The most serious complication is development of vascular damage in the arteries supplying heart muscle which causes coronary aneurysms. It is the most common cause of acquired heart disease in kids younger than 5 (surpassing rheumatic heart disease - a complication from strep throat). So to diagnose this patient we ordered some labs that look at white and red blood cell count and markers of inflammation. Then we sent them to a cardiologist to get an echocardiogram done to look at the coronary arteries to determine if there is any inflammation or damage to them. If the diagnosis is made, the patient is started of IVIG (immunoglobulin) and high-dose aspirin to prevent damage to the coronary arteries. So cool! I'm pretty curious to find out if that is indeed the diagnosis.

And on another note - some more good news. My mom had her first chemo treatment last week and things are going well so far. She did have a bad reaction causing some problems with her hands and feet, but was able to take some meds which helped with that. She said she was feeling tired yesterday, and is having some metallic taste in her mouth, but all things considered seemed to be doing pretty well. Keep her and my dad in your thoughts and prayers please.

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