21 August 2013

The day the mommies slept.


We’re all tired sometimes.

But you have to be REALLY tired to fall asleep in a chair at the doctor’s office with your head on the table, drooling, while your 4 children smack each other.

She didn’t stir when I came in, or when I spoke.

I had to physically shake her awake.

Who knows what havic could have been wreaked if I haden’t walked in?!

Probably no more than when moms “watch” their kids but actually play on their cell phones…

………………………………

Who puts a bib on their 3 month old that says “single” on the front?

Are you saying baby is single?

Or are you, a new mommy with a 3-month-old baby, single?

Or are you saying she’s not a twin baby, she’s a single child?

I guess it’s just like the person who put a onsie on their kid that says: “If you think I’m cute, you should check out my mom.”

…………………………………….
Johnson grass.

Soft.  Cushy on your feet.

Not so nice in your eye…

This little dude was so tough.  He actually went to sleep with grass in his eye because his dad didn’t believe his mom that there was grass in there.  His dad wouldn’t let his mom take him to the ER.

I’m a little surprised she didn’t just go to the ER anyway.  By the time she got to our office the next morning, she was pacing the room, about to have a heart attack.

I wasn’t sure what our office protocol was.

This piece of grass was about a centimeter long and half a centimeter wide.  I felt like I could just pull it out with my fingers.

Can I use forceps near a kid’s eye?!

Should I use forceps near a kid’s eye?!

Turns out, the kid was TERRIFIED of me putting a cotton swab near his eye (go figure) but wasn’t terrified of the forceps.

We pulled out the grass.

And mom about fainted.

Sometimes I offer to let people keep things I pull out of weird places.  Mostly it’s beads and stuff I pull out of ears.

This mom didn’t even let me ask.

She said “I’m going to keep that to prove to your dad I was right.”

Yep, because the same daddy that didn’t think anything was in his kid’s eye is going to believe you got this piece of grass out of his kid’s eye.
………………………………….

Sometimes I think 14-year-old boys are the bane of my existence.

Seriously though.

We had to talk about his rash.

And his weight problem

And his anxiety-eating-problem that Dad wanted ADD medication to fix.

The whole time I’m speaking in Spanish AND English because son doesn’t speak Spanish and Dad doesn’t speak English.

And then I had to listen to dad argue with the son about telling me his “embarrassing little problem.”

And then he said:

“So, you know how little kids pee in their bed?”

Yeah?

“So, I did that.  And then I got a little bigger and kept doing that.  And then I got really big.  And now I still do that.”

AND THIS IS THE FIRST TIME SOMEONE FORCED HIM TO TALK ABOUT IT.


………………………………………..

Why can’t you just send him to the lab to get a blood test so you can figure out what his rash is instead of guessing?

“Honestly, ma’am, that’s not possible.  There is no blood test for rashes.  There’s a test for diabetes.  But not a rash.”

That's one of the reasons they call it "practicing" medicine....

…………………………………………..

So, her vision is pretty bad, does she always wear her glasses?

Only at school and when she’s reading?

What about when she watches TV?

No?

Well, TVs aren’t very big and if she’s staring at a small TV, she might be squinting and that could be part of the problem.

“Oh, no, honey, we have an 80 inch TV.  Than’s not the problem.”

WAIT.

YOU HAVE MEDACAID.

I’M PAYING FOR YOUR KID’S HEALTHCARE AND MY TV IS HALF THE SIZE YOURS IS?

How does that work?!

………………………………………………..

If you have to ask me “what are you saying?” more than twice because your kids are too loud, that’s your problem, not mine.

Maybe you should learn how to discipline your kids.

Or maybe you’ll just never know what I’m saying.

It’s not like you just sat in the waiting room for 45 minutes to hear what I have to say…

……………………………………………

I like to give kids high fives.

For some reason, kids think it’s the coolest thing, getting to high-five the provider.

Like I’m some celebrity or something.  (Clearly, my job is not good for my ego)

But this one kid was WAY too cool for high fives.

He put out his fist and said “um, no, we don’t high-five, we fist bump” and waited until I made a fist.

Then he bumped his fist with mine.

Yep. 

That kid was way cooler than I am.

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


Another kid that's way cooler than I am.


You should've seen it.  We're out shopping and all 3 adults were sitting on the bench playing with their cellphones.  

They say kids are bad at that.  My family is the same way!



Ryan is an artist! I'm ok too.


Us and our friends that painted a master peace! 


