Sharing the joy and humor in life as I work out what it means to be a Physician Assistant, and a "grown up." Cooking stories, travel blogs, and the occassional oddball thrown into the mix!
12 April 2013
The day I called 911. Or the day I got bit!
I’m gunna let you guys in on a little doctor secret.
Sometimes we freak out.
Just never in front of a patient or our nurses.
A little boy came in with an oxygen number of 86. Normal is 100, less than 92 scares me.
So 86 was low enough to really freak me out.
I immediately asked the nurse to give him a lung treatment
and a steroid shot, which is standard for a kid with a number that low.
It was a Friday, and I was really hoping not to have to send
this kid to the hospital. So I had my
nurse continue to monitor his oxygen number after treatment. At 5 minutes after the shot and treatment, he
was siting at 91. I told her to check
again at 15 minutes after treatment and let me know what it was.
She knocked on my door and told me it had dropped back to
I left the patient I was with, calmly explaining I was
needed for a moment, and then I freaked out in my head.
I told my nurse to immediately grab the oxygen tank and
start him at 2 liters of oxygen per minute via face mask.
She had no idea what I was talking about.
I told her to find someone and ask for help, and they I
stayed with the boy until she returned with a more experienced nurse and turned
on the oxygen. His oxygen number went up
to 98 with the oxygen. I told her to
stay with the boy while I called 911, and let me know if he dropped below 92
I felt so silly calling 911.
Clearly, I could handle this kid, but I figured he needed
around-the-clock oxygen if I wanted to keep his brain properly oxygenated, and
my shift ended at 6 pm… so I had to have 911 transport him to the hospital.
They arrived and started asking mom standard questions, only
mom didn’t speak any English.
And her son was only 4 years old, so he hadn’t started
learning English in school yet.
I printed a summary of the patient’s visit, including a
brief medical history as well as allergies and medications for the paramedics
since they weren’t able to get the information they needed from mom. I translated any other questions they had and
then watched them move the little boy from mommy’s lap onto their stretcher.
He started crying and breathing fast again.
And mom was clearly distressed too.
I couldn’t understand why they wouldn’t hook his mask up to
the oxygen tank on the cart, but they’re the paramedics.
I wanted to do more to help, but he was in their care now.
The rest of the day I couldn’t slow down my heart rate again
or get that kid out of my head.
The good news is, I saw him a week later after a 2 day stay
in the hospital. He was doing a hundred
times better, and mom was so thankful for my help.
And I’m so thankful God allowed me to know he was ok!
[Rue, our puppy, playing hide-and-go-seek in our blankets]
Some days are always going to be better than others.
But no doubt more days are looking up now.
I can say, “at least I didn’t get bit today…”
Hypochondria is a pretty common thing in the medical
I get kids all the time that are worried.
And moms that are worried about their kids.
For instance, I had a girl 16 year old girl that was
practically crying because she thought she had meningitis. It didn’t help that I was working with a
student that day and my student came out of the room after being in the room for 3
seconds and says to me “I’m really worried abut this girl.”
‘What do you mean really worried?’ I asked (clearly, she
hasn’t learned when and when not to freak out.
We’re never supposed to freak out…)
“Well, I was just studying meningitis and I think she just
might have bacterial meningitis.”
(Bacterial meningitis is when a bacteria gets in your
brain/spinal cord and it can kill you in less than 24 hours…)
‘Ok, I’ll come take a look at the girl.’
I asked a few questions about the girl’s symptoms: Fever since 7am this morning (about 10 hours)
and sore muscles. The first thing I
asked the girl to do was to put her chin down on her chest, and instead, she
just started crying.
“I just knew I had bacterial meningitis and that I’m going
to die.” She wailed.
Clearly, if you’ve had a fever this long and you’re still
speaking to me coherently enough to understand that’s what I’m testing you for,
you’re probably going to be ok.
I can’t be too hard on her though.
I had another 16 year old girl (Are you sensing a trend here?)
that came in for breast lumps.
She was convinced she had breast cancer.
Maybe, as a culture, we’re watching too many soap operas.
She said the lumps had been there about a week and they were
tender and that even though there was no history of breast cancer in her
family, she knew she needed to have breast surgery immediately if we were going
to save her life.
I explained to her the most likely diagnosis (fibrocystic
breast changes) and the best course of action: more than likely, these lumps in
your bilateral outer breasts are just fibrocystic breast changes, a natural
occurrence in the breasts that happen because of hormones due to your menstrual
cycle. They should disappear and than more than likely reappear around the same
time each month. We’re going to wait 2
weeks until you get your period. Your
lumps should be gone by then. If they’re
not or the lumps are growing or you experience any changes in your skin, come
back and see me and we’ll do an ultrasound of your breast. If they go away and come back, I was right.
