22 September 2012

The day of the soar thought and Mat Kearney.

Speaking of allergies and itchy noses, has your kid been itching her head too?


Ok then, I'm gunna give you some medicine for that before she infects the rest of her friends at school...

Because she's got head lice.

And that's how you know the school year has officially started again.


Some mornings I feel like I have it all together. I have my lunch, I am wearing a mildly professional outfit, and my hair isn't sticking straight up.

And then I get half way to work before I realize there is no cream in my coffee.

And if you know meat all, you know I can't survive without my coffee!

Time to activate the emergency action plan:

 My options include:

1) pulling over at burger king, ordering a breakfast sandwich with extra cream on the side.
2) stopping at a gas station and making something work.
3) turn around and call in sick to work. Days that start off terribly should not end with me in charge of children's lives.

I decided to go with option 2:

my choices at the gas station were:

1) chocolate milk. Which I've had before in my coffee and been sorely disappointed.
2) buy a bottled frappuccino and get rid of my coffee, but I already felt invested in the coffee that had been brewed expectantly and was waiting in my coffee cup.
3) dump a double shot of espresso/cream into my coffee.

Option 3 was a winner.

Double shot + regular coffee.

Now I can put children's lives in my hands!


So, you're here because you get hot at night?


Every night? Do you get a fever? Have you even taken your temperature?


So you don't actually have a fever like it says on my computer chart?


Ok then, do you sleep with a thick blanket? Why don't you try sleeping with a sheet instead when you get hot? Maybe you can keep a calendar of all the temperatures and put a star by the days you get hot. And take your temperature when you get hot.

THEN come back and see me...

And you need a school note because you're allergic to peaches and only peaches?


The good news, at the follow up visit, all was good.

Because I'm not sure what I would say if it wasn't...


Did your 2 year old just spit in my face?

Good thing she's here for a well child exam today.

Nasty children!!


Soar throught

Mom, I know I was atrocious when I was little with spelling words like sed and bead...

But we worked on it, I got better.

Some of my co-workers must not have had moms that were as good as you...

Soar throught.

I really can't make this stuff up!


Sometimes I walk into a room knowing that it's going to be a really long time before I walk out. When someone starts a visit with abdominal pain, diarrhea a cough, AND needs refills ADHD meds, it's going to take forever.

Before we even got started, the mom of this little girl started talking about anger problems.

Deep breath.

Then, in the middle of the visit, as of we didn't have enough to discuss, she wants to tell me about her problem with the postal system.

Really? I care about your daughter, but I only have time to deal with one or two problems and you've already exceeded that, which is allowable but not beneficial.

Do you think I really care about your issue with the mailman?

Is this relevant at all?

No? Then why at we discussing it?!

After gently redirecting the conversation several times, I finally get to leave.

Oh! Wait! She's also got issues with allergies.







After advising her that we could spend a whole hour discussing allergies, she agreed to come back and discuss it at another visit.

And then she asked if she could see me again at the next visit.

The evil little voice inside my head urged me to lie! I might die if I have to see this lady again! I love it when people like me enough to want to see me, but this would be a tragedy.

Unfortunately, ethics won. I told her that she can ask up front and I would be happy to see her again.

Please, Lord, give me the patience when she comes back!!


I had a 14 year old boy come in for a checkup. He also had as runny nose.

Good.  Nice and easy.

But when I walked in, I made the mistake of asking "how are things going?"

"Well, I've got this chest pain every day and one time 9 months ago I passed out from it.

Chest pain?! You can't do that!

That doesn't count as a checkup!

And now I gotta fix it. But that's my job. And most of the time I love it!!


I did it! After messing up at least 10 times, I have finally succeeded in obtaining a clean urine specimen from baby girls!

Thank you Lord!

(and the parents of all the future baby girls thank you too)


Yep, your daughter has a bead in her ear.

"How'd it get there?" mom asked me.