26 June 2013

The day bugs started biting people again.


It's bug bite season.  Again.  It's the only reason I learned how to say ant, mosquito, and spider. (in Spanish)

The good news is, bug bites are rarely life or death situations.

Unless they're target shaped or they're growing rapidly.

I get to see the funniest bug bites though:

“Yep, it but him on his tragus!” (which sounds dirty, but really it’s just a part of the ear)

…………..

“So, you think your kid just has a bug bite or dry skin because that’s what your friend told you, but you can’t seam to figure out why it’s spreading?  And even though your friend isn’t a doctor, she told you to put breast milk on it, but that didn’t help at all?”

“I know beastmilk is kinda magical, and it can cure dry skin, but it’s not dry skin, its Scabies….”     

“…WHAT DO YOU MEAN YOU DON’T BELIEVE ME?!...”               

“…You would rather believe your non-doctor friend even though you’ve already tried her advice and it didn’t work and now your kid’s rash spread to your 5 month old and you?...” 
           
“…DRY SKIN IS NOT CONTAGIOUS AND CAN BE CURED BY BREASTMILK, CLEARLY THAT’S NOT THE PROBLEM.”

……………

“What do you mean BOTH your kids have bug bites on their private areas?   Explain to me exactly how that happened…”

…………..

“You're itchy all over? But you don't have a rash. And you don't itch all the time? And you have a feeling like something inside of you is squirming?  But you have some little red bumps that appear and disappear after about 5 days?”

…………….

“You mean THAT bump on her wrist? The one I have on my wrist and you have on your wrist too?  No, that’s not a bug bite.  Or a broken bone. That's called the styloid process of her radius bone. Yep, it's normal.”

………………

And one mom even asked me:  “Is there some kind of liquid or cream I can put on my kid to stop bugs from biting him?”  “Yes, Ma’am, there is.  Let me tell you about bug spray... “

…………………

Another mom and dad recognized their kid had bug bites, but NEEDED to know exactly what kind of bug bites their kid had.  Because mom and dad had ant bites and mosquito bites, but their kid’s bites looked different.  And it doesn’t matter that it’s the same treatment for all kinds of bug bites.  We went around in a circle for about 5 minutes: me saying they’re most likely mosquito bites because they show up on parts of his body not covered by clothes and parents saying they didn’t think it was a mosquito bite…

…………..

And then I had a kid who “only had 7 bug bites on his hands and on his feet before he went to bed last night, but he woke up this morning with 34 bites on his hands and feet.”  And that’s the only place he had these so-called-bug-bites.  Which turned out weren’t actually bug bites, but they were the manifestation of coxscackie virus, the cause of Hand, Foot, and Mouth Disease.

…………….

Incidentally, it’s also Hand, Foot, and Mouth disease season.  Typically I see kids with a high fever, super sore throat, and bumps on their hands and feet.  One mom, upon me diagnosing her kid with Hand, Foot, and Mouth disease asked me if it was contagious because she had been sharing drinks with her child after she knew her child had a fever.  It is, but not super-contagious to adults, which she was relieved by…  BUT LET’S BE HONEST, SHARING DRINKS WITH A KID THAT HAS A FEVER ISN’T THE SMARTEST IDEA…

……………………………………………

When I say open your mouth and stick your tongue out at me, I just want you to open your mouth.  I don't actually want you to do that AND breathe hot air into my face.

…………………………………........

Just when I think I can't see anything new or funny...

“How do you know your 4 month old has itchy gums?  You want me to give you a medication for that?”

How am I supposed to keep a straight face?

…………………………………..

So you know your kid just peed all over himself.  And you didn't bring a diaper and that's why he's screaming his head off. And you don't want to pick him up because he'll get you all covered in pee too.

But you think it's ok to place him on my countertop?!

………………………………

Man, these cookies are delicious! Your husband made these?!

You trust him with an oven?

Did you have teach him how to make cookies?  Or supervise him when he cooks?

No?!

Man, your husband must be awesome!

(He is)


………………………………………

“Hi, My name is Shannon and I’m a PA that works with Dr. Velez”

And most moms say “Hi, I’m _____________ . Nice to meet you.”

But this mom said, “You know me, remember?”

And I wanted to tell her that I see 80 billion kids and that, sorry I don’t remember her, but only the only thing I knew how to say was “No, sorry.” And proceed with asking what was wrong.

But she pushed, “Remember, you fixed my kid!”

