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.

Sigh.

.................

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.

Sweet.  

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?

Awesome.

.........

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?

None.

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. 

Delicioso!

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!