Really, I'd tell you if I knew. Honestly. Most of the time kids put beads in their own ears. Sometimes their friends do it.

"Did you put a bead in your ear?" mom asked her daughter.


"Did your friend put a bead in your ear?"


Yep, that's kids for you.


I love actually helping people out.

I saw a cute little boy, not even old enough to talk much, with blisters all over his mouth.

He was SO sad. He didn't want to move or anything. He didn't even smile. He didn't care when I put my flashlight in his eyes or ears.

I gave him some medicine, the standard treatment for his condition, and told his parents what to expect. I told them to come back if anything went wrong.

I almost didn't recognize the kid that came back. He was bouncing off the walls!

His parents were SO happy, they told me I was the best doctor ever! After taking a minute to appreciate their praise, I let them know that all I did was standard treatment for their son's condition.

They didn't care. I fixed their son!

And as if that wasn't enough, on the way out, his parents got him to say:

"Thank you doctor," the longest phrase he has ever said in his life.

My heart can melt!

And even if I can't fix people, knowing that I was there and that I listened is enough for some moms. One mom literally teared up when she left because I listened and understood.

Even though I couldn't fix her daughter, I helped ease mom's mind.

Which is better than nothing.


Speaking of pulling junk out of ears, I had this 8 year old with ear pain and a cold, so I assumed ear infection.

After looking at his ear, I couldn't see his whole ear drum, so I told mom I had to move the wax.

Only the wax was crunchy.

The first chunk I pulled out looked like a bug shell.

The second half I pulled out had legs.

Thankfully they weren't moving.

It was all I could do not to vomit in front of my patient.  Sometimes I ask kids if they want to keep the stuff I pull out of their ears.  Most kids or moms like to keep the beads.  But this kid didn't get that option.

The moral of the story:

I pull out just as many bugs from ears as I do beads.

If you think you have a bug in your ear, you just might: so go see a doctor.

Or maybe your child just put a bead in your ear.

They like to do stuff like that.

I walk in to an 11 year old with "muscle aches." I'm thinking he's got a cold or the flu, because muscle aches are super common.


After asking a LONG series of questions, I realized only his abdominal and back muscles were sore AND he just started doing sit ups and push ups in PE class.


It's funny the things I forget kids don't understand yet.

The Sunset from our Terrace!  

Watching the sun set from our terrace!

I was quite proud of my 4 letter word that scored me so many points.

French press coffee and French toast.  Fantastic breakfast.

We thought we bought our puppy a new kennel.  We actually bought her a mansion.


This is Me and Jess watching Mat Kearney singing.

This is me WITH Mat Kearney!!  He played a fantastic acoustic show at the aloft hotel, 2 blocks from my house in Downtown Dallas.   Then he hung out afterwards to meet people.  He was legit.  

09 September 2012

The day I got inducted.

I've been officially inducted into pediatrics.

Meaning, I caught all the phlegms and the mucos and the nasties.

You know it's bad when you walk into the office and your co-worker hands you a prescription for antibiotics.

And another co-worker offers to call you in a prescription.

And then 2 days later another one listens to your lungs and tells you that you need a shot.

Yep, despite washing my hands before, during, and after every patient, I still got sick.

Nasty children.

Stop licking each other and then sneezing in my face!


Sometimes I see really sad things at work. Kids that are super sick or kids that were mauled by a dog or kids that got pulled off the monkey bars by other kids and ended up braking their arm in 3 places.

And lots of times I see kids that cry about dumb things like when I listen to their heart with my stethoscope and they start screaming because they're scared.

They're usually less than 3 years old though.

But sometimes I have silly boys who cry over nothing at all.

Like the chubby 13 year old that wouldn't let me check for a hernia. I'll admit it's a bit embarrassing, but I check everyone and it's really important that I check. I totally understand being shy, but crying?

Big, alligator tears that roll off your check onto my arms?

That's just sad.