The good news is I was right. We didn’t end up having to cut her breasts
But I can’t be too hard on people, I do it too.
I see 3 kids in a room with head lice and suddenly my head
itches for the rest of the day.
Or I see 8 nausea/vomiting/ diarrhea kids in a row and
suddenly my stomach feels a bit queasy….
And don’t even get me started on scabies…
But before you think I’m being too hard on girls, I’ll tell
you a story about a ridiculous teenage guy.
See, he had gotten this red, itchy, spotted rash all over
his body for the past 6 weeks. Which
happens to be the time when he began using AXE body wash because he wanted to
impress the ladies.
Because teenage boys have learned that teenage girls like
teenage boys who smell good.
Mom was talking to his coach and the coach mentioned about a
teenage boy who got a “toxic rash” from AXE body wash and ended up in in the
hospital for 1 week, when mom realized that her son’s rash might also from his
AXE body wash, and she figured he should be hospitalized right away.
So she brought him into my office.
To see if he, in fact, had the toxic rash and needed to be
She had tried to get him to stop using the body wash, but
hormones prevailed and so he continued using it against his mom’s wishes.
After further questioning him, it turns out that when he was
little he broke out in a similar rash from johnson’s baby shampoo and he has
since been using special mild soap that keeps his skin well hydrated and prevents
So isn’t it perfectly logical that he would get the same
kind of rash from a super-fragranced men’s body wash?
The good news: it wasn’t the “toxic rash” mom heard about.
The son was still super resistant to give up his newfound
“good smellingness.” Seems he had gotten
excited about the attention from teenage girls and didn’t want to give it
up. Although once I convinced him that
the rash would scare away just as many girls as the smelly soap would attract, he
changed his ways.
Guess he realized I was right.
So, yep, some days I do get to save the world.
Or just maybe teenage boys from toxic rashes.
I got a serious question from a mom the other day:
“I have a 4 month old baby.
Can I cut his hair?”
I had to re-ask her the question, because I thought maybe I
was translating something wrong.
“is it safe? Can I
cut my 4 month old’s hair?!”
‘Yep. It’s safe.’ I
Just be careful not to cut his ear off too….
Driving to work one morning I saw a sign that said, “be
prepared to stop ahead.”
And just as I was trying to figure out why there would be
that kind of sign, a police officer walked out onto the road and stopped
us. I was the first car in line, so I
got a good view of all the action.
And you have to know, I was wearing my leather jacket and
boots that day, so I felt like I was an undercover agent or plainclothes cop
like detective Beckett (don’t even get me started on how cool I think Castle
So here I am sitting behind this cop who has turned his
direction away from the cars he just stopped and onto the shady-looking bar on
the side of the road where I see someone running.
Then someone chasing someone him.
Then someone stand up from behind a huge rock with what
looked like a gun in his hand.
I was sure there was going to be a shoot out and I was going
Because, clearly, my car was their obvious target.
And then the running guy stopped and someone else ran over
to him and handed him water and looked like they were in a heated debate.
So I took this opportunity to snap a photo.
Only I was too scared to even zoom in because I felt like I
was going to die.
So this lame pic is the best you get: (see the cop and the shady bar and the guy
squatting behind a big rock with that gun-looking-thing)
It was one of those moments where I was half-glad I was
alone so no one else would be put in danger but half-sad that no one would
believe how weird the whole thing was…
After the glass of water thin happened the cop let us
I wanted to shout out my window and make sure it was
ACTUALLY ok to go.
But I figured I was already 10 minutes delayed.
And If I just hung back a for another 3 seconds, the car
next to me would drive by the shady bar first, making them the easiest target…
eat anything. I can't make her. All she does is drink milk."
‘What do you
mean? She's 2 years old. Does she pour it for herself??’
‘Ok then stop
giving it to her!’
I wonder how the
world keeps on turning.
It just makes me
thankful there’s a God who forgives all my ridiculousness and stupidity too…
Like when my husband asks "honey, is there a reason you didn't flush the toilet?!"
'Yeah, um, yeah, I forgot. Sorry!'
And now for some pictures of life and not work:
[My super-cool Aunt Rosemary sent me towels for St. Patrick's day!]
[The roommates came to town for a reunion on St. Patrick's Day!]
[As always, my handsome husband!]
[Ohhh, we got to babysit this cutie-pie together. He really was a cutie-pie until about 9:30 when he woke up screaming and we tried everything we could think of to stop his crying for 30 minutes before his parents came home and saved us.
We loved babysitting him, but we definitely decided we're not ready for kids yet!]