Monday, November 28, 2016

Rotation 5 - Pediatric Cardiology

Posted by Brock Jackson at Monday, November 28, 2016

Most likely this will go down as my hardest rotation of the year. It was an absolute change of pace from my previous rotation (Drug Information). On this rotation, I was at Mott’s Women and Children’s Hospital. It was a drastic change from working at a desk from 9-4.
I would describe my typical day as such:
Wake up around 5am, arrive at the hospital and be working up patients by 6:30am. Because I did not have much exposure to pediatric populations before, this portion was a struggle for me. 
Around 10am – noon, we would round on the pediatric cardiology floor.
Around noon-1, lunchtime 
From 1-4pm, I would have a bit of time to work on topic discussions, adjust my SOAP notes from what we did on rounds, and present topics/patients to my preceptor.
The types of patients that I primarily saw had congestive heart failure, atrial septal defects, ventral septal defects, patent ductus arterious, hypoplastic left heart syndrome, Ebstein’s anomaly, pulmonary hypertension, and other congenital heart defects. Our main goal was to help manage their cardiac conditions and prepare them for surgery or to be discharged.
Throughout my time on this rotation, I had to complete about 10 different topic discussions, which kept me quite busy outside of rotation. When I was presenting topics (such as hypoplastic left heart syndrome, plastic bronchitis, protein losing enteropathy), I would often be accompanied by a PG-Y1 or PG-Y2. I would often listen to them present their patients or topics, as well as they would listen to me. This was a great learning opportunity for me. In addition to that, my preceptor (which I enjoyed working with) often asked questions to failure. This method involved asked questions until the person answer them was unable to answer them. This often led to me having to look up many different questions afterwards and answering them the next day. It was certainly something that I was not used to and took time adjusting to not being able to have an answer for everything. As a side note, I do not believe I am a know-it-all or anything close to that. However, it is disheartening to not be able to leave one day with having answered all the questions about a patient or topic completely.
Highlights of the rotation:
Spending time with my preceptor after hours and talking pharmacy and life
Being on rotation during Halloween. We were able to dress up and round with the kids. The children and their parents APPRECIATED this A LOT. For the record, I was a piece of pizza and the team I was with were teenage mutant ninja turtles.
The food – pediatric rotations (from what I now understand) are laden with food. There is literally good food everywhere. My inner foodie was impressed!
The team – I loved working with all of the residents and medical students. These folks were great and were wonderful to spend long hours alongside.
The wins – Seeing sick children is extremely difficult to deal with…I do not think I need to elaborate on that. However, when we have a great outcome, the whole team is ecstatic. From the beginning, we had a patient that I followed who was in dire need of a heart transplant. They struggled with weight gain and adhering to a sodium and fluid restriction. It was a major struggle watching his condition worsen and worsen and the family try to cope with the reality that a new heart may not come. On my second to last day, the entire transplant team rounded with us (usually it is just one or two of them) and they announced that they had accepted a new heart for them! It was incredible!! The whole team rejoiced, the mother cried, the patient was stunned and it made the whole experience that much better. On my last day, I was able to watch the new heart be put in and the circle was complete.

Overall, the experience was grueling but I learned a lot and I made friendships that I treasure to this day!

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