What am I supposed to do?

I'm not going to force you to pull down your pants. That just feels like rape. But I'm not going to clear you for sorts until I check your groin for a hernia.



Fever always freaks me out.

Especially if your kid is little.  I relax once the kid gets above 1 or two.  

Because then I don't have to stick a tube anywhere to collect urine.

Fever is the body's way of making more white blood cells to combat an illness, so its a perfectly normal response to being sick.

I just worry about missing the right diagnosis when there's a fever.

There was a poor little 6-ish year old girl who was in with Grandma, who was mostly taking care of her.  Only Grandma didn't think giving asthma medication was important, so she hadn't been taking it for a while.

Her lungs sounded terrible! All filled with wheezes and nastiness.  Since her oxygen level was really good and she wasn't breathing faster than normal, I sent her home with refills of her asthma medication and told her to come back in 2 days so I could re-listen to her lungs once the wheezing was gone.  So I could actually hear them.

Only she didn't do what I asked.

Instead, she came in 4 days later, still with fever, only taking 2 of the 3 medications I asked her to.

One of my co-workers saw her and heard pneumonia.  

She was started on antibiotics and fine within a matter of days.  I felt really bad missing the pneumonia, but I tried to make her come back so I could hear her lungs again.  

There's always space for me to improve.

I'm getting WAY better at listening to lungs, which is perfect, just in time for the winter!

It's a little known fact that immune systems don't get bad just because it's cold outside.  You won't catch a cold from swimming in cold wether or going outside with wet hair.  You MIGHT catch a cold from being packed inside with so many other people because its so cold out.  And that's why people associate getting sick with being cold.

So, I saw a kid with fever and diarrhea.

Usually a viral gastroenteritis, I would have sent him home with diarrhea info if he had the fever less than 4 days.

But this was his 6th day with fever.

And now he also is breathing really fast.

Sure enough, he had pneumonia.  

Mom was SO impressed that I found the pneumonia when he didn't have any real symptoms of pneumonia.  But I listened to her when she was scared about him and I took time to really care.  She told me she didn't want to see any other providers at the clinic, just me.


We all miss things sometimes.  But if we're smart, we tell people to follow up with a fever longer than 5 days or in any kid under 1 year old.


Sometimes I get bitter. Here I am handing out ibuprofen to moms who sit at home all day with their coach bags while I work and pay 100s of dollars every month for Medicare out of my paycheck.

And my boss pays 100s of dollars every month for my healthcare.

Yet, I still get HUGE bills from my doctor and dentist.

Maybe what I learned from working hard, is that if I stop working hard and do nothing my kids can get free medical care.

And I can still buy coach shoes...

Yep, I'm learning a lot of important lessons at work.


So our puppy was sick these past 3 weeks.  

I've decided being a vet and being a pediatrician are REALLY similar.

We took her to the vet 3 weeks ago with vomiting and diarrhea.

The vet told me the same thing I tell most kids with vomiting and diarrhea.

But 2.5 weeks later her stool turned from diarrhea to straight water.

Um, something is REALLY wrong now.

So we went back to the vet.  The vet told me she was going to check for giardia, a nasty little parasite that's pretty common in children in daycare.

We had already checked for most of the normal bugs and parvovirus and she was getting worse.  I ALMOST told the vet not to check her for giardia because I read on the internet that dog symptoms of giardia and humans are similar, and she really didn't have the classic symptoms.

But its a good thing I kept my mouth shut.

And a really good thing I'm not a vet.

Because she had giardia. Eeeewww.

And then she made me feel silly because she asked me how I thought we would treat the giardia, and I told her the same way we treat it in humans: metranidazole. 

Yeah, turns out dogs get 2 "azole" drugs.  Because there's so much resistance to metranidazole in dogs.  

REALLY good thing I'm not a vet.


