Sunday, July 29, 2012

Pediatrics: Other people's babies!

Posted by Unknown at Sunday, July 29, 2012

The best thing about working at Mott Children’s hospital is getting to stare at cute children all day without any negative social ramifications.
I know it seems like I’m stating the obvious, but I just have to say—even when they’re sick—these babies are cute. Like, the kind of cute that makes you zone out on rounds for a few seconds. The kind of cute that makes you want to have your own tiny little yawning bundle. Or just run away with other people’s.
DON’T try that at Mott though. Tempting, but you’d go down fast. In addition to being a fun, playful, and colorful environment, Mott is an incredibly safe place for these kids. I forgot my badge once (bad idea) and they not only noticed (more than once); they made me take a new “temporary” photo, and printed me a badge for the day. In other words, I would definitely feel comfortable taking my loved one here. Also, in other words, never forget your badge here. All SORTS of doors you can’t access without it.  

So, these “babies.” Anywhere from about 7 days to 18 years old! My trusty partner in pharmaceutical elegance and swag (Alicia G, if you couldn’t tell from that description) and I covered the PY Gold service, general pediatrics. We would round on these patients every day at 9AM. Working them up involved lots of math; dosing in pediatrics is almost always weight-based. Furthermore, most of the medications would be oral solutions, so you’d have to make sure there was enough of the active ingredient, and then convert the dose into mLs of solution. Rounds were interesting; It was nice getting a picture of everything going on with the patient, and our attending was really good about explaining every step.
The rest of the day involved medication reconciliation, answering drug info questions, practice with order entry, presenting on our patients, and participating in topic discussions and journal clubs. We also followed PMP patients, who were generally in the hospital for months at a time and had extensive drug profiles. We checked all doses and monitored frequency of PRN meds.

One thing I really valued on this rotation was getting familiar with baby/maternal meds and treatment algorithms.  I tried to take this opportunity to learn about drugs in pregnancy, and disease states that are specific to kids. It was pretty much my only opportunity to do so this year!
I also got better at medical lingo from reading a plethora of progress notes:
-          s/p = “status post:” whatever I’m about to say JUST happened to the patient.
-          perioral cyanosis: blue lips!
-          tocolytic: drug used to slow down premature labor. Ex nifedipine.
-          GBS:  Group B Strep. Positive moms are treated with IV ABX prophylactically during labor, so they don’t infect the baby.
-          37/4: baby was born at 37 weeks and 4 days.
-          G3P2 (Gravida 3 Para 2): mom has been pregnant three times, and has two children.

Also, people really care about their kids. When I’d do a med rec, moms and dads generally knew exactly what they’re kid was taking, and were compliant to the best of their ability. When we counseled parents on drugs, they were SO attentive and into it, and asked all sorts of great questions. I don’t think people are as dedicated to their own medication regimens as they are to their kids! It kind of makes sense.

One of my concerns going into this rotation was the prospect of working every day with children that are helpless and sad and sick. It seemed like it would be depressing. I was worried that it would bring me down emotionally. Throughout these 5 weeks, indeed there were very sad cases. It was difficult to be surrounded by children stuck in such unfortunate situations for no apparent reason, at no fault of their own. What surprised me though, is that instead of constantly bringing me down, working with these kids made me a) happy that they were being treated, and generally getting better in terms of their acute problems, and b) thankful every day for the health of myself and my family. Believe it or not, working in peds can actually be uplifting.  A particularly touching moment was when one of our rehab patients, admitted for lower extremity burns, was able to walk again for the first time this week. He was 2 years old and just about the cutest little kid EVER. The entire staff was in the hallway cheering him on. I was so proud.

So, to sum it up, meds and other people's babies. Crying (not you! the babies!) and also playing. And a whole lotta Tylenol! All my P4s: It’s going by quick. I miss you guys. Best of luck on seminars this coming month!

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