I do that a lot, so it wasn’t really jogging my memory, but then mom said, “Look! Look at his arm!”

Which I did, and there was a terrible scar on it with 3 visible stitch marks.  I was thinking I do a much better job suturing, leaving a small scar with almost no stich marks, when it hit me!

OH!

“I do remember you! I told mom.”  I didn’t actually do this kid’s stitches. 

I CUT MOM’S HANDMADE STITCHES OUT OF HIS ARM AND GAVE HIM ANTIBIOTICS BECAUSE THE WOUND WAS INFECTED AND GAPING WIDE WITH PUS COMING OUT!

Mom was so happy that I remembered her as the lady who stitched up her son’s own arm.  In her defense, they had no insurance at the time, and I’m sure she saved herself at least 800 in stitches at the ER.

…………………………………….


Yes.

I know I’m a girl.

And I’m alone at Best Buy.

And I know I’ve been staring at the same display for about 20 minutes.

But no, men-who-work-at-Best-Buy, I do not need your help.

Not now or 2 minutes later.

I’m not actually a damsel in distress.

I just need the person on the other side of the phone to decide if they want to help me pay for what I’m getting.

And then when I hang up the phone, make my decision, I don’t need 20 more people asking if I found everything ok, or if I had any trouble making my “really big decision.”

It just makes me feel like I’m an idiot.

And maybe I am.

But only because I have a fit bit.

Or HAD until I lost it.  And I re-traced ALL my steps looking for it.  (which made me sad, I have no idea just how many steps it was)

I went back to Walgreens, traced my steps, and talked to the store manager.  I went back to Petco and Total Wine and did the same thing.  I went back to my chiropractor’s parking lot (because I had already called and the office manager looked all over for me and it wasn’t there and it was closing so I couldn’t check for myself.)

I even went back to the xray office and checked there.  No sign of my fitbit. 

Online there were tips on how to find my tracker: “Walk around trying to sync your phone with your tracker.  If it syncs, you must be within 20 feet of your missing fitbit!”

Yes. 

Let me travel the world hoping my phone will sync and that I will magically be united with my fitbit.

The good news is, my insurance company gave me the “ok” to get a new one.  And just as I turn it on to set it up, it pops up a screen educating me on “How to Avoid Losing your Fitbit.”

Clearly I’m not the only one who’s had this problem.

However, I seem to be the only female alone at Best Buy…


…………………………………

And now for some fun pictures of stuff we've done lately:



This is on our tour of Deep Ellum Brewing Company.  We got to keep the glasses from our tour.  It was pretty cool.


Ryan's company picnic was at this place, and it was fantastic!


Looking into space!


Running from the dinosaurs (like we were in Jurassic Park)


This is me and Diana.  We picnicked at the Arboretum!



Ryan and I took 1 year photos!


We had so much fun!



Our photo within a photo!






20 May 2013

The day the poop and pee hit the floor. (and thankfully not the fan)



I get it.

I’m mean and scary.

I make kids cry.

(even though I try my hardest not to, and I’ve gotten pretty awesome at not only not making them cry, but also making them laugh when they’re scared.)

Once, I made a kid so scared she vomited.

And today, I had the joy of making a kid so scared that she peed in her pants.

Yep.

And she really had to go too.  It soaked her pants, ran down her legs, and hit the floor.  And then made a huge puddle on the floor.

And for the record, I kinda blame her dad.  Not that I wasn’t the one holding the child-safe scissors to cut her foot stitches out, but I’m pretty sure she was super upset even before I walked into the room.

See, daddy took her to the doctor.

And I think that’s what the problem was.  I’m sure there are some super-fantastic daddies out there (in fact, I know of some awesome ones!) but this daddy wasn’t one of them.

This daddy was so ill-prepared that he didn’t even realize his 3 year old daughter was urinating until the pee hit his shoe.

And even then, he had no idea why she had so much urine.

But he did admit that she was probably crying because she pooped in her diaper so he had to take it off of her and it had gotten on her pants so they went to the car to get her a new diaper and new pants only he hadn’t thought to pack the diaper bag or a change of clothes and he got “lucky” that she had an extra pair of pants in the car.

So she was probably a bit upset that she was going commando for the first time.

And she might have been upset that her daddy was more interested in asking me questions about his nasty pus-covered eye then he was about listening to me tell him signs of an infected foot.

Because after cutting out her stitches and making sure there were no signs of infection, he took her off my urine-soaked exam table and put her in a fresh, dry chair.