There's a ridiculous sign on my way home from work. It's one of those construction signs that flashes warnings about upcoming road closures, only this sign flashes the following messages, in order:

Jail! Jail! Jail!

Warning: police bait cars in the area!

Steal one, go to jail!

Really? You're wasting my taxpayer dollars on a sign that warns criminals not to steal?

What's the point?

Are you only trying to catch illiterate criminals who can't read the sign (therefore targeting only non-English speakers) in a predominantly Hispanic neighborhood?

Or are you trying to only catch the criminals who are dumb enough to steal after being warned?

Because now we have to warn our criminals?



I read that scientists in South Africa may have discovered a cure for Malaria, even types of Malaria that were medication-resistant before.

The CDC estimates that ONE child dies EVERY minute from malaria.

Malaria is the LEADING cause of death in children under 5. (in the world).

Parents in Sub-Saharan Africa put their children to sleep under mosquito nets to help prevent the deadly disease. They set smoke filled fires to rid the area of mosquitoes. They have no money for other forms of protection, so they pray.

If a child falls ill, they are lucky if they can make it to a clinic to get medication, even luckier if they can afford it.

On a typical day at clinic in Zambia, 50% of my patients had malaria.

And all of them were sicker than dogs.

Meanwhile, parents in central Texas are TERRIFIED their children will catch the West Nile Virus.

They do NOTHING to protect their children against it. (the CDC recommends everyone wear long sleeves and long pants, use insect repellant, and avoid being outside around dusk and dawn). They have money and the ability to do all these things, but they "forget."

And how many children have I seen with mosquito bites? At least 100.

How many have had West Nile?


How many children have died from West Nile?

None. West Nile is only deadly if it invades your brain, which doesn't typically happen in healthy people.

It is completely preventable.

80% of the people with West Nile Virus don't even know they have it.  20% of people get a "flu-like illness" (FEVER, body aches, cough/runny nose)

Less than 1% get "neuro invasive" West Nile Virus, where it actually spreads into your brain and/or spinal cord.  The symptoms are the same as meningitis: stiff neck, pain, glossy stare, listlessness.

If you have those symptoms, get yourself to a hospital ASAP!

If not, stop worrying.

And start protecting yourself better!


Bordeom is often the root of trouble.

Thursday, thankfully, we were slow. My boss didn't even notice I was late, but he understood and wasn't mad when I apologized.

But we were so slow that we say around a lot.

Which made our boss talk about how awesome the human body is.

Which got him started about how even though humans and chimps are only 3% different, that means a lot of proteins. (3 million proteins different)

Which started the debate between evolution and creation.

Which got pretty heated for a few minutes,

(or at least, I think it got pretty heated.  It was all in Spanish and I was doing really well understanding everything up until that point, but then they started talking faster and angrier and I got a bit lost)

until finally some patients showed up and we could all go off into a separate room to cool off.

Nothing makes angry providers cool off faster than focusing on fixing a child.


Our first "family" road trip to Houston with the little one.  She did MUCH better in the car than Scrubs did his first trip!

The BEST thing about speaking Spanish at work: Authentic Mexican food just across the street. 


Our attempts at making Chuy's style salsa and creamy jalapeno dip!

We'll have to share the recipes sometime, it was FANTASTIC!

We got dressed up for a wedding!  I think this is the 9th wedding I've been to in the past 9 months.  And I've worn a different dress to all of them.

We almost got in BIG trouble!  We were watching the ceremony and this little 4 year old girl gets up and touches the LARGE earlobe of the older gentleman right in front of her just before her dad could swat down her hand.  

Needless to say we both had a hard time swallowing our laughter!

First time I've been to a Persian wedding.  The older lady in the background is grinding sugar sticks above the bride and groom's heads to sprinkle their marriage with sweetness.

Yeah.  The reception was REALLY fancy.  But we found a way to have fun...

The bride was beautiful.  Friends were fun.  Dancing was Fantastic.  Food was wonderful!  It was a great night!