Tuesday, July 11, 2006

Spanish speaking clinic

Yesterday I spent the morning at clinic, and the afternoon visiting a hospice patient. I saw several patients at clinic. Two little girls came in with their mother for a well child visit, so the doctor had me watch the whole visit including when the nurse was talking to them (for those of you wondering my I am seeing children on my medicine rotation it is because the doctor I am with is board certified in both internal medicine and pediatrics). Both of them were pretty healthy, the mother’s main concern was that the older girl kept developing what she thought were nervous habits, but the girl’s school was really worried about it. Turns out the mother was right, and the doctor recommended just ignoring it. The younger of the girls brought along her toy cell phone that she had gotten for her birthday. It records little bits of sound, so she had me talk into it for a second. I spent the next five minutes hearing my voice saying “how’s it going?” time after time in rapid succession.

Other patients included knee pain secondary to slipping and hitting her knee, abdominal pain, and regular check-ups. That afternoon I went and toured a hospice, which was very nicely set up, and interviewed one of the patients. We were given a list of topics to cover, including things such as the patient’s understanding of his health, religion/spirituality, support system, goals, etc. The man I interviewed was very nice but spoke very very very quietly and I couldn’t tell most of what he was saying. He had congestive heart failure, does have family in the area who visit him, and is Catholic. He is not particularly happy about having to live out of his home, and apparently has given the staff some trouble about it, but I think he is starting to realize that there is no way he could live on his own, or even with a caregiver in his home. Most of his answers were pretty short, but since I had no intention of probing into more personal matters (if I were his doctor or even part of his care team, then yes I would have asked more detailed questions, but as a visiting medical student it didn’t seem appropriate) I spent the rest of the time asking about his family, and what he had done before he retired. He wanted to know about where I was from, and what my siblings are going to do, etc., so I told him about that. Of course, in a doctor-patient relationship, technically it is considered poor form for the doctor to give personal information to the patient, but I don’t think that applied in this case. I felt bad when I had to leave since he seemed pretty lonely. I was fine interviewing him, but it was really weird when I left and realized that he will probably not be alive in another month.

Today I went to the spanish-speaking asthma clinic, and saw one patient. He understood a little English, but not much. Fortunately, the resident I was with is from Peru, so the language barrier was not a problem. I knew enough Spanish to keep up with the flow of conversation, but not enough that I would feel comfortable gathering medical information by myself. He is a very responsible patient, knows how to take his medications, and keeps good records of his peak flow meter. Unfortunately, though he is taking the maximum doses of his asthma medications, he still has symptoms everyday and cannot do more physical activity than walking for 15 minutes. Even so, his lung function has improved considerably in the three months he has been coming to the clinic. Today, a sinus infection was making him worse, so the doctor started him on augmentin (an antibiotic + a chemical that inhibits bacteria’s ability to resist the antibiotic) and is going to have him started on omalizumab for which he is an excellent candidate due to his many allergies.

I have the afternoon off to run errands, study, and relax. I am going to have an incredibly rude awakening next month on inpatient when I will get one day off a week and be at the hospital from 7:00am to 11:00pm every fourth day.

(PS: man the titles of my posts are inane--I'm going to have to go back to the Latin titles. They're still inane, but nobody knows.)


Anonymous Augmentin Side Effects said...

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I suffered from Pseudofolliculitis behind my head for years and by chance I got Augmentin from Libya without any prescription. In Europe all the doctors that I consulted could not find solution for this problem so one day I just worked into a pharmacy in Libya and showed it to the Doctor in charge of the pharmacy who adviced me to take Augmentin. I was a bit hesitant but before my returning date (after 5 days) I noticed that all the bumps are drying. and now I'm very proud of my head.

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10:53 PM  

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