And then proceeded to ignore her sniffles and wet pants.

He was determined that since I was a pediatrician and he was only 20 years old, that I could prescribe him something to fix his eye.

Which is a correct assumption, I know how to prescribe something.  And I could consider him a child after the way he acted toward his daughter.

Only he made the grown-up decision to have sex.

At which point, we kick “kids” out of our clinic and send them to an adult doctor.  Because for all I know, his eye could be infected with gonorrhea (which is not as far-fetched as it may sound) and I don’t want to deal with that.

I signed up to work with kids.

Not kid-like adults who got their girlfriend pregnant at the age of 16.  (now, that’s possibly a wild assumption because he wasn’t wearing a ring.  He could have knocked up his wife, and then left her…)


……………………………………

But urine isn’t the only thing that accidentally comes out of kids bodies.

If you’ve spent enough time around kids, you know sometimes poop accidentally comes out too.

Most of the time it’s runny and squishy when it comes out.



(Should I have warned you before saying that?!)



But it doesn’t just come out of babies, oh no.

Sometimes it comes out of 6 and 7 year old kids.  Kids who are potty trained and WAY big enough to know better, only they can’t control it.

It’s one of my favorite diagnoses, known as encopresis.

For more information, I’ve included this link to a Wikipedia page that more elaborately describes the process:  http://en.wikipedia.org/wiki/Encopresis

Yep, when the (poop) hits the fan (well, you know how the saying goes)

You may be asking yourself, why does this happen?  How does a normal 6 year old go from #2 in the toilet to #2 in his pants when he’s out playing with his friends. 

Which is exactly the question this poor 6 year old’s mom was asking me.  In fact, this poor 6 year old told her mother to take her to the doctor because “something was seriously wrong with her.”  And it’s a good thing mommy listened.

See, usually in kids (but it can happen in adults too) their bellies fill up with stool when they are constipated (because kids love constipating foods like mac n cheese, crackers, and bread and they hate things like vegetables).

That provides prime opportunity for a little bit of runny stool to slide around the hard stool and out their bottom.

(Should I have warned you about that too?)

In summary, if you or your kid is dropping runny poop, it might just be constipation. (or it might be diarrhea)

But rest assured, you’re not the only one.

Just go see your friendly neighborhood doctor, PA, or NP.

…………………………………….

“Do you want me to take off my shoes before I get up on the table.” Such a cute little boy.

"You don’t have to, you can do whatever you want."

“Ok, I’ll take them off.”

"Oh! I like your boots!" I told him.

"OH!  FOR THE LOVE OF ALL THINGS GOOD AND NOT SMELLY, PLEASE PUT YOUR BOOTS BACK ON BEFORE I PASS OUT!

Thanks."

Only I’m not actually brave enough to say that.  So I just held my breath for the rest of the exam…
……………………………………..

“Yeah, he had a fever,” said mom.

"And how high was his fever?" I asked

“85 degrees.” She said.

"You mean 85 Ferinheight? Or Celsius?" 

I guess either way, you’d be dead.

"Um, M’aam, normal temperatures are between 98 and 100.4 degrees.  What was your son’s temperature?" I was trying to be patient.

“I told you a million times.  It was 85 degrees.”

Thanks.  Now I feel dumb.  Surely, I’m the dumb one.  “M’aam, that’s not a normal temperature.”

“MY SON IS NORMAL.  WHO ARE YOU TO TELL ME SOMETHING IS WRONG WITH MY SON.  HE IS NORMAL.”

Ok.

Ok.

I feel like this wasn’t going anywhere.

So I went on with the exam, pretending he might have had a fever.

………………………………..


I took some “anniversary pictures” (where I wore my wedding dress and Ryan wore his suit) the weekend before my birthday.

To make myself really special I got my hair blown out (cheaper than a cut or fancy style)

I also painted my nails.  Because let’s face it, getting hair and nails done all in one weekend isn’t cheap.  And I can paint them myself for about 8 cents as opposed to 50 dollars for a French mani-pedi…

And I put a new hair tie on my wrist after the pictures because my old one was getting a bit stretched out.

So the day before my birthday my hair was all cute and my nails were done and I was wearing a cute sweater, so I looked pretty cool.

I had a 7 year old ask me where I got my hair tie and if someone made it for me.  I told her no, I got it from my hair stylist.

She let out a huge sigh.

“Wow, you have EVERYTHING!” in a jealous tone.

