Wednesday, July 24, 2013

"Turn your head and cough, please!" Day 6-- Sorry for the break

Due to a funeral, I was not in the hospital on Monday or Tuesday.

There is a world of a difference if you have to be in the hospital by 7AM or at the morning meeting at 7:45AM. It sometimes feels like there is a collosal difference, while looking at the alarm clock, between 6:48 (the time I woke up) and 6:50 (the time the alarm was supposed to go off) but I'm sure everyone feels that way.

It is my week to be in outpatient care. Since I'm only present 3 of the 5 days I didn't want to miss out on all the operations. I also don't mind being in outpatient care. You see the most patients and most variety. It's also the place where I get to do the most. Today I even saw my own patients!

The day was not super busy though. I had prepared myself for such an occasion with research papers to read. I read one. It was way more interesting chatting with the nurses :) So what all did lil 'ole me with my innocent eyes get to do and see? Well....

Two double pig-tail stent replacements
Another reason why I am sort of destined to be a urologist. We have pigtail stents! Anyone who knows me can tell you that I LOVE pigs. I even have a pot belly pig Pigcasso at home being taken care of so lovingly by my mom (thanks mom!).

But in the medical field, these stents are used to help urine get from the kidneys to the bladder for various reasons e.g. kidney stones, stenosis, other obstructions.

UTIs are a urologist's daily bread
Next to prostate hyperplasia (large prostate), urinary tract infections really are a very, very, very common thing in urology. Especially with young women. A differentiation can be made between lower (bladder) and upper (kidney) urinary tract infections. I really want to start using the acrynom FLUTI for female lower urinary tract infections. How fun! "I went to the doctor today. I have a FLUTI." Makes it sound so much less painful! I'll see if I can make it a thing.

Usually a FLUTI is caused by E.Coli. Females (unless there are serious complications or are preggers) shouldn't get antibiotics right away because they tend to go away by themselves. Most import is that the patient drinks a LOT of water to wash out the bothersome bacteria. If men have a UTI it is always considered "complicated" and they are given antibiotics because of all their anatomical structures that could easily be harmed.

Two of the patients that I got to take care of had UTIs. Dr.K let me go in by myself, take the history, do the ultrasounds and then report back to him with my suggestion of therapy. I filled out all the paper work and just had him sign off on everything. It was a nice feeling knowing that I could at least do that much.

One of the patients has been having UTIs the past 20 years on and off again. She told me that each doctor just writes a prescription for antibiotics and then says if it doesn't get better, further diagnostic measures will have to be performed. When she then goes back to the doctor they just give her another antibiotic. I talked the situation through with Dr.W to see what possibilities where available so they could be started on the patient and organized an appointment for her with the attending to finally discuss the options she had.

Well I've never seen a piercing there personally....until now
The things people do to their bodies. It's fascinating. I'm one to talk on a small level. It seems every time I fly home, I have a need to get a new piercing. I put a piercing ban on myself though because it is getting exceedingly difficult to coordinate all my piercings. Especially since all of mine are visible in daily life.

The patient I saw today though probably doesn't have the same problem. He had two piercings...down there. And when I walked into the room I perceived him as quite the business man and was not expecting that. I guess you just never know what people are carrying around in their pants.

As much as I don't like waking up early in the morning. I must say I don't mind being there once I am. I feel really comfortable in the department and with the patients. The team really is great fun. Dr.K and I had a lot of time to chat. Dr.W sent the other electives home at 11:30 because nothing was going on. He didn't tell me that though until 2pm. I didn't care though. I was having my fun and was such a nerd and stayed for the afternoon meeting. Me and 4 male doctors. Now we are talking! My kind of crowd! :D

Baci, V

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