One of the things that my medical school friends would joke about from time to time would be people trying to get free medical advice from us. Of course, then it was easy because we genuinely didn't know anything. As they have chosen to get into more specialized fields, I'm sure their requests have become more infrequent. This is something a doctor in, say, Urology or Neurology, doesn't really have to deal with, but we in Primary care frequently deal with. As a general rule, when I'm able to answer these questions in a couple of seconds or a minute it means that it's not that serious and I saved them a doctor's visit. I'm happy to do this, as I know how expensive a visit to the doctor can be.
One wrinkle to this has been getting medical advice questions from my family. To date I've gotten questions about infant bowel movements, a couple of sick children, and questions about whether someone is in labor or not. There has also been random other things of a non-serious nature from other siblings.
This is actually very fulfilling for me. I love primary care because we can have the longest impact on peoples' overall health and have a wide range of influence. That said, it is nice to be able to help someone out in the short term who happens to be someone in my family. And as my brother said regarding why he called me instead of the nurses line, "You're going to give me more of a straight answer" as opposed to their always telling everyone to come in and be seen.
I anticipate this to continue as the years and nieces/nephews multiply, and I'm looking forward to it.
Sunday, August 28, 2011
Sunday, August 7, 2011
TOBP
Part of my job as a Family Medicine resident includes delivering babies. (Quick lesson on the different specialties; Internal Medicine = Adult medicine, Pediatrics = kids, Obstetrics = delivering babies, Family Medicine = all of the above). Overall I really enjoy this. People are generally excited (even if it wasn't planned, which is 50% of pregnancies in the US!!!), generally healthy, and generally things go smoothly. That being said, there are a number of people that I see who are social disasters and have multiple problems outside of being pregnant that are magnified by being pregnant.
I have one such lady that I just delivered. She is 21 years old, this is her 5th pregnancy and 3rd child. She has little education, her husband is a truck driver and a little rough around the edges. Needless to say, the Labor and Delivery ward is a safe place for her and she visited often, starting when she was about 30 weeks along (2.5 months before her due date). She came up probably weekly and saw me in the clinic at least once per week in addition to various other visits to other doctors/residents. She would have the usual "contractions" and back pain all without being in labor, "bleeding" with no evidence of it when she came in, and "seizures" that the Neurologist doesn't really believe are real. But by far my favorite was when she came in the middle of the night because her "water broke". Now, there are some tests we can run on pregnant women to see if they have indeed their water has broken. We don't do this on everyone especially if 1) their clothes are wet, 2) they are very reliable, and 3)are full-term. She met only two of those three criteria (guess which one she didn't meet) so we went ahead and tested her for amniotic fluid: negative. So what happened? She had actually peed her pants, went home to change clothes, and peed them again! She got the diagnosis of TOBP (Tired of Being Pregnant: A benign condition) and sent home. Definitely one of the more interesting stories I've had.
The ending of this story is that she went into labor the same day as Melinda and I delivered her an hour before Melinda in the room next door.
I have one such lady that I just delivered. She is 21 years old, this is her 5th pregnancy and 3rd child. She has little education, her husband is a truck driver and a little rough around the edges. Needless to say, the Labor and Delivery ward is a safe place for her and she visited often, starting when she was about 30 weeks along (2.5 months before her due date). She came up probably weekly and saw me in the clinic at least once per week in addition to various other visits to other doctors/residents. She would have the usual "contractions" and back pain all without being in labor, "bleeding" with no evidence of it when she came in, and "seizures" that the Neurologist doesn't really believe are real. But by far my favorite was when she came in the middle of the night because her "water broke". Now, there are some tests we can run on pregnant women to see if they have indeed their water has broken. We don't do this on everyone especially if 1) their clothes are wet, 2) they are very reliable, and 3)are full-term. She met only two of those three criteria (guess which one she didn't meet) so we went ahead and tested her for amniotic fluid: negative. So what happened? She had actually peed her pants, went home to change clothes, and peed them again! She got the diagnosis of TOBP (Tired of Being Pregnant: A benign condition) and sent home. Definitely one of the more interesting stories I've had.
The ending of this story is that she went into labor the same day as Melinda and I delivered her an hour before Melinda in the room next door.
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