Saturday, July 19, 2008

2 weeks with a "poo" doctor

Well, I have finished my first 2 weeks of clinical rotations for PA school. I only have 48 more to go but who is counting! I am on my internal medicine rotation and somehow that has translated into me working with a GI doc these first 2 weeks; next I’m with lung docs for 2 weeks and then with heart docs for 4 weeks. I just wanted to share with you guys some things that I have learned over that past 2 weeks about the stomach. DISCLAIMER: Some of the below information may just be TMI.

The first day that I got to watch colonoscopy and EGDs being performed. I kept hearing this noise. I knew that at times they were using suction but it really sounded like farting. I didn't really think the patients were truly farting on the doctor until he said, "Gosh, Joe(true name withheld) You are blowing me away down there!" Boy did I feel stupid and disgusted all at the same time.

Doc asks me: “Do you know how many times on average a person passes gas a day?”
ME: “I have no idea.”
Doc: “13.5 times a day”
(Seriously, 13.5 times a day, that is a lot of farts and for those of you who say you don’t ever fart I think you have to be contributing somehow.)

Pt to doc:

“Doc, I’m just feeling “nawzee” all the time
Translation (which took me a second): “Doc, I’m just feeling nausea all the time”

style="font-family:Andy;">Doc asks me: “Worldwide what is the average number of bowel movements in day?”
Me: “I would say 3-4 times a day to once a week”
Doc: “Actually it is up to 8 times in one day if you live in
Africa and eat a diet like a cow, and 1 time in about 2 weeks if you are an Eskimo and only eat fish”
Me(thinking to myself): 8 times a day…are you kidding me and once in 2 weeks…how awful

Pt to doc: “I’m telling you it feels like I’m frying an egg down there”
Translation: really bad heart burn

Doc says to me: “Did you know if you took all the microvilli in your stomach and spread them out they would cover a football field?”
Me(thinking): “DANG”

Doc to patient: “you know if you quit smoking all your stomach problems would go away”
Patient was having nausea, vomiting, diarrhea, and reflux. She was in terrible pain. She didn’t understand what the smoking had to do with it. So the good doctor explains. NOT ONCE DID HE MENTION
ALL THE ILL EFFECTS THAT WERE OCCURING TO HER 12 WEEK OLD FETUS. Yes folks, she was pregnant, still smoking, and the good doctor failed to tell her smoking can harm a baby.

When a patient comes in with constipation or diarrhea it is important to ask the following:
How much do you poo a day?
Is it a small amount or a large amount?
What color is it?
Does it stink? I mean does it stink way more than normal, like makes your eyes water?(word from the good doc)
So my advice to you who don’t look is you better start investigating because we as your health care providers do care!

Pt(who was in his 90s)to doc:"Doc I guess I'm going back to my childhood days...I ain't got no teeth and now I'm messing on myself"
Seriously, I think that was my favorite comment that I heard the past 2 weeks!!

All in all it was a great 2 weeks. I have seen more people’s butt cheeks than I ever want to see again. I have seen exactly what lives in your stomach and your colon. Trust me people it is not pretty. The doctor that I was working with was an awesome guy(aside from the smoking baby mama), and he taught me more about being available to patients. His biggest piece of advise to me was what one of his mentors called the 3 As: be “A”vailable, be “A”miable, and be “A”ble and in that order. I think I can handle that. I’m not sure if working with lung doctors is going to be as interesting as these past 2 weeks but I will update you all soon!