Yeah, I thought.

I really do.

……………………………..


We keep hand sanitizer in our rooms instead of a sink and soap.

I mean, my board books get eaten to shreds, It doesn’t take a genius to realize how high our water bill would be if we kept sinks in every room.

We keep sinks outside the rooms so we can wash our hands every now and then to clean off the hand sanitizer.

This mom left and squeezed some soap onto her hands.

Hmmm.

I wonder how long its going to take for her to figure out that’s not hand sanitizer.

Like at chick fil a where they have the two dispensers right next to the sink and I stare at them for about 20 seconds trying to decide which one is the soap and which one is the sanitizer, because when you pick the wrong one all your skin cells play nasty mean sensory tricks on you…

………………………………..

“So, we have allergy testing at our clinic now and we can provide immunotherapy if your child is allergic to a lot of stuff, to potentially cure his allergies.”

“What is immunotherapy?” asked this mom.

“Immunotherapy is a series of shots with a small amount of the allergen inside, with increasingly larger doses in order for the body to get used to the allergen and not produce a terrible response anymore.”

“Oh, allergy shots!” The mom replied,

“I’m pretty sure those are just voodoo.  We don’t want to do that.”

Voodoo?

Really?

Time for some more education about what allergy shots really are…

Which is funny, because just 3 weeks ago we had some kids come back for their allergy re-test (after being on allergy shots for 1 whole year) and most of them came back allergy-free! (and the ones who didn’t had SIGNIFICANTLY less allergies than they did before!)

It’s so neat when I actually get to heal kids!

………………………………….

One day this week it was REALLY hot in our office.

I mean, patients were borrowing paper for fans and opening the doors to try to cool off.

My boss assured me the technician was coming to fix the air conditioning unit.  Usually our office is an iceberg.

I was wearing black pants and a green sweater with a black shirt underneath.

Naturally, I took off my sweater to cool down.  Resulting in me wearing black pants and a black shirt.

And consequently making people ask, who died?!

……………………………………

Speaking of allergies (earlier), not only is it allergy season right now (look at all the pretty trees and blooming flowers!) but it’s also nosebleed season.

What’s nosebleed season, you ask?

When I get 3-4 patients a week in my office because their nose is bleeding.  Well, because their nose WAS bleeding.  I have yet to see an active nosebleed in my office.  Except for the ones that I’ve caused…

(Caused due to sticking a flu test nasal swab up their nose…)

So, parents are usually SUPER concerned about nosebleeds causing anemia.

Which is ironic, because the most common cause of iron-deficiency anemia is overfeeding on milk, and that’s something almost NONE of our parents are concerned about.

I go through my little spiel about the ways to prevent nosebleeds, treatment for if/when one occurs, and warning signs that may mean something else is wrong.

Most nosebleeds are harmless.  Most of the time applying a little Vaseline with a qtip in the nares or using a nighttime humidifier and getting proper treatment for allergies so your child isn’t picking or scratching their nose anymore is enough to stop them (or slow them down.)

If one occurs, proper treatment is to lean forward and hold pressure (either by pinching the bleeding nares or by putting gauze under the top lip) for 5-10 minutes.

If the bleeding doesn’t stop in about 15 minutes or your child gets constant nosebleeds despite the proper preventative measures, come back and see me.

Whew!

I’m glad nosebleed season is almost over!

…………………………………….


And now for some fun vacation photos that have nothing to do with my job!!



The view from our room! It was beautiful!



Ryan, chilling poolside on our first day.


The infinity pool (at 8 am so the water was too cool to jump in just yet since it was all in the shade).


Reading poolside. We spent most of the day either reading by the pool/ocean or swimming in it!


We had some AWESOME meals!!


The front of the hotel: Riu Palace Las Americas!


MICHAEL JACKSON SHOW!!


Sunset before dinner.

After dinner they used vodka that was on fire to make a flaming Alaska for desert! 


Look at me up on stage dancing!  I got to dance every night!


At the sushi restaurant!


Look at that fresh fruit!!


A storm came in the last night and I got some AWESOME lightning shots over the water!!




Look how cute we are!  Goodbye Beach!


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

And the next day: Hello Colorado!


My favorite place: The Egg and I!


In just 1 day I went from beach to SNOW!


Buffalo Bill's grave.


Wedding!


Aren't we cute?!


With the happy couple!


Enjoying Sweet Tomatoes after the wedding.



We met new friends.  And all brushed our teeth at the same time!