Smothers' Soliloquy: May 2013

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.

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!!